Subtle Medical Interventions that Interfere With Healthy Birth Practices

If you want to learn the most essential information for having a healthy and happy birth, look no further than the Lamaze Six Healthy Birth Practices. These practices, designed from years of trusted, evidence-based research, help guide you through birth in a simpler, safer, and more confident way. In their most simplest form, the practices are:

1. Let labor begin on its own.
2. Walk, move around and change positions throughout labor.
3. Bring a loved one, friend, or doula for continuous support.
4. Avoid interventions that are not medically necessary.
5. Avoid giving birth on your back and follow your body's urges to push.
6. Stay together with your baby — it's best for you, your baby, and breastfeeding / body feeding.

Seems simple enough. And it can be — when you are in the care of a provider (OB, midwife, doctor, nurses) who follows these evidence-based practices -- all of which align with guidelines set forth by ACOG (American College of Obstetricians and Gynecologists). Unfortunately, many providers do not always practice in accordance with these guidelines. Learn more about the most common medical interventions that interfere with the Healthy Birth Practices. 

It can be easier to identify blatant practices that don't support these practices. A care provider who routinely induces at 39 weeks, for example. Or a provider with a high c-section rate (despite caring primarily for low-risk patients). But what about the less overt practices that demonstrate less-than-ideal evidence-based care? The following practices are smaller, more subtle ways that can make it difficult to achieve Healthy Birth Practices. 

Late in pregnancy ultrasound to determine the size of your baby. An ultrasound late in pregnancy, when used to determine the size and weight of your baby, is unreliable and often overestimate baby's size. Some providers may order an ultrasound if they suspect baby is "too big," which may be a reason they use to schedule an induction. "Too big baby" is not supported by medical recommendations as a reason to induce. If your care provider begins talking about this late in pregnancy, push back and ask questions. Seek a second opinion if possible. Ultimately, you are in charge of the decisions surrounding you and your baby's care. 

Requiring IV fluids at the beginning of labor as standard for every person. The routine use of IV fluids in labor are required for only a handful of specific reasons, including health complications and the use of epidural. If your provider requires IV fluids for everyone, it's a red flag. If you don't have a medical reason for IV fluids, you can refuse them in labor. However, it's likely that a care provider who requires their routine use will require other non-evidence-based practices that interfere with Healthy Birth Practices. Talk to your provider early in pregnancy about their practices. If they are not supportive, seek to switch practices and/or providers. 

Animosity toward or dismissive of doulas. If, during prenatal appointments, your care provider displays a negative attitude during discussions about having a doula, it's likely a sign they will not support evidence-based practices, including having continuous support from a doula. 

Little to no experience with people who choose to give birth without an epidural. If your goal is to give birth without the use of narcotic pain relief and your care provider does not attend many births with people who don't choose an epidural, then you may not be paired with the most supportive care provider. Sometimes, this can be mitigated with a supportive and knowledgeable nurse, but you can't guarantee you'll get that nurse when the time comes. A doula can help tremendously with this gap, but ultimately the care provider takes precedence. If you're able, interview other providers in the practice or interview another practice. 

Lack of alternative equipment in the hospital where you plan to give birth. A birthing location that supports alternative labor coping methods, including moving and changing positions, will have equipment that supports them. This includes, but isn't limited to, a rocking chair, an exercise ball, a squat bar that attaches to the bed, wireless monitoring devices (called "telemetry" units), and a bath tub or birthing tub in each room (or available to bring into the room). 

Learn about your provider and place of birth early and often to ensure your birth will be supported with Healthy Birth Practices. Ask questions, encourage dialogue, and if need be, change providers. The provider you choose significantly impacts the outcome of your birth.