IV Fluids Are Not Required in Normal Labors
It’s become common in medical facilities to tell almost every woman in labor that she needs an IV “just in case.” However, using this intervention routinely can actually complicate what might have been a straightforward labor and postpartum.
An intravenous drip (IV) is a plastic bag of water with electrolytes, dextrose, or medications. The bag hangs from a pole by the bed or on wheels, so if a laboring mother walks to the bathroom, she’s maneuvering with the pole along side her.
Obstetricians
often choose to provide liquids and calories through an IV instead of supporting mothers to eat and drink normally during labor.
Obstetricians who say “An empty stomach is best” are drawing on an older era, from the 1950s–60s, when many women giving birth under an OB’s care were also unconscious under general anesthesia.
Back then, it really was dangerous to have a full stomach under general anesthesia, because if the patient vomited, it could be breathed into the lungs. Anesthesia hadn’t yet developed the tools and medications we now have to protect the airway. However, the scope of care has completely changed:
General anesthesia is now rarely used in birth.
Medicines are available to neutralize stomach acid.
Tools have been developed to keep the airway open when needed.
Even anesthesiologists now admit that aspiration during labor is so rare they “cannot accurately describe” how often it happens.
Despite these advancements, routinely restricting oral intake and using IVs has lingered, even in normal labors. Even, or maybe especially, in a medical setting, the mother and her baby benefit from the nourishment and comfort of eating and drinking in ways that feel normal to her.
Mothers
have always simply and easily hydrated themselves during the strenuous work of labor by sipping fluids.
Sometimes an IV may be medically indicated, such as when:
Labor is very long.
The mother has continuous nausea and vomiting.
Local or general anesthesia is needed.
IV medications are needed.
Preterm labor needs to be slowed or stopped.
Labor is being induced or augmented.
An epidural is being used and IV fluids are needed to increase blood volume and help prevent a dangerous drop in blood pressure.
Pain is being managed with IV medications.
Blood pressure needs medical control.
There is a condition that might require immediate medical action.
In these situations, IV therapy can be a helpful tool. The concern is not with IVs themselves, but with using them routinely in normal labors “just in case.”
Overhydration from extended IV therapy
takes days to disappear, and the increasing breast engorgement can make breastfeeding more difficult in the first week.
When large amounts of IV fluid are given in a normal labor, the body has to do something with all that extra water - it often leads to over-hydration, fluid retention, and other risks:
In mothers. Extra fluid typically settles in the legs and breasts. This overhydration can take days to resolve, and the extreme edema is quite uncomfortable; in addition, the amplified breast engorgement can make breastfeeding more difficult at an emotional time. (Homeopathic Nat mur can be very helpful for supporting the body to normalize fluid balance.) A breastfeeding-friendly birth team will be sensitive to these issues, more on them here.
Increased urine output. A high volume of IV fluids results in an unusually high volume of urine. During labor when the baby is low in the pelvis, sensations can be reduced or it can be hard for mom to empty her overly full bladder well, often resulting in catheterization.
Full bladder after birth. A full bladder after birth increases the risk of excessive bleeding because it interferes with the uterus’s efforts to contract down; the bladder is literally in the way. Sometimes a one‑time “straight cath” is needed, which can be inconvenient and stressful.
In babies. Babies' birth weight can also reflect this extra retained fluid - they are artificially plumped up just like their mothers! Normal urination for a newborn in the first 24 hours is 1–2 wet diapers, babies whose mothers had extended IVs commonly have 3–5. When the baby’s weight it checked 24 hours later, an “excessive” weight loss may be noted; this sometimes results in pediatric providers being hesitate to discharge a healthy, robust baby at 24 hours because the fluid issue is not taken into account.
Blood sugar and electrolytes. If IV fluids contained dextrose, this can contribute to temporarily low blood sugar in mother and baby after birth. If they contain certain electrolytes, this can play a role in electrolyte imbalance in the baby at birth.
Local IV problems and rare complications. Sometimes an IV infiltrates, meaning the fluid goes into the surrounding tissue instead of the vein, causing pain and swelling and preventing medications from reaching the bloodstream. Very rarely, excess fluid can collect in the mother’s lungs (pulmonary edema). It you’d like more information on your rights to have informed consent with every suggested intervention, check out my blog here.
“A laboring mom’s hydration needs are around ¼ cup of fluid replacement/hour, or a bit more if she’s sweating a lot or doing mostly light breathing. ”
Hydration in normal labor
Laboring mothers do need to stay hydrated; labor is real work. But when labor is normal and there is no need for IV medications, an IV is unnecessary if the mother is drinking enough.
Labor companions can offer a drink after every contraction or two, which she is free to take or refuse. If labor is rapid, she may not want or need much at all. This is really about remembering that mothers usually have good instincts in labor and finding ways to care for her lovingly without disrupting her process.
Dehydration is something to watch for and avoid, since it can affect the baby (for example, through heart rate patterns) and the strength and pace of labor. When nausea or vomiting shows up, homeopathy and other gentle supports can be very helpful, alongside medical care if needed.
Self-hydration
Water, fruit juice, coconut water, sports beverages, or frozen juice bars.
Electrolyte balancers
Labor Cubes, my recipe for herb and honey ice cubes just right for nourishing a healthy labor.
When an IV is needed: consider a heparin lock
If an IV cannot be avoided, or if IV access may be needed intermittently, a heparin lock can be a good option. A heparin lock is a tiny, flexible tube placed in a vein, often on the arm above the wrist. When it’s not in use, it is capped, so the mother is not attached to IV tubing.
This approach:
Allows the mother to move around freely without being tethered to a pole.
Supports the spontaneous, instinctive movements that help reduce pain and encourage optimal baby positioning.
Makes it easier to use showers and tubs for comfort, often decreasing the need for pharmaceutical pain relief.
Is more comfortable when mothers lean on their arms during labor and when they are cuddling their babies after birth.
Movement, mindset, and nourishment
Normal labors and natural labors rely on the mother’s spontaneous movements to help her cope with pain and help the baby navigate the birth canal efficiently. While IV therapy is considered simple and safe, its routine use can disrupt the delicate balance of both mother and baby—from their internal fluid balance to the mother’s “primitive birthing brain,” as she has to think about the IV line every time she moves.
Real food is real nourishment. The act of feeding herself, or being lovingly fed by others, supports the laboring mother’s confidence and sense of agency. In both sports and labor support, we know that mindset matters.
Birth is a normal biological process most of the time. When healthy mothers are told they must have an IV at the first sign of labor and are not “allowed” to eat or drink, the unspoken message is: “You are a patient, and something is likely to go wrong.” This is the opposite of what most women need in labor.
Healthy women with normal pregnancies and normally progressing labors have excellent outcomes when they are encouraged to eat and drink according to their own needs. Trusting your body, staying nourished, and reserving IVs for when they’re truly needed is one simple way to keep birth as undisturbed and physiologic as possible.
Our mindset strongly affects our experience and outcomes.
Healthy mothers with normal pregnancies and normally progressing labors tend to do best when they are encouraged to eat and drink as desired.