Tell me when an IV/fluids is necessary

welly01

We did our hospital tour last week and I talked to the nurse about hep lock vs IV.  She said they are fine with starting with a hep lock but she wanted me to understand that sometimes getting fluids is necessary.  She mentioned something about D cells.  Also, she said that 60% of their patients do not have an epidural (may be mainly due to economic/social factors) so I asked her of the ones that don't have the epidural how many are required to have fluids?  Her answer was all of them.  I was trying to understand the difference between "fluids are recommended" vs "fluids are necessary" and if I can realistically expect to avoid IV fluids, even intermittent .  At first she made it seem like the situations where fluids are necessary are rare but after her response, I was totally confused.

Can anyone suggest a website or something that would help me understand why fluids are administered during labor?  I definitely don't want to put my baby in danger, but I don't want to receive fluids if not absolutely necessary.

Also, I plan to labor at home as long as possible and will eat/drink even in the hospital (against the nurses wishes). 

 

tokenhoser

Fluids are necessary if you're becoming dehydrated. I did not have an IV or fluids, but I was allowed to drink as much water as I wanted. I think I drank 3 or 4 liters during the 2 hours I was pushing! I chugged water between every contraction. I wasn't forcing it, but it was what I craved.

Some hospitals still adhere to the old "nothing by mouth" guidelines, and if you don't let a mom drink water, then she will become dehydrated and require IV fluids. And as I'm gathering you've read, IV fluids tend to inflate birth weight (and post-birth weight  loss in baby) and boobs (making breastfeeding more challenging). 

judahsmommy1

tokenhoser:

Fluids are necessary if you're becoming dehydrated. I did not have an IV or fluids, but I was allowed to drink as much water as I wanted. I think I drank 3 or 4 liters during the 2 hours I was pushing! I chugged water between every contraction. I wasn't forcing it, but it was what I craved.

Some hospitals still adhere to the old "nothing by mouth" guidelines, and if you don't let a mom drink water, then she will become dehydrated and require IV fluids. And as I'm gathering you've read, IV fluids tend to inflate birth weight (and post-birth weight  loss in baby) and boobs (making breastfeeding more challenging). 

This. 

sschwege

As pp said they are necessary in cases of dehydration.  I was in labor for 17.5 hours and never had a problem, though I was allowed to eat/drink as I pleased.  I put DH in charge of making sure that I was drinking enough and encouraging me to eat.  I think if he hadn't encouraged me I would have ended up needing an IV.  In the earlier stages of labor he encouraged me to eat, even just a bite or two.  Then later he made sure I took a sip after every contraction.  

Jenilyn and Matthew

I was told that fluids are necessary when you have an epidural, but only needed if the mother is getting dehydrated otherwise. You should ask if you can have water by mouth during labor to prevent dehydration instead of fluids, although it sounds like who you talked to was super confusing! I had an epi with my first and one of the worst parts of recovery was dealing with the swelling and fluid retention from all of the fluid they ran in my IV. This will not happen again if I can help it!

littlemaybaby

Unfortunately I was vomiting during labor - and not just briefly during transition, so the writing was on the wall for me needing an IV.  Even the MWs I use now (I used an OB at the time) said that they would have recommended an IV under the circumstances of my last labor.  

 

If you have someone reminding you to drink regularly (and you are holding it down), my understanding is that it's not too hard to stay hydrated on your own.  Our Bradley advice was a drink of water after every contraction . . .

 

Ditto PP on the epidural as well.  If you do decide to get one, most sources recommend getting IV fluids prior to the placement of the epidural to prevent a serious drop in blood pressure that sometimes occurs with epidurals.  My OB must have told me this a dozen times when talking about my birth plan because she wanted me to realize that it would delay my ability to get an epidural if I decided I wanted one.

BransonsBecca

I had a hep lock as well. I ended up bleeding a lot during labor so they gave me fluids to stay hydrated. I still went natural! And my labor staff was great about explaining things to me.

Dman85

I had really specific things in my birth plan about IVS. I requested a heplock if fluids were needed but never ended up getting an one. I drank A LOT of water during my labor and no one ever brought up me getting one.

ncbelle

I ended up with IV fluids both times (including for my birth center birth - both were med free).  Sadly, I'm a labor puker.  I was encouraged to eat and drink during both labors but couldn't even keep water down much less anything else.  I had fairly short labors but with the puking I definitely felt dehydrated and requested fluids - I don't recall the exact amount but it wasn't much.

ETA:  I'm typically a big water drinker so I feel like I feel the effects of dehydration easily - or maybe it was mental - in any case, I recall in my first labor being really worried about dehydration when I couldn't keep anything down.

FWIW, I had no issues with excessive weight loss in my babies or difficulties breastfeeding as a result of the fluids - maybe because I was just replacing what I would have been drinking if I could have kept it down. 

tokenhoser

If you had pretty short labours, you were probably not on fluids for a long time (and thus, a lot of fluids). That probably helped avoid the side effects.

Obviously, sometimes fluids are a good idea. It's just silly as a standard for everyone.

dmhrn13

Yes dehydration. Sometimes fluids are a great way to get the baby to "perk up" on the monitor so you can get the heck off of it. I've also had women say after they get a bag they feel a "second wind". Your gut stops working temporarily in labor at some point cause your body has more important things to do. IV fluids are direct to the source & bypasses this. If you get a bag you can certainly have them unhook it when its complete. If you're GBS + they may try to leave you hooked up after the antibiotic goes in, so look out for that so you can be unhooked. And yes, with an epidural women get this.