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[quote=Anonymous][quote=Anonymous]"And last but not least, heparin can cause serious, catastrophic complications on its own. "

CNM who attends births in a hospital here.  Just to reiterate a PP's point, we use saline locks in L&D, not Heparin locks (even though we are in the bad habit of calling them "Heplocks").  We would not use Heparin in any L&D that I have ever worked in except under extraordinary circumstances because it can cause/worsen bleeding.

There are plenty of reasons to object to IV access in labor, but this, fortunately, is not one of them.

[/quote]

I wonder how long you have been a CNM?  While not in use today, heparin most certainly was used for quite some time.  Point being:  many things are done which are not evidence-based, and then later found to actually be harmful.

For this particular issue, I really don't have a strong opinion.  Though, if a woman wants to refuse it she should absolutely just say no - say no to the fluids, or say no to the heplock altogether.  Yes, the hospital staff will rant and rave at you, but ultimately they cannot change how they are caring for you and certainly cannot kick you out.

The example the nurse gave above is so extraordinarily rare, that I honestly see that story as more of a scare tactic than anything helpful.  And, quite frankly, if anyone (who previously refused the heplock) were even marginally trending towards actually needing one, I would guess that most women would then comply.  I think the issue these women have is the administration of an IV (or even heplcok) to ALL woman as soon as they are admitted.  A simple conversation and examination can determine whether or not a woman has been able to adequately hydrate during the labor, whether her labor seems to be progressing, and whether or not she is at risk for needing/wanting other medications or procedures.

Remember, women in out-of-hospital birth situations do not routinely receive an IV or even a heplock.  If those midwives are able to appropriate and safely judge when that intervention becomes necessary, then it surely cannot be too difficult for a well-equipped hospital to do the same.[/quote]

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