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Discussion Starter · #1 ·
Maybe I'm a freak, but I <i>hate</i> having IVs inserted into me, and I don't particularly like wearing the port around, even if it's not attached to anything. And nurses are notoriously bad at getting it right the first time with my tricky veins. Believe it or not, this is making me more nervous about my VBAC than the actual labor itself. I'm worried that it will rouse a level of anxiety in me that will interfere with my ability to relax and fully enter into the experience.<br><br>
With my first baby (which ended with the c-section), a nurse flubbed up the first attempt to put one in as a routine matter of course, and finally she said forget it, I could go without. (Of course, I ended up having one put in later.) But the bruise that the mess-up left was painful enough that it distracted me a bit during labor, and during one point, I actually joked that it was worse than (what was at that point unmedicated) labor itself.<br><br>
Anyway, what do you think? Is it reasonable to ask for no IV port until there's a real need for one? Has anyone else done that?
 

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I would absolutely insist on no IV until it's needed. But then again, I'm having a HBAC so obviously no IV at all.
 

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I would say you are being perfectly reasonable. They do IVs in emergency situations all the time; if you actually were in a situation where it was needed, they could do it then.<br><br>
I'm going to ask them to put it in my arm instead of my hand this time. Last time it was a scheduled c/s, and I timidly asked if it had to be in my hand, and the nurse said it was standard procedure (so yes). Well that thing was a pain in the neck for the next three days, and that was without any bruising. I think it will be easier to ignore if it's on my arm.
 

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IV's make me nervous as well, like you I find them extremely painful and my veins are weird and they can never get one in a "normal" place. I will refuse one. <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/smile.gif" style="border:0px solid;" title="smile">
 

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They messed up my IV badly last time too. Which makes me think the nurse was basically incompetent (my husband even mentioned this - he used to work as a phlabotomist, so he's pricked a lot of people). When they finally ended up getting it in (after about 4 tries and a lot of bruising) it was right between my thumb and my wrist in my dominant hand. Uck. I agree I'm not looking forward to it either, but I sort of feel like if that's what it takes to make them leave me alone and labor in peace, fine. At least it doesn't need to be attached to anything. Maybe the nurses at the birth center will be better with this....
 

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You can certainly ask them not to give you the IV. Remember that you have the right to consent to anything. I am going to guess that most hospitals/providers will want a VBAC patient to have a saline lock in place.<br><br>
If you do end up going with an IV, ask if anesthesia can place it. They are generally very good and are called in for the tough cases. Tell the nurse you are a very tough stick and scare her a bit- then ask if anesthesia can do it. You can even throw in a "last time they did it."<br><br>
Also, if it helps at all, they can use lidocaine prior to starting. It burns a bit going in, but can take the pain away really well.
 

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It doesn't bother me, really. I can understand worrying about if you've have a bad experience in the past, though. I don't want a routine IV actually hooked up to anything, but I'm ok with my hospital's policy of requiring the port so they have quick access if they need it - it's not something I'll fight.
 

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I'd discuss it with the CNM/OB that you are getting your care with ahead of time. I think that the hospital is going to be pretty insistent that you get one being a VBAC. However, if you can get your provider to agree ahead of time you may be able to get away with not having it.<br><br>
Personally IV's don't really bother me. I'm a nurse though and maybe it has just made me immune to it.
 

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I refused an IV or saline lock until they decided that I was getting pitocin willy-nilly. (I was active duty so at a certain point they said "too bad" when I refused.) But that was for my first-not a vbac.<br><br>
I don't think it should be that big of a problem if you refuse one.
 

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You have every right to refuse one. You don't have to ask anybody's permission, it doesn't matter what "procedure" OR "protocol" are, or "if the doc okays it" You can walk in, say, "No thank you, I will be refusing the IV this evening. I understand my options and will ask you for one if it becomes necessary." Kindly, firmly, gently, but without waver. You have EVERY RIGHT to say no. They don't need to be given a reason why. It is your CHOICE, not their "protocols" that rule. I chose to avoid a hep-lock both times. I HATE IV ports in my body, and I bruise HORRIBLY, so the ones they put in the back of my hand leave bruises that literally last for six or more weeks.
 

