Cascade of Interventions

Midwife examining belly of pregnant woman with CTG scanning in

“If you have to be induced, you will end up with an epidural, which will stop your labor. Then they will need to increase the Pitocin and you will end up with a c-section.”
“Don’t let them break your water because you will end up with a c-section.”
“If you get Pitocin, your baby will be in distress and you will end up with a c-section.”

While many people know that every birth is different and not everyone’s birth story will end up being written the same way, some people still believe in the ‘snowball effect’ or ‘cascade’ of interventions in labor. This is the belief that when one intervention becomes necessary, it leads to another one to counter the effects of the first one, which in turn leads to another one to counter that one, until the birthing individual ends up with a traumatic experience or a cesarean birth.

This is not totally accurate and is hurting birthing women.

Yes, it can happen that one intervention may lead to another. But one intervention is not necessarily the reason for the next.

This logic fails to acknowledge the birthing individual and their unique birth experience. It also may be scaring women out of some very necessary medical procedures.

Every birth is different. It really is. 

Just because your friend ended up with a cesarean after she got the epidural, does not mean you will. And just because one person deems a cesarean as a traumatic birth experience, does not mean another person won’t find it empowering and wonderful.

We don’t always know why medical providers make the recommendations they make, but that doesn’t mean you can’t ask them. Always feel free to use your B.R.A.I.N. for decision making so you can feel confident in the process.

Why is this intervention being offered? Is it necessary? What are we hoping this intervention will accomplish?

As your doula and expert on options, I can answer any questions you may have, help facilitate communication between you and your medical care provider so you can get the information you desire, and help you navigate your feelings surrounding the decisions you make.

You may need to ask yourself: What is the main goal here? What is most important to me?

Do you want a happy, healthy mom and baby? Do you want a vaginal birth? Do you want a speedy delivery? Do you want a more predictable outcome?

These are things you should discuss with you entire birth team prior to your birth so everyone can be on the same page about your care. It is possible that your original birth plan may need to change slightly, or maybe even significantly depending on a number of circumstances that may or may not occur during your labor or leading up to it.

Your birth team, including your medical team, want you to have a great experience, even if things do not go exactly as planned.

Your birth experience is unique. Interventions do not always lead to more interventions. They can lead to positive birth experiences, even if that is not what you envisioned when writing your birth plan.