Why do hospitals not let you eat while in labor? - Mothering Forums

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#1 of 23 Old 12-05-2007, 05:13 PM - Thread Starter
 
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I think this is horrible! Labor can last for days. How can they say you can't eat anything? : Anyone know why?
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#2 of 23 Old 12-05-2007, 05:15 PM
 
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In 1949, a study showed that women who ate during labor had a higher chance of aspiration (food entering the lungs during anesthesia.) Since then, women have often been told that as soon as they feel contractions or think they are in labor, they should stop eating.
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#3 of 23 Old 12-05-2007, 05:18 PM
 
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What Thorn said. But it's dumb for a whole bunch of reasons.
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#4 of 23 Old 12-05-2007, 05:20 PM
 
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Ooops, not a birth professional...deleted my post.

Nothing to see here, people, move along!!

Mama to DS (8) and DD (7) Aristotle was not Belgian. The central message of Buddhism is not "Every man for himself." And the London Underground is not a political movement.

 

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#5 of 23 Old 12-05-2007, 05:26 PM
 
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Originally Posted by BlueStateMama View Post
Ooops, not a birth professional...deleted my post.

Nothing to see here, people, move along!!
Uh oh! I didn't realize that was where I was. (I'm not either.)
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#6 of 23 Old 12-05-2007, 05:27 PM
 
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Gosh, sorry-- I'm not either! I should read more carefully....

I thought this was so silly when I was pregnant and planned to eat during labor. I did read, though, that part of the reason is that the body is using so much energy laboring that the digestion slows. Thus, having lots of food in your stomach isn't good, and you'll end up vomiting. This made a lot more sense to me than the aspiration thing. I ate during the first 24 hours and only had some coffee (I told Dh that i could handle being in labor but could *not* handle a morning without coffee!) and a granola bar during the last 12. I certainly wasn't sick-- but I sure was hungry once it was all over!

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#7 of 23 Old 12-05-2007, 05:43 PM - Thread Starter
 
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I definitely understand if there are reasons why it might be better not to eat, but I think the mother should have a choice and if she feels like she needs something to eat it shouldn't be a problem!:
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#8 of 23 Old 12-05-2007, 06:15 PM
 
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I am a certified childbirth educator and trained (not yet certified) doula. I tell my classes that the main reason for NPO (nothing by mouth) in the hospital is for fear of aspiration during anaesthesia - a reason which is quite outdated due to better anaesthetic techniques. However, digestion DOES slow down quite a bit during labor, so it is probably best not to put a lot of heavy, hard to digest food into the tummy, where it will probably just sit and may be thrown up. However, if a woman is hungry during labor or feels the need for some extra energy, she should certainly be able to eat something easily digested, such as applesauce or honey. I tell my moms that if they feel strongly about this they should discuss with their doctor and get written approval to take with them in labor as part of their "doctor approved" birth plan. I was with a mom once whose labor was induced after water breaking. Once labor got going, all she could think about was eating something, and she and her DH talked about their favorite restaurants. She didn't want to "break the rules" and eat some of the yogurt I had brought, however. I always say, if you're going into the hospital with broken membranes and no contractions, stop off for something to eat first!
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#9 of 23 Old 12-05-2007, 06:20 PM
 
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i was really lucky, my cnm let me eat a 6 in sub while i was in labor at the hospital. i can understand the food to some extent, but some won't let you drink water, which is directly absorbed into the stomach lining. it's just silly at best.

SAHM to Hannah (11/04), Cash (02/08), and Adelaide (07/10) dh, Chris.
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#10 of 23 Old 12-05-2007, 06:32 PM
 
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Go to this website:
http://www.blackwell-synergy.com/doi...urnalCode=jogn

It is the abstract of a 1999 study on the effect of fasting in labor. Here is an excerpt:

Data Synthesis: Research does not support restricting food and fluids in labor to prevent gastric aspiration. Restricting oral intake during labor has unexpected negative outcomes.

Conclusions: Little is known about the differences in labor progress, birth outcomes, and neonatal status between mothers who consume food and/or fluids during labor and women who fast during labor. Research also is needed on the effects of epidural opioids on gastric emptying, nutritional requirements during labor, and the physiologic implications of fasting during labor. Fasting during labor is a tradition that continues with no evidence of improved outcomes for mother or newborn. Many facilities (especially birth centers) do not restrict eating and drinking. Across the United States, most hospitals restrict intake, usually to ice chips and sips of clear liquids. Anesthesia studies have focused on gastric emptying, measured by various techniques, presuming that delayed gastric emptying predisposes women to aspiration. Narcotic analgesia delays gastric emptying, but results are conflicting on the effect of normal labor and of epidural anesthesia on gastric emptying. The effect of fasting in labor on the fetus and newborn and on the course of labor has not been studied adequately. Only one study evaluated the probable risk of maternal aspiration mortality, which is approximately 7 in 10 million births. END EXCERPT


