Is it really safe to eat and drink while in your birthing time?

This is a topic that really presses my buttons.  I think it is safe… but let’s see others say.

1) I love this meaty article from the Journal of Perinatal Education it includes a lot of great links and information in here and basically comes to this conclusion

…no detrimental effects on maternal or neonatal outcomes have been reported, (by mothers eating and drinking during labor)

2) A much friendlier read can be found at in an article discussing routines in birth… they summarize…

“A recent review of the research on this topic found that there is no evidence that restricting food and fluids in normal labor is beneficial.15 Recent research shows that eating and drinking are safe in normal labor.15,20,26,29 Based on the best evidence available, food and fluid should not be routinely restricted in labor.”

3) Here is another easy read… which explains why the threat of emergency cesarean should not inhibit a mother from eating or drinking if mom desires to do so.

The threat of a cesarean under general anaesthetic used to be the reason why women were routinely starved in labour. If you have a general anaesthetic, there is a small risk that food in your stomach might be regurgitated and inhaled into your lungs as the anaesthetic drugs take effect. In fact, this risk is almost non-existent if good anaesthetic practice is followed. As you fall to sleep, the nurse should put a little pressure on the cricoid cartilage in your neck to close the juncture between the gullet and the lungs, and this will prevent you from inhaling anything from your stomach.

Most caesareans are not carried out under general anaesthetic nowadays. The majority are performed under an epidural or spinal (Thomas and Paranjothy 2001). So for the vast majority of women, starving makes no sense if its only purpose is to minimise the risks of a general anaesthetic. It could be argued that far fewer women would need a caesarean anyway if they were allowed to keep their energy up by eating as they pleased during labour!! I have actually seen this in one of my births as a doula. Mom was feeling so nauseous because she hadn’t eaten. She had a phobia of vomiting and I think one of her motivations to have the cesarean was so she could eat and feel better. There were some other factors as well (induction&fatigue) but I think this was part of the deciding factor. While mom and baby were doing fine medically, this discomfort of the nausea was overwhelming to mom.

4) These days, aspiration during labor does not happen. In three large studies conducted in the U.S., women who ate freely during labor had no choking problems. In 78,000 cases, not a single case of aspiration occurred. — This statistic is quoted in Henci Goers Book The Thinking Women’s Guide to a Better Birth. Here is a press release with same information but worded differently.

5) In April 2007 the Journal of the American Society of Anesthsiologists came out with new Practice Guidelines for Obstetric Anesthesia Feel free to read it, not a very easy read so here are the highlights…

“There is insufficient published evidence to draw conclusions about the relationship between fasting times for clear liquids and the risk of emesis/reflux or pulmonary aspiration during labor. The consultants and ASA members both agree that oral intake of clear liquids during labor improves maternal comfort and satisfaction. Although the ASA members are equivocal, the consultants agree that oral intake of clear liquids during labor does not increase maternal complications.The oral intake of modest amounts of clear liquids may be allowed for uncomplicated laboring patients. The uncomplicated patient undergoing elective cesarean delivery may have modest amounts of clear liquids up to 2 h before induction of anesthesia. Examples of clear liquids include, but are not limited to, water, fruit juices without pulp, carbonated beverages, clear tea, black coffee, and sports drinks.

So clear liquids are fine.

As for solids… (ps, I have edited this post to add the complete quote here, as someone felt I was misrepresenting what was said.)

“A specific fasting time for solids that is predictive of maternal anesthetic complications has not been determined. There is insufficient published evidence to address the safety of any particular fasting period for solids in obstetric patients.  The consultants and ASA members both agree that the oral intake of solids during labor increases maternal complications. They both strongly agree that patients undergoing either elective cesarean delivery or postpartum tubal ligation should undergo a fasting period of 6-8 h depending on the type of food ingested (e.g., fat content). The Task Force recognizes that in laboring patients the timing of delivery is uncertain; therefore, compliance with a predetermined fasting period before nonelective surgical procedures is not always possible.”

So they basically say no solids is best, just IN CASE. Mostly because they don’t trust birth and worry that if an emergency cesarean with general anesthesia was needed (VERY RARE that this happens) and they mess up on the intubation and she aspirates, then they may get in trouble. So I feel this is a situation where they are trying to cover their butts… again, just in case. 

Updated July 2009. I just found a new link!  There was a study done in England which found that there was no risk from eating during labor!

In conclusion: I think it is safe to eat and drink during your birthing time.  This is not medical advice, but you are an adult and you can do the research and decide what is best for you.  So if you are hungry, EAT.  But if you are in a hospital you may have to hide that you are doing eating and drinking or risk being lectured.  If you do get lectured, remember the 78,000 women who did eat and drink with no ill effects and just remember you know what is best for YOU!  Don’t let their fear of getting in trouble effect your choice.

