Cascade of Interventions

Cascade of Interventions

Labor Starts Before Labor

In labor there is a concept known as the "Cascade of Interventions." This is a term in the birth world that means that one intervention causes another intervention, eventually ending in an unnecessary c-section. We all agree c-sections save lives, but they also have higher risk factors for both the mom and baby. Long term risk factors include:

  • For the mom: increased rate of placenta previa, abnormal fetal positions and rupturing of the uterus along the previous c-section scar.
  • For the baby: breathing issues, nursing issues and babies born by c-section are more likely to have allergies, asthma, and type 1 diabetes when they get older.

How can you prevent an unnecessary c-section? The key is understanding the cascade of interventions. The main interventions to avoid, if possible, are:

  • Induction
  • Continuous Fetal Monitoring
  • Pitocin
  • Epidural

These are not always bad, but it is important to know why you are having one and limit them to when needed.

Let’s start with Induction. Some main reasons for induction are

  • Post date—40 weeks is an average. When left alone most first time moms go closer to 42 weeks. The concern is that the placenta will stop supplying enough nutrients and oxygen to the baby. It is a good idea to do a non-stress test on the baby, but as long as the baby is doing well there is no reason to induce before 42 weeks. (Some authorities say post date is never a good reason to induce, even past 42 weeks.) As long as the woman is healthy, her placenta should not have any trouble supplying nutrients and oxygen as long as needed. I do recommend women take Gentle Birth Formula with out blue cohosh starting at 35 weeks gestation to help tone the uterus and encourage birth to occur closer to 40 weeks. I also recommend taking Borage oil or evening primrose oil, both orally and vaginally, to soften the cervix.

Click here to purchase Gentle Birth Formula

  • Labor is not progressing fast enough. Do yourself a huge favor and labor at home with a doula before going to the hospital and being put on the clock.
  • Being told by your care provider that your baby will get too big or is too big. Remember, there is no accurate way to measure the size of a baby in utero. Even ultrasound is often a pound of more off. I have seen petite women push out good-size babies with no issues when given the time and support needed. If you have larger babies, diet and appropriate nutrition can make a huge difference.
  • Some doctors want to induce if the baby is too small. Again, remember that ultrasound is not an accurate way to determine fetal size. If the baby does not seem to be growing well the mom can go on full feed of good nutrients (see nutrition section). Babies are usually better off growing in the uterus than in the NICU.
  • High blood pressure or pre-eclampsia—If bad enough these are appropriate reasons for induction, but there is a lot that can be done before a women gets to this point. The right supplements can often prevent or resolve these conditions. The following protocol can help lower high blood pressure and is safe in pregnancy. Click on link to purchase:
  1. Sea salt with minerals 1/2 tsp a day
  2. Vitamin d3 I like cataplex D from Standard Process
  3. Chlorophyll 3 tablespoons a day or 3 capsules
  4. Magnesium Lactate from Standard Process 500 mg 4 x a day
  5. Phosfood from Standard Process 15 drops a day

You can also drink Hawthorne berry tea and Dandelion leaf tea.

  • Low amniotic fluid levels may be why some doctors want to induce labor. Pay extra attention to staying hydrated from 35 weeks gestation on. Low amniotic fluid levels may easily be resolved by drinking a few quarts of water.

If you want more support with diet or supplements or just a second opinion you can make an appointment with Kara Here.

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