The Origins of Restricting Food and Liquids During Labor
The restriction of food and liquids for laboring women was first implemented more than a half-century ago when women often gave birth under general anesthesia. Since vomiting while under general anesthesia can result in the aspiration of the stomach contents into the lungs, leading to serious breathing difficulties and even death, the medical practice of the time was to reduce the risk of aspiration by drastically limiting a woman’s intake during, often allowing only ice chips or sucking on a wet wash cloth to relieve oral dryness. However, the majority of women are no longer delivered under general anesthesia. And, for those women who do require the services of an anesthesiologist, the techniques surrounding the delivery of anesthesia have improved to the point that aspiration is rarely an issue even during a caesarian delivery. Still, the tradition of restricting food and liquids during labor and delivery remains.
Most frequently, whether or not a woman is encouraged, or even permitted, to eat and drink during labor is at the discretion of her health care team. And it is that team’s association and knowledge of labor practices that often determines their viewpoint regarding restricting or permitting a laboring woman to eat and drink. There are two predominating schools of thought; namely, those who believe that nourishment during labor is essential for the sustained health of the labor mother and child, and those who assert that eating and drinking during labor can lead to surgical complications. Currently, The American Society of Anesthesiologists (ASA) and the American College of Obstetricians and Gynecologists (ACOG) recommend that only clear liquids be given to women during labor. They further recommend that this practice be limited to low-risk women. Interestingly, the restriction of this policy to laboring mothers thought to be low-risk may be one reason why high-risk women are subject to medical intervention. Midwives frequently recommend that laboring mothers be encouraged to eat light snacks and liquids to ensure that they maintain their energy during long labors. The Society of Obstetricians and Gynecologists of Canada believes that a woman should be permitted a light diet during labor, and other respected sources believe that, as long as the foods and liquids consumed during labor are light and are not likely to cause nausea, such as heavy foods and juices, they should be not only permitted, but offered.
Permitting a laboring mother to consume light snacks and liquids has been shown to provide several physiological and psychological benefits for women. Several studies remind us that “glucose is the principal source of energy for the fetus and is diffused rapidly across the placenta.” The metabolism of glucose during pregnancy occurs at nearly twice the normal rate because of the demands of the fetus. With this in mind, it makes practical sense to encourage laboring women to maintain these levels by eating and drinking small amounts nutritious foods and liquids. Ketosis also becomes evident in pregnant women after only short periods of fasting and has been indicated as a factor in prolonged labor. It has also been suggested that allowing women to eat and drink during labor has positive psychological effects by allowing them to retain a feeling of control over the process and increased moral during labor. With this in mind, it may be likely that encouraging women to eat and drink while in labor may present more benefits than drawbacks.