Is an IV necessary?

itsmeclorene · September 2013

I know it's routine to put an IV in during labor. Do you HAVE to though? Needles and the idea of something in my vein freaks me out so I'd like to have as little as possible. I've been in the hospital for having such strong nausea and I had an IV then so I know I CAN do it, but I hate them. It's this feeling of having limited movement and what not. It just freaks me out. Also I want to know about the epidural why or why not and how bad is that? Can you do that and not an IV?

Meery82 · September 2013

As far as I know, you need to have one. If there is some kind of emergency, they need access to your veins to give you medication fast. And if you are induced with pitocin, it runs through an IV.

fluttergirlmoonchild79 · September 2013

As far as I know, IV is necessary. Not completely understanding your epidural question. They put a needle in your back (the needle comes out when they're done). It has nothing to do with your IV

itsmeclorene · September 2013

IVs freak me out. I get that being pregnant I'm going to be poked with a lot of needles but as little as possible. What about with natural birth? Do you need an IV then?

WashingtonQueen · September 2013

If you have to have an IV if you want an epidural. If you have no meds of any kind most hospitals will allow you to just get a hep-lock, but that is still stuck in your vein. The only way to completely avoid an IV is to arrive at the hospital ready to push.

I don't understand, though. You don't like needles and the idea of something being in your vein. An epidural is put in through a needle and then you have a catheter stuck in your back. You don't like limited movement but that is exactly what an epidural does. You can't move the lower half of your body and you are stuck in one place. I guess I just don't understand your hesitation about an IV and not the epidural.

itsmeclorene · September 2013

Honestly BOTH freak me out. I guess my veins freak me out more than my back. and since this is my first child AND a surprise I really don't know much.

MannaPants · September 2013

They do want to put you on an IV so they have immediate access to your vein in case of emergency. However, it doesn't have to affect your movement. I am requesting a Hep Lock (approved by my MW already). You can request a hep lock or a saline lock. These are sort of "ports" to your vein. It does stay in your arm, but isn't connected to anything. They just put it in and tape it down. That way you can still move unimpeded, take a bath/shower, whatever.

Also, if it makes you feel any better, the IV isn't actually a needle. They use a needle to put it in, but the part that stays in your arm is a little flexible plastic piece.

In response to your epidural question (although it's worded a little confusingly), they will definitely make you take the IV if you have an epi. Epidurals can have some side effects, such as crashing blood pressure, and they will want quick IV access, in case.
An epidural is also left in. It's not just one needle stick, it's a catheter inserted in your lower back. The tube comes out of your back and is taped somewhere around your shoulder, so they can put more meds in it as needed.

Hope this helped.

Meery82 · September 2013

beckyj2013 said:

You can refuse any medical treatment that you don't want. That being said, at my hospital they take labs when you get admitted and then just hook an IV into the site where they took your blood. You don't automatically get hooked up to fluids or any other medicine (ie the IV isn't connected to anything unless you need it). I'm sure it is different for every hospital, so I would check with where you are delivering.

Also, I think I remember them saying that you can't have an epidural until you receive 1 liter of fluid, so unless you are planning to go med free, you will need to have an IV for the fluid.

ETA: They automatically hook the IV up to avoid having to re-stick you every time they want blood or want to give you medicine. If you don't like needles, it seems like the less sticks the better to me. I don't really have a problem with them, I just didn't want to be tethered to a pole the whole time, which it doesn't seem that I will be unless needed.

Unfortunately, they cannot draw blood from an IV.

jessican08 · September 2013

As the other ladies said, if you get an epidural you need an IV.

FWIW, my epidural didn't really hurt at all, they numb you with a tiny needle first which was nothing - it was the idea of it that was more bothersome than anything. Having the cervidil placed the night before my induction and then having my water broken the next morning was a lot more uncomfortable than getting the epidural. Getting the port put in for the IV fluid wasn't fun, needles never are, but just remember it's only uncomfortable for a few seconds.

Meery82 · September 2013

OP, I can't speak from personal experience, but I'm guessing natural childbirth will be much more uncomfortable than an IV and epidural.

MannaPants · September 2013

Smilz4782 said:

My birth center doesn't do any IV or heplock, it will definitely depend on your hospital's policy and procedure.

I wanted to do a birth center so badly! My mother is an RN at a local hospital and convinced me to use the hospital MWs. I might insist on my next baby.

ETA: Sorry to hijack!

