Let's talk about eating and drinking in labour.
I have seen birthing people cry with hunger, only to be told that it is "not recommended" for them to eat.
Where did this recommendation come from?
Is it still based on current evidence based information?
Is it the best for birthing people and babies?
Let's find out!
So, let's travel back in time in a day when Twilight Sleep was routinely administered to birthing folks.
A time when aspiration under anesthesia (the inhalation of foreign objects/fluids into the lungs) was more common and often due to the lack of modern tools to ensure the airways were kept open and clear, the drugs used were ether or chloroform or the aforementioned, Twilight Sleep (which was a combination of morphine and scopolamine).
The "Nothing by Mouth" policy was born in the 1940's after a study by Dr. Mendelson was released, with the conclusion that people undergoing anesthesia could aspirate their stomach contents into their lungs, causing either suffocation or a rare but severe lung disease (which he named Mendelson's Syndrome).
This became standard practice in hospitals all over and to this day, remains a "standard practice."
But are there more recent studies??
YES!
In 1997, Hawkins et al. 1997 study, looked at 45 million births. They found that the death due to aspiration was 0.7 per million. This study was done in the 1980's, BEFORE, general anesthetic use was reduced from 41% of all cesarean births to less than 6%.
The WHO (World Health Organization) has updated their recommendations to say "For women at low risk, oral fluid and food intake is recommended."
As a birth professional, I am well aware that it can take seconds for a low risk situation to become a high risk one. However, let us look at facts and studies!
In 2015, researchers at an annual Anesthesiology Meeting concluded that abstaining from food is unnecessary in low risk births. (Harty et al 2015)
In 1989, a study was conducted observing over 11,000 births in free standing birth centers, where food and drink were not prohibited. No aspirations occurred. (They also had much lower than normal cesarean rates at 4.4%)
Evidence shows that during labour the digestion process slows down, which means that the length of time without solid food does not necessarily impact how much food is in your stomach. (You may have gone 12 hours without eating and still have solids in your stomach).
Also, fasting may be MORE dangerous, as it increases the acidity of the stomach juices.
These days most studies do not show any harm or benefit from eating and drinking during labour. (Also, note that only one study even considered maternal satisfaction or emotional distress in regards to this.)
There was one study that showed a 16 minute decrease in the length of the labour when birthing people are given the choice to freely eat and drink.
Let's be real. No one wants a full blown meal while in labour but I would wager that most, if not all, would choose to eat some fruit, crackers, anything while undertaking such a huge expenditure of energy!
At the end of the day, it is important to always remember this
"Ultimately, people have the human right to decide if they would like to eat or drink during labor, or not. Hospital policy is not binding on patients, including birthing people, and hospitals do not have the legal authority to prevent a laboring person from eating and drinking if they so choose."
*Rebecca Dekker, Evidence Based Birth, (PHD, RN, APRN)*
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