Eating and Drinking during Labor Deanna K. Sanford MS, CNM, Glenda J. Sanford BSN, RN, & Sheliah C. Jackson BSN, RN. MW11 Critical Inquiry I,

Abstract The restriction of eating and drinking during labor was first implemented more than a half-century ago when many women gave birth under general anesthesia. Since vomiting while under general anesthesia can result in aspiration of stomach contents, the medical practice at the time was to reduce that risk by restricting oral intake to ice chips or prohibiting oral intake altogether. Although most women no longer give birth under general anesthesia, the practice of restricting intake in labor persists. For those who require or desire it, the delivery of anesthesia has improved so that aspiration is rarely an issue. A 1989 National Birth Center study showed that 11,814 women who were allowed to eat and drink at will during labor did not have a single case of aspiration, even among the 22% of women in the total group who required a Cesarean. Labor places a significant demand on a woman’s calorie requirements. Withholding nutrition from a laboring woman has been cited as a factor in accelerated starvation during labor that can produce quantifiable effects on blood glucose and ketone levels. Thus, it is possible that some complications of labor and delivery may ultimately be caused by this state of starvation. Review of the literature reveals current evidence that eating and drinking during labor is a safe practice for low-risk women. This study will describe and assess the benefits of allowing low-risk women to eat and drink to appetite during labor. Nine hundred laboring women in three different health facilities will follow one of three dietary regimens during their labors. Data will be collected using questionnaires, as well as phone and face-to-face interviews. The medical community must be challenged to initiate and adopt evidence based guidelines regarding eating and drinking of low risk women during labor.

Text Introduction to the Problem

The restriction of eating and drinking for laboring women was first implemented more than a half-century ago when women often gave birth under general anesthesia (Parsons, 2004b). Since vomiting while under general anesthesia can result in the aspiration of the stomach contents into the lungs, leading to serious breathing difficulties and even death, the medical practice of the time was to reduce the risk of aspiration by drastically limiting intake during labor (Douglas, 2004), often allowing only ice chips or sucking on a wet wash cloth to relieve oral dryness. However, most women no longer deliver under general anesthesia. For those who do, the administration of anesthesia has improved so that aspiration is rarely an issue. Still, the practice of restricting eating and drinking during labor and delivery remains (O'Sullivan & Scrutton, 2003).

Frequently, whether a woman is encouraged, or even permitted, to eat and drink during labor is at the discretion of her health care team. And it is that provider’s association and knowledge of labor practices that often determines their viewpoint regarding restricting or permitting a laboring woman to eat and drink. There are two predominating schools of thought: 1) that nourishment during labor is essential for the sustained health of the laboring mother, and 2) eating and drinking during labor can lead to surgical complications. Currently, the American Society of Anesthesiologists (ASA) and the American College of Obstetricians and Gynecologists (ACOG) recommend that only clear liquids be given to women during labor. They further recommend that the practice of giving clear liquids during labor be limited to women without risk factors that may increase their chances of Cesarean delivery. Women who are at increased risk for a Cesarean delivery are recommended to have nothing by mouth (NPO) during labor. This restriction of limiting intake to laboring women identified as high risk may explain why they are subject to more aggressive medical interventions. Midwives frequently recommend that laboring mothers be encouraged to eat light snacks and liquids to ensure that they maintain their energy during long labors. The Society of Obstetricians and Gynecologists of Canada contends that a woman should be permitted a light diet during labor, and other respected sources advise that, as long as the foods and liquids consumed during labor are light and are not likely to cause nausea (such as heavy foods and juices) these should be not only permitted, but offered (Parsons, Bidewell and Nagy, 2006).

Page 1 of 4 :: First | Last :: Prev | 1 2 3 4 | Next