What Every Pregnant Woman Should Know About Eating And Drinking During Labor.

 
ISP

I get asked this question a lot. 

I have good and bad news for you.  I am going to start with the bad news.  It's been a common widespread practice to restrict women’s food and fluid intake during labor since the 1940's.  So that means hospitals and doctors are very comfortable with this practice.  But the good news is that restrictions are starting to relax a bit. A TINY bit and that is because more studies have come out on the subject in recent years. Yay! We are finally getting out of the 1940s!

 

What's the big deal?

The reason for the food restrictions is because gastric emptying (digestion) seems to slow down during labor.  The "fear" was, and still is in some hospitals, that a woman might aspirate during surgery.  

What does that mean?  

It's when your stomach fluids go into your lungs.  I know that sounds awful but before you freak out… just know that this is EXTREMELY rare.  Basically 0.667 per million women aspired during a cesarean birth.  Anesthesiologists especially have concerns for women who have eclampsia, pre-eclampsia, obesity and use opioids to manage labor pain because it delays stomach emptying.   

However according to a recent report by the American Society of Anesthesiologists , " Researchers said aspiration today is almost nonexistent, especially in healthy patients.  Plus, anesthesia techniques have come a long way since the 1940's and there are medicines available now that keep you from getting sick".  

I've personally tried one of the medications that is used and it works great.

 

 

What the latest studies say.

Over the years there have been many studies done on whether it is safe for a woman to eat during labor.  Just recently a large-scale, meta-analysis included five studies with a combined total of 3,130 low-risk women. The researchers compared women who:

  • took nothing by mouth 

  • who ate and drank during labor

What's interesting is that they found no difference between the two groups with regards to Apgar scores, vaginal births, cesarean births, instrumental births or any other health issues.  It concluded that that there is no need for these restrictions and supports women eating and drinking as they please.  However, the authors call for further study of what might be effective nutrient and hydration strategies for women in labor.  The results were published in the The Cochrane Library.

There was another recent study that was done regarding whether a laboring mother should only be given ice chips (most hospital standards) and/or sip on a protein smoothie. 

"Women in labor can enjoy a chocolate or vanilla protein shake during labor rather than being relegated to the tedium of ice chips, according to a study presented at the ANESTHESIOLOGY™ 2013 annual meeting.  Mothers who drank a protein drink during childbirth reported higher satisfaction rates, although nausea and vomiting remained the same as for mothers who were given ice chips."  

"This study suggests that more liberal general guidelines regarding what a mother can eat and drink during labor should be considered," explained Dr. Vallejo. "Doctors should feel comfortable, at least, replacing ice chips and water with high protein shakes to increase patient satisfaction."

I can only speak from experience but I have noticed a big difference in the way my client labors whether she has energy or not.  And it all depends on whether she eats or doesn't eat during labor.  

At the ANESTHESIOLOGY® 2015 annual meeting it was suggested that, "most healthy women can skip the fasting and, in fact, would benefit from eating a light meal during labor".  This conclusion was due to the fact that researchers analyzed 385 studies published in 1990 or later that focused on women who gave birth in a hospital.

The research suggests that the energy and caloric demands of laboring women are similar to those of marathon runners.  Without adequate nutrition, women’s bodies will begin to use fat as an energy source, increasing acidity of the blood in the mother and infant, potentially reducing uterine contractions and leading to longer labor and lower health scores in newborns. Additionally, the studies suggest that fasting can cause emotional stress, potentially moving blood away from the uterus and placenta, lengthening labor and contributing to distress of the fetus.  For more info, click here.  

It is important for you to recognize what the American Society for Anesthesiologists’ press release is and what it is not. They are just suggestions. Please be aware that this is not a policy change.  Most healthcare professional stick to policy guidelines. 

 

What do the policy guidelines say?

The current policy of the ASA on oral intake in labor is that laboring women should avoid solid food in labor. You can read the ASA’s most current guidelines, published in 2016: Practice Guidelines for Obstetric Anesthesia An Updated Report by the American Society of Anesthesiologists Task Force on Obstetric Anesthesia.  

The American College of Nurse Midwives recommends “that women at low risk for pulmonary aspiration be permitted self-determined intake according to guidelines established by the practice setting.” They also conclude “drinking and eating during labor can provide women with the energy they need and should not be routinely restricted.”  

American College of Obstetricians and Gynecologists recommends no solid food for laboring women and refers to the ASA guidelines.

 

What you need to know.

