Trust your instincts-as a doula and childbirth educator I find myself advising my clients to listen to their gut often. In fact, had I not heeded that advice myself 4 years ago my son may have been born without our midwife present. Laboring women however are not always “allowed” to follow their instincts especially when it comes to eating and drinking in labor. Its funny-you wouldn’t dream of advising an athlete against hydration or obtaining a little extra energy through food (it has been said that giving birth is like running a marathon). But in hospitals worldwide women are told they cannot eat or drink once they are admitted. Some hospitals allow a clear, liquid diet and others don’t allow laboring women anything other than ice chips-no matter how long their labor!
This practice is decades old and was implemented to prevent Mendelson’s syndrome which can occur (rare-but fatal) if a patient undergoes general anesthesia. The fear is that if a woman has eaten or drank anything the contents of her stomach could be drawn into her lungs while she is under. The message here is that every woman in labor is at risk for a cesarean section. It’s not just a cesarean that is the driving force (for which an epidural/regional anesthesia would be used) but an emergency cesarean where time is a factor. Instinctually it would seem women are missing out on the benefits of fluids and food in labor for a lot of what ifs!
However, The Cochrane Collaboration published an article entitled “Restricting Oral Fluid and Food Intake During Labor” in which it was found there were “no benefits or harms of restricting foods and fluids during labor in women at low risk of needing anesthesia.” In fact, it even went so far as to suggest a correlation between “poor nutritional balance” and “longer, more painful labors.” Ah ha! Brings us back to those instincts that tell us our body needs energy from healthy food and hydration to function properly-especially when we are involved in the process of bringing forth life into this world!
It seems according to a New York Times article “In Labor, a Snack or a Sip” that some hospitals have lifted the no fluids ban but have yet to give the ok for light snacking (we are not talking burritos and enchiladas here) in response to the ACOG’s new guidelines. But is that enough?
Each hospital, each care-provider, and each woman’s labor is different-we get that. But the bottom line is intravenous fluids just aren’t going to cut it, snacking in the car on the way to the hospital may not be enough depending on the length of labor. Women need nourishment. We are not asking for seven course meals in active labor but a little cheese or peanut butter or even some honey to help reenergize our active bodies. And water! Please-some water-dehydration depletes our energy and can even slow labor-believe me a dehydrated uterus is an unhappy uterus!
In the New York Times article Dr. Richardson an Ob/Gyn at Harvard Vanguard Medical Associates was quoted as saying “My own view of this has always been that you could say one shouldn’t eat or drink anything before getting into a car on the same basis, because you could be in an automobile accident and you might require general anesthesia.” This is it in a nutshell really-how much precaution is necessary, especially when the benefits might out weigh the risk? As is usually the case it boils down to this-do you view labor and childbirth as a normal, natural, and inherently safe process or a medical event plagued with danger at every turn-you know my answer to that.
Cochrane Review - http://www.cochrane.org/reviews/en/ab003930.htm
NY Times article http://www.nytimes.com/2010/01/26/health/26child.html?src=twt&twt=nytimeshealth