You know me, finding articles for my blog.  Ran across this one about being NPO during labor.

Short-version -- Unless the OB fears complications that would necessitate a section, nothing by mouth seems unecessary and can change a woman's labor experience -- and should be a woman's choice. 

I remember STARVING when in labor with Kaitlin as I hadn't eaten since about 12pm before my 2pm appt, and they decided to induce that day.  Was whisked to the hospital and admitted, where I asked for food and was denied until she was born the next day.  I was STARVING.

So when I went into labor with Daniel?  Yeah, first thing we did on the way to the hospital (45 minute drive) was stop at a gas station and pick up food for me to eat along the way just in case (which was smart).


From medscape:

Restricting Food and Fluid Intake During Labor May Not Be Helpful

Laurie Barclay, MD
 

January 20, 2010 — Restricting food and fluid intake during labor may not be helpful or necessary for women at low risk for complications, according to the results of a systematic review reported online January 20 in the Cochrane Database of Systematic Reviews.

"Since the evidence shows no benefits or harms, there is no justification for nil by mouth policies during labour, provided women are at low risk of complications," lead author Dr. Mandisa Singata, from the East London Hospital Complex in East London, South Africa, said in a news release. "Women should be able to make their own decisions about whether they want to eat or drink during labour, or not."

The authors note that in many birth settings, fluid and food restriction during labor are common and that some women are only permitted sips of water or ice chips. These restrictions may adversely affect the experience of labor for some women.

The goal of this review was to evaluate the benefits and harms of oral fluid or food restriction during labor. The reviewers searched the Cochrane Pregnancy and Childbirth Group's Trials Register through April 2009 for randomized controlled trials and quasi-randomized controlled trials of fluid and food restriction for women in labor vs women permitted to choose what they ate and drank. Two reviewers independently evaluated the studies to see if they met selection criteria, determined risk for bias, and extracted data.

Five trials were identified, enrolling a total of 3130 women, all of whom were in active labor and at low risk of potentially requiring a general anesthetic. One study looked at complete restriction vs liberty to eat and drink as desired, 2 studies compared water only vs specific fluids and foods, and 2 studies compared water only vs carbohydrate drinks.

The meta-analysis was dominated by 1 study performed in a highly medicalized environment. No statistically significant differences were found in cesarean deliveries (average risk ratio [RR], 0.89; 95% confidence interval [CI], 0.63 - 1.25; 5 studies; n = 3103), operative vaginal births (average RR, 0.98; 95% CI, 0.88 - 1.10; 5 studies; n = 3103), Apgar scores of less than 7 at 5 minutes (average RR, 1.43; 95% CI, 0.77 - 2.68; 3 studies; n = 2574), nor in any of the other outcomes examined.

The pooled data were not sufficient to determine the incidence of Mendelson's syndrome, nor were women's views evaluated. One study did show a significant increase in cesarean deliveries for women drinking carbohydrate solutions vs water only, but the sample size was small.

"While it is important to try to prevent Mendelson's syndrome, it is very rare and not the best way to assess whether eating and drinking during labour is beneficial for the majority of patients," Dr. Singata said. "It might be better to look at ways of preventing regurgitation during anaesthesia for those patients who do require it."

Limitations of this study include domination of the meta-analysis by a single study, failure to assess women's views, and potential bias in the review process.

"Since the evidence shows no benefits or harms, there is no justification for the restriction of fluids and food in labour for women at low risk of complications," the review authors conclude. "No studies looked specifically at women at increased risk of complications, hence there is no evidence to support restrictions in this group of women. Conflicting evidence on carbohydrate solutions means further studies are needed and it is critical in any future studies to assess women’s views."

The National Institute for Health Research, United Kingdom, supported this study.

Cochrane Database Syst Rev. Published online January 20, 2010.

Thanks for the information.

Do they allow you to have water? I can't imagine going very long with out drinking! And now going without food, don't they worry about drops in blood sugar? I would - I HAVE to eat about every 2 hours or I get jittery and can't focus - not exactly a situation I'd imagine is ideal for delivering a baby.

I wasn't allowed liquids, no.

You'll probably be given an IV -- to which you can be given a dextrose solution if your sugars drop.  I'm severely hypoglycemic -- as in THAT'S why I have a med alert bracelet, not my RNY.  They can monitor your sugars and take care of you with IV solutions.

My water broke just after midnight...got to the hospital about 1:30...Aethyn wasn't moving as much as they would have liked...I was offered ice water, apple juice and sprite. (Then I got breakfast right after he was born-I wasn't really hungry after all the excitement...DH ate the rest of my meal.  He was STARVING by then because he refused to eat until I could!)  I am glad I didn't have much to eat though, I felt nauseous the whole time!  I would have puked for sure had I had something else.    The apple juice helped me when I could start to feel my sugars dropping.  I also had an IV about half way through labor.  I only had a 10 hour 3 minute labor...it really wasn't that bad as far as not eating-I worried needlessly-if you are having problems make sure you tell the nurses so they can help before it gets out of control.  Tell them you are worried about it right when you get to the hospital so they have a heads up from the beginning!

Thanks Becca! I am getting to a point where this baby leaving my body is becoming a closer reality! lol So all my first time mommy-to-be labor questions are coming to the surface!

Thanks for answering:)

Liz

Very Interesting!

I was so worried about being denied food - based on the horror stories I had heard.

I asked my OB who said "You can eat a speghetti dinner in while in labor - but I'd advice to eat light because you'll probably see it again..."   (He mean t vomit it back up.)

He explained that women vomit quite often during active labor - although he said with epidurals this risk goes down.

(Once you have an epidural I don't think they want you to eat.... ).

I brought snacks with me... I had a sandwich, chips, nuts, granola bar, etc while in labor....and I was only in labor at the hospital for about 9 hours! 

My biggest fear was having a bowel movement while in labor. 

Thanks for posting!

Cindy

My hospital doesn't allow eating or drinking either.

My plan (lol we know God laughs at our plans) is to wait to go to the hospital for a while.  This is my first so I'm thinking it will take a long time for her to come.  I would rather stay home for a bit and eat a little something and get my water in before I go.

Wow... I cant believe in less about 12 weeks my little baby will be here...

Thanks for the article

Its funny I saw an article just like this and said I was going to post it here and completely forgot (baby brain is what I blame).

I am going to have a doula and we already planned that we were going to bring snacks in for her and my DF and if I got hungry I would be snacking too. I am also going naturally with no IV (maybe just a hep-lock) so I will be able to drink regardless to keep up fluid intake. I just hope I don't get sick.

My article said that the reason for reduced fluids and no food is the fear of aspiration while under anesthesia. But apparently, if your not under general and your anesthesiologist does a good job of administering a perfect dose and your head stays slightly elevated, you will be completely fine.

Simone

I never worried about this, my midwives allowed me to eat with both of my children, with my son even when we transferred to the hospital from the birth center, my midwife had breakfast at the hospital with us