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The Cascade of Interventions [Explained]

Do inductions really lead to c-sections? Do epidurals increase the chance of having more medical interventions? You’ll be able to answer these questions and more once you understand the cascade of interventions, which is what this blog post is all about.

woman experiencing the cascade of interventions

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In America, about 98% of women give birth in a hospital. Just over 32% of women in America give birth by c-section.

Now, obviously, a c-section has to happen in the hospital.

But what if some of those c-sections are happening because mom was in the hospital? Said another way, what if some of those c-sections wouldn’t have happened if those moms hadn’t been in the hospital, for the simple fact that being in the hospital was the very thing that ended up leading to a c-section?

Unfortunately, that “what if” isn’t just a figment of imagination. That is what really happens.

And it happens often enough that there’s a name for it: the cascade of interventions.

What is the Cascade of Interventions?

So what exactly is the cascade of interventions?

At its simplest, this “cascade” is what we call the phenomenon of one medical intervention leading to another…and another…and another. For example, if you get induced, you’ll likely also get an epidural. And if you get an epidural, the doctor may end up doing an instrumental delivery.

(You’ll learn all about each of those later on in this blog post, don’t worry.)

It’s important to point out that what we are talking about here is unnecessary intervention. Of course, there are times when medical intervention is vital for the safety of a mom or her baby. Most of the time, though, these interventions happen without true medical need. That is when they cause problems.

The cascade doesn’t always follow the same path and it can be different for every woman. And of course, like I just explained, it’s not an absolute given that one intervention will lead to another, either.

Still, it happens and it happens more than it needs to. And the possible consequences are no small thing.

RELATED >> The Cascade of Interventions: Myth or Reality?

How Common is the Cascade of Interventions?

I said in the intro that 32% of births in the US are c-sections. Let me give you a few other statistics so you have a picture of how common all these interventions are.

Around 31% of women in the US have labor induced artificially (that number may be on the low end, though). Almost all women who deliver in the hospital receive IV fluids and electronic fetal monitoring during labor. And 71% of women use epidurals (or a similar medicine).

Most women give birth while lying on their back. Many are asked to delay pushing. Very few are allowed to eat or drink during labor. Cervical checks are frequent, and episiotomies are common.

And that’s not even everything on the list.

RELATED >> Medications During Labor: Is It Worth the Risk?

What Hormones Have to Do With It

To understand why interventions can cause problems, you need to know the role that hormones play in labor and birth.

I go into detail in my article The Hormones of Labor and Birth (and Why You Should Care), but here’s a quick rundown.

Basically, oxytocin is running the show. It affects when labor starts, how labor progresses, and how well your body recovers. It even plays a role in bonding between baby and mom.

Besides oxytocin, a woman’s body produces hormones called beta-endorphins during labor. Beta-endorphins are natural pain relievers.

Then there’s prolactin, which is the breastfeeding hormone and which also plays a role in attachment.

And that’s just a sampling. Clearly, hormones are integral to labor, birth, and postpartum.

The thing is, when you introduce any sort of medication into the mix, you mess with the hormones. When you mess with the hormones, you throw off the natural process of things. And when you mess with the way things were designed, you’ve likely necessitated the use of more intervention to keep that process going.

Risks of the Cascade of Interventions

Before we talk about all the interventions, I want to help you see WHY the cascade of interventions matters for you. What does it mean for you and your baby?

Unnecessary medical interventions during labor and birth can lead to five main negative outcomes:

  • C-section
  • Preterm birth
  • Problems breastfeeding
  • Excessive bleeding
  • Dissatisfaction with the birth experience

Each of those topics can be heavy and hard to talk about. Bear with me, though. There are a few things I want you to know, and then we’ll move on.

C-section

First, if you’ve had a c-section, YOU AREN’T A BAD MOM. But if a woman can avoid a c-section in the first place, she and her baby are far more likely to walk away from birth healthy and happy.

Preterm Birth

Second, preterm (or premature) birth is when a baby is born before 37 weeks of pregnancy. And preterm birth is one of the leading causes of newborn death in the US and in the world

Problems Breastfeeding

Third, breastfeeding, sadly, can be a highly controversial topic. But that can’t change the fact that breastmilk is by far and away the best food for your baby. The more difficult it is to initiate breastfeeding, the less likely it is that you’ll continue to try for very long and the less of this miraculous nutrition source your baby will get.