MannaPants · September 2013

RedheadBaker said:

beckyj2013 said:

You can refuse any medical treatment that you don't want. That being said, at my hospital they take labs when you get admitted and then just hook an IV into the site where they took your blood. You don't automatically get hooked up to fluids or any other medicine (ie the IV isn't connected to anything unless you need it). I'm sure it is different for every hospital, so I would check with where you are delivering.

Also, I think I remember them saying that you can't have an epidural until you receive 1 liter of fluid, so unless you are planning to go med free, you will need to have an IV for the fluid.

ETA: They automatically hook the IV up to avoid having to re-stick you every time they want blood or want to give you medicine. If you don't like needles, it seems like the less sticks the better to me. I don't really have a problem with them, I just didn't want to be tethered to a pole the whole time, which it doesn't seem that I will be unless needed.

Unfortunately, they cannot draw blood from an IV.
I've had blood drawn from IVs before on multiple occasions.

I asked Dr. Google (https://allnurses.com/general-nursing-discussion/do-you-draw-341218-page3.html) General consensus seems to be that you CAN draw blood from a central line. You can also draw blood from an IV when it's first started and no meds have been put through. You cannot draw blood from an IV which is already administering meds (although some said you could if you drew some first and trashed it).

WashingtonQueen · September 2013

RedheadBaker said:

beckyj2013 said:

You can refuse any medical treatment that you don't want. That being said, at my hospital they take labs when you get admitted and then just hook an IV into the site where they took your blood. You don't automatically get hooked up to fluids or any other medicine (ie the IV isn't connected to anything unless you need it). I'm sure it is different for every hospital, so I would check with where you are delivering.

Also, I think I remember them saying that you can't have an epidural until you receive 1 liter of fluid, so unless you are planning to go med free, you will need to have an IV for the fluid.

ETA: They automatically hook the IV up to avoid having to re-stick you every time they want blood or want to give you medicine. If you don't like needles, it seems like the less sticks the better to me. I don't really have a problem with them, I just didn't want to be tethered to a pole the whole time, which it doesn't seem that I will be unless needed.

Unfortunately, they cannot draw blood from an IV.
I've had blood drawn from IVs before on multiple occasions.

So have I.

Meery82 · September 2013

MannaPants said:

RedheadBaker said:

beckyj2013 said:

You can refuse any medical treatment that you don't want. That being said, at my hospital they take labs when you get admitted and then just hook an IV into the site where they took your blood. You don't automatically get hooked up to fluids or any other medicine (ie the IV isn't connected to anything unless you need it). I'm sure it is different for every hospital, so I would check with where you are delivering.

Also, I think I remember them saying that you can't have an epidural until you receive 1 liter of fluid, so unless you are planning to go med free, you will need to have an IV for the fluid.

ETA: They automatically hook the IV up to avoid having to re-stick you every time they want blood or want to give you medicine. If you don't like needles, it seems like the less sticks the better to me. I don't really have a problem with them, I just didn't want to be tethered to a pole the whole time, which it doesn't seem that I will be unless needed.

Unfortunately, they cannot draw blood from an IV.
I've had blood drawn from IVs before on multiple occasions.

I asked Dr. Google (https://allnurses.com/general-nursing-discussion/do-you-draw-341218-page3.html) General consensus seems to be that you CAN draw blood from a central line. You can also draw blood from an IV when it's first started and no meds have been put through. You cannot draw blood from an IV which is already administering meds (although some said you could if you drew some first and trashed it).

Yes, this.

babymama619 · September 2013

My hospital requires you to at least have a hep lock in case they urgently need to access your veins, even if you plan a med free birth.

Also, do you know your strep b status yet? Might be a mute point if you're positive. I am and the doc said they want at least 4 hours of IV antibiotics before delivery. So no matter what I want I'll have an IV because it's best for LO.

I suggest you ask you doc at your next appointment about their policy and that of the hospital.

barista411 · September 2013

An IV is not necessary. You will need to check with you provider and hospital policies but you have the right to refuse. If you have an epidural they will require you to have IV to administer fluids to help regulate your blood pressure. You may want to do some research to decide if an epidural is right for you or if a natural birth is something you are up for. If needles are a fear I would encourage you to consider a natural birth in a birth center, natural friendly hospital, or a home birth.

sschwege · September 2013

itsmeclorene said:

IVs freak me out. I get that being pregnant I'm going to be poked with a lot of needles but as little as possible. What about with natural birth? Do you need an IV then?

