Labor and Birth Guidelines for Eating and Drinking

It may come as a shock to a lot of women to find that food and drink are discouraged or, in some cases, not allowed in the labor wards of the modern hospital.

In 1946, Dr. Curtis Mendelson hypothesized that the cause of pneumonia following general anesthesia was aspiration of the stomach contents, due to delayed gastric emptying in labor. He noted that food could be vomited 24-48 hours after being eaten.

Dr. Mendelson experimented on rabbits to examine the effects of content in their lungs. While he found that aspiration (taking particles into your lungs) of undigested food could cause obstruction, he eventually determined that it would not lead to aspiration pneumonia.

Sill, he explained that by forbidding food and drink during labor, you could reduce stomach volume, thereby decreasing the risk of maternal problems from acid aspiration while under general anesthesia.

The answer is no. The assumption is that any woman has a full stomach, regardless of when her last food or drink intake occurred. The emptying of your stomach is managed by two factors: the volume of stomach contents and the influence of chemical and physical properties.

We do know that the stomach empties the fastest when the volume is at its greatest, and depending upon the actual contents (ex. fats delay processing). Pain, nausea, stress, and emotional disturbances, all typically part of the labor process, also affect the emptying process.

It is also known that stress increases the catecholamine levels (stress hormones) during labor and that this can prolong labor. Penny Simkin, a childbirth educator, has done studies showing that 27 percent of women reported that not being allowed to eat or drink was moderately to severely stressful for them.

The risks of aspiration are only a problem when general anesthesia is being used. Two solutions doctors usually turn to at this point are IV fluids and antacids. But IV fluids are not always a reasonable solution to hydration problems, as they have problems of their own. And antacids are usually given in the quantity of 30 mm, a volume known to increase the risks of aspiration pneumonia.

We also know that restricting food during labor can cause problems of its own. Aside from the stress factors, restricting intake during labor can cause dehydration and ketosis.

Recent studies that have been conducted on oral hydration and food intake suggest that women who are allowed to eat and drink to comfort in labor have shorter labors (by an average of 90 minutes) and less need for augmentation with Pitocin. They also tend to require fewer pain medications, and their babies have higher apgar scores.

Another study showed that eating and/or drinking did not appear to increase the frequency of nausea or vomiting. In fact, allowing food and drink provided necessary hydration, nutrition, and increased comfort.

At this point, it is recommended that only women deemed low-risk be allowed to eat and/or drink during labor. The diet that is suggested by some hospitals is as follows:

• tea
• fruit juice
• lightly cooked eggs
• crisp toast and butter
• plain biscuits
• clear broth
• cooked fruits

Ask your health care practitioner and birth place about their policies about food and drink during labor. If they do not reflect the current medical studies, you may share the information with them and see if they will go along with your birth plan. Many hospitals and birth centers have special labor diets now and the women report being very satisfied with the outcomes.