Hep lock or no?

runrinserepeat · April 2014

Hey all,
Starting to think about a birth plan for this time around, and the IV/hep lock part is giving me fits so I thought I'd ask your opinion. With my first, I didn't get an IV or a hep lock and everything was fine. In hindsight, however, a hep lock might have been good to have, just in case?

This brought to you by the fact that my husband decided to share with me only a few months ago that he was very anxious and frightened during my first L&D experience, that something might happen to me. When I brought this up yesterday, he was fine with the no IV/hep lock plan again, but I don't want him to be needlessly stressed if it won't actually bother me all that much.

So give me your thoughts and experiences with this. Ideally, I'll be going the no-pain meds route again and hopefully I wouldn't need anything administered through a hep lock or IV if I had one, it would just be a safety net (and mostly for DH's peace of mind).

seells · April 2014

I'll be getting a hep-lock. I have really deep difficult veins. It took 4 nurses a total of 7 tries to get an IV in with DD. (I was GBS+ So had to have one for the antibiotics) Even getting blood drawn can be a huge trial. So for me it just makes more sense.

Chichigo · April 2014

I feel the same way as @seells‌ and for the same reason. They actually had to call the anesthesiologist in to run my IV since a lot of nurses tried.

If your veins are easy to work with, I see no reason to ask for it if the hospital doesn't require it.

runrinserepeat · April 2014

That's a good point. Before this pregnancy I would have said my veins were fine. This baby seems to want to hoard all the blood, though, and my last couple of visits to the lab have been painful, to say the least. I'll definitely keep that in mind.

marriedinaugust · April 2014

I did not have one and will not next time. I did not see it as medically necessary for myself. My midwife and nurse at the hospital never even asked to put one in. It was in my birth plan that I didn't want one but I have no idea if the nurse ever read it.

aylafsu88 · April 2014

I had planned to have a Hep lock. IMO it was nice to have a port in just in case. However when I arrived at the hospital I was in transition and it was the last thing on my mind. I refused it and went without one. I did not want to deal with it in the tub or wait to get it put in. If I had spent more time laboring in the hospital I am sure my OB would have pushed it since it is their policy but I delivered in less than 2 hours of checking in.
I have veins that are pretty easy to access and felt that if I needed something they could get it in quick or could administer things like pitocin in my thigh after I delivered.

hlm184 · April 2014

GBS+ so I had one. I will get one in the future even if not GBS+. Rather have them blow veins early on than when we're in a hurry.

GPeterson24 · April 2014

Personally I would skip it if I had a hospital birth (however, if I'm going to a hospital it would be under emergent circumstances so I'm guessing I'd probably need an IV).

My thoughts are that they can be annoying depending on their placement and a hospital should be able to get a line in to you in an emergency. Ex. If you were in a car accident and rushed to ER they would have to find a vein somehow.

mb314 · April 2014

I had actually planned to accept a hep lock, but when the nurse said something to me about it when I was in labor, I was in the middle of a contraction, and the only word I could get out was "NO!" I meant "not right this second, I am in the middle of a contraction," but they interpreting my no as me declining it. They never brought it up again, and I never asked about it again. I think this time around I'll just refuse it.

sschwege · April 2014

That's a tough one and one of the few policies I don't have a strong opinion about. If I was at a hospital that recommended one, I probably would have done it. For whatever reason my MWs don't do them routinely, so I didn't have one either time. I do have really good veins and stayed well hydrated, but then again I've heard in an emergency situation they might be harder to get. I guess what I'm saying is, I probably wouldn't decline one, but I didn't request one either.

catsinawindow · April 2014

The freestanding birth center that I plan to birth at doesn't routinely do hep-locks, but because of my history of postpartum hemorrhage, my MWs are strongly suggesting that I get one. I'm a little apprehensive about how it might affect my ability to labor in the tub, but I can totally see their reasoning and have bad veins on top of it. So I'll be getting one.

wintersong139 · April 2014

Can I just say that I love how you are looking out for your husband's experience and safety during the birth as well as your own. :-) It always bugs me just a tiny bit when my friend says something to her husband like, "You don't have to push it out of your vagina, so you don't get to decide." I know that this is mostly in jest, but it still bugs me a little anyway. Granted what she is saying is true, but doesn't the opinion of DH or DW count a little bit?

momofmanyinthemitten · April 2014

I was a 2nd time VBAC, so it was required. I also have hard-to-access veins. If it would make you and your husband feel safer, why not get it? I labored in the tub with mine and it was nbd, just rested it on a towel on my belly.

jenn43 · April 2014

I really wanted to avoid a hep-lock, and I was excited when my GBS came back negative knowing I wouldn't have to have one. But then my nurse midwife asked me to get one just to be on the safe side (I have a mild bleeding disorder), and honestly, I think it won't be that big a deal. Yeah, they're a bit annoying, but I have a hunch I may be focusing on other things.

mrsblueeyes · April 2014

I got one and it was really no big deal, I was well hydrated coming into the hospital, the nurse quickly placed one and then wrapped it up so I could get in the tub right away. Even though it was mildly annoying at first, I quickly forgot it was there and it was nice to know that I had quick access available if needed.

hlm184 · April 2014

We didn't have a tub but I was definitely able to labor in the shower with the saline lock in.

catsinawindow · April 2014

joules235 said:

@lisagde said:

The freestanding birth center that I plan to birth at doesn't routinely do hep-locks, but because of my history of postpartum hemorrhage, my MWs are strongly suggesting that I get one. I'm a little apprehensive about how it might affect my ability to labor in the tub, but I can totally see their reasoning and have bad veins on top of it. So I'll be getting one.

