New research suggests that most healthy women would benefit from eating a light meal during labor.
Many women are advised not to eat before giving birth due to concerns they may aspirate, or inhale liquid or food into their lungs, which can cause pneumonia, but researchers say improvements in anesthesia care have made pain control during labor safer, reducing risks related to eating. Researchers found that withholding food and liquids may be unnecessary for many women in labor.
"Our findings suggest a change in practice makes sense," Christopher Harty, co-author of the study and a medical student at Memorial University, St. John's, Newfoundland, Canada, said in a statement. "Physician anesthesiologists and obstetricians should work together to assess each patient individually. Those they determine are at low risk for aspiration can likely eat a light meal during labor. This gives expectant mothers more choices in their birthing experience and prevents them from being calorie deficient, helping to provide energy during labor."
According to the researchers, aspiration today is almost nonexistent, especially in healthy patients.
For the study, researchers analyzed 385 studies published in 1990 or later that focused on women who gave birth in a hospital. The research suggests that the energy and caloric demands of laboring women are similar to those of marathon runners, Harty said. Without adequate nutrition, women's bodies will begin to use fat as an energy source, increasing acidity of the blood in the mother and infant, potentially reducing uterine contractions and leading to longer labor and lower health scores in newborns. Additionally, the studies suggest that fasting can cause emotional stress, potentially moving blood away from the uterus and placenta, lengthening labor and contributing to distress of the fetus.
"However, certain factors increase a laboring patient's risk of aspiration which outweigh the risks of withholding nutrition," Erin Sprout, co-author of the study and a medical student at Memorial University, said in a statement.
She said these factors include eclampsia, pre-eclampsia, obesity and the use of opioids to manage labor pain, which delays stomach emptying.
Healthy women who are not at risk for aspiration should ask their medical care providers (including their physician anesthesiologist and obstetrician) if eating a light meal during labor is safe for them. A light meal could include fruit, light soups, toast, light sandwiches (no large slices of meat), juice and water. Most women lose their appetites during very active labor, but can continue to drink fluids such as water and clear juices, researchers said.
The findings will be presented at the ANESTHESIOLOGY 2015 annual meeting.
