An intravenous (IV) line is a flexible tube, or catheter, inserted into a vein, typically in the hand or arm, providing direct access to the bloodstream. While many hospitals routinely place an IV shortly after admission for labor, expectant parents often question its necessity. Understanding the reasons for IV placement, from precautionary measures to medical requirements, clarifies its role. The decision depends on the mother’s health profile, labor progression, and preferences regarding pain management and mobility.
Routine Purposes for IV Access
IV placement is often used to maintain hydration, especially if the laboring person is restricted from eating or drinking or is experiencing prolonged labor. Continuous IV fluids counteract dehydration caused by the physical exertion of contractions, helping maintain the body’s function and energy levels.
IV access also provides a route for administering routine medications. If a person tests positive for Group B Streptococcus (GBS), antibiotics must be given intravenously at scheduled intervals to prevent transmission to the newborn. An IV also allows for the rapid delivery of anti-nausea medications or basic pain relief.
The IV is also a precautionary measure, providing immediate access should an emergency arise. A readily available port saves time if life-saving medications or fluids need to be administered quickly to the mother or baby.
When IV Access Is Medically Required
In several circumstances, IV access is a medical requirement. Labor induction necessitates an IV because medications like synthetic oxytocin (Pitocin) must be administered through a controlled infusion to stimulate and regulate contractions.
Receiving an epidural or spinal anesthesia also makes IV access mandatory, as a fluid bolus is typically administered beforehand. This rapid infusion helps counteract the common side effect of a sudden drop in maternal blood pressure that can occur with regional anesthesia, ensuring adequate blood and oxygen flow to the baby.
A planned or emergent Cesarean section requires an IV for administering anesthesia, managing blood volume, and delivering necessary medications. High-risk conditions, such as severe preeclampsia or risk of postpartum hemorrhage, also demand continuous IV access so medications or fluids can be given immediately.
Understanding the Saline Lock Alternative
For individuals with a low-risk pregnancy who desire greater mobility, the saline lock is a practical alternative to a continuous IV drip. A saline lock is an intravenous catheter inserted into the vein but capped off instead of being connected to continuous tubing and a fluid bag. The catheter is periodically flushed with a saline solution to keep the line open.
This approach offers immediate access without tethering the laboring person to an IV pole. Freedom from continuous tubing allows for easier movement, walking, and position changes, which can aid comfort and labor progression. The lock remains in place, ready to be connected to fluids or medication if an intervention, such as an epidural or emergency medication, is needed later in labor.
Potential Effects of IV Fluid Administration
Receiving large volumes of IV fluid can lead to temporary physical effects. A common consequence is temporary maternal edema, or swelling, particularly in the hands, feet, and face. This fluid retention affects a person’s weight immediately after delivery, as the body works to excrete the excess fluid over the following days.
The fluid transfer can also indirectly affect the newborn’s initial weight measurement. Extra fluid in the mother’s system can slightly over-hydrate the baby before birth, leading to a higher birth weight. This results in the baby shedding the excess fluid in the first few days of life, which may appear as a larger percentage of weight loss. Additionally, being attached to an IV pole and tubing can restrict movement and limit the ability to use comfort measures, such as a shower or tub.