Myth Monday: Eating & Drinking in Labor

02/15/2021

Welcome back to Myth Monday, where we discuss a common pregnancy, labor, or birth myth and why it may or may not be supported by evidence. Today's topic: Eating & Drinking in Labor!

Picture the most physically and emotionally demanding experience of your life. Now, picture the food you ate and the liquids you drank and how they helped you get through that experience. Labor is a lot like that. The energy demands of labor are similar to running a marathon. But your birthing location says their policy is for laboring people to have nothing but ice chips or popsicles. Would marathon runners be denied food and water during a race? No... so, why are we forcing people to fast during labor?

"Nothing by Mouth" Policies

These policies began popping up in the 1940's, when most women received either inhaled anesthesia (ether or chloroform) or Twilight Sleep during labor. These types of anesthesia came with significant risks to both the birthing person and the baby, one of which was aspiration. Aspiration, when a person vomits into the lungs, can lead to serious illness and/or death. (This is one reason why you are asked to fast before a surgery.) Since the 1940's, the use of general anesthesia has been reduced to just 4.3% of all cesarean births. Due to more widespread use of epidurals, and advances in anesthesia, aspiration is now an incredibly rare complication. There was only one case of aspiration associated with labor and delivery between 2005 and 2013.

In 2015, the American Society of Anesthesiologists released a press release stating:

"Most healthy women can skip the fasting and would benefit from eating a light meal during labor." 

In fact, the research suggests that restricting food and liquids can reduce uterine contractions and lead to lower Apgar scores in newborns. People laboring without these restrictions had shorter labors (on average 16 minutes) and higher birth satisfaction. So why is your hospital and care team still enforcing a "nothing by mouth" policy?

The Practice Gap

In maternity care, it can take 10-15 years for evidence-based practices to become routinely incorporated into standards of care and reflected in hospital policy. It's important to remember that hospital policies are not always based on the most currently available evidence, as they are often written by non-healthcare professionals (lawyers, insurers, and hospital administrators).

These policies are written to expect the worst possible outcome (in this case, an aspiration during an emergency cesarean requiring general anesthesia) and applied to all birthing people regardless of their individual risk. They are also written with the view that birth is a medical procedure when it is actually a normal physiologic process of the body. Unless the birthing person has individual health conditions or factors that may increase their risk of aspiration (pre-eclampsia, obesity, use of IV opioids in labor), it's more likely that fasting during labor may increase, instead of decrease, risks of harm to them and their babies.

Ultimately, it's up to the birthing person to decide if they would like to eat and drink in labor. 


Were you "allowed" to eat and drink freely during labor? Share your experiences in the comments.


** Special thanks to Sarah Young, for her collaboration on this post!**

Information in this blog should not be taken as medical advice. Any questions regarding your care during pregnancy, birth, or postpartum should be discussed with your provider.