Labour and Birth Interventions

As you near the end of your pregnancy, everything is starting to feel very real and exciting! With just the labour and delivery to go through before you meet your little one, there are a few things you need to know about this time.  

Every pregnant woman hopes for a positive birth experience, but during the birth process, things do not always go exactly according to your original birth plan.  

There is a chance that you may need an intervention in the run up to labour, while in labour or while delivering. This is called a birth intervention. While many pregnant women aim for a natural birth or spontaneous labour without medical procedures, knowing about common interventions helps you make the right choices for your maternity care alongside your healthcare team.

[Post updated August 2026]

What is a birth intervention? 

An intervention during birth, labour or delivery is when a midwife or doctor takes an action to assist with the birthing process. These medical interventions range from simple pain relief methods to instrumental delivery or caesarean surgery. They are designed to protect you and your baby when complications arise, although global health bodies such as the World Health Organization highlight the importance of avoiding unnecessary interventions for low-risk women with low-risk pregnancies.

What are the types of intervention?

Monitoring your baby during labour

Throughout your labour, your healthcare provider will check your baby’s heartbeat to monitor how they are coping with contractions. There are different ways to do this depending on your medical condition and whether you are having a home birth, planning a delivery at a midwife led birth centre, or having a traditional hospital birth.

For low-risk pregnancies, standard practice often involves something called intermittent auscultation. This is where a midwife listens to your baby’s heart rate periodically using a handheld Doppler or Pinard stethoscope. For women who develop complications, continuous electronic fetal monitoring (continuous EFM) using belts around your abdomen may be recommended. Evidence shows that while continuous monitoring tracks the fetal heart rate closely, it can sometimes restrict your ability to change positions or use upright positions, and it can also increase the overall c-section rate without always reducing long term risks like cerebral palsy or infant mortality, so it’s a birth option you may want to discuss with your midwife or doctor and include on your birth plan.

Vaginal exams

During labour, your midwife or doctor will carry out internal checks to assess your progress. These vaginal exams measure how far your cervix has opened, its position, and how far your baby has descended into the pelvis. While standard checks help your medical team track the stages of labour, frequent vaginal examinations carry a slight risk of infection once your membranes have ruptured. You always have the right to discuss how often these are done so you maintain a sense of control throughout your care.

Induction

When you reach your due date at 40 weeks of pregnancy, you will have a midwife appointment. Many of the things that happen at this appointment will be the same as other midwife appointments, but they may also discuss the possibility of an induction of labour with you as you progress beyond your due date and help you understand the reasons and risks. Your healthcare provider will check your blood pressure, monitor your baby’s health, and see if there is any medical reason to consider labour induction early, such as gestational diabetes or other pregnancy complications.  

An induction is usually offered at 41 weeks, which is a week beyond your due date. Unless there is a medical need to progress with the delivery of your baby quickly, it is entirely your decision as to whether you would like to accept an induction. Some women choose not to accept inductions as there’s the risk that they can cause contractions that are more intense, painful or irregular or may increase the risk of infection in certain circumstances.  

Generally healthcare providers would prefer you to go into labour naturally so will offer inductions when they believe the benefits outweigh the risks. We’ve broken down some of the pros and cons of the different types of induction below so that you can easily understand what might be best for you and your baby:  

Stretch and Sweep (Membrane Sweep)

This is the first and most gentle type of induction you’ll be offered, and it may even happen at a midwife appointment around your due date. A midwife or doctor inserts a gloved finger into the cervix and makes circular movements to separate the amniotic sac from the uterus with the goal of encouraging the release of hormones that may start labour.  

Pros: 

• Non-medical and often offered before other induction methods. 
• Can encourage labour to start naturally. 
• Can sometimes prevent the need for further medical interventions.

Cons: 

• Can be uncomfortable or painful. 
• Might not work, requiring further induction. 
• Can cause spotting or mild cramping.

Prostaglandin Gel or Pessary 

A hormone-based gel, tablet, or pessary is inserted into the vagina to soften and dilate the cervix.

Pros: 

• Mimics natural labour by preparing the cervix. 
• Allows some movement and mobility. 
• Less invasive than other methods.

Cons:

• Can cause contractions that are intense and irregular.
• Sometimes requires multiple doses.
• Possible side effects like nausea or excessive contractions (hyperstimulation), which may require medication to slow them down.  

Balloon Catheter (Foley or Cook Catheter) 

A small tube with a balloon is inserted into the cervix and inflated with water, mechanically encouraging dilation.

Pros: 

• Drug-free option with fewer risks of hyperstimulation. 
• Can be used when prostaglandins are unsuitable (for example, after previous C-section, helping reduce risks like uterine rupture in subsequent births). 
• Can be removed easily if not effective.

Cons: 

• Can be uncomfortable and cause cramping. 
• Might not be sufficient on its own to start labour. 
• May still require additional induction methods.

Breaking Waters (Artificial Rupture of Membranes)

A midwife or doctor breaks the amniotic sac using a small hooked instrument. This is usually offered if contractions are irregular or slowing, in order to help dilation to progress, if other induction types haven’t worked, or if baby is not in a good position for birth. Both the American College of Obstetricians and Gynecologists and the American College of Nurse-Midwives advise against the routine use of routine amniotomy in straightforward labours, recommending it only when there is a clear clinical need.

