A recent ACOG article made the following recommendations, which have been part of the Lamaze Healthy Birth Practices for some time now! For low risk women in labor, it is recommended that women wait until active labor before being admitted, have freedom to move around and change positions to maintain comfort and enhance labor progression, to utilize non-pharmaceutical pain management techniques such as massage and/or water immersion, to do intermittent fetal monitoring, follow your body’s urges to push (not forced long breath holding) and – for those desiring it- 1:1 physical and emotional support from a doula! There are a few more details in the article as well- but the big message is- if you are low risk, limiting routine interventions is best for both mother and baby outcomes- things like routine IV’s, continuous electronic fetal monitoring, and amniotomy have NOT been shown to improve outcomes.
Ultimately – talk to your provider about what is best for you and your baby. Open up communication with him/her about your desires or wishes. Find out what is “routine” for their practice or the hospital where you’ll be delivering. (Birth centers and homebirth midwives generally follow the low intervention protocol- unless a medical situation warrants interventions) Stay involved in your care and make decisions if those “routines” apply well to your scenario. Don’t be afraid to speak up for what you want!
Here is the BRAIN acronym I use in my classes when we talk about medical interventions in birth:
B- Benefits- tell me how this could help me, my baby, or my labor
R- Risks- tell me about the potential risks/side effects or trade offs for this procedure/treatment
A-Alternatives- what else should I consider (including non-medical alternatives)
I-Intuition- how do you feel about this intervention?
N-Not now- if not an emergency, take some time to think about it, discuss your options with your support team, or just wait and see what happens!