Three years ago, I went into labor in the middle of the night, 10 days before my expected due date. Things ramped up fast, and by the time I got to the hospital an hour later, I was almost ready to have the baby. However, when my son’s heart rate suddenly dropped and wouldn’t recover with medication, I was told I had to have an emergency C-section immediately.
As I hadn’t planned on surgery, or labor, that night, I had eaten a full three-course meal earlier in the evening. The nurses asked me if I had eaten, and I had to admit yes, and then some! I did feel nauseous as the procedure began, but luckily the wonderful anesthesiologist quickly helped, when I told him how I felt, with some miracle medication in my IV. The surgery proceeded without incident.
Nil by mouth? New research questions a tradition.
It was with interest, then, that I read AJN’s March original research CE feature, “An Investigation into the Safety of Oral Intake During Labor.” In this article, the authors compared maternal and neonatal outcomes among laboring women permitted ad lib oral intake with those permitted nothing by mouth except for ice chips. Restriction of oral intake in laboring women has traditionally been, as AJN’s editor-in-chief calls it, “one of the sacred cows of medicine and nursing.” But results of this study showed there were no significant differences in unplanned maternal ICU admissions postpartum, in neonate condition as determined by Apgar scores, or in the need for a higher level of care between the two groups.
Allowing women ad lib oral intake during labor also caused no increase in morbidity, and there were no deaths in either group.
The findings of this study suggest relaxing the restrictions on oral intake in cases of uncomplicated labor. And while my situation wasn’t exactly “uncomplicated,” the authors drive home the point that because labor often comes on unexpectedly, many women present to the hospital having eaten a meal, and “none are denied an epidural if requested or an emergent cesarean section if warranted.”
Added benefits for women in labor.
In addition, allowing a woman to eat during labor may contribute to her comfort during what may be a long and arduous experience. The authors suggest further study is needed to determine what types of food and drink are most beneficial in labor.
To watch one of the authors discuss this article in a video summary, see here. And the full article can be found here.
This article is amazing! I work in a postpartum unit and you will not believe the number of mothers who have a chief complaint of starving. They beg me to bring them something to eat because they’ve been laboring for numerous hours with nothing to eat. Unfortunately, working nights in my hospital the availability of having food delivered to them is impossible, so they have to make due with crackers and jell-o. If they were allowed to eat ad lib in my hospital I’d be willing to bet that the patient would be much more satisfied with their hospital stay. This provides great insight into the dilemma that is being NPO because of the possibility of aspirating if the need for emergent surgery were to be an issue. I look forward to other research into these types of controversial subjects or “sacred cows” so to speak. Excellent work!!