A Simple, Honest Guide to Birth Interventions

A Simple, Honest Guide to Birth Interventions

From me, @happysoulmama — your doula in Hackney

Birth is natural — but sometimes, interventions are suggested along the way, either to monitor, to start, or to speed up labour.

Every intervention is a choice.

CTG Monitoring:

Belts placed around your belly to track baby’s heart rate and your contractions.

• Why offered: To monitor baby’s wellbeing.

• Things to know: Continuous monitoring limits your movement, which can actually slow labour down. It can also increase interventions. Intermittent monitoring is often safe for low-risk births.

• Risks: Being stuck in bed can cascade into further interventions.

Growth Scans:

Ultrasound to estimate baby’s size.

• Why offered: To detect babies who are growing smaller or larger than expected.

• Things to know: Scans can be 15–20% inaccurate. Anxiety based on estimated weight can lead to unnecessary early inductions. Trust your body’s knowledge too.

Vaginal Exams (VE):

Internal checks of the cervix to assess dilation.

• Why offered: To measure “progress.”

• Things to know: VEs can interrupt the natural flow of labour by “pushing up” against the cervix. They also increase infection risk, especially after waters have broken.

• Emotional impact: Knowing your dilation can be discouraging or distressing — especially if you’re attached to a number. Labour often doesn’t follow a neat pattern, and a “small” number doesn’t mean no progress.

Position Checks:

Feeling your bump or internally checking to guess baby’s position.

• Why offered: To understand how baby is sitting in the pelvis.

• Things to know: Not always essential if labour is progressing naturally.

Scalp Monitoring:

A small clip placed directly on baby’s head for more precise heart rate monitoring.

• Why offered: If external monitors aren’t picking up clearly.

• Risks: Invasive. It requires waters to be broken, which increases infection risk and removes a layer of protection for baby.

Induction Methods — To Start or Speed Up Labour

Membrane Sweep:

A midwife sweeps their finger inside the cervix to stimulate labour hormones.

• Why offered: To try and “naturally” kick-start labour without full induction.

• Things to know: It’s a form of induction and can introduce infection if cervix isn’t ready.

• Emotional impact: May trigger false hope or disappointment if nothing happens.

Pessary:

A gel, tablet, or tampon-like insert containing prostaglandins (sometimes synthetic or pig-derived).

• Why offered: To soften the cervix and encourage contractions.

• Things to know: Can cause hyperstimulation (too many contractions too fast), which can distress baby.

Misoprostol:

A drug sometimes used for induction (inserted vaginally or taken orally).

• Why offered: Stronger induction method.

• Risks: Misoprostol use in labour has been linked to serious risks, including uterine rupture and deaths.

• My advice: Proceed cautiously; ask about alternatives.

Drip Induction (Syntocinon/Pitocin):

A hormone drip to bring on or speed up contractions.

• Why offered: If labour isn’t progressing “fast enough” by hospital standards.

• Things to know: It can create very intense contractions, often making epidural more likely.

• Risks: Can increase need for more interventions, feelings of disconnection from your body and baby, longer recovery, and a higher risk of postpartum depression.

Pushing Too Soon:

Being told to push before your body naturally feels ready.

• Things to know: Can cause swelling in the cervix, exhaustion, and need for instrumental delivery. Trust your own urge if you can.

Progression Support — Helping Baby Be Born

Epidural:

Pain relief injected near the spinal nerves.

• Why offered: To manage strong pain, often after induction.

• Things to know:

• Can affect baby’s position (increasing the need for instruments or C-section).

• Can delay pushing urge.

• Might impact early bonding and breastfeeding.

• Some people experience emotional “flatness” after an epidural.

Episiotomy, Suction, Forceps, Blunt Scissors:

Interventions to assist baby out during the final stage of birth.

• Why offered: If baby needs help to be born quickly.

• Risks: Increased perineal trauma, longer healing time, and emotional trauma.

• Good to know: Not always necessary. Always ask if you have time: “Is this an emergency, or can we wait a few minutes?”

C-Section:

Surgical birth through abdominal incision.

• Why offered: If vaginal birth becomes unsafe.

• Things to know: It’s major abdominal surgery. It has its own beautiful moments but also emotional and physical recovery journeys that deserve respect. You can ask for things like delayed cord clamping, skin-to-skin, and gentle C-section protocols.

Final Reminders

• You always have time to ask: Is this an emergency? Can we have a moment?

• You can say yes or no to anything.

• Knowledge is power — but sometimes letting go and staying connected to your body is just as powerful.

• Your instincts are valid.

• Your birth, your choices.

With love and deep respect,

@happysoulmama

(doula serving Hackney, Stoke Newington, and beyond)