IV needed?

[FondestBianca]

I plan to do another hospital birth late Nov/early Dec and have a question about IV.

I will not be using IV narcotics and want to wait as long as possible before thinking about getting an epi. I also would like to avoid induction (which I had bad experiences with the first time around). My question is, is it typically standard procedure for a hospital to start an IV as soon as you check in for labor? The last time the started it when I got there. They said that since I would eventually be getting a pit I would need it. So can I ask that they don't start one as may not need any IV intervention this time? Or are they going to tell me it's policy so they don't have to try to start one later in labor when pain may make it difficult to get one set?

The hospital I will be going to seems to be more strict than many others I've heard about. They also won't answer any questions over the phone and I'm pretty far away from my birth plan app.

[alegna]

Whatever their policy, you CAN refuse it.

-Angela

[KD's Momma]

It is generally hosp policy to start when they are admitting you but if you don't want it, just say NO. An IV can be started at anytime. you are not there for their convenince, so if you need one later they can start it then. personally, I prefer not to have one, even the saline loc, I don't like the feeling of it in my hand or wrist when I am moving around in labor trying to find the "right" position. I had one with my second delivery because of GBS antibiotics and can still remember my wrist hurting from the IV during my contractions while I leaned on the the chair arm. It's your body, you tell them what you want period.

[kitkat5505]

You do not have to have an IV, you can refuse. My last one I chose to have a hep lock in place, and they did end up using it just to give me a bag of saline during pushing when the baby's heartrate was going was down, but I don't even remember that and they removed the IV right after. What I hated is that they wouldn't take out the hep lock until they were sure my bleeding wasn't too much so it was in until like 3am and it was bugging me so bad.

[peskyflylady]

Our hospital does a hep lock when you check in, but no routine IV. I would think most hospitals would do the same. I was really glad later that the hep lock was in place, because by the time I needed IV fluids I would not have appreciated having someone poking my arm with a needle. I think they covered it over with tape so it wouldn't get wet when I was in the jacuzzi.

[FondestBianca]

Thank you to everyone for responding so quickly! Ok, I feel a little dumb, I don't know what a "hep lock" is.

As far as the IV goes, I don't really want anything stuck in my arm... I don't really care if it has a plug in it or is tubed up to a drip... I don't want anything stuck in my hand or wrist until I actually need or want something in it. I could get my blood drawn all day long and not blink an eye but I hate the feeling of an IV. I don't want to move my arm or hand while I have it. It always leaves a bruise when done anywhere other than the inside of my elbow (can't really use that location during labor because I need to bend the arm for bracing during pushing). The vein they use on my wrist moves back and forth over a bone and the IV often becomes useless and they have to move it. When in the hand it doesn't much work at all. My hands are rather boney and I just end up with a dry IV and brusies. So, honestly, I don't want one at all!

During my last labor the hospital staff was pretty cranky and rude and did things/gave me things without my knowledge and against my wishes (and written, signed, agreed upon birth plan) so I'm a little worried they would just tell me I have to get the IV or leave the hospital and go to another one (which I can't do because my doc is only contracted at one hospital in town).

[KD's Momma]

they cannot make you leave just because you don't want medical interventions like an IV. There is such a thing as a Patients Bill of Rights and one of them is to refuse medical treatment you don't want. FYI a hep loc or saline lock is just the IV cath and port access taped or secured to your arm in a vein, no tubing or bag. I would call the manager and director of the unit and voice your concerns to them about your last labor and delivery and the one you are wanting to have now. also, make sure your labor partner knows what you want and that they are to stand firm on it when asked about it.