Excessive Bleeding

Fourth, many of the interventions on this list put you at higher risk for more bleeding, at birth and in the weeks following. Excessive bleeding – also called hemorrhaging – is the second leading cause of death in pregnant women and new moms.

Dissatisfaction with Birth Experience

Finally, women who experience more interventions are usually significantly less satisfied with their birth experience. Of course, this matters in the moment – no birthing woman should ever have to feel mistreated or uncomfortable during labor. And if she does it’s only going to make things harder.

It also matters in the weeks, months, and years to come. Giving birth is not something a woman forgets. The way birth goes and the way you feel about it will affect you for the rest of your life.

What You Can Do About It

Okay. I know those are hard things to think about. The good news is that all five of those things are, largely, preventable. After you read this blog post, I’d encourage you to learn about how nutrition and exercise play a role in a healthy pregnancy and, therefore, a safe birth.

For now, let’s dive into the details of the cascade of interventions so you can have the information you need to make the right choice for you and your baby.

What Are These Interventions?

We understand now that one intervention can lead to another and that’s not great. But what are these interventions we’re talking about? Let me explain.

There are thirteen interventions that often show up in a typical “cascade”:

  1. Induction
  2. Pitocin
  3. Continuous Electronic Fetal Monitoring
  4. IVs
  5. Oral Intake Restrictions
  6. Epidurals
  7. Catheters
  8. Movement Restrictions
  9. Cervical Checks
  10. Episiotomies
  11. Directed or Delayed Pushing
  12. Instrumental Delivery
  13. Cesarean Sections

In this post we’ll talk about each one – what it is and what it might mean for you – and I’ll link to lots of other sources if you want to dive deeper into any of them.

Without further ado, let’s begin.

1. Induction

Often, the first intervention in any cascade is induction of labor. 

If left to their own devices, your body and your baby will begin labor when they are ready. Induction, on the other hand, is trying to get labor to start (by any means) before labor starts spontaneously.

Unfortunately, when it comes to induction, the benefits are often overstated and the risks unexplained.

The biggest risk of inducing labor is the possibility of accidental prematurity. Because due dates aren’t always accurate and because some babies need a little longer in the womb than others, induction can cause a baby to come earthside before they are totally ready.

To learn about other risks of induction and the benefits, check out Understanding Induction: Pros and Cons of Inducing Labor.

Many of the other risks of induction are also risks of using Pitocin to speed up or strengthen labor, which is intervention number 2.

2. Pitocin

As I mentioned, giving a woman Pitocin is one of the most common ways of inducing labor. Even if not used to kickstart labor, many woman will receive Pitocin later in labor because the doctor wants to speed things up. Often, doctors also give Pitocin immediately after birth to help your uterus contract to push your placenta out.

Pitocin = Pain

Around 50% of women in the US have Pitocin given to them at some point during labor.

Pitocin creates artificial contractions, and those contractions are longer, stronger, and closer together than natural contractions. In addition to that, this is one area where hormones are directly interfered with.

Natural oxytocin creates a cycle in your body that naturally produces endorphins alongside contractions. Endorphins are natural painkillers. Pitocin messes with that cycle and significantly decreases the production of endorphins in your body.

Because of those two things (the intensity of contractions and the decrease of helpful hormones), Pitocin-induced contractions are almost always more painful.

And because women are in more pain, they are more likely to ask for an epidural. (We’ll dive into the implications of that later.)

Pitocin and Fetal Distress

In addition to being more painful, the combination of long, strong, and close together leads to increased pressure in the uterus, more than there would be if the body was left to labor on its own.

That extra pressure decreases the flow of oxygen and blood to your baby and lowers your baby’s heart rate. And “non-reassuring fetal heart tones” is the #2 reason for c-sections for first-time moms.

The Fetal Distress Cycle

This common occurrence is what I call the fetal distress cycle. It goes like this:

A laboring woman goes to the hospital. Labor isn’t progressing very fast, so the doctor gives the woman Pitocin to speed things up. (The same cycle applies if Pitocin is used from the start to induce labor.)

The Pitocin contractions are overwhelmingly painful, so she asks for an epidural.

The epidural relieves the pain but also causes labor to slow down. When labor slows, the doctor speeds it back up by increasing the dosage of Pitocin. Despite the epidural, the laboring woman feels the sensations increase and asks for the epidural dosage to be upped as well. 

