Question about heplock

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Joined: 11/30/08
Posts: 225
Question about heplock

I spoke with my doctor about not wanting an IV, and he said that was fine as long as I had a heplock. At first, I felt like that was a good compromise. However, now that I think about it, I don't see it any more necessary than an IV the minute I walk in the door. I don't want an IV because I want to have as little intervention as possible as long as my birthing experience is going well and low risk. He says a heplock is there to start an IV if something suddenly goes wrong. I'm not against medical intervention if it becomes medically necessary. So my question is this, how often does something go wrong in a low risk pregnancy/ childbirth so quickly that an IV could not be put in? What situations occur that my life or the baby's life would be at risk because they couldn't get an IV in quickly enough?

I would like to discuss not getting the heplock unless something starts to go wrong. So if all goes well, I wouldn't have to have one at all, but if something starts going wrong, I'll have it put it and available for treating complications. My doctor apt is this Friday, so I wanted to ask you ladies on the board (and especially nurses that have had to deal with this) before I go in.

kridda_88's picture
Joined: 01/28/08
Posts: 1798

I was against the IV as well and didn't really want the hep-lock but got it anyways. They could put one in pretty easy in a rush. They do it all the time in the ER. I think they like it in just in case you get dehydrated because getting an IV in a dehydrated vein is NOT easy. I was glad i had the hep-lock because i lost a lot of blood and needed fluids fast.It didn't hinder my being able to move at all and it was only after the delivery that i needed something. By then i just wanted to cuddle my baby. I also went so fast that they put it in LITERALLY 10 minutes before i started pushing.

In my opinion it really wasn't that big of a deal to have the hep-lock. I was dead set against the IV and kept myself hydrated by drinking water at home and sucking on ice chips at the hospital. But in the end it's all up to you.

jooniper's picture
Joined: 08/27/07
Posts: 780

I see no harm in the heplock, and its a good compromise with your doctor.
If you hemorrhage after labor, they'll want to get pitocin or fluids into you quickly (which has happened to some awesome natural low-risk childbirths of my sister- it wasn't until after labor that they needed to intervene but when they did they needed to quickly). ETA: I just think it'd be more pleasant to sit still and be poked early on in labor than during a contraction or during the afterbirth where you have a baby and are still contracting and losing bed. That said, I'm not getting one this time because I'm doing a homebirth. But if I did another hospital birth I'd probably get one.

I don't think it's the end of the world either way, but as far as unnecessary interventions go, you could do much worse:)

sarahsunshine's picture
Joined: 11/29/06
Posts: 1462

I wouldn’t want it simply because it would prevent me from moving freely, getting into a hot shower, or in a birthing pool. Technically, it might not be, but I’ve had needles in me for days on end and I’m not a big fan. It’s just something to worry about, and honestly, I think there’s enough on my plate during labour. I didn’t want any clothes on, why would I want a needle in a vein?

Then again, that’s why I opt for home…

faeriecurls's picture
Joined: 06/04/08
Posts: 790

I have been to the ER for dehydration before when I was sick - they were able to put an IV in me and start IV fluids in very little time - probably under 2 minutes - it was hard to tell when I was puking. If you are taken to the hospital for an emergency they do what they need to do - you don't come in with a heplock.

If you really don't want one, I wouldn't agree to the heplock to make it "easier" for them, because IMO/E it wasn't that hard in an emergency. My m/w says its not necessary and they won't make me do it so I am not concerned about it.

I can't answer how often something goes wrong that is made worse because they couldn't get an IV in fast enough... I don't have any of those statistics. Hopefully someone else will give you more information.

MamaArty_RMT's picture
Joined: 11/09/05
Posts: 805

It's completely unnecessary, IMO, and I wouldn't do it.

ETA: I guess I should expand upon why I wouldn't do it. lol

1. It is easier on your body to stay hydrated through labour by drinking throughout labour. Some hospitals still follow the old policies of not letting anything other than ice chips or clear fluids, but newer research has shown that eating and drinking during labour do not increase risks of asphyxiation and actually decrease risks of having a more difficult labour. Getting dehydrated increases the risk of tiring out your uterus, created more painful, less efficient contractions, along with all the other associated risks/symptoms of dehydration. Re-hydrating with IV fluids carries it own risks. Increased blood pressure, infection at the injection site, swelling of the local site if they mess it up, etc.

