Why Do You Receive IV Fluids During Labor?

What are Intravenous Fluids?

Intravenous fluids, also known as IV fluids, are liquids. But not just any liquids, water-based and rich in salt and sugar. Usually, the healthcare team administrates IV fluids during operations and hospitalization, and the goal is to avoid dehydration. In a routine hospital protocol, healthcare teams deliver IV fluids straight to your vein through an IV catheter, and this is often because you will not be able to eat and drink water normally or replace large amounts of fluid loss.

IV fluids typically consist of water, electrolytes (salt and sugar, in simpler words), and other essential components to keep your body hydrated and maintain proper bodily functions. IV fluids have a critical role in various medical situations, including labor and childbirth.

Why IV Fluids are Given During Labor?

During labor, a woman’s body goes through significant changes and stress. Besides this, labor is an incredibly demanding exercise, and could be a long process. In some cases women are not allowed to drink or eat anything. The reasons for this are many.

To ensure women stay hydrated, maintain the fluid balance, and provide essential micronutrients, like electrolytes such as potassium, to have energy in this process, most women are usually administered IV fluids. 

While there is no consensus on the IV fluid administration protocols, there is a common -scientific- postulate that the routine administration of IV fluids keeps women adequately hydrated and may reduce the duration of labor by reducing the period of contraction and relaxation of the uterus. The reduction of labor duration reduces cesarean section risks. So, routine IV fluid administration is a widely adopted policy in almost every healthcare maternity center.

Another, powerful reason, is the use of painkillers or other medication during labor. IV administration can support the woman’s fluid balance while receiving those additional treatments during labor.

What IV Fluids are Given During Labor?

Although the administration of IV fluids reduces labor duration, little research has been done to compare the different types of IV fluids used during labor. So, when drinking water is restricted women receive IV fluid therapy to maintain adequate hydration. During labor, the three most common IV solutions are normal saline (0.9% sodium chloride), Lactated Ringers solution, and dextrose solutions. These solutions are balanced with electrolytes, minerals like calcium and potassium, to maintain the body’s natural electrolyte balance. Sometimes, healthcare providers may add glucose to the IV solution to provide an energy source.

Is there Always a Need for IV Fluids During Labor?

Well… the short answer is no! However, as I told you before, IV fluids are a routine protocol in most maternity centers and hospitals. 

Nowadays, healthcare teams help women in labor by supporting them personally, avoiding medical interventions, and making them more comfortable. In low-risk labor, some medical practices do not need it. For example, women in the early stages of labor and not admitted to the hospital may be planning self-care activities to manage labor pain or be with someone -like a doula or a partner- that provides emotional support, helping them to have a better experience. If the labor progression is normal, the healthcare team could avoid some medical actions like breaking the amniotic sac or continuously monitoring the baby´s heartbeat. In this same way, if the labor is progressing well, the American Congress of Obstetricians and Gynecologists (ACOG), the World Health Organization (WHO), and the American Society of Anesthesiologists (ASA) recommend offering and encouraging fluids by mouth instead of IV fluids.

Are there Consequences for Receiving Those Fluids?

There are some situations where IV fluids are unnecessary. Low-risk labor and not receiving other interventions, like an epidural or Pitocin, avoid the need for IV fluids administration. 

These are potential consequences of the use of IV fluids. While in mid- or high-risk labor IV fluids are essential to ensure the mother and the baby´s health, in other situations, its use is unnecessary:

• Movement restriction: A routine IV restricts your movements, and, in most cases, this situation has an emotional impact on your confidence and makes you uncomfortable.
• Fluid Overload: Sometimes, administering too much IV fluids can lead to an over-hydrate mother, which may contribute to low blood sugar in newborns and swelling, high blood pressure, and a possible increased risk of respiratory distress in the mother.  An imbalance in electrolyte levels can occur, leading to various complications. There is scientific evidence that an over-hydrated mother may have trouble in breastfeeding.
• Infection: As little as it is, the risk of infection at the site where the IV line is, and the healthcare team has to take precautions to minimize this risk and monitor for signs of infection.

What is the Positive Side of This Situation?

An IV line in labor is a normal intervention in the birth process. When needed, it can be beneficial and even life-saving. 

We know that not all pregnancies and labor are the same. In some situations, medical interventions are helpful. And this is the case with IV fluids. The use of IV fluids during labor offers several positive aspects:

• Mother´s hydration: The positive side of IV fluids is to ensure that the mother stays adequately hydrated during labor to prevent complications and maintain energy levels. The most important issue is that a correct hydration status reduces the duration of labor. 
• Medication administration: In some cases, when labor is a little more complicated, IV lines are a solution for quick administration of pain relief or other necessary medications, which can help manage the pain and discomfort of the mother.
• To feel safety and confidence: We are not all the same, and each of us has a history, and sometimes that history affects us emotionally. The use of IV fluids could serve as a safe net for the mother and the healthcare team, allowing her to adjust the care plan as needed to meet the specific needs of the laboring woman and ensuring that the mother’s fluid and electrolyte balance remains stable, even if she is unable to consume fluids orally during labor.

Final Thoughts

Intravenous fluids are a valuable tool during labor, offering essential hydration, nourishment, and a means to deliver medications when required. However, like any medical intervention, their use is not without risks. Healthcare teams carefully monitor and adjust IV fluids to minimize potential complications.

The decision to use IV fluids during labor is made in each particular case, considering the unique needs and circumstances of the mother and baby. The ultimate goal is to ensure a safe and healthy labor experience for the mother and the baby. If you have questions or doubts about this medical intervention,  it’s essential to discuss them with your doctor to make an informed decision that aligns with your preferences and needs.