And the pattern continues – more Pitocin, higher epidural dosage – and everything seems fine because one takes care of the other. Mom can’t feel the contractions.

But her baby certainly can.

And soon, it becomes too much.

The fetal monitoring systems that mom is attached to (which we’ll talk about in a moment) pick up on the baby’s decreasing heart rate. And, seeing that, the doctor will probably recommend a c-section.

Pitocin and Hemorrhaging

The other main danger of using Pitocin during labor becomes evident right after birth.

Without getting too deep into it, prolonged use of Pitocin can desensitize the uterus to oxytocin. That means the uterus stops responding like it normally would to oxytocin. During labor, that can mean that your doctor and nurses have to continue increasing your dosage of Pitocin to get the same effect.

Immediately after birth, it means something else.

Right after your baby is born, your body is flooded with hormones, including oxytocin. That oxytocin tells your uterus to begin contracting and shrinking. If your uterus doesn’t do that (like it wouldn’t if it’s been desensitized by too much Pitocin), you bleed more.

In other words, this is one reason postpartum hemorrhaging happens.

3. Continuous Electronic Fetal Monitoring

Another common element in the cascade of interventions is continuous electronic fetal monitoring.

Most likely, if you go to the hospital, you’ll have two straps wrapped around your belly after you get checked in: one to monitor your baby’s heart rate and one to monitor your contractions. This is continuous electronic fetal monitoring (EFM). 

You might be thinking, “Wait, isn’t it a good idea to monitor the baby’s heart rate?” And the answer to that is, “Of course.” But there’s actually no benefit to monitoring it continuously. In fact, constant monitoring can lead to more problems than if you went without.

One of the main issues with continuous monitoring is false alarms.

False Alarms

EFM isn’t perfect and can show data that is incorrect. This is especially evident when talking about detecting cerebral palsy, which is one reason given for the use of EFM.

Surprisingly, the false positive rate for detecting cerebral palsy in an unborn baby is greater than 99%. That means that only 1 or 2 out of 1000 babies who are predicted to have cerebral palsy because of what EFM shows will actually have the condition.

Aside from imperfections in the monitoring, researchers have pointed out another issue: doctors’ definition of “normal” fetal heart rate during labor may be too narrow. To put it simply, doctors often see a decrease in heart rate on the fetal monitors and think that the baby is in danger when in reality the baby is fine.

The truth is that babies adapt remarkably well to the conditions of normal labor. So while their heart rates may drop for a moment, they are likely still perfectly safe and well and their heart rate will quickly go back to normal if nothing is done to interfere.

EFM Makes C-Sections (a LOT) More Likely

Unfortunately, doctors do intervene, and quite often.

One meta-analysis (a study that looks at multiple previous studies) found that women who have continuous EFM are 63% more likely to have a c-section than women who received other methods of monitoring and 15% more likely to have an instrumental delivery.

In addition to the increased likelihood of a c-section, EFM can keep mom in bed because the straps, and therefore the monitors, are easily disturbed. Restricting mom to bed has its own risks, which we’ll cover in a bit. 

4. IVs (Intravenous Fluids)

Intravenous Fluids (IVs) can seem like a harmless addition to labor. That’s probably why they aren’t talked about much. But they’re definitely part of the cascade of interventions. The potentially negative effects of IVs are linked to other interventions, like oral intake and movement restrictions.

Do You Really Need an IV During Labor?

Most hospitals will require you to have an IV throughout the entirety of labor. Doctors usually state two reasons for this policy: 1) to prevent dehydration and 2) in case of an emergency later on.

When it comes to hydration, IVs do seem to help.

Unfortunately, no studies have been done comparing only using IVs to only taking liquids by mouth. Still, studies comparing IV fluids alone to IV fluids plus liquids by mouth showed that the combination of both (i.e. the highest fluid intake) led to shorter labors and was more effective at preventing dehydration than IVs alone.

As far as being available for emergencies, it is a valid argument…to a point. If you already have the needle in your arm, they will be able to give you pain medication or Pitocin faster (in the case of postpartum hemorrhaging, for example).

That said, most emergencies arise because too many interventions are used – hence this blog post – so getting an IV for that reason is somewhat counterproductive.

