All the wires during delivery necessary?

TheBorg7of9

Hi all,

My first baby was born vaginally and with an epidural.  One thing that really annoyed me was all the contraptions they had strapped to me.  Can anyone tell me why these things are necessary if they are and whether their OB/MW let them go without them?

1.) IV

2.) automatic blood pressure cuff

3.) contraction monitor

4.) baby heart beat monitor

5.) catheter

Anything else?

I've learned a lot from this board.  Thanks so much!

barista411

I declined the IV and Heplock when I arrived. I wanted to be active during labor so I requested intermittent monitoring. Which means they would occasionally ask me lay down so they could monitor me and the baby quick and then I could return to what made me comfortable. I believe the catheter is due to the epidural but I didn't have one so I am only guessing. My hospital is very natural birth friendly so my requests are fairly common but I think it depends on your hospital and OB/MW.

Tigerlilym15

Different hospitals have different policies but for a natural uncomplicated birth IV's are not necessary, blood pressure cuffs are not necessary, and continuous monitoring is not necessary. Many hospitals use intermittent monitoring now, even if they don't you can request it. At my hospital they don't make you lay down for it, they have a hand held thing that they used wherever I happened to be. The pp is right, the catheter is because of the epidural. In an uncomplicated med free birth it would be completely unnecessary.

Even if some of these things are policy at your hospital you have the right to decline anything. You can check out www.evidencebasedbirth.com for what the evidence says about a lot of these things. Its a great resource with information on why hospitals use things like IV's and what the research actually says about their usefulness and effectiveness.

AmyRI

In short, none of them are necessary to have on all the time.

 

IV: Most hospitals and providers will now allow you to get a hep lock (port for an IV) and not attach an actual IV unless necessary.

 

Blood pressure cuff and monitors can be used intermittently, although the definition of that varies by hospital and provider. Usually they'll take a blood pressure reading, followed by 10-15 minutes of monitoring your contractions and the baby's heartrate, and then let you unhook again.

 

No catheter necessary unless you have an epi and aren't allowed up to pee in a toilet.

TheBorg7of9

Thanks for all the info. I'm using a midwife. But I know my hospital is not known for natural births.
What's a heplock?

CLLDLL

Heplock is just the part of the IV that goes into your arm.  They don't hook in the tubing that delivers fluids/meds unless you need it.

My first delivery was not in a NB friendly hospital.  They required an IV, monitoring for BP and baby HB monitor all.the.time. They only required BP cuff and cather if you had an epi.

My second delivery was in a small, but not necessarily NB friendly hospital.  They only required a Hep lock and monitoring of baby HB and mom's BP for 20 minutes upon admittance and for 10-15 minutes once every 3-4 hours. 

You have the right to refuse anything you don't want. 

tokenhoser

If you get an epidural, then you get:

1.) IV

2.) automatic blood pressure cuff

3.) contraction monitor

4.) baby heart beat monitor

5.) catheter

If you don't get an epidural, you can skip all of them. But IV fluids are required with the epidural to keep your blood pressure high enough. And then they need to watch your pressure, monitor contractions, you can't get up to pee, etc. Those were all required of you last time because of your initial pain relief choice.

sschwege

Keep in mind that as long as you are mentally capable of making decisions you can decline anything.  If they give you problems just offer to sign something saying that you are declining.  Doesn't mean they won't give you a hard time, but the choice is always yours.  That being said, it's best not to go in there with 'guns blazing' because you also don't want them to make you miserable either.

I'm writing this with the assumption that you are planning to go pain-med free, if you want an epi that will change things.

1) IV as long as you are not dehydrated you should not need one.  As a compromise you can offer to do a Hep-Lock for emergencies.  I did not have one either time, but had my MWs recommended one I would have probably agreed to it.  It wasn't a battle worth fighting for me, though I would have declined a running IV.

2) Blood Pressure cuff, the hospital didn't use it either time with me during labor or delivery.  I know with my first they had it on me after DD was born and probably with DS, but I don't remember for sure with him.  That thing is so annoying, I know I wouldn't have been happy with having that on while in labor.

3) Contraction monitor, used at my hospital for the first 20 minutes in triage and then they take it off.

