Restricting food and fluids during labour may be unjustified

Women undergoing labour are routinely requested not to eat or drink anything while some may be given only water and ice chips. However, a large scale analysis of previous research shows that restricting food and fluid intake during labour may not be helpful let alone required. The review actually encourages expecting mothers to eat and drink whatever they want to provided they aren’t at risk of complications.

“There should be no hospital policies which restrict fluids and foods in labour; nor should formal guidelines tell women to take specific foods, such as energy drinks,” declared one of the study’s authors, Gillian ML Gyte, M.Phil, of the department of women and children’s health at the University of Liverpool.

The researchers explain that while some women in labour may not feel like eating, others may be stressed out at the idea of extended hours of imposed fasting.

Study details

The authors analysed 5 studies involving a total of over 3100 women in active labour. These mothers were a low risk of requiring general anaesthesia during labour.

To better understand the maternal and neonatal benefits and harms of oral intake restrictions, the scientists weighed up the effects of completely restricting oral foods and fluids (except ice chips) with no such restrictions.

They divided outcomes into maternal categories (type of delivery – caesarean section or vaginal birth – and the mother’s satisfaction) and foetal categories (the 5-minute Apgar score indicating how well the newborn tolerated the birthing process and low blood glucose levels).

Study findings

“Our study found no difference in the outcomes measured, in terms of the babies’ wellbeing or the likelihood of a woman needing a C-section,” said Gyte.

“No women included in this review suffered from regurgitation during general anaesthesia or Mendelson’s syndrome,” the authors reported. “There is no evidence of any benefit to restricting what women eat and drink in labour.”

They also highlight that while NICE believes that women should be made aware that isotonic drinks (water containing a small amount of carbohydrates) could be more beneficial than water, the evidence gathered suggests the opposite.

The results were published in The Cochrane Library.

Why the restrictions?

In the UK and the US, food and fluids are generally withheld during labour in an attempt to diminish the risk of death from Mendelson’s syndrome in case a general anaesthetic is required. This practice evolved from a 1946 study which showed that women undergoing general anaesthesia are at higher risks of having their stomach contents move into their lungs, a dangerous and potentially deadly syndrome.

What has changed?

Thanks to advances in technology and medicine, general anaesthesia is now safer: the authors write that “Mendelson’s syndrome [is] a very rare complication in modern anaesthesia.”

And nowadays, caesarean sections are more often performed using regional anaesthesia.

The labour ‘menu’

Okay, you might not need to fast when you’re in labour but there are certain foods that would be best avoided simply because they might make you feel sick. Read our article to find out more information on nutrition in labour.

Remember that your nutritional and emotional status may determine your labour ‘experience’.