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Discussion Starter · #12 ·
Thanks, everyone.<br><br>
I guess I'd like to know that <i>if</i> they <i>need</i> to put in an IV later, in case of an emergency, they'll have time to do it. I mean, how much time are we talking about if worst-case scenarios do occur?
 

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Think about it this way-IV's get placed in traumatic situations all the time. Paramedics can place them in the field, in the rain, upside down, in the dark, or in a moving ambulance. People come into the emergency room in much more dire situations than present themselves in labor, and they get the IV in.<br><br>
Routine IV ports for laboring women are for the convenience of the hospital staff ONLY. Period. They can put one in if they need one in the blink of an eye. It might not be a comfy stick with lidocaine, but in an emergency situation most people could care less.
 

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Right - they can get them started pretty fast. That said, (and I say this not to scare you - just because it makes sense) if you actually *had* a uterine rupture you'll probably have a ton of people all around prepping you for a crash c-section ASAP. Yes, they can start an IV as part of this, and it may or may not add a minute or two to the entire prep process (depending on whether they can do it at the same time as they do other things). I imagine that if that actually happened, you'd be very far from caring how gently they started the IV port, but it's one less thing they'd need to do if it were already there. I believe the choice should be up to you, but it's hard to make that choice unless you really know how much - if at all - it would slow people down in a time-critical situation. Probably best to ask your MW/OB so you can make an informed decision.
 

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When my mother was extremely concerned that I had chosen not to get a hep-lock, my midwife (hospital employed CNM) said to me in front of her, "Courtenay, any surgeon worth his degree can get a line in in seconds."<br><br>
Keep yourself hydrated, it'll make it easier to start an IV if they need to.
 

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This is one of the things my midwives were insisting upon for my hbac. They said that in the case of an emergency my veins could collapse and make it difficult to insert the iv.<br><br>
I have small tricky veins and a bad needle phobia so I refused because it would be extremely stressful for me. My logic is that you don't see everyone walking around with a hep-lock in just in case. I'm sure that the general public has a risk of getting into some kind of emergency situation that is the same or greater than my chance of uterine rupture at a home.
 

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The hospital I delivered my son at required an IV/heploc which I was willing to do to get a VBAC with my dream OB. I ended up at the hospital too late to get one----10 cm and pushing. My doctor seemed happy that I'd bucked the system.<br><br>
Ironically, the nurse totally screwed up a blood draw a couple hours after the birth---I'm rH negative, my son was rH positive which is why I had that done.<br><br>
So my advice, get to the hospital too late for the IV.<br><br><img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/smile.gif" style="border:0px solid;" title="smile">
 

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Discussion Starter · #18 ·
Me again, the OP, with another question that this discussion has led me to wonder ... <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/smile.gif" style="border:0px solid;" title="smile"><br><br>
What exactly would they need to administer through the IV in the event of an emergency? I mean, is this how they would anaesthetize me for a c-section, or would it be for fluids and hydration in addition to the standard c-section spinal block?<br><br>
(I do plan to ask my midwife this tomorrow, but I thought you might have a good idea, too.)<br><br>
Thanks!
 

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I say if you don't feel like you can refuse the IV (which you can) try using the same coping strategies for the IV insertion as you use for dealing with the labor. I'm going to try to do hypnobabies this time, and I think it will help a lot with this kind of thing. Also maybe let them have one shot, and if it doesn't work, say NO! In a real EMERGENCY yes it sure would be nice if the IV was already in, because it can be tricky to get them in under pressure, especially if you are rapidly losing fluids, but by no means impossible or life threating. Ultimately you can refuse, but I'm going to try to keep my battles to a minimum, and this is one that *I* can deal with. If it's not one you can deal with fight it, or like a previous post sugegsted come to the hospital too late!! (that's my ultimate plan!!!!) Good luck!!!
 
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