Low Intervention Birth

Posted by Beverly Vavricka

As an obstetrician, I have dedicated my life to partnering with women and their families to ensure a healthy pregnancy and delivery for both mom and baby. Sometimes that means I have to use all the tools in my toolbox and sometimes that means I just need to let nature take its course. The culture of “birth without fear” is a very warrior like, feminist term however as obstetricians who see it all, we all have a healthy respect of birth. Birth is beautiful and natural and should not be turned into something full of interventions unless they are needed. However, we have all seen the most normal births turn into a firestorm necessitating maneuvers to preserve the life of the mother and baby. That is why you need a birth attendant who knows when it is time to intervene and have the knowledge to be able to tell the difference. That is where we come in.

Recently, the American College of OB/GYN released a committee opinion titled “Approaches to Limit Intervention in Labor and Delivery” and promotes several measures to limit intervention in low risk pregnancies.  These measures include such things as alternative pain management strategies, delaying admission until true active labor, position choices while in labor, intermittent monitoring, and oral intake during labor. It also discusses having a “support person” such as a doula.  Remember that these measures apply to low risk pregnancies meaning that no medical complications exist, no previous cesarean section, and no need for Pitocin for induction or augmentation.  Many of these things we are already doing but it just emphasizes their availability. I am proud to say that we at Mercy care about these measures and are actively keeping these desires of women in mind as we make plans to renovate our labor and delivery.  Our nurses are also amazing and I venture to say we are likely one of the best in promoting natural labor and delivery.  

While I whole-heartedly support the emphasis on the normal birth process and the body’s natural ability to do so, I also want to highlight the importance of being with an experienced birth attendant in a facility capable of providing life preserving measures for times when nature is not so kind. I was fortunate to have two low risk births but as an OB who has seen seemingly low risk labors turn into more difficult ones, I knew I wanted an experienced birth attendant in a place where resources were available to care for my baby and me should extra care be needed.  For example, when my 9 lb 3 oz baby was coming a little slower than expected, I was reassured to know that my OB had handled many shoulder dystocias and knew just what to do in that circumstance. Fortunately, all was well and no interventions were needed.  I also knew that with my ginormous baby I was at risk for postpartum hemorrhage and was reassured to be in a facility with medications and blood products available should I need them. Fortunately, I did not. We are proud to deliver in a natural labor friendly hospital that also has the full resources available if a low risk pregnancy suddenly turns high risk.

We are here to partner with you. Please do not be afraid to discuss your optimal birth experience with us. There are many tools online to help you think through what you want for your delivery. If you want an un-medicated birth---great we can facilitate that!  If you want an epidural---fantastic we got it! If you are low risk and want intermittent monitoring, then talk it over with your provider and we can probably make that happen.  We want to make this the least stressful that we can for you and make that magical first meeting with your little one amazing!

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