Medical Interventions
What they are, why they're offered, and what to ask
The Framework for Every Decision
Any time a test or intervention is recommended, work through BRAIN: Benefits, Risks, Alternatives, Intuition, Nothing (what happens if we wait or decline?). These are not adversarial questions. Good caregivers welcome them. They're how informed consent actually works.
Electronic Fetal Monitoring (EFM)
Continuous monitoring of the baby's heart rate and uterine contractions. External EFM uses two belts on the abdomen. Internal EFM uses a fetal scalp electrode and intrauterine pressure catheter, more accurate but requires ruptured membranes.
IV Fluids
An IV line is standard in most hospital labors. It may run continuously or be capped (heparin lock) and accessed only if needed.
Artificial Rupture of Membranes (AROM)
A caregiver uses a thin hook to break the amniotic sac. Studies show it shortens active labor by an average of about 40 minutes, but only when the baby is well-positioned.
Induction and Augmentation
Induction means starting labor. Augmentation means speeding up labor already in progress. Methods range from cervical ripening agents (prostaglandins, Foley balloon) to Pitocin IV to AROM.
Episiotomy
A surgical incision to enlarge the vaginal opening at birth. Once routine, now rare. Spontaneous tears heal more easily than episiotomies in almost all cases.
Vacuum and Forceps
Operative vaginal delivery tools used when pushing alone is not delivering the baby. The baby must be fully dilated and low in the birth canal.
Fetal Scalp Stimulation
When an EFM tracing looks concerning, the caregiver strokes the baby's scalp during a vaginal exam. If the heart rate accelerates by at least 15 beats per minute for 15 seconds, the baby is oxygenating well and the concerning tracing is likely a false positive.
What Your Role Is
You are not the decision-maker, your partner is. Your job is to make sure your partner has the information your partner's needs and the time your partner deserves before deciding. Ask questions calmly. If the team says there's no time, trust them. If there is time, use it.