Even if an IV isn’t routine at the hospital you choose, IVs are used to administer Pitocin, so you’ll get one if you want that. And IVs are almost always required if you get an epidural or a c-section. So keep that in mind too.

IVs, Breastfeeding, and Movement

Another thing to know about getting an IV during labor is that it can affect breastfeeding.

Taking in too many fluids during labor, which is far more likely with an IV, can lead to a decreased likelihood of exclusive breastfeeding. (And if you aren’t exclusively breastfeeding, for whatever reason, your milk supply can diminish or even disappear.)

Finally, IVs come on a stand and that means you’ll be attached to something throughout all of labor. That will naturally restrict movement, even if it’s only because it becomes inconvenient to change positions.

5. Oral Intake Restrictions

The normal policy for eating and drinking during labor in most hospitals is “NPO,” which stands for “nil per os” and means “nothing by mouth.” But this is one of those routine things that has no evidence to back it up.

Giving birth is one of the most physically taxing experiences a human can go through, so it really doesn’t make sense to restrict eating or drinking. Trust me, you’re going to need your energy. 

Most women will get tired during labor. But the faster exhaustion sets in, the more likely it is that mom will need or want interventions like an epidural or instrumental delivery (hence why I included this section in the cascade).

Why the Restriction?

The reason for restricting oral intake is, like IVs, “in case of emergency.” If you end up needing full anesthesia at some point during labor, it’s supposedly safest if your stomach is empty. That’s because of the possibility of aspirating, or breathing in bits of food while unconscious.

The risk of aspiration alone is quite low with our modern anesthesia methods, and the chance of needing full anesthesia during labor is next to zero, too.

Suffice it to say, women should not be forced to fast during labor; on the other hand, they should be allowed and encouraged to eat when and what they want.

Why You SHOULD Eat During Labor

The main benefit to eating and drinking freely during labor is the comfort and satisfaction of mom. Some studies have also shown that less restrictive eating and drinking policies led to shorter labors by about 16 minutes. That may not seem like much but it shows that it can make a difference.

READ MORE >> Snacks for Labor: Why and What You Should Eat During Labor

6. Epidurals

Oh epidurals. Seemingly such a simple thing, yet there’s so much more to it than choosing pain or relief.

Here’s what I mean.

About 71% of laboring women in the US get an epidural at some point during labor. For most, it seems the obvious choice for managing the pain of labor. What a lot of women don’t know is that it isn’t just a needle stick and you’re good to go.

First of all, epidurals come with side effects for a lot of women. One of the most common side effects is an all-over itching feeling. (They can give you another medication to help that go away but we’re talking about avoiding a cascade of interventions here.)

Secondly, an epidural doesn’t come alone.

Before getting an epidural you receive a numbing shot in your back. Then, after you get the epidural shot, you’ll be hooked up to an IV, continuous fetal monitoring, and a blood pressure cuff, if you aren’t already. You’ll probably also have to get a bladder catheter since you likely won’t be able to get up to go to the bathroom on your own.

All of that means that you’re probably going to stay in bed for the rest of labor, either because you’re strapped into too many machines and things or because you’re too numb to safely move around.

7. Catheters

A catheter is a soft hollow tube used in medical procedures. Most often, catheters are used to empty the bladder when a person can’t on their own. That is the kind of catheter you’ll likely get if you get an epidural.

It is inserted directly into your urethra (the opening where urine comes out) and pushed up just far enough to drain your bladder automatically.

If you are receiving Pitocin, you may also be hooked up to an intrauterine pressure catheter (IUPC). This type of catheter is inserted into the uterus through the vagina and requires that your amniotic sac be broken if it hasn’t already.

An IUPC monitors labor internally (rather than externally, like EFM) to ensure that Pitocin-induced contractions are neither too strong nor too weak.

The main concern with catheters, other than discomfort, is that they can lead to infection because they provide a line directly into your bladder or your uterus for bacteria to follow.

8. Movement Restrictions

As I’ve already mentioned, all these machines and medications can lead to you being restricted to bed for the entirety of labor. Lying on your back is also just the typical position for birthing in the hospital, even if you’re not necessarily stuck there.

To be clear, not every woman who gets an epidural will be on her back for labor. If you aren’t completely numb, you may still have the choice to move around and change positions. But most women will stay on their backs and many nurses will encourage staying still (so as to not disrupt the monitors).