Pros: 

• Once waters break, contractions often begin naturally. 
• No medication involved. 
• Can be combined with other methods if labour doesn’t start.

Cons: 

• If contractions don’t start, further intervention (eg. oxytocin drip) may be needed. 
• Increased risk of infection if labour doesn’t progress. 
• Can cause discomfort and make contractions more intense.

Oxytocin (Syntocinon) Drip 

If your labour is not progressing well, you may be offered a synthetic oxytocin version of the hormone oxytocin through an IV drip to stimulate contractions. You may also be given intravenous fluids at the same time to keep you hydrated.

Pros: 

• Usually very effective at stimulating labour. 
• Labour can be closely controlled and monitored. 
• Can be adjusted in strength if needed.

Cons:

• Often results in stronger, more painful contractions.
• May require continuous monitoring, limiting movement.Higher chance of needing an epidural due to pain.
• Increased risk of hyperstimulation, which can distress the baby.

Pain relief and pain management during labour

Managing pain during labour is a personal choice, and your options range from natural pain management techniques to medical pain medication. For low risk pregnancies, non-pharmacological methods can be a great way to cope with early labour. Creating a supportive environment with continuous support from a birth partner, a dedicated birth doula, or your midwife can make a substantial difference. Evidence comparing continuous labour support against control groups demonstrates that constant one-to-one care helps labour progress faster and reduces the need for clinical intervention.

Other natural options include position changes, warm baths, water birth, and breathing exercises. When these are not enough or if you prefer medical options, your hospital team can provide gas and air (Entonox), pethidine or diamorphine injections, or epidural analgesia. An epidural is a regional anaesthetic administered by an anaesthetist into the space around your spinal nerves. While it offers the most complete relief from contractions, it may lower your blood pressure, temporarily limit your ability to walk or change positions, and slightly increase the likelihood of needing an assisted delivery.

Assisted Delivery (Instrumental) 

During the second stage of labour, you may need some assistance to deliver the baby. There are a number of reasons why this may be necessary but the most common include the mother tiring during a prolonged second stage of labour, if the baby is showing signs of distress, such as their heart rate rising or falling, if baby is positioned awkwardly, or if baby is not descending well. This procedure is also referred to as an instrumental vaginal birth.

There are two types of assisted delivery: ventouse and forceps.

If the baby is lower in the birth canal, a ventouse (sometimes known as vacuum cup) can be used. This has less risk of tearing for the mother, but is not as useful if baby is not positioned well.

If the baby is not well positioned, forceps are usually used. These are better for an emergency and can help to guide the baby out, but baby may have marks and bruising on their face, and there is a higher risk of tears for the birthing mother too.

Episiotomy

An episiotomy is sometimes used alone or with an instrumental delivery. This is where a doctor makes a small incision to the perineum. This may help to reduce the risk of larger tears or to assist with an instrumental delivery. This cut will be stitched and should heal within 4-6 weeks of giving birth. Clinical guidelines in both the United Kingdom and the United States no longer recommend the routine use of episiotomy for standard vaginal delivery, reserving it instead as a preventive measure when instrumental assistance is required or when a severe natural tear seems likely.

Emergency C Section

A caesarean section may be planned in advance, but an emergency c-section falls into the category of a birth intervention. This usually takes place if the risks to the mother or the baby are high and it is more important that the baby is delivered quickly. A caesarean birth involves major surgery where a doctor makes a cut in your abdomen and womb to deliver your baby. While a C-section can be life-saving when unexpected complications occur, it carries longer recovery times and potential adverse effects compared to an uncomplicated natural childbirth, which is why your medical team will only recommend it when clinically justified.

Third stage of labour and immediate postnatal care

The third stage involves the delivery of the placenta and umbilical cord. You can choose physiological management, where the placenta delivers naturally without drugs, or active management, where a synthetic oxytocin injection is given into your thigh to help your womb contract and speed up delivery. Active management is standard practice in many hospital settings to reduce the risk of heavy bleeding after birth. Following delivery, enjoying immediate skin-to-skin contact with your baby helps regulate their breathing, temperature, and heart rate while encouraging initial bonding.

Understanding the “cascade of interventions”

In maternity care, healthcare professionals sometimes talk about the cascade of interventions or unintended consequences. This describes what happens when one intervention leads to the need for another. For instance, being induced with an oxytocin drip can cause very intense contractions, which might lead you to request epidural analgesia. An epidural often keeps you in bed, reducing your ability to use upright positions or move around freely, which can slow down the second stage of labor and increase the likelihood of needing an instrumental vaginal birth or an emergency c-section. Understanding how different interventions connect does not mean you have to avoid them when they are genuinely needed; rather, it empowers you to ask questions and seek the right balance of medical help for your circumstances.

Can I collect my baby’s cord blood with birth interventions?

In the vast majority of cases, birth interventions should not impact cord blood collection. The main reason why cord blood collection may be impacted is if there is significant distress or complications for the mother and the baby, in which case, the medical team will prioritise their safety. This is very unlikely though and is usually not as a result of the birth interventions themselves as it could happen at any birth. Whether you have an unassisted vaginal delivery, an instrumental birth, or an unplanned caesarean section, our phlebotomists work alongside your healthcare team to harvest stem cells from the umbilical cord safely and efficiently without disrupting your delivery or the use of preventive measures for your baby’s health.