4) Again my hospital strongly recommended 20 minutes in triage, then if everything looked good the nurse came every 15 min or so to listen on the doppler (they could even use it underwater which was wonderful).  They used it more while I pushed.  In the two years between when DD was born and I was pregnant with DS they changed their policy.  Said they wanted 20 min in triage and then every two hours they wanted you on the monitors for 20 mins.  I had planned to decline the extra monitoring if baby was looking good, but luckily it didn't come to that because I arrived fully dilated.  

5) You would only need that if you can't walk to the bathroom, like in the case of an epi.

Above all else labor at home as long as possible.  My hospital is very pro-natural childbirth, but it's still a hospital, which is why I labored at home for as long as I did.  My second was born in triage, even if they had wanted to connect me to everything they wouldn't have had the time.  Also don't be afraid to ask questions and perhaps even more importantly make sure your support person/people will advocate for you.  I remember the triage nurse was trying to get me to lay down to be monitored and I wanted to stand next to the bed.  I basically stopped talking to the nurse and just stood next to the bed until my mom said, "Why don't we try it with her standing next to the bed and if it doesn't work she will lay down?"  My mom even helped her strap the monitors on me and of course it worked fine.  Be polite, but firm in your wishes.  And just keep doing what you are doing asking questions, reading, etc. It's far harder to push around someone who not only knows what they want, but also knows why.

rooftop

I went without anything attached to me. I birthed at a birthing center though so it was much more NB friendly. We made sure I was drinking between contrax and I was GBS- so I didn't need an IV. I didn't need blood pressure monitored and they could tell when my contrax happened just by watching/talking to me then makingnote to see frequency. They did intermittent fetal monitoring with a handheld doppler so I didn't even have to lay down for that if i didn't want to, and since I was mobile I didn't need a catheter to pee, I just sat on the toilet, which was actually nice to labor on btw.
Those interventions are only necessary if you start with other interventions ie; the epidural and seem to lead to the possibility of other intervention so are best to be avoided if possible.

aylafsu88

I had none of those things. I refused a Hep lock, CFM, and any form of pain medication when I arrived.  I delivered in a hospital with an OB. Since I stayed home for a long time I delivered pretty quickly once I arrived at the hospital.  Many of those things are needed when you have an intervention (induce labor, get an epi, etc) so they can be avoided. 

robyn2201

sschwege said:

Keep in mind that as long as you are mentally capable of making decisions you can decline anything.  If they give you problems just offer to sign something saying that you are declining.  Doesn't mean they won't give you a hard time, but the choice is always yours.  That being said, it's best not to go in there with 'guns blazing' because you also don't want them to make you miserable either.

I'm writing this with the assumption that you are planning to go pain-med free, if you want an epi that will change things.

1) IV as long as you are not dehydrated you should not need one.  As a compromise you can offer to do a Hep-Lock for emergencies.  I did not have one either time, but had my MWs recommended one I would have probably agreed to it.  It wasn't a battle worth fighting for me, though I would have declined a running IV.

2) Blood Pressure cuff, the hospital didn't use it either time with me during labor or delivery.  I know with my first they had it on me after DD was born and probably with DS, but I don't remember for sure with him.  That thing is so annoying, I know I wouldn't have been happy with having that on while in labor.

3) Contraction monitor, used at my hospital for the first 20 minutes in triage and then they take it off.

4) Again my hospital strongly recommended 20 minutes in triage, then if everything looked good the nurse came every 15 min or so to listen on the doppler (they could even use it underwater which was wonderful).  They used it more while I pushed.  In the two years between when DD was born and I was pregnant with DS they changed their policy.  Said they wanted 20 min in triage and then every two hours they wanted you on the monitors for 20 mins.  I had planned to decline the extra monitoring if baby was looking good, but luckily it didn't come to that because I arrived fully dilated.  

5) You would only need that if you can't walk to the bathroom, like in the case of an epi.

Above all else labor at home as long as possible.  My hospital is very pro-natural childbirth, but it's still a hospital, which is why I labored at home for as long as I did.  My second was born in triage, even if they had wanted to connect me to everything they wouldn't have had the time.  Also don't be afraid to ask questions and perhaps even more importantly make sure your support person/people will advocate for you.  I remember the triage nurse was trying to get me to lay down to be monitored and I wanted to stand next to the bed.  I basically stopped talking to the nurse and just stood next to the bed until my mom said, "Why don't we try it with her standing next to the bed and if it doesn't work she will lay down?"  My mom even helped her strap the monitors on me and of course it worked fine.  Be polite, but firm in your wishes.  And just keep doing what you are doing asking questions, reading, etc. It's far harder to push around someone who not only knows what they want, but also knows why.