The problem is that being on your back is the least effective position to be in!

Not only is gravity working against you when you’re on your back, but it can also make contractions feel more painful. For me, lying down made it way harder to cope with contractions, so I stayed upright throughout my entire labor.

If you find yourself in the middle of a cascade of interventions, though, you may not have that option.

9. Cervical Checks

Cervical checks, also called vaginal exams, are the way care providers check the condition of your cervix. The entire purpose of the first stage of labor is for your cervix to dilate and efface, fancy words for opening and thinning.

Trained care providers can feel the difference between a cervix that’s effaced and one that’s not, and they can measure with their fingers how dilated a cervix is. (A fully dilated cervix is about 10 centimeters across.)

Many care providers start to do cervical checks at prenatal appointments around week 36 of pregnancy. 

how big is 10 cm explanation

The thing is cervical checks are unnecessary for most women. A woman’s body will do what it needs to do when it’s ready to do it. And no amount of checks will change that. On the contrary, frequent checks will likely just add stress to your life when nothing is wrong.

Some women start to dilate days or weeks before the day the baby is born. Some dilate from zero to ten quickly, all in one day. How dilated you are really is no indicator of how soon your baby will arrive. 

You Can Say “No”

In addition to potentially causing stress if the doctor inadvertently (or directly) suggests you should be more dilated than you are, cervical checks can be quite uncomfortable, even painful.

Just remember: you have every right to decline a cervical check, even during labor.

My midwife checked my cervix once during the entirety of pregnancy and labor, and that was after 14 hours of labor. She let me choose and I’m glad she did.

READ MORE >> Understanding Cervical Checks During Labor: You Get to Choose

10. Episiotomies

Another common element in hospital births and the cascade of interventions is episiotomies. I had no idea what an episiotomy was when I got pregnant, so don’t feel bad if you’ve never heard of them either.

An episiotomy is a cut a doctor makes in the opening of the vagina to widen the opening for a baby to come out. 

Why Doctors Do Episiotomies

Episiotomies used to be routine; nearly every woman got one. Three now-outdated arguments provided the reasoning for this.

First, people thought episiotomies preserved the function of the pelvic floor muscles and tissues.

Second, episiotomies supposedly healed better than natural tears. Third, people thought the extra space provided by an episiotomy would protect babies’ brains from having to push against so much tissue.

All of these have now been proven to be invalid.

Why NOT to Get an Episiotomy

Quite the contrary to original belief, episiotomies lead to worse damage and tearing.

Think about it: if you pull on opposite edges of a piece of paper, it might rip if you pull with enough force. But if you tear the top of a paper just a little bit first, pulling on opposite edges has a much higher chance of ripping through the entire paper.

In addition to that, a natural tear has a higher chance of healing well because it’s not a straight line like an incision. 

All that said, not everybody tears or gets an episiotomy. And if you do, your doctor or midwife will numb you and stitch you back up after your baby is born and your body will heal.

11. Directed or Delayed Pushing

Near the end of labor, we see a new element of the cascade of interventions: directed or delayed pushing.

After your cervix is completely dilated and effaced, you’re at the pushing stage of labor. Some women feel a distinct, undeniable urge to push. Some don’t. Either way, it’s common for doctors and nurses to intervene and “coach” you on how and when to push.

As is almost always the case, following your body’s cues is better than having an external directive.

Directed Pushing

Directed pushing usually means taking a breath at the beginning of a contraction and holding it for 10 seconds or until the contraction ends, pushing the whole time you hold your breath. Some people call this “purple pushing” because holding your breath for that long can make your face go purple.

Pushing like that is not usually a great idea because you and your baby need a good flow of oxygen. It can also cause little blood vessels in your face and eyes to burst, leaving tiny bruises.

Delayed Pushing 

Delayed pushing is when a laboring woman reaches full dilation but is told not to push. Usually the reasoning for delayed pushing is either that it’s hospital procedure to have a woman “rest” for an hour or two before pushing or that the doctor is with another patient.

Studies have shown that delayed pushing (versus spontaneous pushing) doesn’t have much effect on how likely a vaginal birth is. But that doesn’t mean this intervention comes without risks.

Two things are important to know about delayed pushing.

First, not pushing with pushing contractions can make them feel more painful. Your body wants to get your baby out! And working with your body, for a lot of women, makes pushing contractions much more bearable. (That’s how it was for me!)

