Eat, drink and be merry during childbirth

Eat and drink anyway -- merriment can come later. The former advice comes from a new Cochrane Review analysis; the latter is actually just reassurance that such emotion (and the energy required for it) will ultimately be possible once again. 

In an analysis of five studies assessing the risks of consuming food or fluids during childbirth, researchers found, essentially, that there seems to be no good reason to forbid mothers-to-be enough nourishment to keep them going. And going. And going. So, if they want a snack or a drink and they're at low risk of complications, well... why not?

The analysis concluded: "Since the evidence shows no benefits or harms, there is no justification for the restriction of fluids and food in [labor] for women at low risk of complications."

Here's the summary. It includes both a "plain language" version and the more traditional kind. (The best part: "Women's views were not assessed.")

This practice of denying women sustenance while they're trying to bring new life into the world comes from a fear that general anesthesia might be required. This attitude has been relaxing in recent years, but only marginally... 

A committee opinion from the American College of Obstetricians and Gynecologists, published last year in the journal Obstetrics & Gynecology, said that women could have "modest amounts of clear liquids." But it drew the line there. Food, the statement said, should still be off-limits.

The organization's Pain Relief During Labor and Delivery pamphlet spells out the concern:

"A major risk during general anesthesia is caused by food or liquids in the woman's stomach. Labor usually causes undigested food to stay in the stomach. During unconsciousness, this food could come back into the mouth and go into the lungs where it can cause damage. To avoid this, you may be told not to eat or drink once labor has started."

Similarly, the Merck Manual offers this on the matter: "When fluids are given intravenously, the woman does not have to eat or drink during labor, although she may choose to drink some fluids and eat some light food early in labor. An empty stomach during delivery makes the woman less likely to vomit. Very rarely, vomit is inhaled. Inhaling vomit can cause inflammation of the lungs, which can be life threatening."

The Cochrane Review might give more physicians pause.

And, for the heck of it, here's general information on labor from WomensHealth.gov. The information is solid enough, if fairly routine. But the highlight is the photo of the preternaturally relaxed, even chipper-looking, woman wearing a fetal monitor.

-- Tami Dennis

Photo: You might want to consider the during-childbirth snack. It could be the least-interrupted dining experience you'll have for a while. Credit: Los Angeles Times

 

Comments

[Hilary Gerber]

Not only do they deny food and oral fluids, but I was at a four day elective induction recently in which they weren't even putting glucose in her IV, only lactated ringers, which is just electrolytes and water. No one was checking her for ketosis, a sign of starvation that is easy to check, either.

After about 24 hours of this, I asked the labor nurse on duty about the policy. She said they don't give them glucose until they start showing signs of confusion - you know, due to severe hypoglycemia. And, they deny food and fluids to all laboring mothers who are admitted. Ice chips only. We told her she was woozy, (which she was), and got her some glucose.

How is this good medicine?

[KateNonymous]

This is why my friend's mother, when in labor with her last of three or four children, stopped on the way to the hospital for a cheeseburger and fries.

[jhf]

The reason eating is denied during labor is that if a woman in labor were to need an emergency c-section and she has been eating, she could vomit resulting in an aspiration pneumonia and possibly die!! Of course in this litigious society --->LAWSUITS GALORE. Do you think any sane doctor should allow eating?

[Mama of 2]

What people need to know is that they care REFUSE any of the rules imposed on them when they are in the hospital giving birth. They say you can't eat? Go ahead! They say you have to stay in bed? Get up and walk around! They say you HAVE to have an IV, say no! Or ask for a hep lock. They say you have to give birth on your back? Heck no! This is YOUR birth and make sure you stick up for what YOU want.

[BeautyQueen]

If a patient wants to go against the Dr.'s advice, if that advice is clearly expressed and impressed upon the patient with regard to its importance, a simple signed waiver is all the hospital needs to keep itself out of harm's way, should the patient demand something that goes against the Dr.'s advice.

[KateNonymous]

On the other hand, jhf, people have emergency surgery all the time and don't die of that.

[JH]

I was starving when I arrived in labor at the hospital, and my lovely doctor agreed to let me to have breakfast (nearly had to twist the arm of the nurse to get her to order it for me though!) - of course, I threw it all up once the contractions got crazy:)