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are you going to sneak food at the hospital? - Page 2

post #21 of 36
If it had not been a true emergency, why would they be doing it?

I drank some water right before my c/s, and the nurse got a little freaked and said I would probably vomit it up, which I didn't. I was so dehydrated I'm sure my body sucked it up instantly. I was still thirsty 2 days later.
post #22 of 36
Quote:
Originally Posted by richella View Post
If it had not been a true emergency, why would they be doing it?
If you are going for an ERCS and tell them you ate something after the allotted time frame, they'll post-pone surgery. If it's a c-section for breech or placenta previa, they'll post-pone. There are several reasons a woman might have a medically indicated c-section scheduled that aren't an EMERGENCY, as in, surgery does not have to take place at that very moment in order to save mom and/or baby from dying.

They tell you not to eat for x amount of time prior to surgery for your protection. Problem with that is when they treat ALL women in labor as a section waiting to happen. Of course, in many hospitals these days, that's not far from the truth.

Anyhow, I digress...

Being married to someone who does anesthesia for a living, my biggest piece of advice would be to BE HONEST with your anesthesia provider should the need arise for a c-section. Making the choice to eat 'against medical advice' isn't really that big of a deal in my mind as long as you know, understand, and accept the risks of doing so. If you end up puking everywhere, well, it's YOU that'll be puking, so I honestly don't see why they make quite the ordeal out of eating during labor that they do.

The risk of needing a crash c-section under general anesthesia (which is when the risk of aspriation is at its highest) is truly not that high to begin with, and I can certainly see where eating light snacks as tolerated makes more sense as long as there is no indication of a problem with mom/baby during labor.

BUT PLEASE....*IF* the time comes that a section is warranted, PLEASE tell the anesthesia folks what you've eaten, had to drink, how much, when it was, etc. They need to know this information to be able to treat you to the best of their ability during surgery, and lying to them is not going to do you any good (not that anybody suggested they'd lie if it came down to an emergency, but just as general precaution).

It is true that if you are in a car wreck on your way home from gorging yourself over a huge 8 course dinner, they'll operate on you despite this fact if your life depends upon it. HOWEVER, there are precautions they can/do take in those cases, and they will monitor you closer for signs of aspiration if it is known you went into surgery on a 'full stomach'.

All that said, for myself personally, when going in for ERCS, I adhere to the no food after midnight (or 8 hours prior to scheduled surgery) rule. I do *not* adhere to the nothing by mouth rule, as I will 'eat' ice chips up until they take me to the OR. Not gallons of them mind you, but I refuse to have NOTHING to quench my thirst, and it's a risk DH and I are both comfortable with me taking.

I also do not adhere to the 24 hour clear liquids after my sections. I eat whatever sounds good, usually in massive quantities as my horrid reflux is finally GONE after delivery. I had fried chicken, mashed potatoes, green beans, and a roll 3 hours after my second section. The nurse was horrified, but I knew my anesthetic history had never involved puking, I was STARVED, and I figured my body has ALWAYS been pretty good at sending off appropriate signals as to what I could/could not eat without getting sick. So I ate.

It's really a choice that has to be made ultimately by mom after considering why it is 'they' tell you not to eat/drink during labor, weighing the risks/benefits to yourself, and making a decision you feel comfortable with. I'd have dared that nurse to take my fried chicken after surgery. He'd have lost a hand I'm afraid.
post #23 of 36
With my first (38 hour induction ending in c-section) I was not "allowed" to eat. I came in earlyTuesday morning, was induced, ended with a c-section late Wednesday night. I remember dh sneaking me chips from the vending machine at some point because I was literally starving. I had the shakes from hunger prior to even having the c-section. Then, after the surgery, because I had so much gas buildup in my abdomen, they wouldn't let me eat (clear liquids only) until Friday afternoon!!! OMG. I had nothing but a handful of Cheetos and some chicken broth from 5am Tuesday morning until Friday around 4pm.

Never, ever would I let them do that to me again. I had serious milk supply issues from birth until about 8 months. Which I don't doubt may have had something to do with the fact that I had no calories for the 4 days surrounding the birth.

