What is an intervention during labour?

An intervention is an action taken by a doctor or midwife to ‘intervene’ in the birthing process to help with the birth of your baby. Every labour and birth is different. In some cases, your doctor or midwife might recommend intervention to help you birth your baby safely.

Why might I need an intervention during labour?

Different kinds of interventions assist at different stages of labour and birth.

You might need an intervention to help start your labour (known as an induction), to support your labour while it progresses (known as augmentation) or to directly assist in your baby’s birth (by assisted birth or caesarean section).

There are many reasons your doctor or midwife might recommend an intervention during labour, including if:

• you have a health condition that puts you at a higher risk of complications during labour
• you have complications during your pregnancy or labour
• your waters have broken but you have not gone into labour
• your labour is progressing very slowly
• your baby is in a position that will make vaginal birth more difficult
• your baby is showing signs of distress

What are the types of intervention?

Induction of labour

Induction of labour is the use of medical methods to both start and progress your labour, instead of your body going into labour and labouring by itself.

There are a few different ways your doctor or midwife may induce your labour, including by using medicines intravenously (IV) or placed in your vagina, or by breaking your waters (artificial rupture of membranes). The method used will depend on your and your baby’s health, your stage of pregnancy and the state of your cervix on the day of your induction. You will often need a combination of these induction methods.

Augmentation of labour

Augmentation of labour is an intervention to help your labour progress. Your doctor or midwife may recommend breaking your waters (artificial rupture of membranes) or giving you an intravenous medicine called oxytocin to increase the strength or frequency of your contractions.

Assisted birth

Assisted birth, also known as instrumental delivery, involves your doctor or midwife using forceps or a vacuum cup (ventouse) to assist your vaginal birth.

Episiotomy

An episiotomy is a cut made in the area between the vagina and anus (perineum). This is done to make the vaginal opening bigger. This is sometimes needed during an assisted birth, or if your baby is distressed and needs to be born very quickly.

Caesarean

A caesarean section, also known as a C-section or caesarean birth, is a procedure in which your baby is born through a cut in your abdomen and uterus. Caesarean births may be planned (elective) because of your and your baby’s circumstances, or because of complications during your pregnancy. A caesarean section may also be done during labour (emergency). Your doctor or midwife may recommend an emergency caesarean if your labour is not progressing, if there are signs that your baby is distressed or is in a life-threatening emergency.

How do I decide whether I want an intervention?

It’s a good idea to think about your birth preferences before your labour begins, and to discuss them with your doctor or midwife. Having a birth plan is one way you can let your healthcare team know your preferences about interventions, including any you would prefer to avoid. It’s important to know that you may also need to change your plans during labour if unexpected complications occur.

Remember that your doctor and midwife are there to support you throughout your labour and birth, and to make sure that you and your baby stay safe and healthy. They are trained to manage situations where the unexpected happens.

In most situations where you doctor or midwife suggests an intervention, there will be time for them to explain why it is needed, and you will be able to discuss your options together.

It’s important to consider the risks and benefits of having an intervention to both you and your baby, as well as any risks associated with declining the intervention.

Some questions you may wish to ask include:

• Why has this intervention been recommended?
• What does the intervention involve?
• What are the potential risks of having the intervention?
• What are the potential risks of a not having the intervention?
• What are the potential risks of waiting and reconsidering the intervention at a later point (a ‘wait and see’ approach)?

Do I have to agree to an intervention?

You have the right to choose whether to have any intervention in your labour or birth.

If you aren’t sure whether you want an intervention, it’s a good idea to ask your doctor or midwife for more information to help you decide. Many women also find it helpful to involve their partners or other support people when making a decision.

In what situations might my doctor or midwife override my choice?

In an emergency, your doctor or midwife may decide what to do on your behalf to protect your health or your baby’s health. If you are unconscious, your doctor or midwife may discuss this with your partner or family (if possible) to understand your preferences. In all situations, your doctor or midwife is legally required to act in your and your baby’s best interest.

What are the risks if I don't want a particular intervention?

Every pregnancy and birth is unique, so the risks of declining a particular intervention will vary depending on your situation.

Most interventions are recommended because your doctor or midwife consider that they are in your or your baby’s best interest.

It’s important to ask your doctor or midwife why they suggest an intervention, and any potential risks to you or your baby if you choose not to have the intervention.

It’s best to learn the risks and benefits of interventions during your pregnancy. It is also helpful to discuss your preferences with your birthing partner, as well as your doctor or midwife, before your labour begins. This will help you to make decisions during labour and birth.