Anonymous wrote:Why not require every person who enters the hospital to get an iv from minute one, then?

Kind of depends on what you're there for, doesn't it? I'm trying to think of a reason for hospital admission that wouldn't also be appropriate for placement of an IV. Heart, lung, liver, stomach, neuro, infection, surgery, severe fracture - all seem IV appropriate (saline lock, not dripping line of fluids).

In my general medicine unit, standard orders were for placement of an IV. Usually if you're admitted to the hospital there is a reasonable chance that you'll need an IV or that you should have one placed for the same reasons discussed above - emergency access.

Anonymous wrote:Former RN: Thanks for the info. That is good food for thought. Question, by "saline lock", do you mean an IV that administers only saline, or a hep lock?

Saline lock is an IV "lock" (capped off IV, mot connected to fluids) that is flushed with saline rather than heparin. It used to be standard practice that all were flushed with heparin but many hospital have moved away from that and instead flush with plain saline. The term "heplock" is a bit like "Kleenex" in that people may use it interchangeably even though it's a slightly different product.

Former RN: Thanks for the info. That is good food for thought. Question, by "saline lock", do you mean an IV that administers only saline, or a hep lock?

Why not require every person who enters the hospital to get an iv from minute one, then?

Former RN here. I've seen cases where it took incredibly experienced nurses more than 20 tries to place an IV in a dehydrated patient. In one case I recall, our resident IV expert (former prison nurse who excelled at finding veins even in junkies) could NOT find a vein on a 20 something young woman. Next step was to call in the flight nurses (trauma team) to try. Oops, flight nurses were on a flight. Next up: anesthesiologist. Oops, all were otherwise engaged with patients. The poor girl was about two minutes from having a central line placed (MUCH more invasive than IV and placed in the patient's neck or chest) when FINALLY, after dozens of tries, we finally found a vein in her lower leg. This all took probably around two hours and by then she was in far more serious condition.

Now clearly that's not typical - but I share it as an example of an otherwise healthy young woman who happened to be fairly dehydrated and was suddenly a terrible candidate for a "quick and easy" IV. There is no good reason to refuse having a saline lock placed. It could make a HUGE difference in case you eventually do need fluids or IV medication.

Keep in mind that agreeing to a saline lock doesn't mean you agree to anything else. It's just a good safety measure to have one in place.

Anonymous wrote:I asked for a hep lock. Just the needle and you can barely see/feel it. Ask them if this is an option.

I would hate to be flushed with fluids for no reason. You'll get all swollen - and the baby too - depending on how long your labor is. It happened to me. Not fun.

There's no "needle in your arm." The needle used to stick you is encased in an open ended plastic tube. Once the tube is in your vein the needle is removed and thrown away.

Also, inside the crook of the arm is the worse place for an IV. the unless you keep your arm straight, the tube gets bent and can't infuse, and the alarm constantly goes off.

To the poster who thinks that problems in birth can be seen "a mile away" and that an IV can be inserted in 30 seconds, why don't you talk to some actual OBs and RNs about it. Wherever you're getting your info from is wrong.

Anonymous wrote:I started out with an OB, wanted completely natural unmedicated birth, but she said the hospital would require an IV. She said I could get away with just the lock, but that got my wheels spinning on how they could "require" what is essentially a "treatment". I was pretty sure I could decline, but then what would they do? Toss me out? For that reason, and a few others, I switched to a birth center with some amazing midwives. Currently 23 weeks, feeling great, and far less stressed about the birth.

If you needed an IV for who knows what reason, they can start one in under 30 seconds. Those nurses and doctors "should" be able to see trouble coming a mile away, meaning they would have plenty of time to start an IV should you need one. I see no reason why women can't start the labor/birth process in hospitals without one, then reassess later on.

Not necessarily. I've seen plenty of cases in which skilled nurses had substantial difficulty placing an IV under calm circumstances, let alone in an emergency. Some people are truly more difficult to stick than others, for various factors, and stress only exacerbates that. I'm not knocking your choice at all, just pointing out that starting an IV is not always a simple procedure.

Anonymous wrote:I am planning to attempt a drug-free delivery, and while my doctor says they are supportive of my plans, the hospital would require me to have an IV when I'm admitted for delivery - even if the IV is just running a saline solution into me. For some reason, this freaks me out. The thought of looking down and seeing a needle in my arm during labor makes me uneasy. I realize this must be a pretty standard policy in most hospitals - can anyone tell me what your experience was like having an IV during labor? Am I making a big deal out of nothing?

I had a drug-free delivery. The nurse asked when I was admitted if I wanted an IV. I hate needles and said no (that was allowed at the hospital). However, later in the day I wasn't progressing and the midwife suggested an IV with fluids might be the thing to move things along. At that point, I just wanted the baby out. The IV did the trick and DD was born soon after. I was glad not to have the IV at the beginning because I was able to labor in the tub. I like a PP suggestion about asking about a hep lock - might give you a bit more freedom to walk around/shower/bath if available.

