Peripheral Nerve Injuries Medical Interventions

Jan 01 2008

Sometimes birth isn’t straight forward, and this is even more likely to be the case if you are older. While many women carry an ideal of natural childbirth in their minds, the reality is that many medical interventions will be recommended to you in hospital. It is critical to think about these issues before labor, since it is hard to take in new information while you are in pain.

Intravenous Lines

Most hospitals want you to have an intravenous line, known as an IV, during your labor no matter what your age. It consists of a narrow plastic tube that is inserted in to one of your veins in your hand or lower arm. Your IV does not need to be hooked up to an IV pole unless you are actively receiving medications or fluid through it. The tube can be kept from clotting with a small amount of anticoagulant, and the IV covered with plastic if you want to take a bath. An IV can have several purposes.

It can be used to give you different medications, such as narcotic analgesics for pain relief or oxytocin for speeding up labor.
It can be used to make sure you have plenty of fluids (it’s often hard to drink enough when you are in labor). The drawback is that you have to be hooked up to a bag of fluid attached to an IV pole, making you less mobile.
Blood and medications can be given quickly, if needed.

Pros And Cons

The risks of having an IV are very small, but an IV can be annoying. The benefits can be very real. For example, if you know you want epidural analgesia, you must have an IV. Keeping well hydrated (by intravenous fluids) may even help labor progress. In a study where IV fluids were given more than usual, the risk of a long labor (more than 12 hours) was reduced by half. Finally, while rare, profuse bleeding is a major cause of death during childbirth. An IV is an insurance policy that you can be treated quickly if the worst happens.

Foley Catheter

A catheter is a tube that is placed in your bladder and attached to a bag that is used to collect your urine. A foley catheter with a small balloon attached to the end is also sometimes used to bring on labor.

If you have a cesarean delivery, or a complication that can affect your kidneys (such as preeclampsia), then you’ll need to have catheter that’s left in place around the time of your delivery. However in many situations you can avoid a catheter and even if it is suggested when you have epidural analgesia, it is probably safer to try to use the bedpan. If you cannot urinate on your own, the nurse can place a catheter in you bladder every few hours, but remove it each time. The risk of bladder and kidney infection is far less using either of these strategies than with a tube that stays in your bladder for the duration of labor. Bladder infections can make you ill and or prolong the length of time you need to stay in the hospital.

Monitoring

During labor you will be monitored to confirm that your baby is coping with labor and to check your con tractions. Electronic fetal monitoring (EFM) refers to the combination of devices that listen to your baby’s heart rate and time your contractions. During (EFM) elastic belts are placed around your abdomen to hold the monitors in place one a circular ultrasound like device to check the baby’s heart rate, one a small plunger to monitor contractions. Monitoring may be continuous or intermittent.

Intermittent Monitoring

Unless your pregnancy is high risk (not based on your age alone), you do not need to be monitored all the time during labor. Studies have shown that intermittent monitoring is just as safe as continuous monitoring, provided that you have your own labor nurse. Your baby’s heart rate will be checked every half hour during active labor and every 15 minutes while you are pushing.