All of this! 

Adding onto the bolded part, whether you are being monitored continuously or even intermittently for a short amount of time, you do not have to be laying down/laying in bed while it is being done.

DD1, I had planned for intermittent monitoring but I didn't find the monitors to be annoying at all so I went ahead and just kept them on. I stood next to the bed for the entire time and there were no issues. I never asked for permission to get out of bed, I just did what I wanted. 

I mention this last part, because I have had other women make comments to me about how they thought they had to stay in bed, so they did. Their nurse never said they had to, and they never thought to ask or just to do just get out of bed.

With DD2, I arrived ready to push so there was no time for anything.

SweetPeaK26

Previous hospital IV was required, natural or not. My new hospital will just do a hemlock.

The bp cuff is was actually a very good thing for me to have on. I have zero bp issues, but during my labor with dd2, mine dropped super low, and they needed to help me get it back up.

Contraction monitor, well, that one I could do without once things started. I knew when I was in pain! Didn't need a machine to tell me!

Baby HR monitor, saved my dd1's life, so I'm all for that one, but I don't allow the internal fetal wire monitor.

Catheter, only needed if you have an epi, basically so you don't pee all over yourself the whole labor.

annabelle.27

I didn't have any of those things with either of my births*. When I first got to the hospital they attempted to get a reading on the contraction monitor but I was thrashing around so much with every contraction they quickly took it off. After that, they monitored the baby via doppler periodically, bringing it to me while I sat on the birth ball in the shower. Other than that I was left to labour naturally, at both my hospital and home birth.

*strictly speaking I did end up with all of those things at my first birth, which ended in csection. But since they didn't start hooking me up until they were prepping me for surgery (after I had pushed for three hours), I think it is safe to say that if I had been able to push the baby out, he would have been born without any of it.

insertclevername

The only "contraption" that I remember being used during my labor was the external fetal hr monitor.  They may have also monitored my BP with a cuff but I definitely don't remember it on until after delivery.   I did not have a hep lock, iv, or anything internal, but I also arrived at the hospital 10cm dilated and ready to push.

natalie202

During my first (midwife attended hospital) birth, I had a hep lock due to hospital policy. BP cuff, thermometer, and Doppler were used intermittently to check on me and LO, but at no point were any monitors left attached to me. Hospital policy also called for 20 minutes of monitoring at check in, but once it was established that I had arrived fully dialated, this was skipped.

I would agree with those who have argued that many of the cords you experienced last time came about because of the epidural. In a drug free birth, you don't need as many of these interventions because your body isn't dealing with all the side effects of the epidural.

tiffanyranville

NYMama1 said:

The only "contraption" that I remember being used during my labor was the external fetal hr monitor.  They may have also monitored my BP with a cuff but I definitely don't remember it on until after delivery.   I did not have a hep lock, iv, or anything internal, but I also arrived at the hospital 10cm dilated and ready to push.

This but I did have an IV put in just in case, I was never hooked up to anything until after. My body was loosing a lot of blood and not contracting after giving birth so I was actually hooked up to pitocin to induce afterbirth contractions so I wouldn't hemorrhage.

TheBorg7of9

That makes sense. Thanks guys!

JCWhitey

I had none.  I turned down none, they didn't even try connecting me to anything.  I had a very NB friendly hospital.

Actually, that's a lie.  I had an IV of saline for about 20 minutes because I was dehydrated.  But that was my decision and request.

sthomas1222

For an epidural all of those things are needed since no matter what they tell you the drugs are getting to baby and you. For a natural birth absolutely none of those are needed if mom and baby are doing fine. Intermittent monitoring is shown by evidence to be better and safer than continuous monitoring.

msjanet02

whoa! that's a lot! i should have refused the hep lock from the get-go. i let them convince me and i said yes, but 10 minutes of laboring in a gazillion positions, it kept getting in the way and getting hit and snagged on things so i asked them to remove it. i hated it.

in my birth plan i requested only intermittent fetal monitoring. i had to lay down for 20 min 3 times for that. then they took it off and i continued doing my thing. they checked blood pressure twice and my pulse twice. i was never hooked up to anything, and i specifically request that in my plan. the staff was great about reading my plan and honoring it.