Natural Hospital Birth IV Question — The Bump
Natural Birth

Natural Hospital Birth IV Question

I've never posted on this board before, but I had a question for you ladies. I'm planning on birthing as naturaly as possible within a hospital setting. I would have loved to do a birthing center or homebirth, but it's not a feasible option for me with the military insurance I have and the area we live in, so I'll be delivering at a Naval Hospital.

My question is: for women who had a natural (completely unmedicated) birth in a hospital, did you have the option of refusing an IV (as long as you weren't in danger) and if so, were you given a hard time about it? How hard did you have to defend you descision?

I know there are exceptions, such as if you have group B strep you have to have an IV for the antibiotics.

I just don't know how common it is to be "allowed" to say no to this. I'll be asking my provider next week when I go in, but I wanted wider input anyway. I pass out when I get stuck with needles, it's an entirely uncontrolable physical response, and if I know going into the hospital that I won't have to have one outside of an emergency, I think it will help me relax.

Sorry about the length, and TIA! :)

Re: Natural Hospital Birth IV Question

  • I delivered at a birth center inside a hospital but had discussed this (and other policies that L&D had) with my provider just in case the birth center was full when I went in to labor because then I would have had to go to L&D. The hospital does them routinely in L&D so my doctor told me that I would need to refuse it and then the nurse would call her and she would tell the nurse that it is fine for me to not have one.

    Being in a hospital you will need to be your own advocate (or get a doula to be one for you). Nurses have "standing orders" which are things that they do routinely with every patient such as routine IV's and restricting diet. You will probably need to tell them specifically to call your doctor when you refuse. That being said you need to have your doctor on the same page as you. You can easily refuse something from the nurse if your doctor will back you up but it is a lot harder to refuse if your doctor wants it. 

  • Hopefully you aren't slated for Portsmouth Naval because,from what I understand from my doula, you'll have quite a battle there. Just remember though, you have the right to refuse anything and just because you are at a military hospital it doesn't mean you don't have that right. Do not let them bully you.
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  • even at my hospital (a non military one) they won't let me go without SOMETHING. You do not have to be hooked up to an IV. but they will want to at least have the IV line redy if they need it. So what they are going to do for me is put in the line but block it off. Sometimes I've heard this called a Heplock, and other people call it a Saline Lock. So they'll put the needle in and the first part of the tube but it won't be connected to anything. you'll be able to move around and won't have anything tying you down.

    ask your provider and hospital if this is an option for you. it might not be exactly what you were hoping for, but it might be enough to shut them up.

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  • I wanted to add just in case you aren't aware that Tricare has Universal Maternity Coverage which means you are covered 100% no matter where you deliver or what provider you choose.

    I chose to switch to Standard for my second child (to avoid Portsmouth Naval or Langley AFB and to have a birth center birth) and paid a total of $25 for the delivery.  

    You still have time to switch to Standard if you so choose.  It is immediate when you disenroll from Prime.  The only downside is if your sponsor is E-5 and above then there is a lockout to return to Prime for 12 months.  For me, it's worth it because even if I needed care in the following 12 months the catastrophic cap is $1k.  That's all I could potentially pay over the course of a year in co-pays or deductibles.  

  • Is a heplock/saline lock an option for you? If you're low-risk, no IVis reasonable, but if they give you a really hard time, suggest a port. I had it for both my births, but it didn't bother me.
    DS1 - Feb 2008

    DS2 - Oct 2010 (my VBAC baby!)

  • I am not familiar with military medical information.  My hospital really pressured me not to refuse anything, especially the IV.  When I refused that they said, fine, then do the catheter.  When I refused that they really tried to pressure me.  They finally agreed because there is nothing they can do.  They admitted that a patient can refuse anything.  And I think that is pretty much the case with most if not all things (example - a do not resuscitate order, in an extreme case).  I think that a care provider must have consent to treat for each thing they do, unless there is no one to consent and the patient is incapacitated, but I don't know for sure. 

