IV Fluids Are Not “Required” in Normal Labor
It’s become common to tell all women who are birthing in medical facilities that they need an IV placed in their hand or arm “just in case.” However, when this routine medical intervention is examined more closely, it becomes clear that it’s massively overused, and unnecessarily complicating labor and postpartum for far too many mothers.
An intravenous drip (IV) is a plastic bag of water and electrolytes, dextrose, or medications. This bag hangs from a pole that is attached to the labor mom’s bed or is on wheels, which allows her to take her IV with her when she walks to the bathroom holding on to the pole.
Obstetricians
often want to medically provide the mother with liquids, calories or both, instead of supporting her eating or drinking normally in labor.
Obstetricians who say “An empty stomach is best”, are basing this directive on a long out-of-date scenario from the1950-60’s, when most of the women giving birth under an OB’s care were also unconscious under general anesthesia.
Back then it was dangerous to have a full stomach under general anesthesia; because if the patient vomited, it could be breathed in, and the anesthesia profession had not yet developed techniques for protecting the patient’s airway. However, the scope of care has completely changed:
General anesthesia is now rarely used in birth,
Medicines are available to neutralize the stomach acid,
Tools have been developed to keep airway open,
And even the anesthesiologists don’t care, saying in a recent editorial about eating in labor, “The actual incidence of the complication (aspiration) is so low, we cannot accurately describe it.”
Mothers
have always simply and easily hydrated and nourished themselves during the strenuous work of labor.
Even (or maybe especially) if she in birthing in a medical setting, the mother and her baby need the boost of nourishment and comfort without increasing their risk, as an IV does in normal labors and births.
There are circumstances in which an IV may be medically indicated, such as when:
Labor is very long
Mother has continuous nausea and vomiting
Local or general anesthesia is needed.
IV medications are needed
To stop preterm labor
Because labor is being induce or augmented
IV’s fluids are needed with epidurals to increase mother’s blood volume to protect against the common (and dangerous) drop in blood pressure.
To reduce pain
To control blood pressure
There’s a condition that might require immediate medical action.
But there are disadvantages and risks of routinely giving IV fluids in large amounts during normal labors, such as OVERhydrating, resulting in fluid retention -
In mothers, especially in her legs and breasts.
Overhydration from extended IV therapy
takes days to disappear, and the increasing breast engorgement can make breastfeeding more difficult in the first week.
By-the-way, homeopathic Nat Mur is brilliant at supporting the body in resolving this miserable state more quickly.
In mothers having an abnormally increased volume of urine.
This frequently results in catheterization, if mom can’t keep empty her bladder enough because the baby is low in the pelvis or the pressure has reduced your urge to pee.
A Full bladder after birth increases the risk of excessive bleeding, as it interferes with the uterus’s efforts to contract down on itself, because the bladder is physically in the way.
This sometimes necessitates a one-time (‘straight cath’) after birth, which is inconvenient and stressful for the moth
In babies, as their fluid retention becomes established as part of their ‘birth weight’.
In other words, the babies are artificially plumped up just like their mothers! This is quite obvious to natural birth workers who observe that normal urination for most newborns in the first 24 hours is 1-2 diapers, but often 3-5 times for newborns who’s mother had extended IV’s.
I’ve yet to see the hospital staff willing to acknowledge this common sense observation that even the parents often reason out.
Can become a very annoying issue as pediatricians then refuse to release the infant at 24-hours to go home, citing the newborn’s excessive early weight loss. They have usually been unwilling to consider the unusual volume of wet diapers in the context of an otherwise robust infant.
Temporarily low blood sugar in mother and baby after birth (if fluids contain dextrose), or electrolyte imbalance in baby soon after birth (if fluids contain electrolytes)
Sometimes the IV ‘infiltrates”, or pokes through the vein. Fluids then go directly into the mother’s tissue, causing pain and swelling, and the medicines do no good in tissues instead of the bloodstream.
Rarely, excess fluid accumulates in the mother’s lungs, known at ‘pulmonary edema’.
Laboring moms do need to stay hydrated; labor is a strenuous activity. But an IV is unnecessary if the laboring woman drinks enough liquid and is not in need of IV medications.
“A laboring mom’s hydration needs are around ¼ cup of fluid replacement/hour, or a bit more if she’s sweating a lot or doing mostly light breathing. ”
Labor companions can offer the laboring mother a drink after every contraction or two, which she is free to take or not. And don’t be concerned if labor is rapid, she may not need it. This is really all about remembering that mothers typically have pretty good instincts in birth, and reminding ourselves of ways to care for her lovingly without disrupting her process!
Some alternatives to IV’s during normal labors include:
Self-hydration
Water, fruit juice, coconut water, sports beverages, or frozen juice bars.
Electrolyte balancers
Labor Cubes, my recipe for herb and honey ice cubes just right for nourishing a healthy labor.
IF YOU ARE PUKING
Dehydration is a thing to avoid and pay attention to, as it can affect the baby (as evidenced by certain heart rate patterns) and the strength and pace of your labor.
Homeopathy can be very helpful with nausea in labor, for instance here.
Enemas are a kind of home IV, as the lower intestine’s whole job normally is to absorb fluids. Nutrient may be added, like honey/molasses/sugar, salt, homeopathics, or even the labor helper red raspberry tea.
Hep-lock
In the case that an IV cannot be avoided, or is expected to be intermittently needed, consider asking for a ‘heparin lock.’ This is a tiny, flexible tube that is placed in the vein of the arm above the wrist instead. When it’s not in use it is plugged and disattached, relieving mom of being tethered to an IV line.
This freedom to move around unencumbered best supports the normal spontaneous movements of laboring women; this mobility in turn reduces pain and promotes ideal baby positioning.
Also, it’s typically easier to use hydrotherapy for pain relief with a hep-lock, so this promotes less need for pharmaceduical pain relief as moms more smoothly are able to use showers and tubs for pain relief.
This placement and ability to cap off is also especially handy during labor when moms commonly lean on their arms quite alot (bending their wrists), and right after the birth when they are cuddling their baby.
Normal labors and natural labors all rely on the mother’s spontaneous movements to help her relieve pain and help the baby navigate most efficiently through her birth canal. While IV therapy is considered generally safe and simple, it’s routine use is unnecessarily disruptive to both mother and baby’s sensitive balance - from their internal hydrostatic balance, to interference with mom’s primitive birthing brain as she has to make sure that the IV is out of the way every single times she moves.
Real food is real nourishment, and the simple act of nourishing herself, or being nourished by her loving family, promotes the laboring mother’s personal confidence and agency. It’s common knowledge in sports and in labor coaching that one’s “mindset is everything.” Since under most circumstances birth is a normal biological process, what subliminal messages are given when healthy mothers are pushed to submit to IV therapy at the first sign of labor? Aren’t IV’s at the hospital for “sick people?”
Our mindset strongly affects our experience and outcomes.
Healthy mothers with normal pregnancies and labors have the best outcomes when they are encouraged to eat and drink normally!