Question about Refusing IV at Alta Bates

I don't have a recent experience, I delivered at Alta Bates in 2023, but wanted to share some context. It was explained to me that they like to place the IV when you're admitted so that if it is needed later, they don't need to place an IV at a moment of emergency. I can't recall the correct terminology, but they will insert the IV with a valve that allows them to connect the line for fluids, medicine, etc. later when it is needed. Your wife would just have a tube taped to her hand/wrist that isn't attached to anything until the need for any medication occurs - she shouldn't be encumbered by the IV at all. This is what I agreed to and experienced - I was in L&D for MANY hours and was able to walk around the floor and get into any position I wanted (honestly, I could still do all of this once I was getting IV fluids/medication). The monitors are much more limiting - so requesting intermittent monitoring and wireless monitoring seems more critical to me. 

I am sympathetic to your wife feeling stressed about wanting to be free to move - that was very important to me too. My experience was that the L&D staff wanted to support free movement in any way possible, so my best advice is to just be clear that this is very important to her. 

Good luck!!! 

I delivered twice at Kaiser but had similar concerns. However I had misunderstood what it means to have an IV placed. The IV cap thingy is put into your vein so that it’s immediately available but it’s not actually hooked up to anything until/unless you actually need it. So it doesn’t limit your ability to move around. If you get an epidural or start needing fluids, that obviously changes. Also there can be a lot of situations where they want continuous monitoring of baby’s heart rate and that does limit you somewhat though they can usually hook it to a cart with wheels so you can still move around and get into different positions as long as you get your partner’s help navigating the cords. I am betting Alta Bates is similar.

I think hospitals are pretty strict about placing an IV for all hospital admissions, period. This is in case there is an emergency and there isn’t time to place an IV. But no need to stress about movement. The IV will not be connected to anything unless something is needed. So unless fluid or medication is needed, movement will not be limited. And even if you are connected, it’s very easy to walk the halls or move around in bed with an IV pole. I encourage you to think of the IV as a helpful safety precaution to make sure you and your baby have a safe and healthy delivery. 

I delivered there in late 2024 and went in with the same concerns. Two things to assuage nerves: (1) the default placement allows for ease of movement, and (2) placing the IV does not necessarily mean you're automatically "hooked up" too -- it'll just be the "shunt" [i think it's called] at first. My understanding is that they place the IV right away in case of emergency.

Moreover, just talk to the nurses and midwives. They are there to help you and make sure you're comfortable! 

I hope you get midwife Ilana (sp) and nurse Katy at some point. Dream team <3

Disclaimer - I have no experience at Alta Bates, so my advice is more general for how to work around the fact that she is very likely to have to get an IV when she's admitted. 

1. You mentioned a doula, so if you have one contracted for your birth that will be a big help in terms of shortening the amount of time you need to be at the hospital. If you don't yet have a doula, I cannot recommend getting one enough. If you want them to, a doula can help you labor at home until you really need to go to the hospital. This will help to minimize your time there. If you want to, ask her in advance to try to talk you out of going to the hospital before you need to if you start to get antsy about going. For example, my doula for my first birth asked me 'If you feel like you want an epidural during labor, do you want me to support you in that, or do you want me to try to help you delay/avoid it?' With my first birth, I avoided getting an epidural with my doula's help, and with my second birth, my doula kept me laboring at home until I was farther along. I think in both cases, if I had not had a doula, I would not have had the support and resources to achieve both of those things (which I had wanted). 
2. I don't know if this is possible, but you could ask, when you are admitted, if you can just get an IV port put in. 

Now, if she ends up getting induced or there is some type of medical issue, all this goes out the window and an IV is necessary. This is also where a doula can be helpful. She can help your wife move into different positions with the lines in place, help you guys know how to advocate for yourselves, and help you feel more empowered during your birth process. I ended up being induced for my first birth and was so afraid that it meant I would not be able to give birth sans epidural, but with my doula's help, I made it through 11 hours of labor attached to IVs and monitoring without an epidural. If she had not been there, I would not have been able to do that. I say all this as just my experience and with no judgement towards anyone else's. 

I attempted, but they said no. Instead they placed the IV port but didn't connect it to any fluids. I was able to move freely and even use the tub. They want to place it in case of emergency and also for pitocin after the birth.

I'm sure others will jump on this, but just in case...they do put the IV in right away, but don't attach it to anything. It's just there in case you need it later. IVs gross me out and for both of my births at Alta Bates they wonderfully wrapped up the port so I wouldn't fixate on it. And when I was ready for some meds, it was already ready already! All that's to say...it won't preclude her from moving around. 

Good luck to you both!