    Whether it will negate your insurance coverage is another matter. They said to me that there are some things if I refuse then insurance will refuse coverage. 

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  • The policy at my hospital is no IV or heplock unless for epidural, GBS+, etc.   It's not routinely given.
  • Talk to your Dr it is all going to depend on policy. Mine said I at least had to have a hep lock. He is all about natural birth so I am all about making his job easier in case something goes wrong. He told me as far as he is concerened even if I was GBS + (which I'm not thankfully) that he would have them hook me up and un hook me every 4 hours if that is what I wanted. My Dr has been the best and very supportive in about all these things so like I said I'm all about making it easier on him to.
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  • My hospital put in a hep/saline lock, but never even suggested hooking up an IV.

    I was glad I had it, because I had a lot of bleeding right after DD was born and I needed pitocin to deliver the placenta.  I was NOT in a place to have an IV put in during those moments.

    image

    TTC since 11/05...ectopic pg 4/08...early m/c 6/09...BFP 10/5/09!
    Nora B...June 15, 2010...8lbs, 8oz...Med-free birth!
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    TTC #2 since 7/11...cycle #3 of Clomid + IUI = BFP
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  • I refused the IV compleatly I HATE needles I turn colors and get sick when stuck.  I had my MW on board with me and she had ordered them not to put on in but I still have to tell the nurses no then they tried to sneak it like they could... I finally had to sign a liability thing and they then let it go
    Me DOR amh .64 ng/mL  
    DH Brain Cancer
    BFP #1 12/11/08 DS born 8/23/09
    BFP#2 10/13/11 DC 11/4/11
    BFP#3 12/6/13 Lost 12/29/13
    Told IVF is the only option and have not found a clinic that will take me.



  • My hospital is pretty pro-natural childbirth and an IV wasn't even mentioned to me.  At my first prenatal appointment my MW told me that they don't start IVs unless they have a reason to.  I still wrote it in my Birth Plan though.  I had my baby without being stuck with a single needle, these types of hospitals are few and far between but they do exist.  
  • Two separate hospitals, but MWs both times.

    #1, no heplock or IV even mentioned until the c/s obviously

    #2, I was supposed to have a heplock for the VBAC (otherwise not something routinely done), but I was lucky that the admitting nurse forgot it and then when my midwife noticed she didn't remind them! 

    It's funny b/c I had a c/s and then a completely med-free VBAC and the thing I was looking forward to the least was the heplock.  I found it uncomfortable during labor (I was induced for 3 nights prior to my first birth, but went home before coming back for the real deal) and it hurt to position my hand for nursing afterwards b/c of the bruising.  I was very happy to not have to deal with that again.

    DS born via c/s 11/08 and med-free GD VBAC DD 3/11! Baby Birthday Ticker Ticker Baby Birthday Ticker Ticker
  • I refused it upon admittance.  My midwives suggested this ahead of time.  No one even blinked an eye!  I'm not sure if it varies from hospital to hospital...ours is very natural birth-friendly (it's actually a "birth center" affiliated with a hospital, but off-site).
    Childhood cancer (DH) + chemo + radiation = 0 sperm.
    LO #1 - 1 unmedicated/self-monitored IUI w/ donor sperm.
    LO #2 - 1 m/c, 2 BFNs, 4th IUI worked (unmedicated/self-monitored with new donor sperm).
    Life is beautiful!

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  • I birthed without an IV and wasn't pressured to get one. I laboured at home and arrived at 10 cm, though, so there was little time for them to bother me.

    I did end up with a saline lock for antibiotics after the birth, though. I tore fairly badly, and the OB recommended antibiotics for 24 hours. I was sad to get the needle in my hand after avoiding it for the whole birth, but it worked in that I didn't get any post-birth infection or complications.

  • I'm delivering at a military hospital, too. Here, the obgyn dept is at the hospital, all of my appts are there, and I don't have one specific provider I see when I go - I'm not sure if it's the same where you are. Maybe you're lucky and get to see the same provider every time :)

    Does your hospital have a midwife program? I was told that the midwives at my hospital are a lot more flexible. I'm not sure if this applies to having an IV (which is supposedly required), but it will be something I ask at my next appointment.

