Cascade of Intervention

The cascade of intervention refers to the likelihood of one medical intervention leading to the need for more interventions. Many women are unaware of the unintended effects of interventions when they accept an initial intervention during labour and birth. Often these unplanned and possibly unwanted effects are “solved” with further intervention, which may in turn create even more problems and the increased chances of further interventions. When these effects happen, women may feel that their bodies have failed them, not realizing that the things that went wrong could have actually been triggered by maternity practices themselves. Remember to apply the B.R.A.I.N acronym and weigh up the benefit, risks and alternative options.

By interventions, we are referring to many common and routine medical pregnancy and birth interventions, beginning with testing, working up to induction, fetal monitoring, pain medications and epidurals, assisted births (such as forceps and ventouse and episiotomy) to Caesarean Section operations. Many antenatal tests have high rates of false positives which can lead to additional testing and monitoring and often recommended induction. For this reason, it is suggested that antenatal tests and interventions are carefully researched and considered, so you can make an informed decision and decide to consent or decline.

Common maternity practices that can lead to a cascade of interventions include:

• Unnecessary growth scans.
• Induction of labour.
• Using synthetic oxytocin, to make contractions stronger.
• Using medications for pain relief.
• Labouring in bed versus being upright and moving about.

These practices often cause problems because they disrupt the normal physiology of pregnancy, labour and birth by:

• Interfering with labour and birth hormones.
• Triggering fetal distress.
• Prolonged second stage.