Labor and delivery

Eating during labor

By Jennifer Vanderlaan

Do you know the policy about eating during labor at your birth place? Hospitals can have very different policies so unless you ask, you may make assumptions that are not true. Some hospitals restrict eating with a policy called NPO which means "Nothing by mouth". Other hospitals allow clear liquids, and some make no restrictions.

Why restrictions?

The policy of restricting a woman's intake during labor is based not on the physiological needs of labor, but on the potential need for surgery. In some hospitals, every woman who comes in for labor is treated as a potential surgical patient and subjected to the same routines as patients admitted for surgical reasons. One of the standard preparations for surgery is to restrict the food and fluid intake of the patient so the likelihood of vomiting while under anesthesia is reduced. Vomiting is a very real danger with general anesthesia since the patient can choke (aspirate) on the vomit. The overall risk of aspiration is low, and the major reason for aspiration is a failure to apply proper anesthetic technique.

Interestingly, restricting oral intake does not help ensure the stomach is empty, nor does it lower the acidity of the stomach contents. This means that not eating or drinking will not improve the outcomes for women who do vomit during labor.

Though the standards for anesthesia during cesarean surgery have changed, the policy of restricting food has not. A woman undergoing a cesarean is most likely to use a regional anesthesia, which allows her to remain awake and alert during the procedure. This reduces her risk of aspiration from low to very low. In A Guide to Effective Care in Pregnancy and Childbirth (Oxford Medical Publications), researchers report that women who were allowed to control their own oral intake enjoyed the control without any harmful effects found.

Should I eat?

There are no hard and fast rules about when you should or should not eat in labor. There are no studies on the nutritional needs of a woman in labor, although some experts theorize it would be similar to an athletic event. Your decision will need to be based on your body's needs at the time.

Most women lose their desire to eat when they enter active labor. A good standard to follow may be to eat when you are hungry, if you are hungry. Never feel like you need to force yourself to eat, but at the same time do not deny yourself food because you may be in labor.

Though forcing yourself to eat is not smart, you may want to set up a way to be sure you drink water or juice throughout labor. Dehydration increases the amount of pain you feel while decreasing the amount of work your muscles are able to do. This means labor may be less productive, but hurt worse than if you stayed hydrated. Some women find keeping a water bottle nearby reminds them to take frequent sips of water.

If your labor is slow to start, it can be difficult to decide to eat. The concern that labor may begin at any moment can prevent you from feeling comfortable eating. However, it is important to remember that choosing not to eat can mean that you go without food for 24 hours or more. Since most women's hunger naturally subsides, as long as you want to eat, you should feel free to do so.

What should I eat?

When trying to decide what foods to eat in labor, think about what foods appeal to you and how the food makes you feel. Consider the way the food digests, and how it feels in your stomach. You may want to avoid overly fatty or heavy foods. Some good choices may be yogurt, eggs, toast, fruit, or soup. Frozen berries or grapes can often be enjoyed into active labor.

If you are giving birth in a hospital that restricts your intake, you may choose to wait until active labor to go to the hospital to ensure you do not experience hunger. If that is not an option, ask whether clear liquids will be available. Tea, broth, juice, popsicles, and honey are all clear fluids and may help you feel nourished more so than if you simply drank water.

If your hospital or your health prevents you from drinking clear liquids during labor, your only option may be ice chips. While these will not prevent hunger, they can help you avoid the uncomfortable dry mouth feeling that accompanies times of fasting. You may also find that brushing your teeth or using mouthwash helps take away the taste of a dry mouth.