My VBAC wasn't in a hospital, so I ate. I didn't really feel like eating much as I was concentrating so hard on labor, but I did eat when I felt hungry. Towards the end of my labor (35 hours), I was exhausted and not hungry at all, but my m/w encouraged me to eat (mostly soft fruits) to help me regain some stamina.
post #24 of 36
If the worry is that you will aspirate something under general in an emergency c/s, well, isn't that why they stick a tube down your throat anyway? I mean, if they are doing that already to prevent the problem, why should a laboring woman go with out food if that is what she wants?
post #25 of 36
I REALLY hope to give birth in an environment where sneaking was not an issue.

When I was laboring at home the MW had to really push me to take anything, eating's just not where I was "at" either mentally or physically. Although objectively, I needed it. Having to sneak would probably be the straw that breaks the camel's back as far as motivation to eat. I tend to be a very open, compliant person (part of why I ended up with a c/s), and by nature I find it almost impossible not to be open and upfront with people, especially when I have other things to worry about (such as labor pains). One thing I learned from my first experience in a hospital was that strategies based on scheming, resistance and subterfuge (which is so much of what gets recommended when it comes to dealing with medpros) are not realistic for me and do not help me find my strength. I would not accept starvation though. Between that and open defiance I'd choose defiance. And if you were confident and had spouse/doula/friend support, combined with the fact that they cannot legally forbid you to eat, I think defiance would be just as effective as sneaking anyway, given how likely you are to get caught sneaking with all the people going in and out all the time....and again, "getting caught" is not a place of strength. "I'm an adult, I'll eat as I please" is.

ETA I have read, although I don't know how true it is, that there are no actual cases of fatal aspiration during c/s in the medical literature.
post #26 of 36
Quote:
Originally Posted by jennkraig View Post
If the worry is that you will aspirate something under general in an emergency c/s, well, isn't that why they stick a tube down your throat anyway? I mean, if they are doing that already to prevent the problem, why should a laboring woman go with out food if that is what she wants?
They put the tube down your throat to deliver oxygen to your lungs. You can aspirate around the tube if your stomach contents come back up the espophagus and enter the lungs. The tube itself doesn't 'block' this from happening, and it can be life threatening if it occurs.
post #27 of 36
They don't like you to eat before any kind of surgery, even if you're just having an epidural/spinal. The epidural for my c-section made me super nauseous, and I probably would have thrown up during the surgery if I'd had anything to eat in the previous 8 hours. As it was, I started puking about 10 minutes after getting into the recovery room, and spent the whole day throwing up bile :

It would definitely not be pleasant to throw up during a c-section, even if you didn't then aspirate.

My friend who aspirated nuts at the end of her labor had a totally natural labor. Labor can make you puke too, and I guess there's a small risk of aspiration everytime you puke.

I still thinking eating during labor is a GOOD idea, but I can understand why there are rules against it in some hospitals. Most medical folks are always fearing the worst.

Lex
post #28 of 36
Quote:
Originally Posted by lexbeach View Post
I still thinking eating during labor is a GOOD idea, but I can understand why there are rules against it in some hospitals. Most medical folks are always fearing the worst
I think they're also fearing lawsuits. It's so sad that so many hospital policies are based on the fear of malpractice suits
post #29 of 36
Quote:
Originally Posted by wifeandmom View Post
They put the tube down your throat to deliver oxygen to your lungs. You can aspirate around the tube if your stomach contents come back up the espophagus and enter the lungs. The tube itself doesn't 'block' this from happening, and it can be life threatening if it occurs.
What's the point then of using a cuffed v. uncuffed ET tube? Cuffed are a damn sight bigger, and I vividly remember being extubated with a cuffed tube.
post #30 of 36
Quote:
Originally Posted by maxmama View Post
What's the point then of using a cuffed v. uncuffed ET tube? Cuffed are a damn sight bigger, and I vividly remember being extubated with a cuffed tube.

Had to wait for DH to get home for this one.

He says cuffed tubes are for adults, uncuffed are for peds.

Having the cuffed tube inflated DOES protect the airway from aspiration, BUT you put the patient under THEN insert the tube, leaving the opportunity for aspiration after patient is under but before tube is inserted and inflated.

There is also the risk of aspiration AFTER the tube is removed but before the patient is fully alert again.

Does that make sense?

Edited to add he said IF the tube is inflated exactly as it should be with no space whatsoever, the patient won't aspirate with it in place, but you are still left with the time before the tube is in place and after it is removed but before patient is alert that the concern for aspiration is highest, thus the no food or drink rule. Also, even the tiniest bit of error can allow liquid contents to enter the lungs, so it's just a whole lot simpler if patient has an empty stomach.
post #31 of 36
Quote:
Originally Posted by wifeandmom View Post
Had to wait for DH to get home for this one.

