The good news and bad news about eating during labor

Good news, ladies!

It’s safe to eat and drink during labor.

The American Society of Anesthesiology‘s recent research review suggests, “Most healthy women can skip the fasting and, in fact, would benefit from eating a light meal during labor.”

(With a short list of exceptions. These factors include eclampsia, pre-eclampsia, obesity and the use of opioids to manage labor pain, which delays stomach emptying.)

First, here are some important numbers…

Cases of aspiration during labor and delivery in the USA, 2005-2013 = 1

Cases of death due to aspiration in the United Kingdom, 2000-2005 = 0

Cases of aspiration during the 1940s = 1.5 per 1000

The 1940’s. I’d guess a thing or two has changed in “modern medicine” since the days our mothers, grandmothers, and (for some of you) great-grandmothers were giving birth, wouldn’t you?

Well, in some ways, yes. Epidurals during labor and cesareans that allow a woman to be alert and awake when their baby is being born are now commonly used (too much, I’d say). Being “knocked out” during a c-section is reserved for true life or death emergencies, which are rarer than you’d guess by reading the average birth story.

What exactly is aspiration, anyway?

To summarize one medical definition, it’s inhalation of foreign material while unconscious under general anesthesia.

Is eating during labor safe?Now, ask all of your friends who have had c-sections, “Were you awake or asleep (unconscious) during the surgery?” Odds are high that up to 95% of them were not under general anesthesia, as it is not frequently used in the USA these days. An equal amount of them may have been told that eating during labor — at least anything beyond ice chips — was strictly forbidden.

What’s on the menu now?

“A light meal could include fruit, light soups, toast, light sandwiches (no large slices of meat), juice and water. Most women lose their appetites during very active labor, but can continue to drink fluids such as water and clear juices,” researchers said.

Let’s get more specific. What exactly did this article say? How did they decide that eating during labor is safe?

Researchers analyzed 385 studies published in 1990 or later that focused on women who gave birth in a hospital. The research suggests that the energy and caloric demands of laboring women are similar to those of marathon runners, Harty said. Without adequate nutrition, women’s bodies will begin to use fat as an energy source, increasing acidity of the blood in the mother and infant, potentially reducing uterine contractions and leading to longer labor and lower health scores in newborns. Additionally, the studies suggest that fasting can cause emotional stress, potentially moving blood away from the uterus and placenta, lengthening labor and contributing to distress of the fetus.  (American Society of Anesthesiologists)

Wait a minute. Did they just say that NOT eating during labor might reduce contractions, cause emotional stress and contribute to distress of the baby? Why yes. Yes, they did. And what might those side effects of inadequate nutrition lead to? Interventions? Cesarean? Maybe.

So all this withholding of food and drink during labor “just in case you end up needing an emergency c-section” may have been setting you up to need an emergency c-section.

<Insert frustrated face here>

But there’s Bad News, ladies!

Many hospitals are very strict in their routine of not allowing food or drink during labor.  Even with updated info such as this, it will potentially be 15 years before this even begins to become routine practice in maternity care. Seriously, it takes that long for research evidence to become routine practice.

What can you do about it? Print out the article quoted here, bring it to your care provider at your next prenatal appointment and talk about it. Help them get up to date and show them that you are educating yourself on these important topics as well.

And then tell me about it. How did the conversation go?

What is the “policy” at your birth place when it comes to eating and drinking during labor?

 

Resources

http://asahq.org/about-asa/newsroom/news-releases/2015/10/eating-a-light-meal-during-labor
http://medical-dictionary.thefreedictionary.com/aspiration
http://www.uptodate.com/contents/anesthesia-for-cesarean-delivery

The good news and bad news about eating during labor

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