Eating, Drinking during labor

[crowbaby]

I am studying to be a childbirth instructor, (Bradley) and I was hoping to get opinions from some professional women and men about eating and drinking during labor. Of course this is a nono at most hospitals, however at most birth centers it is common practice. (At our birth center they have a kitchen (with snacks supplied!).

I understand that it is because the chance of choking on vomit during anesthesia that most hospitals do not want you to eat, but I thought that was why the anesthesiologist was there. What about ice chips, don't they just turn into water in your stomach anyway? Why can't you just drink water or juice? Don't women who haven't eaten throw up (dry heave) as well? What about saline/glucose build up in the blood? Side-effects?

You have probably guessed my bias, but if you have an opinion to the contrary I would love to hear it. I want to give out good and accurate info on this. I have known a lot of women who had stalled out labor after not eating for hours and I want that to be avoided by my couples...

Karen

[lisamarie]

My experience is, if you are planning a natural birth (in the hospital-at least the two in our area), you may drink juice during your labor. Of course, if you are going in to the hospital and plan to have an epidural, they give you an iv.

When my water broke at home in the morning, I called my midwife~I was hungry and she said it was just fine to eat, just nothing super heavy (like a Denny's Grand Slam breakfast-YUCK!) So I had peanut butter toast (good protein) and made a yogurt/strawberry smoothie. It hit the spot!

IMO~I feel that laboring moms need to keep up their energy and endurance~labor is like running a marathon and you need to keep hydrated and keep your energy level up.

Warmly~

Lisa

[BusyMommy]

Well, I was down to the wire (day 14) so had home & hosp. plans. At the hosp. I had to argue w/my dr. to allow me to NOT be on an IV from the moment I walked in. NO FOOD from midnight on if I were induced. NO FOOD at all except ice chips until baby was out. She'd had a patient die once from dying on her vomit.

At home, 2 hours to spare , I had just eaten a huge dinner. Went into labor, puked up the dinner. Ate popsicles and ice chips.

All went well.


Tough call!

[candiland]

According to research, the no eating and drinking rule is totally outdated. Before the epidural women were routinely knocked out for their births, and in this instance, it was probably wise to advise them to not eat beforehand. But nowadays, research has found that even if you require general anest. (i.e., if the epi did not work and you need an emergency section), the dangers of aspirating the highly acidic liquid found in an EMPTY stomach is more harmful than the stomach acid that is diluted with food and drink. But this should make no difference, anyway, as aspiration is extremely rare regardless of if your stomach is empty or partially full. My doula partner recently went to a birth where the mother labored for 30 hours and was denied food and drink!! Imagine running a two day marathon and not refueling your body. It's simply ludicrous.

[crowbaby]

Thanks for your input ladies. I also wanted to let you know that I contacted some anestisiologists (sp?) and one wrote back saying pretty much the same thing as candiland. He said that drinking liquids is great and soft foods are great too. He suggested yogurt. Nothing heavy, but when you are in active heavy labor the idea a big meal dosn't seem so appealing anyway...

Karen

[kama'aina mama]

My midwife was trying to get me to eat between pushes! I had no interest at all and maybe she thought my energy was flagging although I felt great. She actually insisted at pne point that my husband go to the kitchen and bring back some fruit and cheese. So, that's the priority of a midwife of thirty years.

[darlindeliasmom]

the hospital where I labored was actually more like a birth center; the stocked kitchen was right outside my room, I labored in a jacuzzi, and gave birth in a queen sized bed. So I could havbe eaten all through my labor, and was encouraged to try...I vomited so much in the morning, we thought I had the flu. I tried all day to "eat", but would vomit every time. So we ruled that out, because as active labor started, I had no interest in vomiting AND laboring.
But i seem to remember juice...and once the baby fell asleep after birth, we made a "feast" out of the healthy snacks in the kitchen.

As an aside, out Bradley instructor suggested these things called honeystix. They are basically flavored honey in a straw that she said you could carry with you and that would give you a boost of energy if they didn't let you eat. I think a suggestion like that would be welcomed by lots of moms.

[crazy_eights]

It's funny, b/c at work (I'm an RN in L&D) we were discussing this last night. The hosptial where I work only allows juice and popsicles. A woman came in last night in labor who was scheduled for a c/sec and she had just had dinner. The anesthesia staff wouldn't do the c/sec for 6 hours after we ate. We (the nurses) were all talking about the lunacy of this, b/c with decreased absorption during labor, we have all seen women throw up food that they had eaten *many* hours earlier. The anesthesia staff agreed and shrugged it off as policy.