Just lurking over here. I had two med-free hospital births and didn't have a running IV or heplock either time. My hospital is pretty low intervention and provided everything looks good they don't do them routinely, now if you want an epi or are being induced that's a different story.

sschwege · September 2013

BrittAnnie19 said:

What @MannaPants said. Check with your provider and hospital to find out their policy with IVs. Many hospitals require at least a heplock in place even if you don't want an IV. I'm going to a birth center and don't have to have an IV, but with DD I had an IV even though I didn't have any meds because of the hospital I was at.

Regardless of policy, provided you are of sound mind you can refuse any and all medical procedures. The staff might make you miserable and it might not be a battle worth fighting, I would have agreed to a Heplock if it had been 'policy' at my hospital. But again, you can always refuse.

PrimRoseMama · September 2013

The hep lock in your hand is necessary. If you need fluids, or other medications then it allows quick access. It doesn't hurt & it's more annoying than anything. The only part that involves a needle is initial placement. The needle doesn't remain at all. It's just a plastic tube or catheter that stays in place.

Same is true for the epidural. If you are asking "how bad" the administration & placement is. The worst part of that was the prick n' sting of the numbing agent they use on your back. That only lasts like 3 seconds. The rest is painless. The needle doesn't remain after the initial poke. It gets replaced by a catheter that feeds meds to the area.

Because I had it done at 9cm, the transition labor pains were the hardest part of sitting for the epidural. You have to remain in a certain position & still. That's really tough when you are in agony. Next time I plan to ask for the epi much earlier.

RNmommyof2 · September 2013

They're going to want IV access no matter what. If there is an emergency that is not the time to go looking for veins so they can give you medications. The needle doesn't stay in your arm, all that is left is a flexible plastic catheter.

CamFam · September 2013

If it makes you feel any better, you could request the IV be placed in the back of your forearm, out of sight. Mine was. I was also induced, so the IV was the first thing in before anything else. I got over the annoyance and fear of the IV as soon as Pitocin kicked in and those contractions started. ;-)

gladygirlca · September 2013

itsmeclorene said:

IVs freak me out. I get that being pregnant I'm going to be poked with a lot of needles but as little as possible. What about with natural birth? Do you need an IV then?

Yes, even if you're going for natural. They need to be able to quickly hydrate, medicate, or transfuse you if there's a problem. Talk to them about placement options and ask lots of questions before hand, but trust me...if something needs to happen quickly, you don't want them trying to put in an IV during active labor. You'll be ok. Don't look at it when they do it and ask them to dress it so you don't have to see it after.
;;)

RoosterWrangler · September 2013

OP - it totally know where you're coming from. My issue isn't a fear of needles, it's a fear of stuff in my veins or any sort of venipuncture. I'm covered in tattoos and the nurses always give me weird looks when I tell them how much of a weenie I am about getting blood taken. I have to go in tomorrow morning to be induced so I don't really have an option - I'm getting an IV. I'm really stressing about it - even more than medically induced contractions or any other part of labor. It's very bizarre, but that's how I feel. The only thing that's gotten me through the blood draws of pregnancy is the fact that I know that I'm not doing them for me - I'm doing them for LO. I wish you the best of luck and know that you're not alone. Just focus on the baby at the end of the whole ordeal; you'll forget all about it.

JilllyBean · September 2013

RNmommyof2 said:
They're going to want IV access no matter what. If there is an emergency that is not the time to go looking for veins so they can give you medications. The needle doesn't stay in your arm, all that is left is a flexible plastic catheter.

Mine was not at all. It was giant and metal. I have a scar from it

Meery82 · September 2013

JilllyBean said:

They're going to want IV access no matter what. If there is an emergency that is not the time to go looking for veins so they can give you medications. The needle doesn't stay in your arm, all that is left is a flexible plastic catheter.

Mine was not at all. It was giant and metal. I have a scar from it

If you had a peripheral IV, a needle was not left in you.

JilllyBean · September 2013

I didn't say a needle was left in me, it wasn't a flexible piece of plastic. It was a few centimeters wide and was metal. Like a metal tube.

Meery82 · September 2013

JilllyBean said:

I didn't say a needle was left in me, it wasn't a flexible piece of plastic. It was a few centimeters wide and was metal. Like a metal tube.

Then you must've had something else that I've never heard of because peripheral IV catheters aren't that big and aren't metal.

