Have you or someone you know been told you can’t eat or drink in birth? It is incredibly common for hospitals to still restrict laboring parents from nourishment. In this blog post, I’m going to talk all about the policies, procedures, and protocols surrounding this topic and offer you some “food for thought.”
Why do some hospitals still restrict the ability to eat or drink in birth?
On a little note about my personal wellness routines… I typically try to get out for a walk for about 45 minutes each day. Yes, I do this in all types of weather (unless its incredibly extreme, but sometimes even then I try!).
On this walk, I’m usually listening to music or a podcast of some sort. This week I have been listening to a lot of Sleater-Kinney, whom you may or may not have heard of. One of the lines in one of my favorite songs says, “Could I turn this place all upside down, and shake you and your fossils out.” This just makes me think of how we get stuck in so many old ideologies and patterns in the world.
This applies to birth as well. So many of the policies, procedures, and protocols (my 3 p’s) that make up the maternity care system are based on outdated ideas and really just oppression. Very little is based in evidence, or honestly even common sense and a biological understanding. It’s definitely not gentle or compassionate.
In this post, my goal is to present you with new ways of thinking that will help you follow your own compass in birth. Today, I want to talk about the importance of eating and drinking in labor. And, why it makes NO sense to tell a birthing person that they can’t eat or drink. And yes, this still happens all the time.
The 3 P’s and the Evidence
In terms of the 3 p’s (policies, procedures, and protocols), eating and drinking in labor is something that comes up all the time. Based on evidence and honestly common sense, there is no legitimate reason to prevent a laboring person from eating and drinking in birth. However, this is still often the policy at many hospitals around the country. As Sleater-Kinney would say, I want to shake some of these fossils out as I dive deep into this topic.
In many hospitals around the country, it is very common for parents to be told they cannot eat or drink in labor. The medical terminology for this is NPO, or nothing by mouth. This is a direct result of the medicalization of birth as we know it.
In a recent study of people birthing in hospitals, 60% of people reported not drinking during labor, and 80% reported not eating in labor. Interestingly, a study of parents birthing at a birthing center, where eating and drinking is encouraged, showed that 95% of people chose to eat and drink.
So what’s the deal with this? Where does this come from? What’s the history? Why do I need to eat and drink in labor? WHAT’S GOING ON HERE?
Why you should eat and drink in birth…
One study revealed that people who had freedom to eat and drink in birth had a slightly shorter labor.
97% of parents who ate and drank in labor reported that they were satisfied, versus 55% for those who were not allowed to.
In one study, it was revealed that stress greatly increased the pain experienced during birth. This study showed that one of the greatest reported stresses was restricted food intake. It is commonly reported that people who are restricted from eating and drinking feel greater exhaustion, pain, dissatisfaction, and report feeling undernourished in their birth experience. Also, a big thank you to Evidence Based Birth for this information.
Firstly, the “nothing by mouth” policy started during the 1940’s. Birthing parents were routinely given inhaled anesthetics or twilight sleep during birth. They were basically unconscious and had no memory of the birth.
At this time, the anesthesia technologies were very primitive. Also, the tools used to support an airway were also very primitive. Many of the drugs used for anesthesia were also unpredictable, and birthing people were often unconscious for birth. It was noted that birthing people could potentially suffer from aspiration and suffocate or experience damage called Mendelson’s syndrome.
During research in this time period (a study of 44,000 people), 1/667 people suffered from aspiration, and 2 died after aspirating solid food. The people in this study were given uncontrolled amounts of anesthesia without airway support. At this time, it was then recommended that birthing people are given IV fluids in labor to replace food and drink, as well as local versus general anesthesia for labor.
Moving closer into the present time, and we see that anesthesia and airway support has come a long way. A study from 1997 showed that the risk of death from aspiration during a cesarean was 1 in 1.4 million births.
A recent study from the UK reports 1 death in 6 million births.
In 2015, at an annual meeting of anesthesiologists, they recommended that most people would benefit from a light meal in labor. Also, they published a paper stating that “nothing by mouth” is an outdated policy.
Today, even in the case of general anesthesia in a cesarean, doctors use many strategies and medications to reduce any risks of aspiration that were unavailable in the 1940’s.
Professional Organizations on Restricting the Ability to Eat and Drink in Birth
The World Health Organization, The American College of Nurse Midwives, and the Society of Obstetricians and Gynecologists of Canada also recommend eating and drinking as desired in labor.
However, the American College of Obstetricians and Gynecologists and the American Society of Anesthesiologists recommends prohibiting food during labor because there isn’t “clear evidence on waiting times related to aspiration of stomach contents.” Interestingly, neither group recommends restricting parents to ice chips or water.
Any doctor recommending that a birthing parent only consume ice chips or water in labor is not in line with their own professional organization.
We know that there is no good evidence to support the practice of nothing by mouth in labor. And, it is actually harmful to labor progress and your levels of satisfaction in labor.
Birth is a holistic process…
If you are deprived of food and drink in labor, your body cannot possibly work at an optimum physiologic level. Labor is hard work and your body needs nourishment! Also, restricted food and drink leads to major stress in labor. Feeling stress and other disruptions in labor inhibits the progress of your labor. When a birthing person is stressed, oxytocin cannot flow freely. All of this affects your labor progress and your birth experience.
No one has the right to tell you that you cannot eat or drink in labor. I want you to feel free to listen to your own body and follow your own compass in birth. No one can forcibly restrict your ability to eat and drink in birth. Most parents will snack throughout the early labor process. It’s best to rest during this time, stay well hydrated, and eat nourishing foods. As your labor progresses, it is very common to have little appetite at all. Most parents don’t feel like eating much once their labor becomes very intense.
It can be normal to experience vomiting also as active labor sets in, and as transition sets in. This is all a normal part of the labor process.
What should you eat and drink in birth?
In birth, you want to focus on eating small, easily digestible foods. Snacks such as Greek yogurt, fruit, crackers, oatmeal, broth and other simple foods can help support your energy levels and help you have a more comfortable experience. It’s great to drink water to thirst, and you can also drink electrolyte drinks or broth as desired. For example, labor aid is a home made drink with electrolytes and minerals to support your labor.
Your uterus is a muscle, and your body works hard in birth. You have to feed your uterus and your body to prepare it for the marathon of birth. Would you run a marathon after fasting? What would your performance be like?
So, many of the 3 p’s that happen in birth are really old fossils that have been kicking around forever that are not supported by evidence or current research. There is no great evidence, at all, to support restricting food or drink in labor. And in fact, it can be really damaging to your birthing process. Remember that you have the right to eat and drink in labor as you see fit. Feel free to listen to your body and your intuition in labor and follow your own compass.
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