Does everyone get an IV?

I'm just a nursing student, but I would encourage an IV during labor. You never know what will happen, and it's nice to be prepared.

Much depends on where you deliver. At the birthing center where I work, if there is no indication for an IV, we don't insert one. We haven't had any real problems with this policy, though a couple of times I have had to insert one in fairly intense situations. Ask what the policy is of the L&D unit where you will be delivering.

Editted to add that yes, pitocin is given IM, if necessary, in the absence of IV access.

I don't work in L&D but I've had three kids and never had an IV. At that time in my area it was standard not to insert them routinely.

Everyone gets an IV...but we deal with so many high risk patients.

Not low risk women, if they don't want them. High risk women all do, and a lot of low risk women wind up with them because they want epidurals.

Our pitocin is routinely given IM rather than IV anyways.

I will tell you a bit about where I work:

We are a Smallish community hospital in a fairly large metropolitan area---

about 70-75 Deliveries a Mo---

Level 2 care for moms and babies only----

LRDP concept---(meaning they labor/deliver/recover/remain IN ONE room, usually with the same nurse until shift changes).

Low risk patients do NOT have to have IV unless they choose epidural/intrathecal anesthesia HOWEVER it seems roughly 80% come in ALREADY wanting anethesia ASAP. Most are VERY well educated as to what anesthesia is, its risks, benefits and pitfalls. If they elect to have it, obviously, IV is started at that point.

VERY FEW patients have IV narcotics. Most either elect to have NOTHING or epidural anethesia. I support this choice, as I see it a lot safer for the babies and narcs are very limited in providing relief.

Another "must have IV group" would be those ladies who are Group B strep positive, requiring IV antibiotic therapy per protocols.

If they want/need no IV,

YES they CAN have PITOCIN IM --20 units---- after delivery IF their breastfeeding and our fundal massage is NOT succeeding at keeping uterus firm and bleeding scant.

My goal as an RN is to educate and support family decisions...and if a family comes in wanting LOW intervention labor/delivery I do all I can to help make that happen. Fortunately, most of our doctors are supportive of this, too.

SOME still want a heplock/saline lock in everyone, however......

sigh.

Hope this helps.

NPJohnson, have you looked into a birth center?

Where I work, an IV is NOT mandatory and we have many people deliver without one. We do not give any pit after delivery either, if there is no bleeding problems. Bleeding is frequently heavy after a birth, but that is no indication to immediately give meds.

For the nursing student here, please don't get sucked into the idea that a birth is just an accident waiting to happen. As you gain more experience, you will learn to "think outside the box" and individualize your care, no matter what type of patient you are caring for.

There are enough nurses out there who are still after years of practice, unable to personalize their care and think for themselves as opposed to "doing it because we have always done it that way.":rolleyes:

No, not everyone, but labs are usually drawn....Anyone who comes in with no risk factors and feels they do not want an iv, as long as the strip is good, is usually honored. However, those are often the people who eventually elect to have an epidural...That changes things dramatically. Often, people will consent to a saline lock vs iv since they have to be stuck for labs (CBC, TPSC in some cases), as that means they don't have to be stuck twice.

Not everyone gets pitocin either. Depends on the doc and the individual situation....Also, pit can be given Im if needed.

Originally posted by NPJohnson

What if someone comes in in normal active labor with no risk factors. They want a natural birth. Will they get an IV anyway??? Can the get the pitocin IM after the birth?

No, they will not get an IV if they are low risk and not planning for IV pain meds or an epidural. And yes, pitocin can be given IM if it is needed. Not all pts need pitocin after delivery.

And I agree with Bets. Birth is a normal, natural experience, and left alone, intervention is not necessarily necessary.

And you can always get a line in. Even in an emergency situation.