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  • AT my 32 week appointment with my OB I discussed my birth wishes.  One was to be allowed to only have a heplock instead of a full IV.  she said, sure no problem.  It was in my written birth plan that was given to her, put in my file, and carried with me to the hospital. 

    I showed up to the hospital at 9cm dilated.  I didn't have my birth plan with me, it was in the car because things were moving pretty fast.  The nurse went to put the IV in.  I told her I didn't want an IV and my doctor said I could just have a heplock.  She said and I quote, "You baby needs fluids."  And put in the IV.  So I would have to say that I couldn't fight it very well.  At that point I was more concerned with the contractions and all that that I couldn't continue to fight her.  I was pretty darn furious though. 

    I asked my OB about 6 months later at my annual exam if I could avoid an IV next time and she basically told me that the only way I would be able to was to physically stop the nurse from inserting the IV.  And if I wanted to push in a way other than on my back then I would physically have to fight for that as well and "the only mom she'd ever delivered not on her back was a druggie and was all strung out and refused to lie down."  That didn't sound like fun.  I switched to a birth center with midwives after that. 

    Mama to Lucy (7/06), Lexi (5/09), and Max (11/11) M/C 12/17/10
  • imagesuperned:

    My hospital put in a hep/saline lock, but never even suggested hooking up an IV.

    I was glad I had it, because I had a lot of bleeding right after DD was born and I needed pitocin to deliver the placenta.  I was NOT in a place to have an IV put in during those moments.

    Technically they can give you the pitocin as a shot in your thigh so you don't really need the heplock for that.  My second at a birth center I was bleeding too much and they just put the shot of pitocin directly in my thigh.  No IV required.

    Mama to Lucy (7/06), Lexi (5/09), and Max (11/11) M/C 12/17/10
  • imageMrs.Greeko:
    imagesuperned:

    My hospital put in a hep/saline lock, but never even suggested hooking up an IV.

    I was glad I had it, because I had a lot of bleeding right after DD was born and I needed pitocin to deliver the placenta.  I was NOT in a place to have an IV put in during those moments.

    Technically they can give you the pitocin as a shot in your thigh so you don't really need the heplock for that.  My second at a birth center I was bleeding too much and they just put the shot of pitocin directly in my thigh.  No IV required.

    Yep, they just jabbed me in the thigh. It wasn't a big deal. I only got my lock (for my antibiotics) after I had breastfed and had a shower.

  • My friend just did this.  Natural birth in a hospital.  She said the IV was the only thing that the doctor refused to budge on.  GL
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  • I ended up needing an IV for the antibiotics because I was GBS+, however I had the option to decine an IV. I drank so much throughout my labor, in addition to being on the IV, there is no way I would have been dehydrated.

    If they aren't willing to budge on an IV, perhaps you can get a hep lock instead.

  • imagesuperned:

    My hospital put in a hep/saline lock, but never even suggested hooking up an IV.

    I was glad I had it, because I had a lot of bleeding right after DD was born and I needed pitocin to deliver the placenta.  I was NOT in a place to have an IV put in during those moments.

     

    This is my reasoning for not going to battle with my OBs/midwives. (Also, I'm not a nice person if I get dehydrated and then all of my veins just disappear.)

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  • I got a heplock. It was one of those compromises that seemed to make the hospital staff play nice and also allowed me freedom of movement. I had heard that they have instantly raised defenses with patients who refuse the heplock.

    Because I labored in water so much, I had to wear a  taped rubber glove over that hand, which was distracting at best and sometimes painful at worst. If I hadn't been in water, I think I would've been fine with the heplock, but in retrospect, I would've pressed more to not have it because a medical professional should be able to get a line in ASAP in an emergency.

    I did end up needing the IV over the course of my long, dramatic labor so I may have felt differently having to deal with the insertion in the midst of crisis (like when I started to hemorrhage after delivery).

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