Congrats on the baby! I delivered at Kaiser Oakland, not Alta Bates, but I had similar concerns about limiting mobility. At Kaiser, they just put the IV needle / insert into your arm so that it's ready to go, should you need it later (vs trying to put it in once you need it). It's wasn't noticeable to me to have the needle in my arm, and it was not connected to any tubing, so I had full mobility.

That being said, you should still have the right to refuse any IV if you wanted. Some people I know have allergic reactions to the insert, so didn't even want that in until it was necessary. But just wanted to share another possible route for your wife!

Hi there!

I gave birth at Alta Bates in February and successfully refused the IV port. From my experience, it was really just luck that the nurse didn’t push back when our doula said I didn’t want it. (Of course having a doula is also incredibly helpful, as they are an advocate more trusted by the nursing staff). I also noted that I’d been drinking water all day, showed her the coconut water, Gatorade, and water bottle I’d brought, and was already somewhat far along in my labor with no complications. Aside from hoping to get lucky and putting it in your birth plan, I would also suggest bringing it up at all coming appointments with the midwife/OB team so that they can note it in your file. 

Our doula was Lenore Musambacine of LUNA Birth & Wellness and I highly recommend her. She knew a few of the staff members at Alta Bates that night which I’m sure also helped. 

I have so much sympathy as I was really scared of this bit the most ahead of my first delivery. One thing to realize is that if all is well and she’s hydrated, the IV can stay disconnected throughout the laboring process; it’s not like she has to be tethered. And I think she may be occasionally tethered to the fetus and contractions monitors anyway. 

What you don’t want is to be futzing with the needle part if god forbid something happens to her or the baby and she has to be rushed to the OR. So they do the scary bit with the needle, and then all it is is a tiny plastic tube in her vein and some tape on your wrist.

Do not stress about the IV. "Required upon admission" is vague term, based on YOUR situation and the nurse.

I delivered twice at the Alta Bates. First time, we arrived I was already dehydrated (due to vomiting) and doctor prescribed IV right away....I did get the IV in an hour or so later...

For the second delivery-there was no time for IV, so I never got one.

I delivered at Alta Bates last October. I did get an IV, but they put the port out of the way on my arm and it didn't impede me from moving around at all— I labored in multiple positions and walked around and never even noticed it. The port itself is relatively small and stays taped to your arm; they don't need to hook it up to an actual IV line with the pole and everything unless you get prescribed fluids or an IV medication.

That being said, the placement of it is really just so that in an emergency situation it's one less thing to do. It is not medically necessary to have it placed for labor and I'm surprised the doula you spoke with suggested they wouldn't be okay with your wife refusing it. It's perfectly within her rights to decline and if she doesn't want it she should feel empowered to stand firm on that point. A helpful talking point can be to ask if it is currently clinically indicated and why, and then barring some urgent medial reason just reiterate the "no" from there. I found the staff at Alta Bates to be very receptive and accommodating to my birth plan, including the refusal of a handful of non-urgent interventions.

Hi! I gave birth at Alta Bates in February. I don’t specifically have advice on refusing the IV at admission (so feel free to ignore me!), but I wanted to note that the IV input they place on admission doesn’t stop you from moving around - it’s just a small box on your arm. They don’t actually hook you up to an IV bag/pole on admission, only when you need something injected. And at that point I’d work with your doula to advocate that the team respect her preferences (eg, no pitocin, etc). 

I also suggest requesting the wireless fetal monitors! They don’t have enough for everyone, so you might have to ask for them, but they are amazing and very freeing in terms of movement in early labor. 

I don’t have any first hand experience with Alta Bates policies but it may set your wife’s mind somewhat at ease to know that in general, placing an IV does not mean she will be attached to any machines from that point. They like to place it and cap it upon admission so that it’s ready in case anything happens so they aren’t trying to insert it during an emergency, but they wouldn’t connect her to any tubing/meds until she consented to those. She would still be able to move — the IV is a small hook up fully taped to her skin so it won’t move, dangling from her wrist until that point. Best wishes to you both!

Most of the time hospitals like to place an IV right away, so it is ready in case of an emergency. They don’t necessarily hook it up to anything - it can be what is called a “saline lock” where the IV is just in and taped to her arm. As long as they place it away from her hand, wrist, and elbow, she could have a saline lock and still move about freely. It usually only has a big effect on movement when it is hooked up to IV fluids or medication. Would she consider a saline lock? That might give you some middle ground to be able to work well with the hospital staff. 

Hi! So I just had a baby at Alta Bates on 3/29. The IV did not limit me from walking laps around L&D. I also had the wireless heart monitors. The IV was only to push fluids when needed it had a cap on it so I didn’t have to pull a pole around either. I hope this helps a little. The only day I had to stop walking around was the day I got the actual epidural. They have doulas who walk through the halls to offer assistance too. We went to the L&D tour they offer 2 weeks before we were admitted. 

