Friday, December 18, 2015

The Evidence Says: Yes, Virginia, you can eat during labor!

Since the landmark article in 1946 that identified aspiration of stomach contents the lungs during anesthesia (also called Mendelson’s Syndrome after the author of the 1946 article), the medical community has maintained the policy of food and fluid restriction.  Now, 70 years later, that policy seems to be changing.

At the 2015 Annual Anesthesiology Meeting in San Diego, the research is finally being recognized.  It was stated that researchers who analyzed over 380 studies after 1990 found that the energy and caloric demands of laboring women were quite similar to those of marathon runners.  Without foods and fluids during early labor, a woman’s body will start to utilize fat as
an energy source, increasing the acidity of the blood in both the mother and newborn.  This has the potential of reducing uterine contractions and leading to longer labors and lower Apgar scores in the newborns.  It was also noted that fasting can cause emotional stress, which may move blood away from the uterus and placenta, again lengthening labor and contributing to fetal distress.

An analysis of labor and birth practices also concludes that analgesia and anesthesia protocols have changed in 70 years, especially the use of epidural and spinal blocks.  Prior to these developments, women were more likely to have general anesthesia during a cesarean birth, which included thus use of a tube placed in the windpipe for breathing, increasing the chance of aspiration of vomit into the lungs.

Healthy women are now encouraged to eat light meals during labor.  Items that can be consumed include non-acidic fruits, non-creamy soups, toast, crackers, light sandwiches (with no large pieces of meat), juices, sports drinks and water.  These items can be consumed during early labor, as during active and transitional labor, a woman’s appetite diminishes.  This slowing of digestion redirects energy from the digestive system to the uterus and baby.

With these evidence-based findings in mind, it is time to change 70 year old traditions to meet the needs of the laboring woman and her unborn child and reducing complications that can lead to unnecessary interventions.

Resources for this article:

O’Sullivan G., Liu B., Hart D., Seed P., & Shennan A. (2009). Effect of food intake during labour on obstetric outcome: Randomised controlled trial. British Medical Journal, 338, b784 Retrieved from [PMC free article] 

Smith, L.J. (2009) Impact of Birthing Practices on Breastfeeding. Jones and Bartlett Learning.

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