I started out with an OB, wanted completely natural unmedicated birth, but she said the hospital would require an IV. She said I could get away with just the lock, but that got my wheels spinning on how they could "require" what is essentially a "treatment". I was pretty sure I could decline, but then what would they do? Toss me out? For that reason, and a few others, I switched to a birth center with some amazing midwives. Currently 23 weeks, feeling great, and far less stressed about the birth.

If you needed an IV for who knows what reason, they can start one in under 30 seconds. Those nurses and doctors "should" be able to see trouble coming a mile away, meaning they would have plenty of time to start an IV should you need one. I see no reason why women can't start the labor/birth process in hospitals without one, then reassess later on.

Anonymous wrote:I refused an IV at INOVA Ffx. I refused heplock, too. I don't like the "why do you even go to a hospital, then" type of comments. I don't know why some people suggest that going to a hospital for delivering a baby somehow means that you must relinquish control, that your rights/preferences go out the window and that you just need to do whatever they say and be grateful. You are in charge of your baby's birth.

Okay, but...why DO you even go to a hospital then? If you're there just in case of emergency, why fight the staff's effort to be prepared for the emergency? That's just a foolish "I'M IN CHARGE HERE AND YOU CAN'T MAKE ME DO
IT!" mindset. Do you also refuse blood typing?

Anonymous wrote:I am planning to attempt a drug-free delivery, and while my doctor says they are supportive of my plans, the hospital would require me to have an IV when I'm admitted for delivery - even if the IV is just running a saline solution into me. For some reason, this freaks me out. The thought of looking down and seeing a needle in my arm during labor makes me uneasy. I realize this must be a pretty standard policy in most hospitals - can anyone tell me what your experience was like having an IV during labor? Am I making a big deal out of nothing?

Not getting into the IV v. Heplock debate...

It seems to that you are concerned with having a needle in your arm. I feel you! I hate needles and did not enjoy have my heplock. Mine was inserted into the outside of my wrist. At first, it was painful (I'm a wimp), but eventually I didn't notice it. With all else that will be going on, it honestly will not bother you, I promise. You sort of get used to it, as odd as that is. And you don't feel or think about it. Mine was in for a really long time - 40 plus hours due to a long labor that ended up requiring fluids, pitocin, etc. I was even able to watch them flush it clean the day after and not even flinch (from a person who has fainted while getting blood drawn, this was incredible). Overall, you may find that labor makes you braver!! GL.

Had a saline lock at VHC for my unmedicated birth. Easy breezy...even though it's "painful" to have one in your arm under normal circumstances, I can honestly say I never felt that damn thing ONCE. Unmedicated labor is good at taking your mind off piddling little things like a saline lock

My doula also recommended forearm, and it was definitely out of the way. It's not a big deal...a DRIP is a big deal, though, but a lock? No bigs.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Personally, I think you are making a big deal about nothing. It's an IV, not a c-section. If you are THAT averse to medical intervention, you shouldn't be delivering in a hospital (or using a doctor).

Or, she's an educated consumer who has read the research for best practice which states that standard use of IV fluid isn't indicated necessary for every labor. Hep-locks for easy IV access are a hospital policy of convenience. Standard IV fluid on the other hand, is not an evidence based practice. She has every logical reason (and right) to question her provider about this intervention.

Heplocks are not a policy of convenience. Trust me, it's inconvenient to insert a heplock and it's inconvenient to remove it later. Both take time and a trip to the supply closet. It would be far more convenient to save that time and take care of the 1,001 things that need to be done during a shift. However - in the event of an emergency, that inconvenient heplock can save your life or have a significant impact on outcome. If your BP suddenly dropped, or baby's heart stopped beating, would you want te hospital staff to have to spend time looking for a good vein? Good veins are often quite hard to come by when your body is on distress, or dehydrated, or you're hemorrhaging. The heplock is about being prepared for an emergency, not about making it convenient for the staff.

I'm on board with unmediated labor (had one myself) but find it utterly foolish to resist something as simple, yet potentially invaluable, as a heplock. Big deal - you get poked with a needle and have a canula in your arm. You're not tethered to anything - it is just there in case of emergency. I'd prefer the heplock to lost one if my or my baby's life were at stake.

This. So true. Now, I underwent several painful attempts to have it placed, since the nurse ignored my suggestion of where to place it before relenting. Still worth it for the peace of mind.

you can talk to the nurses about where they suggest placing it, and tell them where you've had it before that was uncomfortable. for a lot of women, forearm is the least disruptive but it depends on the person.

Anonymous wrote:when you say a heplock goes in the arm, where in the arm? Inside the elbow? I've had IVs placed there before and it was horribly uncomfortable for me.

I refused an IV at INOVA Ffx. I refused heplock, too. I don't like the "why do you even go to a hospital, then" type of comments. I don't know why some people suggest that going to a hospital for delivering a baby somehow means that you must relinquish control, that your rights/preferences go out the window and that you just need to do whatever they say and be grateful. You are in charge of your baby's birth.