During labour, low-risk women should be free to choose whether to eat and drink, so it isn’t justified for healthcare professionals to restrict this.
Eating and drinking are considered important factors that affect comfort during labour. Even so, labour practices often restrict fluid and food intake during labour. This has been the case since 1940, when Mendelson’s syndrome was described—aspiration of stomach contents during general anaesthesia—which can result in the mother’s death (Singata, Tranmer, Gyte 2013).
For decades, anaesthetists, gynaecologists and midwives have discussed eating and drinking during labour. The main factors are:
- the risk of aspiration of stomach contents if general anaesthesia is needed
- energy needs during labour,
- the effect of ketosis on mother and baby,
- hyponatraemia due to hypotonic solutions,
- stress for the mother due to restricted movement because she is connected to an IV drip,
- the impact of oral fluid and food intake on vomiting, the length of labour, and the baby.
Studies on this topic carried out in the USA, Australia and Europe show that vomiting and prolonged labour, which may result from eating and drinking during labour, do not affect birth outcomes for the mother or baby. In 2007, the American Society of Anesthesiologists’ Task Force on Obstetric Anesthesia issued a recommendation that low-risk women should consume only clear fluids at least 2 hours before anaesthesia. Greater restrictions apply to women at higher risk, such as women with diabetes, obesity, or a difficult airway. Since 2009, the American College of Obstetricians and Gynecologists has recommended consuming clear fluids. And since 2008, the American College of Nurse-Midwives has recommended that women at low risk of aspiration of stomach contents decide for themselves, in line with established guidelines.
The World Health Organization (WHO) advises that healthcare providers should not restrict food and drink intake during labour when there are no risk factors, as energy needs during labour are high and food intake supports the wellbeing of mothers and babies. Midwives and nurses working with women in labour are encouraged to take part in multidisciplinary teams and be involved in policy changes that unnecessarily restrict oral food and drink intake during labour for low-risk women (Shartsh-Hopko, 2010).
Poor nutritional balance can also be linked to a longer and more painful labour. Restricting food and drink also does not guarantee an empty stomach or lower acidity of stomach contents. A review of the research found no proven disadvantages or benefits of restricting food and drink during labour for low-risk women. Therefore, the authors say women should decide for themselves whether they want to eat and drink during labour (Singata, Tranmer, 2013).
Read more about how you can prepare your own drink for hydration during labour—and it’s tasty too. You can also drink it after birth.