He says cuffed tubes are for adults, uncuffed are for peds.

Having the cuffed tube inflated DOES protect the airway from aspiration, BUT you put the patient under THEN insert the tube, leaving the opportunity for aspiration after patient is under but before tube is inserted and inflated.

There is also the risk of aspiration AFTER the tube is removed but before the patient is fully alert again.

Does that make sense?

Edited to add he said IF the tube is inflated exactly as it should be with no space whatsoever, the patient won't aspirate with it in place, but you are still left with the time before the tube is in place and after it is removed but before patient is alert that the concern for aspiration is highest, thus the no food or drink rule. Also, even the tiniest bit of error can allow liquid contents to enter the lungs, so it's just a whole lot simpler if patient has an empty stomach.
Except that pregnant women, by definition, never have empty stomachs (progesterone causes delayed emptying), and gastric secretions (with their pH of 1) have been shown to cause aspiration pneumonia.

Must have lucked out, because I know I've been intubated with an uncuffed ET as an adult, and damn, that was more comfortable the next day. Or my anesthesiologist was confused as to my age .
post #32 of 36
Quote:
Originally Posted by maxmama View Post
Except that pregnant women, by definition, never have empty stomachs (progesterone causes delayed emptying), and gastric secretions (with their pH of 1) have been shown to cause aspiration pneumonia.

Must have lucked out, because I know I've been intubated with an uncuffed ET as an adult, and damn, that was more comfortable the next day. Or my anesthesiologist was confused as to my age .

You're right that pg women are treated as if they have a 'full stomach' regardless, but actually HAVING a stomach with food in it DOES make a difference in the risk of aspiration.

I'm not sure that DH meant uncuffed=peds and cuffed=adults as a matter of rule or if it is just his preference. Actually, he just said 'You don't use cuffed tubes with peds', so I'm thinking maybe it's up to the provider in question as to whether or not they use cuffed or uncuffed with adult patients.

Although...if cuffed tubes are available, it would make sense to use them on a pg woman due to the increased risk of aspiration even without food in the stomach. Hmmm....it would be interesting to hear opinions of various providers that choose not to use cuffed tubes in pg women for whatever reason.

DH is already asleep or I'd ask him why someone would choose to do it that way as I really have no clue whatsoever.
post #33 of 36
This is what I brought (did not have to sneak):
Frozen banana, sliced
Yogurt
Vitamin water

When I threw up at 10 cm, it was only water, so everything digested easily.

BTW, the reason they don't want you to eat is in case you have a c/s under general anesthesia and they do not intubate your properly and you vomit and aspirate vomit while unconscious, which is about 1 in 1,000,000, literally.
post #34 of 36
I packed snacks for my hospital birth last time. I wasn't all that hungry for the snacks and I only at a little of the sandwich, but I also ate all the jello and popsicles they had! I had a homebirth this time and I planned labor snacks and managed to eat them all as I went 16 days past my due date. I wasn't hungry anyway b/c I woke to contractions at four am and by 8 am she was here! I seriously inhaled a big bowl of oatmeal afterwards, though!
post #35 of 36
I planned to sneak food. My doula brought honey packets and squeeze peanut butter, but I was ready to push when I arrived at the hospital - NO time to eat!
post #36 of 36
For me, what I ate at the hospital remains one of the more amusing aspects of my hospital experience. I had intended to come prepared with healthy/light snacks and drink and my midwives had said I could eat and drink as much as I liked. In fact, they pushed the juice and water so much I thought I'd float away. As it was I was sweating so much during transition and pushing...anway - I digress. I think I did have a bag packed with food but dh got really hungry and since my labor was stalling he went out and got veggie sub sandwiches and veggie sushi. OMG that sushi tasted so good to me! And there I was with huge mouthfull of sushi when the midwife came in, came to a shocked stop, giggled, and said "Oh my - don't you dare let any of the nurses see you with *that*!" I was sort of surprised since that had always said food was OK. I guess veggie sushi was just not the typical thing. And - as it was - I never saw a nurse until pushing time and then she was in the background. I think my hospital birth was atypical for this country as I had midwives the whole time. Worked for me. I never threw up and I think the eating really helped as I was exhausted from a week of heavy prodromal labor. I needed the energy.

J
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