[FondestBianca]

Originally Posted by KD's Momma

they cannot make you leave just because you don't want medical interventions like an IV. There is such a thing as a Patients Bill of Rights and one of them is to refuse medical treatment you don't want. FYI a hep loc or saline lock is just the IV cath and port access taped or secured to your arm in a vein, no tubing or bag. I would call the manager and director of the unit and voice your concerns to them about your last labor and delivery and the one you are wanting to have now. also, make sure your labor partner knows what you want and that they are to stand firm on it when asked about it.

thanks for the clarifcation. I figured thats what it was. They did give me the hep lock the last time when I came in at 9pm at night. They didn't put anything in it (other than saline flush once or twice) until the next morning. But, either way, I hate it... it hurts, and half the time has to be redone later anyway. My hubby does know what I do and don't want and will stand up for me when I'm lying there and can't do much on my own behalf. The first time around we were both a bit nieve and figured whatever they did they needed to do. I feel pretty horrid about it now it hindsight. I was given sleeping pills after saying "absolutly not" 3 or 4 times. I was given narcotics in my IV after saying I absolutly did not want them in my birth plan (done with hospital staff) and also refused them in person at my birth. The guy who moniters pain killer intake (narcotic and epi) came around to my room. I asked what he was try ing figure out and he said my narcotic levels. I said I didn't want any and with a funny look he said, "the nurse had me start you on them a few hours ago." !! Lots of things went on that shouldn't have. I don't want a repeat. I plan to be a pain in the butt to them this time around if they start barking orders at me... but, I'm still unsure how far I can push them before they deem me an uncoroperative patient and ask that I be transfered.

[SublimeBirthGirl]

Miraculously, babies can be borm without their mothers being filled full of fluids and drugs. Check out The Thinking Woman's Guide to a Better Birth.

[Mommal]

You can refuse any intervention. Discuss it with your midwife or OB and make sure you are on the same page about it. It's a lot easier to turn down an IV when you can tell an IV-toting nurse "No thank you, I don't need an IV, and my midwife/doctor agrees."

Reasons to have an IV or hep-lock:
- easier delivery of IV medications
- in an emergency, the IV is already in place, which can speed care

Reasons not to have an IV or hep-lock:
- uncomfortable or painful
- IV reduces mobility, since you are tied to the IV stand and bag of fluid
- some women are given drugs without their consent (!)
- IV fluids can inflate a baby's birth weight with excess fluid, making apparent neonatal weight loss appear more severe than it really is, which can lead to calls for formula supplementation
- in an emergency, an IV can be started very quickly

[FondestBianca]

Originally Posted by Mommal

You can refuse any intervention. Discuss it with your midwife or OB and make sure you are on the same page about it. It's a lot easier to turn down an IV when you can tell an IV-toting nurse "No thank you, I don't need an IV, and my midwife/doctor agrees."

Reasons to have an IV or hep-lock:
- easier delivery of IV medications
- in an emergency, the IV is already in place, which can speed care

Reasons not to have an IV or hep-lock:
- uncomfortable or painful
- IV reduces mobility, since you are tied to the IV stand and bag of fluid
- some women are given drugs without their consent (!)
- IV fluids can inflate a baby's birth weight with excess fluid, making apparent neonatal weight loss appear more severe than it really is, which can lead to calls for formula supplementation
- in an emergency, an IV can be started very quickly

All of those negitives happened to me , inculding being given drugs (narcotics) without consent or even telling me until hours later. And also was encouraged to give formula after my dd had lost 1/2lb or more) within the first 48 hours or so.

[alegna]

Have you considered homebirth so that you don't have to fight in labor?

-Angela

[FondestBianca]

Originally Posted by SublimeBirthGirl

Miraculously, babies can be borm without their mothers being filled full of fluids and drugs. Check out The Thinking Woman's Guide to a Better Birth.

I will check that out, thank you! I've realized since having my dd that a lot of what nurses tell you is nessesary actually isn't nessesary for your health or your child's health but, rather for the hospitals safety so they have less of a chance of being sued. I don't want any decisions about my birth to be made based on the hospitals well being this time.

[FondestBianca]

Originally Posted by alegna

Have you considered homebirth so that you don't have to fight in labor?

-Angela

I have a number of issues medically that may make home birth far more anxiety producing for me. Besides that I don't feel comfortable knowing that if there was a problem with my baby the closest hospital is a 20 minute drive away.... and the closest ambulance gargage is 15 minutes away. I want to be at a hospital for the medical advantages but, you are right, it doesn't help much to be worrying about staff and treatment the entire time. I didn't enjoy a single minute of my birth the first time. Nor did I enjoy the aftercare the following day.

[not now]

Hep lock is an old term that shouldn't even be used anymore. Back in the day all IV's were "locked" with heparin, then heparin induced thrombocytopenia was discovered and it changed. All hospitals I've worked at do a saline lock that needs to be flushed every eight hours but does the job fine. Sorry, nursing pet peeve.