I had my daughter at a freestanding midwifery clinic as well and my midwife covered the hep lock in a plastic sleeve that was taped to my arm so it wouldn't get wet. The most irritating part of the whole thing was taking the tape off afterwards, other than that it wasn't a problem. GL and I hope the don't need to use your hep lock

That's encouraging to hear. I think I'll ask at my next appointment if they have a plastic sleeve like this to waterproof the heplock so I can labor in the tub without worrying about it.

CMarie11 · April 2014

I'm GBS+, but even if I wasn't I would be getting a hep lock. They can wrap it up for the tub/shower so its not irritating you.

In a TRUE emergency c/s, like a cord prolapse or placental abruption, where you every second counts, I would hate to waste even 60 seconds getting an IV in so they could give me general anesthesia. Obviously this is a rare instance, but it happens.

nursekatie47 · April 2014

I didn't get one with my DD (5 yrs old), but ended up having an IV placed after I had a post partum hemorrhage (I lost about 1 L of blood after I delivered the placenta). I delivered my DS (almost 3 yrs old) at home with the same midwife and although she wasn't as insistant about having the hep lock, the other midwives on my team where. I am a very easy IV start and have garden hoses for veins, so I came up with a compromise. Since I wanted to labor and deliver in a birth tub I told them then once I was 9 to 10 cm and almost ready to push they could place the hep lock, but then they were to give me the pitocin post baby delivering and pre placenta delivering through the hep lock. It worked out perfectly and I'm glad I did it the way I did.

abbyful · April 2014

Policy at the hospital I had DS at (and will have baby #2 at) is that they give everyone in L&D a hep-lock. No biggie, it was a little annoying at first, but soon it was the last thing I cared about. And I'm glad it was there in case things started to turn bad, luckily everything went smoothly.

Summer889 · May 2014

seells said:

I'll be getting a hep-lock. I have really deep difficult veins. It took 4 nurses a total of 7 tries to get an IV in with DD. (I was GBS+ So had to have one for the antibiotics) Even getting blood drawn can be a huge trial. So for me it just makes more sense.

This was me, exactly.

The only thing I'd add is ask that they put it in your arm, not your hand or wrist. When my induction started, the only place they could get it in was my wrist. But it bothered me immensely so I insisted they move it. The nurses gave me a lot of crap about it (and I had to endure a number of failed attempts!) but they finally got it in my arm and I hardly noticed it there.

iris427 · May 2014

I'm having a 2ndVBAC and my hospital requires it for all VBAC moms. I figure it's a small compromise to let them feel more at ease with me laboring, so fine. I can see that it would be less stressful not to have to deal with getting a line started in the midst of complications (should they occur). But if I didn't have a medical reason, I might skip it.

Mphelms523 · May 2014

I've lurked on this board, but don't normally post. I had a natural delivery in a hospital 5 days ago. I had a perfectly healthy pregnancy and was 41w 4 days when I delivered. I was undecided on the iv port and ended up having it put in about 20 minutes before I started pushing. I pushed for roughly 10 minutes in the water and the iv didn't bother me at all. They could not find the baby's heartbeat using intermittent monitoring, so they made me get out of the water to try to find it. He ended up being in respiratory distress and between my pushing and a vacuum was delivered 10 minutes later. My oxygen saturation was low so they pushed fluids as I was pushing and then due to the quick nature of the delivery, they pushed pitocin to help prevent hemorage. I am fine and my baby is fine, but my opinion is that it's not that big of a deal to have it if minutes make a difference like they did in my case. Hope this helps

jenn43 · May 2014

jenn43 said:

I really wanted to avoid a hep-lock, and I was excited when my GBS came back negative knowing I wouldn't have to have one. But then my nurse midwife asked me to get one just to be on the safe side (I have a mild bleeding disorder), and honestly, I think it won't be that big a deal. Yeah, they're a bit annoying, but I have a hunch I may be focusing on other things.

And I did have a hep lock, and it was really no big deal. I hardly noticed it, and it wasn't a problem even when I spent half my labor in the shower. They took it out first thing in the morning.

NYGirl02 · May 2014

I have awful veins so for me having a hep lock eases some of the fearful what if questions I have. Unless I get to the hospital with no time to get one, I plan to get a hep lock only.

Hep lock or no?

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