Why You Should Eat and Drink During Labor

As you are writing your birth plan, one of the items you may cover is whether or not you want to eat or drink in labor. If you were to give birth in the hospital 50 years ago, most likely you would not have been given that option, and in some places today you may still have to fight for your right to eat and drink during labor.

How did this routine practice begin? At one point, any woman who had a cesarean section would give birth under general anesthesia. Back then, administration techniques of general anesthesia involved greater risk of a woman vomiting and inhaling her stomach contents, thus getting sick, and increasing her chance of dying in childbirth. So doctors decided to refuse women anything except for IV fluids to prevent catastrophe.

Later on, studies revealed that labor fasting did not guarantee an empty stomach; a woman who ate several hours before labor began may still have food in her stomach. They also found that IV fluids alone resulted in increased stomach acid, which could burn the lining of the lungs if vomited and inhaled. So many hospitals began giving their patients antacids prior to surgery, which helped but did not eradicate the incidence of aspiration pneumonia.

Today, many hospitals still restrict all laboring mothers to clear fluids, but general anesthesia is rarely used. The epidural is the new standard, which has drastically reduced vomiting, and even if a woman does, she is conscious, and therefore, able to spit out her vomit instead of inhaling it. For the women who do need general anesthesia, administration techniques have improved to the point that regardless of stomach contents, the risk of aspiration pneumonia is very low.

Now that death by aspiration is not the same concern as it once was, researchers have been looking at what food and drink restriction has been costing women who do not require a cesarean. Studies show that routine restriction of food and drink is not beneficial, has harmful side effects, and that all healthy women should be offered food and drink during labor.

Restricting food and drink intake often results in dehydration and starvation, symptoms of which include maternal irritability, nausea, lightheadedness, shaking, inefficient and more painful contractions, stalled labor, longer pushing phase, and fetal distress.

IVs may help with hydration, but they do not help to provide energy (thus causing inefficient and painful labor), and they carry the risk of infection, movement restriction, convulsions, pneumonia, and respiratory distress and seizures in the newborn. Some hospitals like to use IVs routinely in case of emergency, but any competent medical staff person can administer an IV quickly in such a situation.

To counter dehydration and starvation, drink at least 4oz an hour of a fluid that will replace sugar or electrolytes, and eat something every 2-3 hours in early labor. You may not have an appetite in active labor, so you'll want to fill your energy stores just in case. Of course you will want to talk to your care provider about their routine on food and drink, and emphasize the importance of good nutrition during labor if they are unaware.

If you drink frequently during labor, you are sure to find that you will be making frequent trips to the bathroom. This is very good because it means that your body is getting the fluid it needs, and it will also reduce your chance of needing a catheter to release urine. Sitting on the toilet is also an effective way to encourage descent of the baby, and increase cervical dilation.

If you are healthy, and your baby is healthy, you will be doing yourself a favor by eating and drinking during labor. If you are considered high risk, you will still benefit from drinking fluids, but will have to discuss with your care provider the types of foods you can eat during labor.

Resources
The VBAC Companion by Diana Korte
Birthing From Within by Pam England
Ina May's Guide to Childbirth by Ina May Gaskin
Immaculate Deception II by Suzanne Arms
Care Practice Paper #4 by Lamaze Institute for Normal Birth