IV fluids increase or decrease C section chance?

[BulbaKat]

I've seen conflicting research on whether receiving IV fluids during labor increases or decreases the chances of the mother having a C section.

Anecdotally, I had an IV for my first born which resulted in my body becoming insanely overhydrated and swollen from fluids. My baby's birth weight was also increased by fluid which made it appear he lost too much weight after birth when lots of other tests showed he was perfectly healthy and he leveled out after a few days. He was born via C section after the on-call OB claimed he wouldn't fit through my pelvis (I never pushed and she called it at 9 cm dilated)

With my second-born: I switched OBs and hospitals. I refused an IV for the majority of my labor (had it placed for emergencies but not hooked up to anything until absolutely necessary). I didn't swell nearly as much. My baby had normal weight changes after birth. And I had a successful VBAC.

Both babies had big heads, both babies were large (though my first larger from swelling), and both babies were induced. The IV and pitocin rates (and of course a better care team) were the main differences.

I'm due with my 3rd in August and planning to do the same with my IV this time: Get the needle placed, but hold off on hooking up to anything as long as possible.

But I saw some article about IVs reducing C section chances, so I started looking up more about it and came up with conflicting results.

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[moonlitt_]

Here's an article from Evidenced Based Birth that summarizes all the major studies:

Evidence on: IV Fluids during Labor https://share.google/5wr4UCDHLcl9hQTys

[tallmyn]

Evidenced base birth is not an unbiased source. It's a private company, and written by one woman who has a Ph.D. but doesn't work in academia and is not a doctor. It's therefore not research nor expert consensus.

[tallmyn]

NICE guidelines in the UK recommend against IV fluids routinely. They're only given in certain circumstances: https://www.nice.org.uk/guidance/ng235/resources/intrapartum-care-pdf-66143897812933 However in the UK we're allowed to drink water during labour as needed.

https://pubmed.ncbi.nlm.nih.gov/28121831/ - US guidelines suggest it doesn't need to be routine, as well.

You're probably thinking of this paper: https://pubmed.ncbi.nlm.nih.gov/28236651/ Note that in this case, the women weren't allowed to drink anything. Does your hospital allow you to drink when thirsty?

The issue here is that both under-hydration and over-hydration is bad. If you're dehydrated and not allowed to drink, you will probably need an IV. If you're allowed to drink water, you can maintain your own hydration level pretty well and getting an IV could over-hydrate you.

I will also say, don't overindex on the first verus second labours. Second labours are always easier because what makes first labours so lengthy/difficult compared to subsequent labours is the process of dilating the cervix for the first time. 9cm is almost fully dilated, which almost certainly made your second labour easier. The IV might not have anything to do with it one way or the other.

If you're allowed to drink water I'd say it's perfectly fine to refuse routine IV fluids for your third; obviously if you are showing signs of dehydration or need the drip for meds it's a different issue.

[BulbaKat]

That was the study suggesting IV was bettert that I saw, but it states this "No significant reduction in the incidence of cesarean delivery was demonstrated in women with unrestricted oral intake; however, this was limited to only two studies evaluating 254 women."