2. Hemorrhage can be dealt with just as easily with a pit shot.

3. If there was a true emergency, they can do things FAST. Even with true emergencies, there is a window of time before they can get you in to the OR. That window of time will allow them to get all the needles in you that they need.

4. Purely for my own comfort, I don't like anything poking into me. It's uncomfortable, it restricts my movement, it stresses me out, and it gives me the willies.

Joined: 03/16/15
Posts: 53852

Well I answered on our bb, but yeah I would not do it. As to pp hemourage after I had a really bad one after DS and a shot of pitocin to the leg worked better than an IV would have.

MrsMangoBabe's picture
Joined: 04/09/07
Posts: 2276

The things that you would need IV access for are pretty rare. It would be necessary for a c-section, but very few c/s are real, time-sensitive emergencies. If it is an emergency, they can place the IV anywhere (in my experience, they seem to be able ot find good veins in elbows better than in hands, but you wouldn't want it in your elbow while laboring).

It is not necessary to have an IV line to get anti-hemmorhage drugs in you if you bleed too much after the birth. A shot of intramuscular pitocin works just as well, if not better, and they don't have to use as much because it is not diluted by the IV fluid.

But you have to decide if avoiding the heplock is worth arguing for. If you decide to get it, you might want to ask to have it placed on the outside of your arm so it will be less likely to interfere with positions you want to use (having it in the hand can make hands&knees uncomfortable). Also ask if it will interfere with your ability to use a tub or shower (I don't think it has to)

cmljll's picture
Joined: 11/28/06
Posts: 1409

Something to consider is how easy it is to get an IV in your veins normally. Mine are tough to get an IV started in so the heplock was a no brainer for me!

Btw, there is no needle left in your arm when you get a heplock. It's a flexible tube. How annoying it is depends on where they do it...

Joined: 03/16/15
Posts: 53852

I think it's really up to you.

Personally, if I were to do another birth in a hospital, I would go ahead and get the heplock if my doc wanted, but refuse the IV. Why? Because it's one less thing to fight with my attending about. Part of the give and take. The docs are up against hospital policies, etc. Depending on the doc, they might be more willing to go with other "non-standard" things are most important to you if you are willing to do a few things that are important to them.

Of course, if not having anything in your arm is high on your list, then you want to go to bat for it.

rainymama's picture
Joined: 08/24/07
Posts: 409

I will be birthing at a hospital and my ob said I don't need a heplock. If she's not concerned, than I am not, either. I am excited to NOT have an IV or heplock during labor. Seems like they didn't want me taking it out until I was discharged. it was a pain. Like the pp said, you don't come into the er with a heplock.

kridda_88's picture
Joined: 01/28/08
Posts: 1798

You also need to take into consideration that you are dealing with labor and delivery nurses here not ER nurses. ER nurses are trained to get an IV started ASAP no matter what's going on. Labor and delivery nurses are use to taking their time to put IV's in. If you have an emergency situation it will be harder to get an IV in especially if you are dehydrated. I know i sound like a broken record and it totally sounds like i'm trying to convince you to get one, that's not my intention at all, i'm just trying to let you know why most doctors like to at least have a hep-lock in. If they are put in the right place you would barely even notice too. Having the hep-lock in, not an IV will not hinder your movement one bit. I even showered with mine in.

But like i said. They aren't absolutely needed. Emergency situations rarely happen if the natural birth isn't meddled with. The decision is completely up to you.

cactuswren's picture
Joined: 10/19/09
Posts: 4658

That's a good point, but at the same time the difference is not one that is going to make or break an emergency situation. We're talking seconds here. It really does seem like one of those things that is entirely for the convenience of the staff and not really any actual benefit to how hard you want to fight it depends on how much it bothers you. I think you have every right to put your foot down about it if you think it's going to bug you (it would bug me!). If you really don't care, maybe not worth the battle, but that's an entirely personal decision.