The one thing I have heard from the anesthesia staff is that it is not the anesthesia that is the big problem, b/c if you need a general, they intubate you. BUt they give you a paralytic to intubate and many people throw up from that med. So it can make the intubation difficult and this is the point they can aspirate. But any anesthesia staff who works in emergency med., this has to be routine since most traumas involve people who haven't been kept without food in case they are in an accident! Since general anesthesia is *rarely* used in OB, I think this is a good comparison.

[sarahwebb]

Eating, Drinking during labor

Candiland wrote: According to research, the no eating and drinking rule is totally outdated

I tend to agree based on anecdotal experiences of my friends, but does anyone have any references for the research? Negotiating exceptions to doctor/hospital policies should be much easier with some hard research references in hand.

Also, I keep hearing that hospitals won't let laboring women eat or drink, but how much power do they have? If a laboring woman shows up with her own snacks and drinks, how are they going to stop her?

A doctor I interviewed said that eating and drinking wasn't necessary because laboring women are routinely put on IVs, but I read somewhere (Sheila Kitzinger?) that the IV dilutes the laboring hormones and increases the chances of doctors ordering pitocin.

[Corriander]

You've hit the nail on the head Sarahwebb. If you bring your own food and drink they cannot stop you. I would OK it far ahead of time with your Dr. or midwife during a prenatal appointment, make sure there is not any reason you may not have considered that would contraindicate. And then bring your own and have at it!

Granted with each of my labors I have eaten early on and then regretted it when I threw it up later! But lots of liquids are essential. Don't ask for permission, just do it. That nurse ist not going to be in the room continuously, in fact, the hospital staff usually leaves you alone more than you would imagine.

So if they catch you sipping some gatorade what are they gonna do, throw you out? We should all be so lucky!

[valeria_vi]

Originally posted by Corriander
So if they catch you sipping some gatorade what are they gonna do, throw you out? We should all be so lucky!

Well,
I ould think that if a damn nurse is really determined, she could possibly take all your snacks and throw them away, or just take them from you. :

[sarahwebb]

Originally posted by Corriander
<snip> what are they gonna do, throw you out? We should all be so lucky!

Reminds me of a friend's funny story--she was laboring in the hospital with twins when they tried to strap her down (16 years ago). She refused and when the nurse insisted, she threatened to walk out. The doctor (with visions of news headlines "Woman Gives Birth to Twins on Hospital Steps") told the nurses to do WHATEVER my friend wanted...

[Curious]

Cheating Doctor

I had a wonderful delivery in a hospital by a teamed midwife/MD.

Labor was 28 hours at home and 2 more days in the hospital where I was allowed only clear liquids.

I cheated. When the nurses were out of the room, Dh gave me sips of the banana-protein drink that was ostensibly his. During transition, I took refuge in the bathroom behind a locked door, with a package of healthy oatmeal-walnut-raisin cookies.

After 10 hours of pushing I delivered Dd who was much larger than expected, through my funnier shaped than initially realized, little pelvis. The staff all marveled how well I did, how I managed to keep up my strength and spirits.

It was my secret weapon - snuck solids.

PS. I'm an anesthesiologist. Even though I'm well studied in the risks of aspiration of stomach contents into the lungs should I have needed anesthesia, and the serious pneumonia that may result, I was bad bad bad.

[woldkill]

I didn't even realize that there were still places that did not allow you food. When I checked in, they gave me the food menus and brought me a meal. I was brought every meal after that although I could not eat the last meal right before dd was born.

[BusyMommy]

I love this thread. SarahWebb-so interesting about the IV perhaps leading to pitocin. My dr. is deadset on everyone getting that IV as soon as they walk in the door. Hmmm...she does lots of C-sections, too!

IF I'd had to go to the hosp., we were planning to sneak food. We loaded my bag w/light snacks; ie. those little packets of "GOO" you keep in your pocket when you ski/bike hard. And, my dr. and I had discussed that I was the one in control and I had the full option of leaving at any point.

Could you imagine being strapped down? YIKES

[Allana]

Curious,
How in the world did you push for 10 hours!! I admire that determination. How did the hospital let you go that long? The max they will let you go where I live is about three hours. My midwife was shocked that the hospital I delivered my first let me go four. How big was he?

[Curious]

Since you ask - food and teamwork

Allana,

I have no idea how I pushed for 10 hours. I wasn't watching the clock. I also had a great doula, and Dh got in the bed with me. Yes, I finally agreed to an epidual which I'd really wanted to avoid. It was inserted at 3AM the night before, after I had taken 6 hours to go from 8.5 to 9cm, and the midwife wanted me to get some sleep so I'd be fresh for pushing. That's why Dh was in the bed: holding me in position because my lower body was too weak to squat.

I have done a lot of yoga and meditation, chakra visualizations, and QiGong (Best described as Chinese meditative yoga if you aren't familiar), which I used the whole time. This was very helpful since of course the epidural takes away some sense of how to push. But I can't neglect the solid food aspect.

