Interventions as Tools

We will ... move technology where it belongs - 
in the service of birthing women, not their master.
Dr. Christiane Northrup

Over the last century, medical interventions have become a widespread and routine part of maternity care. While it is a mistake to claim that every intervention is unnecessary, evidence has revealed that it is also a mistake to embrace intervention as part of routine care for every mother, and there is increasing emphasis to limit interventions. 

Interventions have their place if we approach them appropriately: as tools that can prevent or treat complications. When the care provider recommends an intervention, according to the article “First Do No Harm: Interventions During Childbirth,” published in The Journal of Perinatal Education:

"Every nurse [or care provider]... must be mindful of the possible consequences and risks of each intervention he/she initiates to weigh the possible benefits of the intervention against its potential detrimental effects... These consequences include the... psychological impact of maternal feelings of failure and guilt.”

Part of the decision-making process involves a discussion with parents so they can make an informed decision. The authors of an article promoting informed consent for the Cochrane Institute of Primary Care and Public Health wrote:

"[Consent] is a complex process which requires patients be provided with information which they can understand and retain, opportunity to consider their options, and to be able to express their opinions and ask questions. There is evidence that at present some patients undergo procedures without informed consent being achieved.”

For anyone to make a truly informed decision to use or decline an intervention, they must be given:

1. information about exactly what the intervention seeks to accomplish
2. any negative aspects or side effects
3. any available alternatives to this intervention
4. time to consider these factors and ask questions before making her decision.

In the absence of an emergency scenario, there is no reason for any of these steps to be skipped.

Interventions as Tools

It is helpful to recognize that the mother is at the center of her labor and birth experience and decisions. When the mother is placed in the center of the birthing experience, interventions no longer need to be “set in stone” as part of routine care, but rather viewed as a chest of tools at the disposal of the mother and her care team to take or leave as determined by her individual situation.

If you are looking for a resource to help you convey these concepts to parents, our Birth Choices booklet provides an easy four step process. The book aims to empower parents in each of these areas:

• to place the mother back in the center of the birthing experience, making sure that she has care that is individualized for her unique situation
• to ensure that parents know what their options are, and how to get what they need for informed decision-making
• to provide parents with the tools to recognize abuse or manipulation from a health care provider
• to help equip parents to balance the many factors that weigh into decision-making about interventions

Jennifer Stutzman, Freelance Writer

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