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Pregnancy

11th Mar 2020

Research finds that doctors are often too quick to intervene in labour and delivery

This can end up having a negative impact on your baby's long-term health.

Trine Jensen-Burke

When it comes to giving birth, most of us dream of a straightforward, natural labour.

One where we feel supported and safe and are allowed to, as much as it is possible, labour the way nature intended.

However, while this is not always possible, and in some cases not the best option for mum and baby, experts are now warning modern medicine is too quick to intervene in the birthing process, causing a rise in inductions, forceps deliveries and C-sections.

The problem? Well, according to a study, many of these birth interventions are not only unnecessary, but also carry possible long-term implications for mothers and babies.

Women progress much slower in labor than we previously thought,” say the authors of a study published in the journal Birth in an analysis of the research for The Conversation. “For 70 years, clinicians believed the cervix should dilate by 1 cm per hour. If the cervix was slower to dilate, intervention was initiated because labor was thought to have slowed.”

And although the authors note there are certainly cases where interventions are warranted, the actual rates of intervention exceed the labor and delivery guidelines from the World Health Organization. We know this is certainly the case in Ireland, where the rate of C-sections has steadily increased over the past two decades.

However, in their analysis of nearly 500,000 healthy, low-risk births in New South Wales from 2000 and 2013, as well as follow-ups with the children in the first 28 days and five years later, the researchers found unnecessary intervention may also create unnecessary health consequences.

The main problem with not allowing women enough time to try to labour naturally, several studies argue, is that overall, the healthiest thing for mother and baby is a natural, vaginal delivery with as little intervention as possible.

In fact, compared with babies born by spontaneous vaginal delivery, babies born with some intervention were at higher risk for respiratory infections, metabolic disorders, and eczema. Researchers believe this may be because “vaginal birth provides an important opportunity to pass gut bacteria from mother to baby to produce a healthy microbiome and protect us from illness.”

For instance, studies have shown that “instrumental births” are tied to struggles in the first month, with babies born with the use of forceps or a vacuum were at the highest risk for jaundice and feeding problems, which they hypothesize is linked to the babies’ response to the bruising or bleeding often caused by these interventions.

And compared with babies born vaginally, those born via C-sections are more likely to need more treatment at the hospital, which the researchers believe is because skin-to-skin recommendations are not always followed. Even more worringly, babies born by emergency C-section are also at higher risk for metabolic disorders, such as diabetes and obesity, by the age of 5.

It is a complicated issue, as the reasons for more interventions and a climbing rate of C-sections are many. However, the authors of the Australian study say they hope the takeaway from their work will be to work towards giving expectant mothers more time to progress naturally in labour, and, for low-risk women and healthy babies, hold off on intervening for as long as it is possible.

What is YOUR experience, mamas? Did you feel like you had enough time to labour naturally? Were you induced in the end? Ended up having a C-section? Did you at any point feel like you were rushed or not heard in the labour process? Let us know in the comments or send me an e-mail at trine.jensen@herfamily.ie