I am SO tempted to print out these articles and show the nurse and anesthesiologist if a mom is badgered about this again. Like I printed the law that I have the right to Breastfeed in Public in CA and carried it with me everywhere, just in case I needed to whip it out and show someone if they confronted me while breastfeeding. So if someone bugs my mom about it, I would whip out this article and say, READ THIS!

I will finish this topic by adding that in Europe (I had a question on this, apparantly not in England?  But yes in France, Italy and Germany) women eat and drink lightly throughout their birthing time to keep up their strength, with no problems and have much better birthing outcome statistics.

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14 thoughts on “Is it really safe to eat and drink while in your birthing time?”

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  2. River Eden Doula

    “in Europe women eat and drink lightly throughout their birthing time”

    Is this recent? I know my boyfriend’s Mother was told not to eat when she was in labor at an NHS hospital, but that was in 1985. Maybe its just the UK. I don’t have any trouble believing the rest of Europe is ahead of us… grr.

    By the way, when I am with doula clients I educate them beforehand on the issue of NPO policy and I bring them food when the nurses are gone. 😉

  3. GREAT post Sheridan! I think I may print all this out and post it in the birth center where I work. People DO read this stuff!

    Reminds me of my own first birth… I had a doula with me who snuck food to me throughout my very long labor and I KNOW this fuel kept me going. If you don’t refuel your car, it won’t run! If you don’t refuel your body, it won’t run well either!

    I have never, never understood how so many “well-educated” people still believe that if you don’t give your body nutrients, it will still continue to treat you well. We tell athletes to “power up” before a game… and be sure to eat snacks before and after to replenish lost nutrients and calories. Yet we’ll allow a mother to labor for 24 hours without a single bite to eat. How brilliant (not) is that???

    I think people are also afraid of vomiting during labor. Well, women VOMIT during transition… many do. It happens… you can’t stop it. It’s not a reason to starve someone!

    As usual, great post!

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  6. I ate and drank in the labor and delivery room blatantly during my first birth, and despite all warnings.

    If you’re running a marathon, you can’t do it on an empty stomach. I wound up going through 65 whole hours of labor with a shot of Nuvain at the end… and I wasn’t going to ‘not eat’. In fact, I think the reason I pooped out at the end was because I wasn’t consuming enough!

    How may calories does it take to pop out a baby?

  7. I thought it was abusive when I had been in labor for 24 hours and they gave me those awful ice chips. I had hubby sneak me a blueberry muffin and nothing bad happened. I think women should be allowed to eat and drink as well.

  8. Dr K Johnston (Anaesthetics Registrar)

    Despite starvation practice varying from hospital to hospital in the UK, My personal opinion is that overall your comment that anaesthetists only recommend not eating because ‘they don’t want to get into trouble if they mess up’ is dangerous, derogatory to anaesthetists and misleading. Airway difficulties are unpredictable and when they do occur, they may threaten the life of any woman even when looked after by a very experienced doctor. ‘Messing up the airway’ makes it sound like any competent anaesthetist will always be able to prevent problems, Sadly, this is simply not true. It can happen to anyone and if it does, having food in the stomach is bad news. Acid aspiration is one thing but the inhalation of solid food is even more serious. You seem to suggest that anaesthetists are only concerned about not getting into trouble because of their errors. I would suggest we are primarily concerned with minimising risks of serious complications which, when occuring, are usually nobody’s fault. Eating is a bit of a gamble and yes it will indeed be perfectly safe just as long as you are not unlucky enough to have to have an emergency section under general anaesthesia and then even more unlucky enough to be difficult to intubate. Yes the risk of both of these things happening is very very small (which is why guidance is so varied and most women who have eaten in labour have lived to tell the tale) but to put it in context however, Personally, I would take no such risk if it was my wife. We would go for water or perhaps high energy drinks for strength but not solid food.

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  12. Of course eating and drinking during labor is only “okay” if you aren’t obese. Because fat phobia is one of the few socially acceptable phobias we still allow–no–ENCOURAGE in our society.

    I was wanting to print something to mail to a nurse who was petrified of my recent client drinking WATER during labor (ice chips or snow cones doused in high fructose corn syrup and artificial colors were okay–can someone explain how this makes sense?), but the 2009 article is fine until it says that obese women shouldn’t eat. My client was obese.

    Ironically…24 hours later when my client was being prepped for a cesarean another nurse gave my client Tylenol with water. My client’s husband asked the nurse if it was okay for her to “drink the poison water.”

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