What to Know About an IV During Labor and Birth

IV stands for "intravenous," and though many of use it as a noun ("Did you have an IV?"), it's technically an adjective and often paired with a noun like fluid, drip, medication, or injection. I promise this post is not about grammar, but it's important to understand the language and usage of medical terminology!

IVs are used to get a substance, like fluid or medication, into the body quickly and efficiently, through way of your veins. During labor, when an IV used, it is most often used to administer fluid, Pitocin, or pain relieving medications. However, an IV is not required for many people in labor. Despite the fact that a large number of hospitals and care providers (doctors and midwives) routinely order an IV for people in labor, it is only truly needed in certain cases. 

Use of an IV in labor and birth is an intervention in the normal process of birth. When needed, it can be beneficial and even life-saving. When used unnecessarily, it can have negative impacts. Let's look first at the different reasons why an IV would be needed during birth. 

When Is an IV Needed in Birth?

• If you develop complications before or during labor that require medication or fluids
• You have a high risk of complications
• You need to be induced using Pitocin
• You have an epidural
• You are having a c-section
• You need antibiotics or other medication in labor

When Is an IV Not Needed in Birth?

• When it's given for routine fluids in labor (without any medical reason listed above), when practitioners say "We don't want you to get dehydrated," or when it's given routinely because the hospital doesn't allow food or fluid by mouth

Essentially, if you have an uncomplicated or normal labor and birth, and you are allowed to drink and eat as needed, you shouldn't need an IV "just in case." You can learn more about the evidence for and against IVs given in labor for fluids in this well written, easy-to-read, in-depth article on Evidence Based Birth. 

What's the Alternative to an IV?

If an IV is suggested for hydration and energy/nutrition, the alternative is to eat and drink on demand. Ideally, your partner or doula (or both!) will help you remember to eat and drink throughout labor so you can help yourself maintain hydration and energy for the hard work of labor. 

As for alternatives to pain medicine administered by IV, there are many non-medicinal pain relieving techniques available to you that are effective in labor. The best way to learn and use these techniques is to take a quality childbirth education class with your birth partner. Hiring a doula is another excellent way to ensure you get adequate access to a variety of coping techniques while in labor. 

When it comes to the use of Pitocin for induction, have the conversation with your care provider about alternatives to Pitocin to start an induction. If Pitocin is being suggested to speed up your labor, there are alternatives to consider for that, too.

What Are the Drawbacks and Risks of IV Use During Labor 

• Most basic is that movement is restricted, which can affect your ability to cope with pain, increase the length of labor, and increase the use of Pitocin to strengthen contractions and speed up labor
• May over hydrate the person in labor, which can cause swelling in hands and feet; difficulties breastfeeding due to swollen breasts; and an artificial drop in newborn weight in the days after birth (due to shedding of IV fluids after birth rather than weight), which can also be harmful to breastfeeding
• Using IV in place of eating and drinking in labor depletes a laboring person's energy when it's needed most. The World Health Organization (WHO) recommends offering women fluids by mouth and eliminating routine IV use during labor, and the American Society of Anesthesiologists (ASA) recommends that low-risk laboring women be allowed to drink clear liquids (such as water, juice, carbonated drinks, clear tea, and black coffee).

Your Care Provider Matters

Who you choose to care for you in pregnancy, labor, and birth matters, as does the location where you plan to give birth. These choices will determine the likelihood of the use of routine interventions vs. only interventions that are medically necessary. Talk with your doctor early and often about their practices in birth. It's almost never too late to switch care providers if you feel you may not be receiving the best care. 

Tips and Negotiations

Many hospitals and providers will request that you have an IV port placed at the very least, even if you do not require or refuse IV fluids or medications. A port allows access should an IV be needed quickly. Many hospitals consider this a "non-negotiable" alternative to routine IV usage. Find out about your hospital's policies and routines by calling or taking a hospital tour well in advance of labor.

If you have an IV port or IV placed, ask to have it placed in your forearm rather than your wrist or near your elbow. This allows for easy movement and bending by reducing irritation from the IV if it's placed at/near a major joint. 

Did you have a routine IV? What was your experience like?