IV Hep-Lock During Labor: What to Expect

Let’s explain what an IV hep-lock is and the role it can play in a natural hospital birth.  Many hospitals request that laboring moms have an IV placed during admission to the hospital. When people think of IVs, they often envision metallic IV poles with bags of fluid running through long mazes of tubing. IVs in labor are usually much more simplistic, and take the form of an IV hep-lock.

What is an IV?

Before we discuss an IV hep-lock, let’s talk about IVs in general. IV is an abbreviation for intravenous. “Intra”, or within, “venous” a vein. An IV is placed by inserting a needle into a vein, typically on the forearm or hand. The needle contains a small, flexible plastic catheter. Once the needle is placed correctly in the vein, it is removed and only the plastic catheter remains. There are no more needles and the arm then can be moved without pain. At this point, the IV is taped down onto the arm or hand so that it’s securely in place and doesn’t accidentally get pulled out of the vein.

What is an IV hep-lock?

The basic IV unit is simply comprised of the plastic catheter and a few inches of tubing with a port at the end. The long IV tubing, IV pole, and bags of fluid or medication are all separate items that can, at times, be used in conjunction with the IV. When the IV unit alone is in the arm without any tubing attached, it’s described as an IV hep-lock. Back in the day, heparin was injected into the IV port to prevent any blood from clotting and blocking off the port…thus the name. Today, saline solution is typically used instead of heparin, so it’s more accurate to call it a saline lock instead. Despite this, the words hep-lock and saline lock are often used interchangeably by many non-medical people.

What are the benefits of an IV hep-lock?

During a low-risk natural birth in a hospital, an IV hep-lock is the ideal. The hep-lock allows for immediate venous access in case of an emergency, yet it does not confine mom’s mobility. You can move freely without worrying about tugging or tripping on tubing, or being confined to the tether of the IV pole. You can get into a tub, walk the halls, or transfer easily from one position to another.

When may tubing or IV fluids need to be attached to the hep-lock port?

There are several circumstances in labor where tubing and IV fluid might be used. Your provider may describe this as a continuous IV. We’ll discuss a few more common scenarios. First, IV fluids are always given before epidural medication is placed to help counteract the common side-effect of a drop in mom’s blood pressure. Second, IV fluids and IV antibiotics may be administered during labor if mom has Group B Streptococcus (GBS). Third, IV fluids may rarely be used if mom becomes dehydrated during a very extended labor or if mom is experiencing prolonged and excessive vomiting. Lastly, fluids and medication may be administered if mom chooses pitocin augmentation. Pitocin may be used to stimulate contractions, to help birth the placenta, or to curb postpartum bleeding.

Depending on your healthcare provider and birth facility, you may have to make choices about IV access. Whenever possible, an IV hep-lock can allow for the most flexibility and comfort during labor.

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REFERENCES:

Dekker, R. (2012, May 30). Evidence for the saline lock during labor. Retrieved from http://evidencebased- birth.com/the-saline-lock-during-labor/

Klosser, N.J. (2006). Introductory Maternity Nursing. Philadelphia, PA: Lippincott Williams & Wilkins, 214.

Rosdahl, C.B., Kowalski, M,T. (2008). Textbook of Basic Nursing, 9th Edition. Philadelphia, PA: Lippincott Williams & Wilkins, 858-859.

Simkin, P., Whalley, J., Keppler, A., Durham, J., & Bolding, A. (2010). Pregnancy, childbirth, and the newborn: The complete guide. Minnetonka, MN: Meadowbrook Press, 250.