As a doula, with my hospital moms, I always support them at home as long as possible (they eat and drink as much as they like) and then we always bring snacks, such as apple and bananna slices, whole grain bread/crackers, cheese cubes, and carrot sticks, plus plenty of filtered water, to the hospital with us and mom takes bites and sips whenever the nurse is not in the room. WARNING, RANT! This is one of my pet peeves. The research clearly shows that eating and drinking in labor is not harmful, and I know that reduced blood sugar will produce fatigue and low spirits in a laboring mom. She's doing the hardest work she'll ever do in her life--come on people, she needs food and water! Athletes will not run a marathon without something in their body, but hospitals demand that women do much harder work with an empty gas tank. But like I always say, doctors/hospitals do not do evidence based practice; they do tradition based practice. Thus they accept the 1949 study and ignore the 1999 study, simply because tradition dictates that women should not eat in labor. END RANT

I hope this is helpful!!

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#11 of 23 Old 12-05-2007, 07:05 PM - Thread Starter
 
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Originally Posted by BirthIsAwesome View Post
Go to this website:
http://www.blackwell-synergy.com/doi...urnalCode=jogn


As a doula, with my hospital moms, I always support them at home as long as possible (they eat and drink as much as they like) and then we always bring snacks, such as apple and bananna slices, whole grain bread/crackers, cheese cubes, and carrot sticks, plus plenty of filtered water, to the hospital with us and mom takes bites and sips whenever the nurse is not in the room.
I hope this is helpful!!
Great idea!
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#12 of 23 Old 12-05-2007, 07:20 PM
 
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Sometimes it's hard to get someone in labor to eat. I certainly have seen digestion slow - sometimes with vomiting you see food that she ate a day ago or something.

I do think it's a risk analysis question. There is a slight risk of aspiration if you need general anestethia. If you use the one in 7-10 million as the risk that someone in labor would need a c-section AND would need general AND would aspirate AND that it would cause pneumonia AND that would be fatal. I feel pretty comfortable with that number. But someone else might not.

People gotta embrace their inner desires - in general, not exactly birth related. But if she wants to eat, she should eat. If not...then she shouldn't be forced to. It's always important to stay hydrated and energized in labor. Many people have short enough labors and good enough glycogen reserves that they can labor with no food or drink. Others will need to have drink/food/IV/something to allow their body to function well.

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#13 of 23 Old 12-06-2007, 03:02 PM
 
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I am not a birth profession, but that isn't going to keep me from chiming in!

The hospitals in this area definitely not only permit a laboring mom to eat, but encourage it by providing a fridge full of snacks (plus we can bring our own). I don't know how widespread this is, but its not like I live in some sort of progressive, crunchy area. My impression is that most hospitals with so-called birthing centers got rid of the "no eating" rule long ago.

Of course, I am also free to give birth in the water, so maybe I have found an especially open minded hospital.

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#14 of 23 Old 12-06-2007, 06:14 PM
 
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Our hospital doesn't allow women to eat or drink in labor (though they can have ice chips or those horrible "fruit" popcicles).

We are very interventive, though. I would guess at least a 30% section rate. 95% epidural rate. Yuck. I would imagine, given that we have a high intervention rate, we probably have a higher rate of people yacking during labor. Since virtually everyone gets an epidural, and they are then in bed, often lying with their head flat or down since their bloodpressure sometimes bottoms out, I guess they probably are at greater risk of aspirating; so I can understand the NPO status, in a strange, sad, cynical sort of way.

Urgh.

I find that most moms don't want to eat a heavy meal while in labor, though. (talking normal, unmedicated labor now) I think that light meals and juice/soda/whatever to thirst is great.

There's always the exception, though. I remember a mom at the birth center who, at 8 cm (this is a multip), developed an overwhelming craving for tamales from the mexican restaurant from across the street. When her husband balked at going to get them, she started to put her clothes on to go herself. He ran out, got six, she ate three, pushed out a baby in about half an hour, then at the other three. Whatever works! I'm glad papa didn't miss the birth because he was getting tamales, though.
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#15 of 23 Old 12-06-2007, 06:34 PM
 
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There should be a standard. If some hospitals allow women to eat in labor safely, why can't they all? We should develop a union of birthing mamas and fight for our birthing rights!

