Friday, January 22, 2010

Studies show oral intake during labor has no ill effects!

You may not have already known this, but if you give birth in a hospital they are most likely not going to allow you to eat anything but ice chips. (I always think of Lorelai from Gilmore Girls talking about how she kept pelting the nurses with ice chips). Sometimes you can work out an exception, like drinking clear liquids, maybe juice or gatorade, having a popsicle or a lollipop. 

Frequently the reason is 1. you'll just puke it up. to that I say, I might puke anyway what does it matter whats in it? and what if I don't puke? I might not and then I'll get to have a full stomach. and 2. if you need a c-section and you've eaten there's a risk of aspiration, which the studies have found to be a minimal risk.

If your fluids and blood sugar are down they're likely to put an IV in you, which I would hate. I hate the way IVs feel and I'd hate to have my movement restricted. Plus if you have an IV they might get drug-happy now that you've got a nice easy line already in you! 

 The news that eating and drinking during labor is no big deal is not news to many members of the "natural" birth movement. Women are encouraged to eat before coming to the hospital anyway, as you'll need your strength. Women who give birth at home or in birth centers always eat if they so desire, for the same reason. 

But now, thanks to these studies, maybe hospitals will begin to change their policies!



Eating during labor has no ill effects: study

NEW YORK (Reuters Health) - Allowing a pregnant woman to eat during labor does not seem to have any impact on the outcome of the infant or mother, and doesn't increase the risk of vomiting, according to a new study.

The findings come from a study of 2426 pregnant women in labor who were allowed to eat lightly or to have just water during labor.

Researchers failed to see any significant differences between the two groups. Eating lightly during labor had no effect on the length of labor, the need for assisted delivery, such as the use of forceps, or Cesarean section rates.

Forty-four percent of women who ate a light diet during labor had a spontaneous normal vaginal delivery -- a rate identical to the rate seen in their peers who were permitted to have only water, Dr. Andrew Shennan, from King's College London, and colleagues report.

The cesarean delivery rate was 30 percent in each group, and rates of instrument-assisted vaginal delivery were 27 percent in the eating group and 26 percent in the water group.

The average length of labor was slightly but not significantly shorter in the eating group versus the water-only group (597 vs. 612 minutes).

The incidence of vomiting was nearly the same as well, at 35 percent and 34 percent in the two groups. There were no significant differences in any infant outcomes were observed between the groups.

The study appears in the March 24th Online First issue of the British Medical Journal.

In a commentary on the study, Dr. Soo Downe, from the University of Central Lancashire, UK, notes that the results "reinforce what has already been shown in many observational studies" and show that low risk women may eat lightly during labor.



Restricting oral fluid and food intake during labour 

from the Cochrane Review January 20. 2010



Eating and drinking in labour

In some cultures, food and drinks are consumed during labour for nourishment and comfort to help meet the demands of labour. However, in many birth settings, oral intake is restricted in response to work by Mendelson in the 1940s. Mendelson reported that during general anaesthesia, 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.

Since the 1940s, obstetrical anaesthesia has changed considerably, with better general anaesthetic techniques and a greater use of regional anaesthesia. These advances, and the reports by women that they found the restrictions unpleasant, have led to research looking at these restrictions. In addition, poor nutritional balance may be associated with longer and more painful labours, and fasting does not guarantee an empty stomach or less acidity.

This review looked at any restriction of fluids and food in labour compared with women able to eat and drink. The review identified five studies involving 3130 women. Most studies had looked at specific foods being recommended, though one study let women to choose what they wished to eat and drink. The review identified no benefits or harms of restricting foods and fluids during labour in women at low risk of needing anaesthesia. There were no studies identified on women at increased risk of needing anaesthesia. None of the studies looked at women's views of restricting fluids and foods during labour. Thus, given these findings, women should be free to eat and drink in labour, or not, as they wish.

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