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    Routine interventions in U.S. maternity care, such as continuous fetal monitoring and epidural analgesia, disrupt natural labor and birth. This cascade of interventions increases risks for mothers and babies, including cesarean surgery.

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    Area of Science:

    • Obstetrics and Gynecology
    • Perinatal Health
    • Public Health

    Background:

    • Maternity care in the United States is characterized by high rates of intervention.
    • Routine practices include intravenous fluids, dietary restrictions, continuous electronic fetal monitoring, epidural analgesia, and labor augmentation.
    • While episiotomy rates have declined, they remain elevated.

    Purpose of the Study:

    • To describe the utilization and impact of routine interventions on the physiological processes of labor and birth.
    • To identify unintended consequences arising from the common use of these interventions.

    Main Methods:

    • The paper reviews existing literature and clinical practices regarding common interventions in U.S. births.
    • It analyzes the effects of these interventions on the normal physiology of labor and birth.
    • The focus is on the cascade effect of interventions and associated risks.

    Main Results:

    • Routine interventions significantly disturb the natural physiological progression of labor and birth.
    • These practices can limit a woman's ability to cope with labor effectively.
    • The cascade of interventions is linked to increased risks, including cesarean surgery for both mothers and infants.

    Conclusions:

    • The routine use of interventions in U.S. maternity care disrupts normal labor and birth physiology.
    • This disruption leads to a cascade of interventions with unintended negative consequences.
    • Reducing routine interventions may improve outcomes and decrease risks for mothers and babies.