Eating and Drinking in Labor

Pregnant woman cookingAs a childbirth educator and birth doula, I am frequently asked about whether and what a mom can eat or drink in labor.  In the end, the answer depends on the recommendation of a woman’s care provider, but let me share some of the statistics and facts sprinkled with a few personal experiences with doula clients.

First, labor is often an intense physical activity for which a woman needs strength, endurance, energy and stamina.  Similar to someone who is running a marathon, a woman in labor needs sustained energy from food and/or drinks.  For many decades, based on the findings of a study dating back to the 1940s, the American College of Obstetricians and Gynecologists (ACOG) recommended NO food and NO drinks, just ice chips during labor, fearing that a woman could choke on her own vomit if she needed general anesthesia for an emergency cesarean birth.

Fast forward 75 years and most women who have a cesarean birth have regional anesthesia (epidural) not general anesthesia, and medications are now available that reduce the risk of nausea and vomiting.  Thankfully, last year, ACOG reaffirmed its 2009 guidelines that relax liquid restrictions.  ACOG’s position now is that clear liquids are okay for women in labor, and even appropriate for up to two hours prior to a planned cesarean birth.

Smoothie for LaborIt’s a point that the The American Society of Anesthesiologists (ASA) agrees with:  In this study, researchers found no complications and no difference in the incidence of nausea and vomiting among women who drank a protein shake in labor and those who didn’t.  (Nausea and vomiting are not uncommon experiences in labor, especially in the transition phase of labor, as the cervix completes its dilation and the body gets ready for pushing.)  The ASA also states that “oral intake of clear liquids during labor improves maternal comfort and satisfaction…and does not increase maternal complications.”  You can read all of their recommendations here.  The ASA does make it clear that the guidelines might not apply to certain high-risk situations.

As for food in labor — ACOG and the ASA still don’t support it.  The ASA says that “the oral intake of solids during labor increases maternal complications” and that women undergoing a planned cesarean should fast for 6-8 hours prior to the cesarean birth.  But many women in the later stages of labor aren’t hungry anyway, and in early labor, when they might feel a need to stock up on some energy-sustaining foods, they are still usually at home where they can eat at will, leaving several or many hours for the meal to digest before they head to the hospital.
Feel free to share these ACOG and ASA studies and opinions with your caregiver so you can have all the energy you’ll need for labor and birth.