Why Eating During Labor Should Not Be Forbidden

by Debra Flashenberg, IMI Advisory Board Member and Guest Blogger

In the movies and on TV, laboring women are often depicted as panting, sweaty and sucking on ice chips. Luckily, that image can finally change! After years of food and fluid intake being restricted for women in labor, there has been a closer scientific look at this practice and the ban has been (somewhat) lifted.

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Even as some of my most athletic, marathon-running students will agree, labor is one of the most physical acts a woman will go through in her life. So why restrict energy providing nourishment during this time? The reasoning for this protocol is rather outdated. “In many birth settings, oral intake is restricted in response to work by [Dr. Curtis] Mendelson, [a New York obstetrician], in the 1940s. Mendelson reported that during general anesthesia, there was an increased risk of the stomach contents entering the lungs. The acid nature of the stomach liquid and the presence of food particles were particularly dangerous, and potentially could lead to severe lung disease or death” (1).

While Dr. Mendelson’s findings may sound like good reason to avoid food or fluid, obstetrical anaesthesia has changed considerably since the 1940s. With better general anaesthetic techniques and a greater use of regional anaesthesia (2), risks of potential danger have been greatly reduced. Even the ACOG, the American College of Obstetricians and Gynecologists, has announced they are in support of women with uncomplicated pregnancies now consuming “modest” amounts of clear liquids such as water, juices, carbonated beverages, tea, black coffee, or sports drinks (3). While ACOG is still not in support of laboring women eating food, many individual doctors and midwives allow liquid intake for low risk women. A recent study published in the British Medical Journal states, “consumption of a light diet during labor did not influence obstetric or neonatal outcomes in participants, nor did it increase the incidence of vomiting. Women who are allowed to eat in labor have similar lengths of labor and operative delivery rates to those allowed water only”(4). So why not let women eat if they want to?

Truthfully, most women will not have a huge appetite during labor, although it is still important to keep the blood sugar balanced and provide energy for the task at hand. For those who are allowed to eat and have the desire to munch a bit, I would recommend staying away from sugary, processed foods. Keep it light since you will not want anything too heavy in your belly. Think energy food! Ask your helpers to prepare foods like whole wheat toast and almond butter, scrambled eggs or quinoa salad. Also, fresh cut fruit or a brothy vegetable stew are good options. Complex carbohydrates, protein and natural sugars are great energy providers. Years ago, I read in a copy of Midwifery Today a blurb from a midwife about a concoction she always made for her clients. She called it the “midwife’s pitocin” – oatmeal, honey and nuts. Sounds pretty delicious, even if you’re not in labor!

Labor is often a physically draining, dehydrating experience, so remember to also keep hydrated! Dehydration can actually slow labor down. For fluid options, you can try herbal tea, water, watered down sports drinks, coconut water (which is also a great source of electrolytes!), watermelon juice or vegetable broth. You can also make or buy fruit juice popsicles.

It is really important to discuss the option of eating and drinking with your care provider ahead of time, as you definitely do not want to start negotiating this during your labor. For those at a hospital or with a provider who follows the older recommendation of fasting during labor, you will most likely be hooked up to an IV to compensate for your lack of food or fluid. The IV delivers dextrose, which is basically sugar and water. Dextrose is a refined sugar with deleterious physiological effects:  it rapidly elevates blood sugar content, causing a temporary energy rise, but this too-high elevation causes the pancreas to secrete more insulin, resulting in a rapid drop in blood sugar and a sudden energy slump. When dextrose is administered intravenously for many hours, the result can be internal physiological havoc, which the patient will experience as exhaustion (5).  This artificially induced glucose high can also lead to the baby suffering from hypoglycemia (6).  This seemingly innocuous dextrose IV certainly has its downsides that should be considered.

I encourage you not to be shy about asking your care provider for a little leeway in having a light nosh during labor. The benefits really seem to outweigh the risks for both you and your baby.

Happy birthing!

About the Author:

Debra is a graduate of the Boston Conservatory of Music with a degree in Musical Theater. She has spent most of her life performing and was introduced to yoga through a choreographer in 1997. After several years as a yoga student, she decided to continue her education and became certified as a Bikram Yoga instructor. In 2001 Debra headed out to Seattle to study with renowned prenatal yoga teacher Colette Crawford, R.N., at the Seattle Holistic Center. Debra has received certification for Vinyasa Yoga from Shiva Rea as well as completed the OM Yoga advanced teacher training with Cyndi Lee in 2004. Debra has also studied the Maternal Fitness Method with Julie Tupler. Debra currently studies with Cyndi Lee, Genevieve Kapular, and Carrie Owerko.

After being witness to several “typical” hospital births, Debra felt it was important to move beyond the yoga room and be present in the birthing room. In 2003, Debra attended her first birth as a DONA certified labor support doula. In that short period of time, Debra has attended about 100 births. She is continuously in awe of the beauty and brilliance of birth. In 2006, Debra received her certification as a Lamaze® Certified Childbirth Educator. In September of 2007, Debra completed a Midwife Assistant Program with Ina May Gaskin, Pamela Hunt and many of the other Farm Midwives at The Farm Midwifery Center in Tennessee. Most recently, Debra had the incredible experience of helping one of her clients give birth on the bathroom floor. Luckily, the EMS arrived seconds before the baby did!

Drawing on her experience as a prenatal yoga teacher, labor support doula and childbirth educator, Debra looks to establish a safe and effective class for pregnancy and beyond.
Debra is the proud (and tired) mother of new baby boy, Shay.

www.prenatalyogacenter.com

Sources

(1)    http://summaries.cochrane.org/CD003930/eating-and-drinking-in-labour

(2)    http://summaries.cochrane.org/CD003930/eating-and-drinking-in-labour

(3)    http://www.news.com.au/breaking-news/snacking-during-childbirth-is-safe-says-study-in-british-medical-journal/story-e6frfku0-1225715391139)

(4)    British Medical Journal: Effect of Food Intake During Labor On Obstetric Outcome: Randomised Controlled Trial (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2660391/)

(5)    http://www.birthingnaturally.net/barp/iv.html

(6)    http://pregnancy.about.com/od/birthplans/a/Choices-That-Affect-Breastfeeding.htm

Disclaimer: The views and opinions expressed in this article are those of the authors and do not necessarily reflect the official policy or position of  the International Maternity Institute.

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