Intravenous (IV) fluids are given to the vast majority of women in labor, making it perhaps the most common routine intervention in the childbirth process. Even women who want to birth naturally often have fluids adminestered to them intravenously, more often as a “just in case” measure than as a truly necessary intervention.
IV fluids are usually given to a women through a vein in her hand. A small, tube-shaped piece of plastic is injected into the vein and taped into place, and is connected to a bag containing a saline mixture, labor augmenting drugs, and/or antibiotics. Some doctors and midwives prefer to have women connected to IV drips so that they can be given drugs very quickly in the event of an emergency cesarean section. While these IV fluids may be necessary for some women, they have serious drawbacks for others.
Saline mixtures are the most common IV fluid. Most women are asked not to drink (or eat) during labor, since some doctors and midwives fear that they might choke on their own vomit if they need to be placed under emergency general anesthesia. This causes many women to become dehydrated during labor if they do not receive saline intravenously.
However, the risks of the saline drip may be greater than the very minimal risk of aspirating vomit. Pumping a woman’s body full of saline often drastically slows down labor, and is indeed the most commonly prescribed treatment for preterm labor. According to a study published in Evidence-based Obstetrics and Gynecology, this lends to an increased need for the labor-augmenting drug Pitocin, which carries many very serious risks of its own.
Pitocin, being the second-most common IV fluid for laboring women, mimics the natural labor-stimulating hormone oxytocin, which has been linked to violent labor, which is dangerous to both the mother and the fetus, and is usually resolved with emergency cesarean section. Additionally, augmented labor is much more painful for most women, requiring an increased need for pain medications and epidurals. Pitocin has also been strongly linked to uterine rupture, fetal distress, and cesarean section.
IV fluids may also contain antibiotics, which are critically necessary for women with bacterial vaginal infections, including bacterial vaginosis, gonorrhea, and strep B. While these interventions are truly necessary to prevent infection in the baby, a heparin lock (or hep well) can be inserted to give temporary access to the vein and leave the women unhindered for the remaining portion of labor.
Additionally, a heparin lock can be a safe comprimise for women who do not want an IV during the entirity of labor, but who want the reassurance of safety in case an emergency required immediate administration of drugs. Unlike full IV drips, unconnected heparin locks do not hinder movement and carry none of the side effects of saline, pitocin, or other IV fluid mixtures.
If you are interested in pursuing an alternative to the use of IV fluids during labor, talk to your doctor or midwife about the options that are available to you. Depending on your specific situation, it may be possible for you to safely forgo the use of routine intravenous fluids. Your practitioner can help you to decide the safest route for you to choose given your circumstances.
Evidence-Based Obstetrics and Gynecology, Volume 4, Issue 1. March 2002, Pages 15-16
Varney’s Midwifery, Fourth Edition- Helen Varney
Holistic Midwifery– Ann Frye
Maternal-Newborn Nursing and Women’s Healthcare, Seventh Edition- Marcia L. London