As a nurse I understand the "need" that compels a nurse to want IV access in all my patients (I don't work L&D). If something goes wrong it can go wrong very quickly. With that kind of action and adrenaline a few seconds can feel like an hour. You don't want to be trying to throw in an IV with a doc calling out orders. It's just the way we are trained to think "Hope for the best and prepare for the worst" is what I was always taught. You always have to think ahead to what could happen so your not caught off guard or surprised or unprepared.

That being said. Tell them you don't want an IV. Or ask that the IV not be in the hand or the wrist. I always request that my IV be in my forearm (I have really good veins) and wrapped in rolled gauze to keep it out of my way. I also always disconnect my patients from their IV fluids when they walk so they don't have to drag around a pump.

[paquerette]

Will you have a doula? If you are going to be in a hospital, I strongly recommend that you have a doula with you.

[honeybee]

I suggest you read Henci Goer's The Thinking Woman's Guide to a Better Birth to understand the "reasoning" behind many common hospital practices and what the research actually says about the benefits/risks of such interventions. It is a very eye-opening book.

IVs are not necessary. It's better to eat and drink during a long labor than to rely on IVs (of course, many hospitals refuse laboring women anything but ice chips, which is NOT supported by research). IVs are convenient to hospitals. They will try to tell you that the need the IV in case of an "emergency"... but it's a little scary to me that L&D nurses don't feel competent enough to get an emergency IV started in a hospital, when paramedics and EMTs do it under strenuous in-the-field conditions all the time. Once that IV is there, they can add pitocin or other meds before you are even aware of it.

Also, there are risks. IVs limit your range of motion and get in the way while laboring. IVs can inflate your blood-fluid level and that of your baby's. This can cause you to become engorged, which makes latching on for the baby more difficult and can make bf harder to establish. Also, I have heard that hb babies do not seem to lose as much weight as hospital babies in those early days. It could be that 10% mark of weight bf babies lose is due to flushing out all the extra fluids from IVs. And, of course, "not gaining enough" is the primary reason newborns are supplemented, thus disrupting bf even more.

And, yes, you can refuse ANYTHING, no matter what "hospital policy" says. Ask to sign a waiver. However, they may still put a lot of pressure on you, or try to tell you it is "safer" or for your baby's health that they HAVE to do x, y, or z. And when you're in labor, you're pretty vulnerable and not well able to stand up for yourself.

It helps to be REALLY and THOROUGHLY informed ahead of time about all the different interventions, their side-effects and risks. If you really KNOW what you will/will-not compromise on, then you will be better able to stand up for yourself. You also need to have an advocate with you (I recommend a professional doula) to help make sure you get what you want, and to ask the tough questions (Do we need to make a decision now, or can we wait?)

[~Katie~]

Not all hospitals have IV's as standard procedure, mine didn't. I wrote it up in my birth plan and when I went in for my pre-admission, they said no problem. The majority of moms birthing at my hospital don't get them. I drank fluids regularly throughout my labor and nobody made a peep. I would call around and ask about standard procedure at different hospitals and if it will be an issue or not, but you can decline any procedure, it just depends on how much of a fight you want to deal with I suppose.

[veronicalynne]

I know with my vbac, they put an iv in without consulting me....I complained to my ob and she has put notes in that I am not to be given an iv. I have agreed to a heplock since I am vbac and I dont mind that as long as they dont attach anything to it. I am planning to have a friend come with me and speak up for what I do want and do not want (hubby is useless that way and I am going to sign waivers if I have to and use the magic words "No! I do not give you permission, and if you do this I will sue you". Mind you, I am in Canada and I am not sure how different it is in the States. Can you have someone with you to help back you up if need be? If you dont want an iv or heplock it is your right to say no....to say no to any intervention they want to do.

[ShadowMoon]

My hospital was supposedly very strict with the IV policy (as in you had to either have one or be prepped to have one). I refused and made sure everyone knew it. There was no argument from anyone on the night I was admitted. Be vocal about what you want/do not want or have an advocate such as a doula with you. You can refuse it no matter what their policy.