I've not given birth at Kaiser, but the several hospitals I have have allowed you to just have a IV port placed, but not being hooked to the IV the entire time. You might also ask about different places to put the port. Some might be more comfortable than others.

I delivered at Kaiser so I can’t help with the Alta Bates question, but since you mentioned it’s causing a lot of stress to your wife, I thought I’d share my experience there:

I also asked about waiting on the IV placement, and they explained they wouldn’t need to connect me to the IV bag/pole — literally just insert the needle in my forearm and tape a small tube down next to it so it would be ready to connect if needed. I wasn’t as insistent as your wife so decided to allow it, and it didn’t impede my movement in the slightest… and pain-wise it was absolutely the last thing on my mind from that point forward. I think a lot of books/posts/podcasts (rightly) highlight truly bad practices. But in my experience there was a world of difference between the idea of navigating tubes and an IV pole while laboring and the reality of what Kaiser was willing to offer. My sense talking to other parents is that Alta Bates also tends to be more reasonable in meeting you part way with things like this. 

I share this not to dissuade your wife from advocating for what she wants, but in hopes that it can alleviate some of the stress or provide an idea of alternatives you can ask about.

Good luck! 

Hi I’m writing this as a homebirth midwife. Although anyone can technically refuse anything at any hospital, IV access is standard of care. Refusing to have the IV port placed will be tricky and may take some major arguments on your part in labor, which may not be the energy that you want to bring to the birthing room. I think it’s also important to know that having the IV placed does not mean that it’s connected to any tubing - it’s just a “portal” so that if anything goes wrong they do not need to try and start the IV in an emergency which can waste valuable time. It’s totally possible to move freely with the port in and she can even get into the shower - they just cover it up with some plastic so it doesn’t get wet. And just FYI, it is not standard of care in out of hospital births (home or birth center) to require IV access. 
  Best wishes for a great birth!!

I'm just writing to assure you (and her) that she will be able to move freely - they will likely just install a line that is there in case there is an urgent need to administer any medication, but not necessarily hooked up to any fluids or anything initially. Believe me when I say that in that moment it will probably be one of the last things she is worrying about - labor tends to take your mind to other places. Happy baby!

Hi sorry for the stress this is causing. The main thing to know is that an IV in no way limits any aspects of labor and movement. You arent hooked up to anything, its just there and capped. Its way better to have in place than if there is an emergency (assume you are having a hospital delivery for the rare cases of needing  emergency care?) and there is no access and they are trying to get an IV to care for her and by default the baby. I didnt care about the IV at all in all three labors, many other things were more  noticeable. That said you can always refuse one, they wont force it but will make clear the same arguments above.

Hello! Delivered both my kids at Alta Bates in 2021 and 2024 and was never pushed to get an IV that I can recall. I didn't have one at all for the birth of my first-it was unmedicated and unnecessary as I was able to stay hydrated enough. With my second I eventually went for an epidural so yes, I got an IV at that time but that was after we'd been there for maybe hours so things had been moving along for quite some time and because I asked for the epidural. Has she been given a birth plan to fill out? With both my kid's births at a prenatal appointment the OB gave me a birth plan to fill out in advance where I could state my preference re IVs. The L and D nurses were wonderful and they seemed to honor my birth plan/wishes as much as possible. I actually saw them refer to it a few times  I suggest she ask about this at her next prenatal appointment and bring extra printed copies of her birth plan to the hospital as well just in case. 

I delivered at Kaiser Oakland about a year ago and declined the IV. They gave me a spiel about why they wanted me to have it but I knew what I wanted, stayed firm, and they left me alone. I didn’t have to sign anything. I ultimately got it hours later when I decided I’d have an epidural and it was all fine. I don’t know if Alta Bates is different, but your wife has the right to make her own medical decisions, and if she wants to decline an IV, that’s her right (I can scarcely imagine a hospital would refuse her further care simply because of that!).

FWIW I did have to sign an AMA when my doula had me labor down (wait for baby to descend) instead of pushing when the (relatively inexperienced) doctor said to. I signed it with no regrets. When the nurses brought the form, they said, “All the nurses completely agree with your decision to labor down.” Their experience told them it was too early for me to push, just as my doula said, even when the guidelines said otherwise. It all worked out well and I had a great birth experience. Wishing you both luck. 

I gave birth in 2018 and 2023 and did not have an IV placed. I had a "birth plan" that stated no IV unless medically necessary but from what I remember, the IV issue wasn't discussed at all. Unless your wife's pregnancy/delivery is high risk, it seems unusual the doula would suggest it's something she just had to accept.