My birth center certainly doesn't make you have one unless you're getting the GBS antibiotics, and if something went wrong, I'm looking at a two to five minute transfer to the hospital--I'm pretty sure if you're already in the hospital it's not going to take them five minutes to put in an IV!

MamaArty_RMT's picture
Joined: 11/09/05
Posts: 805

If hep locks made the difference between good outcomes and bad outcomes, the stats would show that. They would also show that home births, birth centers and hospitals that don't require hep locks routinely have higher incidences of bad outcomes as a result. But they don't show that.

kvo's picture
Joined: 12/18/06
Posts: 902

My OB required it, but I'm not sure about the MW--I haven't asked her about it yet. I would rather not have it, but I'm not totally against it either. I just don't want to be pumped full of fluid unless it is an emergency and I need it for life-saving purposes. I was a freakin balloon after my last birth (5 IV bags pumped into me) and I was NOT dehydrated. I know why they started it, but there was no need to keep adding more once Zoe's heart rate stabilized.

I guess if that was the only point of contention your doctor had with your birth plan, then it's worth giving in to it.

Joined: 11/30/08
Posts: 225

I spoke with a nurse at the hospital about it the other day when I went in for a NST. I found out that it's not a choice according to the hospital, I have to have a heplock. And, I have to have it put in upon being admitted. I'm sure I could sign an AMA or something, but after reading and researching and considering, I'll go with it. Part of it is "pick your battles" and I'd rather save the fight for something more important. The other part of it is that although this is MY birthing experience, I don't want to do something that is going to make the doctors and nurses completely on edge. I want them to work with me, not against me, and I feel that goes both ways. I will ask, however, to have it placed somewhere that it will not be in the way of any of the positions or birthing methods I want to use (hands & knees, be in the water, etc). I feel good about the overall experience so far, and that's what matters.

Thanks for all of your opinions and thoughts and experiences. They helped me come to peace about it. Even if I couldn't make the decision, I feel better about having it.

rainymama's picture
Joined: 08/24/07
Posts: 409

"selosmini" wrote:

I feel good about the overall experience so far, and that's what matters.

Thanks for all of your opinions and thoughts and experiences. They helped me come to peace about it. Even if I couldn't make the decision, I feel better about having it.

I am so glad you are ok with it and feel good about it. I agree with you that if you feel it is going to make the experience go smoother, and it doesn't make it or break it for you, then just go with it. I am glad you posted about this, it has been a good discussion which brought up various points and opinions I had not previously considered. Smile

krazykat's picture
Joined: 08/11/07
Posts: 1143

I'm glad you are feeling ok after speaking with them!

Hopefully you can wait long enough and labor at home so that the hep-lock will probably be the last thing you are thinking of. If I had to do a hospital birth, that would be my plan; to wait at home as long as possible. Just doing that cuts the potential for so many interventions.

Winky_the_HouseElf's picture
Joined: 02/10/02
Posts: 292

Issues with the heplock come down to restricting positions (if it's placed in a joint), feeling painful/irritating, and having an open vein into which undesired medications may be inserted. If a mom chooses to have one, the best place is the outside of the arm (between the elbow and the wrist) so that if you want to use hands and knees or move your arms a lot, you can.

I only ever had an IV needle with my first baby. My last four were born without any needles. I did bleed heavily after my second baby, but instead of doing an IV I got a shot of pitocin in my thigh. I prefer that anyway because I can't stand the feeling of having an IV. It drives me bonkers and I just want to rip it out. Blum 3

If it's not a big deal to you and it puts other people at ease, then it's a reasonable compromise. If it were me I'd insist that it not be in a joint and I'd request a phlebotomist if the nurses aren't good at it. Smile

Spacers's picture
Joined: 12/29/03
Posts: 4087

My biggest concern with a heplock is the easy access to put things into me that I might not want. They can put a shot into it without hooking up an IV bag, and without you even knowing, and I know women IRL that that happened to. If I agreed to a heplock, I'd have them tape plastic over it so they couldn't get to it without my express approval.

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