What to Expect: Routine IV Hep Lock During Labor

Last Updated: February 8, 2024
Liesel Teen, RN-BSN

By Liesel Teen

BSN, RN, Practicing Labor and Delivery Nurse

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It might not be at the forefront of your mind when you think about what your delivery day will look like. I will say though, I am surprised by how many patients come in absolutely dreading the IV part of the birth process.

Today is all about what to expect with a routine IV hep lock during labor. 

What is it, when are they used, will you need one, pros and cons, and more! Eager for more? Come along with me!

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What is an IV? What is a hep lock?

IV, at least in the medical world, stands for intravenous. An IV is one, very common way that medical professionals can administer medication to patients. 

A big advantage to an IV is that the medication enters and travels through your bloodstream – which means it works very quickly. This is especially important in the event of an emergency.

What then is a hep lock and how does it differ from an IV? If you aren’t familiar with the phrase “hep lock”, don’t worry. If I’m being totally honest, I had no idea what a hep lock was until I got into the medical field. 

So, if you are a stranger to hospitals (which I hope you are unless you work in one), there’s a good chance you’ve never heard of it before.

Often used interchangeably with saline lock, a hep lock is simply an IV without anything actively infusing through it. This means that you have an IV in place but you aren’t connected to an IV line and are not receiving continuous medication. 

Basically it is there for intermittent medication administration and for emergencies.

When are IVs used during labor?

I know IVs get a bad reputation, but as a medical professional – with a good amount of experience under my belt I might add – hear me out! 

The very last thing you want your medical team to be doing in the event of a true emergency is to “waste” precious time getting an IV started. 

And yes, typically pregnant women have “juicier” veins due to the increased blood volume but this is not always the case! 

I don’t say this to scare you! I say it because minutes, heck seconds, can make a huge difference when you are in a medical emergency.

The main reason we want a routine IV placed

Before I get going on this, believe me, I am aware that some people have some pretty strong opinions about IVs. 

Being that I work in a hospital setting, where we care for some very high-risk mamas, it is preferred that all our patients have a saline lock in place in case of an emergency. 

This likely would not be the case for a mama delivering at a birthing center or possibly even a low-risk mama in a hospital setting – it really depends on the provider and hospital policies.

So when are IVs used during labor then? 

As you are probably aware, IVs are one way we can administer medications and fluids. Here are some of the more common ways we might use an IV during labor:

1. Pitocin

For mamas that are being induced, be it for medical or elective reasons, an IV is how we administer Pitocin (oxytocin). 

Pitocin helps the uterus to contract and is one, very effective tool used to induce and augment labor.

2. Antibiotics for GBS+ mamas

Another use for IVs during labor is to administer antibiotics for mamas that are Group B Strep (GBS) positive. Group B Strep is a bacteria that’s naturally present in as many as 25% of women.

GBS is not harmful to you but can cause issues for baby if they are exposed during birth. To protect baby, we treat mama with IV antibiotics throughout labor!

Related Reading: Group B Strep and Birth: Explained by an L&D Nurse

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3. Fluids

If your labor involves an epidural then you will need an IV to receive extra fluids. You see, one of the biggest potential side effects of an epidural is a drop in blood pressure. To help prevent this from happening, we give you additional fluid prior to or during the epidural placement.

Not to worry, should you still experience a drop in your blood pressure despite the extra fluids, we have medications we can give you (also through your IV) to bring it back up quickly!

4. IV Pain Medication

Another medication that is commonly administered through an IV during labor is pain medicine. 

The hospital where I work uses IV Fentanyl for pain management for labor but different facilities use different things.

5. Magnesium

Magnesium, another medication sometimes used during pregnancy and labor, can be used for preeclampsia or preterm labor. 

6. And others

Other, not as common things are medications for…

  • Nausea
  • Blood pressure control
  • Controlling and slowing bleeding after birth

The bottom line? The setting of your birth, the presence of any complications, and your plans for pain management heavily influence whether or not an IV will be recommended for you during labor.

Will I have a routine IV placed during labor?

As I mentioned above, whether or not you have a routine IV placed during labor (or at least recommended) depends on where you give birth, whether or not you have any known or potential complications, and your pain management plan for labor.

I have cared for a small handful of mamas that were adamant about not having an IV in place during labor. 

However, if you plan on giving birth in a hospital, I would expect to have one placed. 

Pros and cons of routine IV placement

As with most things, there are pros and cons of having an IV in place for labor and birth. 

I’m sure you have gathered as much but a big pro of having a routine IV during labor is that we can quickly administer medication in the event of an emergency

In addition to any type of emergency medications, we can also give pain medication through your IV. Not to mention you must have an IV in place to receive an epidural. 

The biggest con of an IV is that the placement can be a bit uncomfortable. Once the IV has been placed, it’s typically more of a nuisance (for some) than it is actually painful. Usually the placement is the worst part as a needle is used for this process.

Aside from the initial discomfort there really aren’t many cons associated with a routine IV for labor.

Final thoughts: Routine IVs during labor

Wrapping up all things IVs I want to leave you with a few final thoughts! As a medical professional, my job is to keep you and your baby safe and be both of your advocates. 

If you are adamant about not having an IV in place for labor, I will provide you with the appropriate education; remember, one of my jobs is to keep you safe! 

Having a routine hep lock in place is definitely preferred in a hospital setting, but at the end of the day, you are entitled to your own opinions and encouraged to advocate for yourself. 

While no one is going to hold you down and force an IV in your arm, I strongly encourage you to do the appropriate research ahead of time and respectfully listen to your medical team regarding their recommendations.

After that, feel free to make whatever decision you feel is best for you and your baby!

I hope this article has answered all your questions regarding what to expect with a routine IV during labor.

Cheers to an even better birth, mama!

More pregnancy and labor resources for your wonderfully curious brain:

Birth Plan
Liesel Teen, RN-BSN

Liesel Teen

BSN, RN, Practicing Labor and Delivery Nurse

As a labor and delivery nurse, I’ve spent countless hours with women who felt anxious — even fearful — about giving birth. I want you to know it doesn’t have to be that way for you!

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