Second, women who delay pushing have a higher risk of hemorrhage, intrauterine infection, and severe perineal tears. Their babies have a higher likelihood of being admitted to the NICU. And nobody wants that.

12. Instrumental Delivery

Instrumental delivery is when doctors use forceps (kind of like big salad tongs) or a suction device to guide your baby out of the birth canal.

This kind of assisted delivery is done most often when the baby is in distress or the mom is too tired to push effectively anymore. Instrumental delivery is less dangerous than a c-section but there are still risks for both mother and baby.

For mom, more severe tears and longer recovery time are common. She may also have a harder time going to the bathroom in the first little bit after birth.

For babies, bruising or swelling is fairly common but not severe. Sometimes, the procedure damages nerves. Rarely, internal bleeding happens.

While some doctors still use forceps and suction devices, they are becoming less and less common. These kinds of births account for only about 3% of vaginal births now. Why? Because many OBGYNs are not trained on how to use them anymore.

So what do they do instead? They opt for cesarean sections.

13. Cesarean Sections

Last but certainly not least, the cascade of interventions can lead to a cesarean section (usually shortened to “c-section”). Some people choose to schedule a c-section before they even go into labor. So why is it such a big deal to avoid one?

I’m glad you asked.

C-section is Major Surgery

First, c-sections are major abdominal surgery. This is no small thing. Obstetricians are surgeons and this is their specialty. In order to get the baby out, OBs have to cut through 7 layers.

Recovery from a c-section is longer and harder than recovery from a vaginal birth. Like all surgeries, there’s a risk of infection while the incision is healing. You also have a higher chance of needing a blood transfusion because you lost too much blood during the surgery.

Vaginal Birth Has Benefits

Second, babies who are born vaginally get benefits that babies born by c-section miss out on. Those benefits include exposure to good bacteria in their mother’s vagina that helps their immune system develop and undergoing the natural “fetal heimlich maneuver.”

This “maneuver” is a fancy way of saying that pushing your baby out through the vaginal opening effectively clears amniotic fluid out of his or her lungs and airways.

Missing out on this fetal heimlich maneuver is arguably the biggest risk of c-sections for babies. Since c-section babies don’t get fluids squeezed out, they often have more breathing problems than vaginally-born babies.

Babies born by c-section also have a lower rate of successful breastfeeding

One C-section Affects Your Other Births

Third, c-sections have implications with each successive pregnancy and birth. If a mom has one c-section, many doctors will recommend that all of her following births be c-sections.

While those doctors have their reasons, that isn’t necessarily the best choice. VBACs – vaginal births after cesarean – have benefits beyond a mom simply wanting to experience vaginal birth (though that’s still a valid reason!).

Fortunately, more providers are shifting to allow VBACs.

Still, both have risks that you need to weigh (ideally before giving birth to your first child).

The main concern with attempting a VBAC is uterine rupture, which is when the scar from a previous c-section tears open. It is a life-threatening situation, but it is rare – very rare. Other than that, the benefits of a vaginal birth still apply. 

READ MORE >> Everything You Need to Know About VBAC

Repeat c-sections, on the other hand, have more common risks. These risks include placenta problems, excessive bleeding, infection, injury to nearby organs, and hysterectomy.

In short, the more c-sections you have, the more dangerous they get. (That means that if you want a big family, you probably want to avoid c-sections if you can.)

READ MORE >> C-sections: Why and How to Avoid Having One.

My Wish For You

Now you know what the cascade of interventions is. Not only that; you also know what each of those interventions is and what it might mean for you. Now you are ready to make intentional choices about your birth experience.

In the end, more than anything, I want you to have a good birth experience. I want it to be a sacred time that you look back on with joy and that you cherish the memory of. With your new knowledge about the cascade of interventions, you’re on your way to just that.

Until next time,

Allison

Blog posts about nutrition and exercise, as mentioned:

The Brewer Diet: What, Why, and How (+ free checklist)

Why “What Not To Eat While Pregnant” is the Wrong Question

The Best At-Home Pregnancy Workouts

6 Exercises to Prepare Your Body for Labor

READ MORE :

Medications During Labor: Is It Worth the Risk?

Hospital vs Birth Center: What’s the Difference, Really?

Are Home Births Safe?

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