I was just thinking about this. I will definitely drink water during my next labor. Getting it from an IV is just really not what I want. IDK if I will eat. I didn't happen to feel like it in my last labor. I am considering insisting on GA if I ever have a section though. I don't want a needle in my spine and I feel as though I would have trouble emotionally. I don't want to be awake while someone cuts me. :cry
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#16 of 23 Old 12-07-2007, 04:25 PM
 
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With DS the hospital had a snack fridge and the policy was "no holds barred" on the snacks. We are having a home birth this time but our crummy back up hospital says you have to "get permission" from a doctor before they will "let" you eat. I don't need anyone's permission to "let" me make my own darn decisions so I told DH that in the event of a transfer we are just bringing snacks with us (unless I am transferring specifically for a c sec), forget this wheedling for permission like a grade schooler. If I feel like eating snacks then I am eating snacks. And I'm not bothering with hiding them either. Poo on the hospital, what are they going to do, duct tape my mouth shut? LOL
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#17 of 23 Old 12-07-2007, 04:31 PM
 
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To be cruel to women. The hospital I was considering told me I couldn't even drink water during labor, that the IV would keep me hydrated and I could suck on ice chips if my mouth was too dry. I said, "The ice chips will melt into water in my stomach so why can't I just have sips of water?"
They didn't have an answer.
It's actually to make things easier for the doctors, in case you have to have a c-section and they use general instead of a epidural there is a tiny, tiny, tiny risk that you may vomit. If you vomit, there is a tiny, tiny, tiny risk that you may choke on it, and if you choke on it there is a (you guessed it!) tiny, tiny, tiny risk that you may die.
I ate and drank throughout my 29 hour labor and was able to keep my strength up and delivered at home - without an IV, can you imagine that?!
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#18 of 23 Old 12-08-2007, 01:34 PM
 
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Originally Posted by Kitten View Post
With DS the hospital had a snack fridge and the policy was "no holds barred" on the snacks. We are having a home birth this time but our crummy back up hospital says you have to "get permission" from a doctor before they will "let" you eat. I don't need anyone's permission to "let" me make my own darn decisions so I told DH that in the event of a transfer we are just bringing snacks with us (unless I am transferring specifically for a c sec), forget this wheedling for permission like a grade schooler. If I feel like eating snacks then I am eating snacks. And I'm not bothering with hiding them either. Poo on the hospital, what are they going to do, duct tape my mouth shut? LOL


So true! They have no right to tell you what you can or can't put in your own body. Go girl!

Proud wife to my handsome husband partners.gif Malachi David (2010) and Jeremiah Daniel (2012) joined our family via two lovely homebirths. Rainbow.gif Doula for 7 years and now finally an apprentice midwife! bellycast.gif 

 bfinfant.giffamilybed1.gifnovaxnocirc.gifcd.giffemalesling.GIF
 

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#19 of 23 Old 12-12-2007, 12:35 PM
 
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It's outdated crap.

But I do tell my moms not to eat anything they don't want to see again -- vomiting is very common because peristalsis essentially stops in labor. No big, and I've seen some moms almost literally barf their babies out during second stage (it raises the intra-abdominal pressure like pushing does).

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#20 of 23 Old 12-12-2007, 01:29 PM
 
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So true, maxmama. If a mom is vomitting a lot, especially towards the end of second stage, I usually try to say something like "Puking and pushing are pretty much the same thing at this point. It's no fun to be this sick, but at least every time you vomit, your body is pushing your baby a little bit lower. The more vomitting you do now, the less pushing you'll have to do later!"

Not that I want to minimize how crummy they feel; but just to give them hope that the vomitting actually will serve a purpose (and I feel this is absolutely true it does help--just like pain with contractions, there is a reason for the vomitting, and it is not a threat to them, just a part of the process) and also to remind them that a baby is coming. You know, you get so focused on what is going on right then and now, sometimes the idea that a baby is the end result gets lost in your mind. Refocussing on that I hope is helpful.
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#21 of 23 Old 01-03-2008, 04:14 PM
 
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im a doula and went into my first client's birth expecting the clear liquids rule.
We got two cups, water for me, ice chips for her. I asked for a straw so that she could drink the water from the melting ice and the nurse asked is it for you or her, i said her, she said she could only have ice chips. i said "they melted." she said "ill get her some more" and took the cup away.
Another nurse started the same thing and then kinda trailed off when she got to the part about ice chips being different than water.....
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#22 of 23 Old 01-03-2008, 05:24 PM
 
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It's dumb. My first birth, they had the no food or liquids, but I could have popcicles and ice chips. Dumb. After telling meI couldn't have anything, they told me partner that there was a snack area and he could help himself if he got hungry/thirsty.: I had him bring me some crackers just on principle.

My 2nd birth, different hospital, the nurses said I couldn't have anything until my doc got there b/c different docs had different rules and they weren't allowed. The first thing my doc did when she came was give me a sprite and ask me if I wanted juice or something else. That birth was overall and awful, awful experience, but at least my doc was nice.

My 3rd birth at home w/a mw, my mw kept silently leaving little plates of food and glasses of water or juice next to me my whole labor. Once I told her I wasn't hungry and she said that's ok, if I got hungry it was there and I needed to keep my strength up.
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#23 of 23 Old 01-03-2008, 06:22 PM
 
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--------ritual and habit
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