JilllyBean · September 2013

Meery82 said:

JilllyBean said:

I didn't say a needle was left in me, it wasn't a flexible piece of plastic. It was a few centimeters wide and was metal. Like a metal tube.

Then you must've had something else that I've never heard of because peripheral IV catheters aren't that big and aren't metal.

It looked like this

Meery82 · September 2013

JilllyBean said:

JilllyBean said:

I didn't say a needle was left in me, it wasn't a flexible piece of plastic. It was a few centimeters wide and was metal. Like a metal tube.

Then you must've had something else that I've never heard of because peripheral IV catheters aren't that big and aren't metal.
It looked like this

It's too blurry to see the insertion site, but it looks brutal!

ETA: ok, I looked at the picture on your blog, it's much clearer there. It's an 18G IV, which is good sized, but pretty standard. I had the same thing. And a tiny scar as well. And I promise, there's no metal in there!

Mollyp11 · September 2013

karissa2009 said:

Sorry, ICU nurse here. When do you think it's easier to find a viable vein to give you fluids/meds--when you're "ok" or when you've crashed from some complication? Get the damn heplock.
If you have an epidural, you'll have to have it anyway. If you decide (at this late point in the game) you want to try for a natural birth, it could be unnecessary (until you hit transition and need something NOW. Is that when you want to have some nurse trying to poke a vein?). And if by some set of ill factors you require a C-section, you'll have to have one. PPs are right when they say you can refuse anything, but in the long run you might only be endangering yourself and your baby over a needle stick. Talk with your OB/MW and your hospital/delivery place--most have policies that require them. GL deciding OP.
As an aside, it truly depends on the IV/nurse/hospital policy as to whether you can draw blood from it--brand new ones usually draw pretty good. After it's been in, sometimes it just won't draw back the right amount of blood. And once anything has gone through it, you have to draw back enough to "waste" (to avoid screwing up test results), making it even less likely you'll get enough. And some hospital lab's have policies that won't allow blood to be drawn from it after the initial stick. And some brands/sizes have better luck than others.

She's totally right. I am an L&D nurse, and when things start hitting the fan... it can happen fast. And these are definitely not times I enjoy trying to place an IV. The reasons we use IV access can vary, but many times it is in order to help baby tolerate labor in one way or another. From a mothers perspective, there is no way I would refuse something that would allow them to help my unborn baby.

In my hospital, we place the IV and draw initial labs from that if possible. After meds are given through the IV, we can no longer draw more labs. It is nothing compared to the pains of labor, and although it is not my favorite thing to have to do, it is so much more important to have that access than to worry about a simple poke.

TashnBabii · September 2013

I know some IVs are necessary, while others are not. The ones that are necessary are those that are needed in case of an emergency, or if you carry GBS. If you carry GBS, you'll get an antibiotic through IV. I'm a FTM, but that's what my doctor had told me. Fortunately, there are other IVs you can avoid, like getting an IV to stay hydrated. The other opinion is to eat ice chips. That's what I will do. I love water/ice so eating ice chips will make me somewhat normal while I'm hooked up to monitors and why not. Haha

TashnBabii · September 2013

Oh, I'd like to add that I hate needles as well, but I am still going to get IVs. People who work at hospitals went to medical school and/ or are qualified to do such medical procedures. Granted, there are some idiot staff/ doctors, but I think you have a higher chance of doing just fine. Just be sure to ask questions so that you are well informed. Doctors and nurses are there to answer any questions or concerns you may have.

sschwege · September 2013

TashnBabii said:

I know some IVs are necessary, while others are not. The ones that are necessary are those that are needed in case of an emergency, or if you carry GBS. If you carry GBS, you'll get an antibiotic through IV. I'm a FTM, but that's what my doctor had told me. Fortunately, there are other IVs you can avoid, like getting an IV to stay hydrated. The other opinion is to eat ice chips. That's what I will do. I love water/ice so eating ice chips will make me somewhat normal while I'm hooked up to monitors and why not. Haha

Or if you're feeling up to it just eat and drink, particularly during early labor. DD was 17.5 hours and I managed to not need an IV. Just ate in early labor and drank water/juice later. After every contraction DH would give me a drink and I never became dehydrated. Popsicals are also really good if you like ice

MrsJG3 · September 2013

My veins make it near impossible to start an IV. With my last delivery they called in the anesthesiologist after numerous failed attempts. It took him 30 min to get it in. I guess my point is if it had been life or death I may not have had that time and I wouldn't want to take any chances.

mrscountry527 · September 2013

beckyj2013 said:
You can refuse any medical treatment that you don't want.
ETA: They automatically hook the IV up to avoid having to re-stick you every time they want blood or want to give you medicine.