If your wife's main concern with the IV is that it will limit her mobility, there will likely not be a need to actually hook up the IV to anything at the onset unless your wife requests medication or IV liquids. What Alta Bates will likely insist on is to place the IV port into her arm. That will typically be taped onto her arm and perhaps even be given a mesh sleeve to help keep it in place. The port should not limit her movement at all. 

Also my Alta Bates experiences is a few years old, but I was successful in having them delay in placing the port until I was further along in my labor (but I was not in active labor when I arrived).

Hi there--

My wife gave birth at Alta Bates with a team of midwives a year or so back. 

Our experience was that we got an "IV tap" installed early on--this is basically a small plastic piece that allows them to quickly start an IV if needed, but nothing is actually attached. This means you can that you can still move into many positions -- my wife did labor unmedicated and actually gave birth on the floor of the delivery room. The tap did not impede any of that. 

After labor, she needed an IV due to blood loss quickly and we were very grateful that we had the tap in place. 

Happy to talk more about our experience if helpful! 

I gave birth at Alta Bates in November. I don’t fully remember the order of operations, nor did I refuse anything, but basically when they place the IV early on they are just putting the port in your hand—there’s no tube attached to it, i.e. it doesn’t restrict movement. I was moving freely about the hospital, around the halls, trying different positions, getting into the shower, etc., until the moment I requested an epidural, about 4 hours into active labor. I think they do it this way so that they don’t have to try to stick you when you’re already in distress, possibly dehydrated (which makes veins harder to find), etc. Of course no one should force you to accept care you don’t want, but it sounds like what you’re imagining they do doesn’t match my experience when I gave birth there. In general I had a great experience at AB, wonderful nurses & midwives etc. Congrats and best of luck on your delivery!

I gave birth there in February, and though I didn’t refuse an IV, I was very hesitant at first because of mobility concerns and they did not push it on me. The IV wasn’t really a big deal for mobility, since you don’t move too quickly from one spot to another. It was the fetal monitoring that really hinders mobility. They have a limited amount of portable monitors that are first come first serve. Make sure you request one as soon as you arrive. They didn’t have any available when I was there so I was really stuck to the bed.

Does your wife want an epidural? If you want an epidural, you have to get an IV. I toured Alta Bates but ended up going to Highland, which has a tub in every room (Alta Bates does not have a tub in every room). 

I had a midwife for pre/postnatal care and also a doula, and brought my midwife + doula to the hospital with me for emotional support (though technically a homebirth midwife can't practice in a hospital).

In my experience, getting the IV in was miserable (you want someone experienced if you have to get it - they had to try 3 times to get it placed!!) - BUT being able to get an epidural meant I could sleep, and being in pain and exhausted was worse than the IV for me. Not being able to move around was the least of my worries although I can see why it would be frustrating. If you get an epidural, you also have a catheter, so you don't need to walk to the bathroom. 

You may want to ask your primary care doctor for the right legalese to sign to avoid an IV but it may not be possible in a hospital... particularly if there are complications, having the IV already in means they can give you medication immediately and that's important for things like a hemorrhage which are easy to fix with IV medication.

You can consider doing a home birth, but that may cost more out of pocket + you may have to go to the hospital anyway depending on how it goes. I considered a home birth so I hear you on minimal interventions.

Hello, congratulations on the pregnancy!  I think they just place an IV access, not an IV line.  The IV access (not sure if that's the correct term) is like a tiny plastic tube with a cap on it that's placed into the vein and secured with tape.  That way, in case of emergency or any need for medication / fluids etc, they already have access to the vein and don't have to deal with finding the vein at that point (when the birthing woman may be moving a lot and/or dehydrated, etc) - they just have to insert the IV line or medication or what have you into the IV access.  I think it was mildly uncomfortable having something stuck in the back of my hand or arm (honestly don't remember) but it was nothing, nothing at all, compared to contractions.  Anyway, it is not something that should impede movement into different positions.  I wonder if there was a miscommunication between you and the doula?  This also seems like something worth discussing with your OB if it's something your wife is concerned about - if your OB doesn't know, let them know it's a big concern and they can call Alta Bates Labor and Delivery with you to try to figure it out.  This is not something worth stressing about.  I promise you, the nursing team at Alta Bates is on your side - you're on the same team.  They want the labor and birth to be as safe and positive for everyone as possible.  Ever labor & birth is different, but if there are policies like placing an IV access on admission, I would trust that there is a good reason for them. You can definitely ask about the reason for them, but I would recommend not coming in with the idea that you have to fight to refuse things.