The Cascade of Interventions: How One Step Can Lead to a C-Section

When we imagine birth, many of us picture a natural, steady process where our bodies know just what to do. And that vision is true, our bodies do know how to give birth. But in hospital settings, what often starts as one intervention (like an induction) can set off a chain reaction that increases the risk of further interventions, and sometimes, an unplanned cesarean section.

Let’s break down how this happens and why it’s so important to trust the natural timing of birth whenever possible.

How Inductions Can Lead to More Interventions
Inducing labor is sometimes necessary, for medical reasons like preeclampsia, concerns about the baby’s growth, or if labor doesn’t start well beyond term. But elective inductions (those without a medical reason) have been shown in studies to significantly increase the likelihood of needing a cesarean birth, especially for first-time moms.
The numbers say it all:
• In first-time mothers with no complications, induction can more than double the risk of cesarean compared to spontaneous labor.
• A large Pennsylvania study found cesarean rates were nearly 36% in induced labors, compared to 19% when labor started on its own.
• Other research confirms that, unless induction is medically indicated, letting labor begin naturally tends to lead to fewer interventions and better outcomes.

Pitocin: Stronger Contractions, Higher Stress
When induction begins, Pitocin (synthetic oxytocin) is often used to stimulate contractions. While it can effectively jumpstart labor, Pitocin can cause contractions that are much stronger, longer, and closer together than the body’s natural rhythm. This can:
• Increase pain, leading more people to request epidurals
• Put stress on the baby, sometimes showing up as changes in the fetal heart rate
• Lead care teams to recommend additional interventions, like continuous monitoring, more medications, or cesarean delivery if they’re concerned about baby’s well-being
While Pitocin has an important place in medical care, its use without a true medical need increases the chances of getting swept up in the “cascade of interventions.”

What Is the Cascade of Interventions?
The cascade of interventions refers to how one intervention can set off a series of others. Here’s how it might look:
Elective induction → Pitocin → intense contractions → epidural → slowed labor → concern about baby’s heart rate → emergency C-section
Each step might feel necessary in the moment, but often, it all started with that first decision to intervene before the body was ready.

Your Body Knows How to Birth
In healthy pregnancies, there’s wisdom in waiting. The body releases hormones at just the right time to prepare for birth, softening the cervix, starting contractions, and even helping baby find the best position.
Unless there’s a medical reason to step in, allowing labor to begin naturally gives both you and your baby the best chance for a smooth, uncomplicated birth.

• How to Protect Your Birth Experience

• Ask questions. Before agreeing to induction, ask: Is this medically necessary? What are the alternatives?

• Know your options. Continuous labor support from a doula has been shown to reduce the risk of cesarean by up to 25%.

• Trust the process. Every birth unfolds in its own time. Patience can be powerful.

Final Thoughts
Interventions can be life-saving when truly needed, but they should be used thoughtfully. As you prepare for birth, remember: your body was made for this. With the right support and information, you can make choices that help protect your birth experience and your baby’s safe arrival.

If you have questions about induction, birth planning, or would like support on your journey, I’m here to help. Reach out anytime.

Lamb & Latch Doula Services operates around the Winston-Salem, Triad area of NC. Contact Sydney to schedule your free consultation!

With love and faith,
Sydney
Founder of Lamb & Latch Doula Services
DONA International Doula, Aspiring IBCLC, Breastfeeding Advocate