My Case against the HEP-LOCK and the IV altogether
I am so tired of these Doctors justifying their ROUTINES by saying it's for my sake or for the baby's sake and especially when it comes to my mobility to move during labor in the hospital. FINE! I can't afford a home birth and my husband would be most comfortable in the hospital setting! But I'll be ding-dang durned if I let some Nurses and Medwife, or ANYONE tell me HOW to have this baby. Not after having a taste of a natural birth with my second son! My revelation came after they couldn't get an IV in (due to small veins and my not drinking enough they claimed) during my labor and I got to move around, dance, sway, even get in the shower which was such a great experience since water soothes me and all the other pregnant women I've spoken to up here. Anyway...I finally thought...why not just google the IV v/s Hep-Lock and hand it to the Doctors/Nurses when they tried to convince me to get one. Guess what?! IT IS FOR THEIR CONVIENCE! THE NERVE!!! Nothing to do with me or my baby! But more to come in my research. How about yall? What negative effects have you had with either the IV or the Hep-Lock, or both? Make this case for me when I present it to them...
Hep-lock or IV?
Q: I have encouraged my clients to have birth plans for many years. I urge them to discuss using a heparin lock as an alternative compromise to routine IV. Very few moms report back that they had a lock--most all had IV. I discussed this with a CNM and she said she uses IV routinely, mostly for the "convenience" of the nurses because, she states, "heparin locks frequently get blocked."
Should I continue suggesting this alternative to "routine IV" to my clients (most of whom get IVs as a sort of "insurance policy" for the staff's comfort)?
I too have recommended clients request a heplock instead of the whole IV. I am beginning to believe, however, that they should refuse both altogether until proven necessary .... I believe the "risk" of needing an IV is small enough in properly prepared and well supported moms that any pre-IV "just in case" is unnecessary, and the greater mobility of mom is much more important. If a nurse can't do a quick IV if it becomes necessary, then I'm not sure I'd want her treating me or any of my clients.
Doula and aspiring CNM
We were told in midwifery school that the only times a woman absolutely needed an IV was when getting an epidural, when having a cesarean section or when dehydrated and unable to take anything by mouth. In other situations like trial of labor after previous cesarean, antenatal history of anemia, or other medical conditions, a heplock can be used. It gives access to a vein without the burden of the drip and pole (if a woman wants to walk). A well placed heplock like a well placed IV should not block off. Is that CNM starting IV on every laboring woman? Who is she there to serve, the nurses or the laboring women? It's like the time when the RN told me her lady wanted an epidural; when I went to talk to the woman, all she wanted was an aspirin. The nurse was angry because an epidural frees her up. She doesn't have to spend time with labor support. We must always remember who we are serving and do what's best for them and their health. This doesn't include unnecessary interventions.
A running IV tends to encourage laboring moms to change positions less, and this is more harmful to them than the small risk the lock may plug and need to be restarted. As always, the bottom line is assessing if the IV access is justified in the first place!
-Sharon Breidt RNC, BSN
I am a paramedic and in the INTs I start, we use plain saline. Most EDs here are using INTs exclusively because IVs waste tubing, saline and other products. This saves money for the hospital. Usually money talks. I would suggest to keep offering this as an alternative. I see it as a trend that maybe has not reached the L&D floor.
Why are you suggesting they need an IV line at all? Routine IV access is not something I would recommend to a woman who is having a baby. Perhaps they would be better off putting on their birth plans that they decline to have either.
-Andrea Quanchi, Australia