PREGNANCY

10 Reasons You Might Need an IV in Labor

Getting an intravenous line or IV at labor and delivery is a pretty common occurrence for pregnant women during the birth experience. Why do you need (or NOT need) an IV during labor. What do they use it for and is there any other option that will still keep you safe?

Woman laying in hospital bed with IV

So, who am I to talk about IV’s in labor? Hi, I’m Hilary — The Pregnancy Nurse 👩‍⚕️. I have been a nurse since 1997 and I have 20 years of OB nursing experience, I am also the curly head behind Pulling Curls and The Online Prenatal Class for Couples. 🩺​ I have put in thousands of IV’s, so I know why people need them, or might not (and I am not a fan of putting in IV’s so believe me, I also get it — I’m an expert). Follow me for more positive pregnancy & labor tips! 😊⁣

BTW, if you’re looking for accurate, helpful information about your experience in labor and delivery, look no further. As a nurse with 20 years of labor and delivery experience I am here to support you. I am to help you with a confident collaborative hospital birth. You can get prepared in just three hours!

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Reasons You’ll Need an IV in Labor

This list is certainly not exhaustive, but these are the basics of why having an IV is a good idea. Don’t miss my video on the entire IV process, and a happy medium that you might be aware of.

Stay tuned to the end of the “reasons” because we’ll talk about if you CAN refuse the IV.

IV Antibiotics

Now, I’m not a huge fan of antibiotics, but they have found that a bacteria called beta strep leads to poorer outcomes in the NICU if present in the mom’s vaginal canal.

The only way to make a clean way for baby is to wipe it out with IV antibiotics given right before a vaginal birth. You won’t have to have the IV “plugged in” all the time — these usually go in every 4 hours (but depends on what one your health care provider orders).

There can be other reasons you’d need IV antibiotics during labor in the delivery room, but that’s the most common one.

Induction

Being induced usually means you’ll need an IV. The reasons are two fold:

  • You increase your risk during an induction, and an IV is needed in case we need to give you increased levels of care.
  • The induction agent pitocin must be given via IV.

I have a ton of information on inductions on my sister site The Pregnancy Nurse.

Magnesium

Magnesium is something given when you have severe preeclampsia. It isn’t a fun medication, but is used to mostly keep you from having a seizure.

Honestly, a lot of things that are medically wrong will likely require an IV even in low-risk pregnancies… including….

Diabetes

If you have diabetes during pregnancy they will really want you to have an IV line in during labor. We may not need to run fluids to you, but we will be checking your blood sugar and making sure it stays in a safe zone. Often, we need to give you fluids with sugar or insulin for your medical condition to keep it in a safe zone.

Hydration

If you’re severely dehydrated and unable to keep fluids down, we will often put an IV in. This doesn’t often happen during labor but since all patients who are advanced in their pregnancy come to L&D for their hospital care, we put in a lot of IV’s for this (especially in hot Phoenix).

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Getting an Epidural

If you want an epidural for labor pain you will need an IV.

Get an epidural is anesthesia and we need to give you extra fluids before the placement (often your blood pressure drops as you relax as the pain decreases — so the fluids are to counteract that). We also need access if you were to have any issues with the medications we give you.

I have a whole podcast on the most frequently asked questions about epidurals you might enjoy:

IV Pain Medicine

Obviously, if you want pain medication for pain relief during labor you will need an IV. There are a few things we can give you as a shot (sometimes happens in early labor and we send you home), but during labor we give things that need to go in the IV.

BTW, I talk about all your pain management options in that linked article.

Replace Lost Blood

If you lose too much blood you will need an IV in to give you fluids and possibly blood products.

Bleeding after delivery isn’t unusual and it is one of the main reasons we want to have IV immediate access.

Remember, after delivery your placenta come off your uterus leaving an open wound (I sometimes call it a placental scab) that can bleed out huge amounts of blood flow (postpartum hemorrhage) if your uterus doesn’t cramp back down.

Pitocin After Delivery

We most often give pitocin after delivery. This can be given as a shot, but a lot of women feel the best way is to have it in the IV in case you need several doses. It also allows us to give other medication besides pitocin if you were to bleed a lot.

You Want to Be Safe

If you’re planning on a hospital setting delivery, it is likely that you are doing so because it seems safest. One of the “bumpers” of safety that the hospital uses is having that IV. Now, there is an other option….

Other Options Besides a Running IV During Labor

While we haven’t invented wireless IV’s, you’ll notice that a lot of the things I mentioned above don’t need an IV running all the time (but some do).

We have a product called a saline lock (I share exactly what it looks like and how it works in that video) That is just a tube that stays in your arm, and isn’t hooked up to fluids. It does allow you to move in different positions a little more freely.

We really don’t want a laboring woman to feel confined to the bed or over-medicalize the birth process, but having that in your arm or wrist just helps everyone feel safer for various reasons.

Most often, your doctor will ask us to draw labs when you come into labor and delivery. It is a simple process to grab the labs, and then insert the tube so we can have it there if we need it.

And, if we don’t, we can remove it soon after your baby’s birth.

How Long Will I Need an IV in Labor?

It depends on what is happening. Most often we can turn it to a saline lock like I mentioned above a couple of hours after the birth of your baby. The hospital staff and health care providers would prefer you keep that lock in for a few more hours if possible in case you do start to bleed or need antibiotics, but it would be up to you at that point.

Can I Refuse the IV in Labor?

Of course — you can refuse anything. You’re an adult who can make their own choices. Keep in mind:

  1. If you refuse the IV we obviously can’t give any of the medications given IV (incluiding pain medications or an epidural).
  2. That choice may end-up you refusing an induction of labour as we can then refuse specific medical interventions we don’t think are safe without an IV.

If you really don’t want an IV, talk with your provider early in your prenatal appointments. It will give them time to discuss the risks and benefits with you and what will be in your best interests. It will also allow you some thought about a point you might need to get one. You can add it as part of your birth plan too as a reminder. At the end of the day, it’s much easier to consider things like this when it is calm and we can make an informed decision and rational choices. Doing all of this is called informed consent.

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What If I Don’t Get an IV in Labor?

We would just have to put one in if something happens.

That sounds pretty simple, right? But IV’s are a skill that delivery nurses learn with time and are best done when everyone is calm. It can take precious minutes for us to put the IV in, and if you’re bleeding a lot it makes it extra hard to get an IV since your veins won’t be as large to fit the needle.

If you liked this post and want more information about what will happen in the labor room I would 100% recommend taking a prenatal class. Studies show they greatly reduce stress at delivery and can make you enjoy your delivery and your new bundle of joy even more. Save 10% with coupon code PC10.

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