You have the right to refuse anything. I plan on not arriving until I'm in transition, but I will be refusing an IV all together. You cannot have an epidural without having an IV. Epidural a tend to lower the BP so you need access. Regarding the quote above, you will still have to be stuck for lab draws. They cannot draw blood through an IV.

If an emergency arises and you do need an IV, they can get one in you within minutes.

Be your own advocate and know that you have rights and can refuse anything you don't want. Some things may require you to sign a waiver, but you can do that. Also, the nurses won't always "ask" you if they can do something. And they won't always tell you that you can refuse. But you can. They're just following orders and protocol.

zou bisou · September 2013

@lissydee Good insights. I can see how some hospital staff would think of the worst case scenarios and make blanket policies on them, but most mothers are not going to fall into that category thankfully.

FWIW, I have had two hospital births and I declined the IV for both without issue. For me, the IV is uncomfortable and managing a delivery naturally takes a lot of concentration. My experience with IVs for other surgeries has not been very positive. I need to focus on working through contractions and the fewer things adding pain to the experience, the better.

jamrosj · September 2013

zou bisou said:

@lissydee Good insights. I can see how some hospital staff would think of the worst case scenarios and make blanket policies on them, but most mothers are not going to fall into that category thankfully.

FWIW, I have had two hospital births and I declined the IV for both without issue. For me, the IV is uncomfortable and managing a delivery naturally takes a lot of concentration. My experience with IVs for other surgeries has not been very positive. I need to focus on working through contractions and the fewer things adding pain to the experience, the better.

I agree. I will be giving birth at a hospital that doesn't require any heplocks for unmedicated births. I agree that putting an IV in for an emergency is inconvenient and can be more difficult but ER nurses do it every day. This thread has had some good insights, with lots to consider.

mskatiep · September 2013

For what it is worth, you are absolutely able to refuse an IV while at the hospital. Your nurses may side eye you, and they may complain about you, but just because a hospital calls something their policy doesn't mean that you have to follow it. They cannot refuse you care, or hold you down and force an IV (if non-emergent)

Now, is that that the "best" decision? Probably not. I am going to get a saline lock "just in case." I agree that I do not want IV lines hindering my movements or keeping me in the bed the entire time. I would rather just have a saline lock in my hand/arm than have to deal with having it done in an emergency situation.

JilllyBean · September 2013

Haha tiral

Meery82 said:

JilllyBean said:

Meery82 said:

JilllyBean said:

I didn't say a needle was left in me, it wasn't a flexible piece of plastic. It was a few centimeters wide and was metal. Like a metal tube.

Then you must've had something else that I've never heard of because peripheral IV catheters aren't that big and aren't metal.
It looked like this

It's too blurry to see the insertion site, but it looks brutal!

ETA: ok, I looked at the picture on your blog, it's much clearer there. It's an 18G IV, which is good sized, but pretty standard. I had the same thing. And a tiny scar as well. And I promise, there's no metal in there!

Haha totally not my blog:) I just google image searched:) yeah the outside was...the inside felt like it!! Good to know! Bleh

Meery82 · September 2013

JilllyBean said:

Haha tiral

JilllyBean said:

JilllyBean said:

I didn't say a needle was left in me, it wasn't a flexible piece of plastic. It was a few centimeters wide and was metal. Like a metal tube.

Then you must've had something else that I've never heard of because peripheral IV catheters aren't that big and aren't metal.
It looked like this

It's too blurry to see the insertion site, but it looks brutal!

ETA: ok, I looked at the picture on your blog, it's much clearer there. It's an 18G IV, which is good sized, but pretty standard. I had the same thing. And a tiny scar as well. And I promise, there's no metal in there!
Haha totally not my blog:) I just google image searched:) yeah the outside was...the inside felt like it!! Good to know! Bleh

LOL, oops! They are big, but they come even bigger. 24G-14G. Google a 14G... Those bastards are ginormous!,

DebateThis · September 2013

No, you do not need an IV. And pending your hospital policies (and/or your OB/MW/nurses' willingness to fight them) you can often decline.

My hospital/MW do not require them unless you're GBS+, and even then they disconnect the IV for the hours between antibiotic dosage.

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