It is very important to discuss this issue with your healthcare provider, after all they are responsible for your well-being and your baby's well-being.  So it is only fair to discuss your plans with them.  If you get the green light, follow your instincts on what will be good for you in that moment.  

 

HYDRATION:

It is extremely important for you to stay hydrated during labor.  Basically you should pee every hour while in labor.  Water is always best but coconut water is great during labor because it keeps you hydrated and replenishes your body with important electrolytes.  Sport drinks often have added food coloring and tons of sugar in them.  But sometimes the women I work with just want the sport drink mixed with water. 

 

NUTRITION:

If your healthcare provider has said it's okay for you to eat during labor, you'll want to focus on easy to digest foods.  Broths, seedless watermelon, yogurt, apple sauce, plain pasta, popsicles, etc.

I have seen laboring moms snack on all kinds of different things such as broth, strawberries, apple sauce, bananas, popsicles, chocolate, a snickers bar, bagel and cream cheese and chicken soup.  The snickers bar was the craziest.  

Everyone is different and that is what these mammas wanted and got permission from their healthcare providers.  Labor is very hard work and the body needs nutrients to perform its best.  I always have honey and homemade Labor-aide standing by if any of my moms begin to lose energy.  It is amazing to see what a little honey or labor-aide can do!

With that being said, some woman just don't feel like eating anything during labor and only want to drink fluids.  Others may welcome some food and drink.  Others have a hard time holding anything in their stomachs.  Believe me, I have held a lot of buckets.  But it's actually a good sign and means labor is progressing.  Ina May Gaskin likes to say, an open mouth and throat means an open cervix.  Don't worry, not every women vomits during labor.  But as a woman gets closer to delivery she naturally stops eating. 

 

Extremely nutritious broth recipes:

Magic Mineral Broth - I love this one and drink it all the time. It would be great all throughout your pregnancy, labor and postpartum. This is full of magnesium, potassium, sodium and allows your body to refresh and restore itself. Magic Mineral Broth recipe.

Bone Broth is full of collagen and minerals the body uses. Its super nutritious and restorative. Bone Broth check out...All You Need To Know About Bone Broth.

Miso Soup is another great option. But make sure its organic - non GMO miso. Here's my teacher Aviva Rohm, MD recipe:

Immunity-Boosting Miso Soup
This soup taken by adults several times/week as a tonic, and given to your child in small amounts once or twice weekly. It is especially beneficial during cold and flu season for PREVENTION. You'll have to get the herbs ahead of time. Mountain Rose herbs (online) is a good source; the soup can also be made without the ginseng, astragalus, and codonopsis and is still immune supportive. 

Ingrediens: 

  • 1 yellow onion, sliced
  • 10 shiitake mushrooms, chopped
  • 2 large carrots, sliced
  • 1 teaspoon fresh grated ginger
  • 4 cloves chopped garlic
  • 2 quarts water
  • 2 slices dried astragalus root
  • 1/4 tsp teaspoon dried red ginseng slices
  • 1 3" length of codonpsis root
  • 1/4 cup pieces of wakame or kombu seaweed (get from Maine Seaweed/Larch Hanson as a reliable source -- also online)
  • 1–2 cups cooked rice or noodles (optional)
  • 1/2 pound organic tofu, cubed, or organic chicken (optional)
  • 1/4 cup organic red miso paste

To prepare: Sauté the onion, mushrooms, carrots, and ginger. Add the water, astragalus root, and ginseng slices. I put them into a little stainless steel tea ball, then just remove it at the end before serving. It has a slightly stronger and earthier taste than the usual miso soup. Simmer for 45 minutes, then add the cooked rice or noodles and the optional tofu. Cook for 15 minutes more. Remove the astragalus and ginseng slices. Dissolve in the miso paste. A serving is 1/2-1 cup. Will keep in the fridge and can be reheated for several days.

This is safe in pregnancy a couple of times/week, and while BF'ing. 

For labor you can just use the broth. Or you can eat this right before you go into the hospital. 


QUESTION:  Did you snack or eat during labor?  If you did what did you eat and drink?   I'd love to know!   If you are pregnant, what are your thoughts regarding eating during labor? Will you or won't you?  Please share your answer with us in the comment box below.

If you find this information useful please feel free to share it with your friends and loved ones. 

 


Resources:

American Society of Anesthesiologists website

Hawkins, J. L., L. M. Koonin, et al. (1997). "Anesthesia-related deaths during obstetric delivery in the United States, 1979-1990." Anesthesiology 86 (2): 277-284. 

The Cochrane Library

Health Behavior News Service, part of the Center for Advancing Health (2013, August 22). Center For Advancing Health