How did I go so long in the hospital? That's another good one. There were 2 midwives in the practice. One I really clicked with and hoped I'd deliver with her. The other one always had something negative to say, and was stubborn when it came to her thinking that I was underweight, small for dates. She strongly suggested an ultrasound. I was told Dd was fine but on the small side, and would probably be under something under 6 pounds.

When I got to the hospital, my favorite midwife was on, but her shift ended before I delivered and in came Ms. Stubborn. Ms. Favorite looked pretty wrung out and I was happy to see Ms. Stubborn's well rested face.

Finally, it was her assumption that Dd was small, combined with her stubbornness, that made them let me go so long. I had read in Birthing From Within about 4 day labors, so I wasn't worried. And if our era of technology, of course all looked good on the monitor. I loved hearing the little heartbeat.

After I'd been pushing for some number of hours, it appeared Dd was stuck because there was some funny angle to my pelvic outlet. Dd was facing posterior (I'd known that for months), because the shape of my pelvis didn't allow her to rest any other way, not even to rotate during labor. But to pass the outlet, she needed to turn anterior. Catch-22.

Her little head was wiggling (I'd meditated to her all about the labor process and how she could help) trying to work it's way out, to no avail. So we called the OB covering the midwife. We talked about forceps, C-section, continuing as we were. She was great, coached me through the real hospital pushes I'd hoped to avoid but needed (count to 10 - not the more fluttery pushes described in Birthing From Within).

She also did some sort of maneuver with her fingers that rotated Dd under the odd angle. She did all this with me in positions that the doula and I decided on. The research is right: I'm convinced it was because of the doula that I avoid a c-section). After one great push and a flip of the OB's fingers, Dd rolled out all curled up in a little ball.

And she weighed in at 8lb 7oz. Small for dates indeed! Maybe all those cookies I ate in the bathroom went onto her at the last minute.

[Allana]

What a great story!! I am planning on becoming a doula and am going to remember this story. Birthing From Within is a great book. I also really enjoyed it.

[Naomi]

For research-oriented information on eating and drinking in labor, check out "The Thinking Woman's Guide to a Better Birth" by Henci Goer. I think every pregnant woman should read that book; it's EXCELLENT.

I birthed at a very progressive hospital (they've got a long-standing midwife practice, they're working on baby-friendly certification, etc.) They keep snacks around for women who get hungry during labor -- mostly kind of light stuff. Fruit, fruit juice, bagels, yogurt. When I asked about eating during labor at my first prenatal checkup (I have blood sugar crashes sometimes, so this was REALLY important to me -- if the hospital wasn't going to let me eat, I was going to have a homebirth, even if it was going to cost us a ton) my midwife said, "Well, we don't recommend that you, you know, order a pizza with double sausage, because sometimes women end up getting sick towards the end of their labor. But we keep fruit and yogurt and stuff around if you'd like that."

I mean, logically, it makes no sense that you MUST be fasting to have surgery. If you get run over by a bus on your way back from eating a pizza with double sausage on it, it's not like they have to wait eight hours before they can do surgery on you : ...so, they OUGHT to be able to cope with the one woman in a million who has to have a crash c-section under general anaesthesia.

My baby is 17 months old now and my HMO has changed hospitals. The next time I have a baby, assuming our coverage stays the same, I will have to deliver at another hospital in town. When I heard about this change, I called them up and quizzed them about their maternity policies. You're allowed to eat when you first check in, but after a certain number of hours of labor, you are only "allowed" to have juice, and then a certain number of hours after that, you're restricted to ice chips. But this is "up to your doctor." The policies at Fairview-University (where I had dd) were as progressive as they were because of the influence of the midwives who worked there, so it's possible that by the time I get around to having another baby, Abbot Northwestern will be just as progressive. If not, well, I'll check into homebirth, because this is STILL a dealbreaker for me. (Heck, I may want a homebirth anyway. Certainly I'm going to educate myself and my dh on unassisted birthing -- because with dd, real labor kicked in at 10 p.m., I checked into the hospital just after midnight, and dd was born at 3:51 a.m. after somewhere between 30 minutes and an hour of pushing. And that was my first birth. Everyone says that first births take the longest. My second could well be born on the way to the hospital. I have to admit that one of the things that most appeals to me about homebirth is NOT having to GO anywhere!!! The drawback, of course, is that it would be much more expensive. The total out-of-pocket cost to us of dd's hospital birth was $0 -- well, okay, we had a doula, so $350. It's possible that our HMO would agree to kick in part of the cost for a homebirth -- it would be a LOT cheaper for THEM -- but inevitably, our out-of-pocket cost is going to be a lot higher.)

[crowbaby]

Naomi,