Hey ya’ll! Welcome back. We’ve been talking a lot about essential oils recently, but we’re going to take a break to talk about one of my favorite things – food!
Specifically, food during labor. We’ll discuss why American hospitals don’t like food during labor, and how to navigate hospital policy tactfully.
Why Does Standard Hospital Protocol Say No Eating or Drinking During Labor?
The short answer? American hospitals and doctors are behind the times. Like, sixty years behind.
The long answer? We’re going to get a little technical here, but stay with me.
In the 1940’s, hospital childbirth was like the Wild West. When women received anesthetics for childbirth, they were often sedated to the point where they could not even remember their own child’s birth. This sedation was usually caused by injecting two drugs, morphine and scopalamine, into the patient’s vein.
When these sedated moms couldn’t effectively deliver their own babies, they would be given nonspecific amounts of general anesthesia, usually cholorform gas or ether, to make them completely unconscious. Once these moms were completely under anesthesia, doctors would then deliver the baby. Because mom’s body was so sedated, doctors often had to use forceps and episiotomy (a procedure of cutting the vaginal opening to allow for easier delivery) to get baby out.
One of the biggest risks of these dangerous deliveries was aspiration (when stomach contents flow backward into the lungs, causing lung irritation and infection). This can be fatal. No-food-and-drink policies, or NPO policies, stem from the risk of aspiration during standard birth protocol in the 1940s.
What Does the Research Say About Eating and Drinking During Labor?
Anesthesia today is much different than the routine heavy sedation of the 1940s. Women are routinely offered epidurals instead of complete sedation, and even when C-sections occur, moms are often awake throughout. This virtually eliminates the risk of aspiration or lung damage.
Research indicates that with today’s normal procedures, low-risk pregnant women should be allowed to eat or drink as they please during labor. The only time a laboring woman should be kept NPO (nothing by mouth) is when the medical team has a reasonable suspicion that she will need to undergo general, or complete anesthesia.
This 2015 study concluded the same thing: dietary restrictions for low-risk moms in labor are not justified. Finally, the American Society of Anesthesiologists made a statement in 2015 agreeing; in fact, they stated that many women would benefit from a light meal during labor, including “fruit, light soups, toast, light sandwiches (no large slices of meat), juice and water.”
The same study also noted that most women don’t want to eat during active labor. (That was my experience as well.) However, women can and should eat during early stages of labor to prepare for the hard work of childbirth.
The general conclusion from research is that eating during labor does not put mom at risk.
Why do American hospitals still have food restrictions for moms?
Most hospitals are slowly changing their policies. For example, Clements University Hospital in Houston, TX, proudly announced that they would start allowing women to have clear liquids (like juice, tea, popsicles, and jello) during labor in 2016.
(As I read that, I thought, Umm, okay, Clements. Are you helping to delivery a baby, or hosting a tea party? Allowing clear liquids is a baby step in the right direction, but come on, you can do better. That’s almost insulting.
Like, “Okay, mama, I know you’re working as hard as someone running a marathon, but would you like strawberry or orange jello? Maybe some chamomile tea or a popsicle? I can’t get you anything with actual carbs or protein in it, sorry.“
However, most hospitals still place restrictions on what a mother can eat during labor. The American College of Gynecology (ACOG) still recommends only clear liquids, despite what research says. Most hospitals are very hesitant to implement policies that go against ACOG’s recommendations.
Although ACOG has not updated its recommendations, other major organizations have. The American College of Nurse Midwives and World Health Organization both recommend that hospitals do not place restrictions on mom’s diet during labor.
Why is Eating Important?
Labor is hard work. One researcher compares the caloric demand during labor to the caloric demand during endurance athletic events.
We have a billion-dollar sports nutrition industry because we understand that athletes need fuel to perform. We wouldn’t expect someone completing in a triathlon or in the Tour de France to go without food. They probably wouldn’t finish the race, and they definitely wouldn’t perform to their top potential.
Yet we do this thousands of times each day to mothers across the United States. We prevent mothers from nourishing their bodies during one of the most energy-intensive feats they’ll ever undertake.
And then we wonder why almost a third of births in this country happen via C-section. This is riskier, more traumatic, and more costly than vaginal birth. And in many cases, it’s completely unnecessary.
Being Tactful with Hospital Staff When You Disagree with Policy
This is the really tricky part. You may know that you want to be free to eat and drink as you please during labor. However, if you’re planning to give birth in the hospital, you’re probably going to be told about their “nothing but clear fluids” rule.
I understand the need for nutrition during labor, as a mom who has gone through natural childbirth. I also understand the nurse’s frustration with having to enforce policy, as a nurse. Let’s discuss the nurse’s perspective for a minute.
Most nurses working in hospitals aren’t aware of the research that indicates that moms shouldn’t have dietary restrictions. And even if they are, these nurses are required to follow hospital policies. Also, most nurses don’t enjoy enforcing rules or confrontation; after all, they’re coming to work to help you meet your baby. Generally speaking, most nurses want to have a great relationship with their patients.
However, many nurses (as well as other healthcare professionals) feel as if you are making their job harder if you are intentionally not following policies. When that happens, they can feel frustrated or even threatened. At that point, many nurses and doctors get really petty. They will often stop advocating for you, treat you poorly, or even pressure you into doing things you don’t want to do.
Please hear me correctly. I’m not defending those nurses and doctors.
It’s not right. It’s not okay. But I’m simply saying that it happens all the time. I’ve seen it many times while working as a hospital nurse.
Bottom line: You want your medical team to be on your side. Tact is important.
Tips for Navigating Hospital NPO Policies During Labor
Build a relationship with your nurse. You can probably hide just about anything from the doctor. But your nurse will most likely find out if you’re eating. Trust me, we know. 🙂
If you are in the hospital for some time before active labor starts, you can kind of feel her out. Say something like, “Did you hear that the WHO is saying that women in labor should be able to have light meals? That’s huge! What’s your take on that, since you do this every day?” Her response will tell you a lot about her opinion. Some nurses are genuinely okay with you eating during labor, as long as you’re discreet about it.
Also, if you’re not in active labor, do your best to be polite and appreciative. Common courtesy goes a long way with healthcare professionals.
Wait to go to the hospital until you’re in active labor. Like we said earlier, most women don’t feel like eating in active labor. Stay home as long as you can, and get a couple of good meals or snacks in before going to the hospital. If you feel like eating, you should! Nutrition is going to help you later. Once you get to the hospital and your contractions are coming hard and fast, you are probably going to be happy with just water or ice chips.
Have your baby in a different setting. If you’re comfortable having the baby at a birth center or at home, go for it! After all, when you’re in a hospital you agree to abide by their policies. Most birth centers will allow you to eat and drink whatever you’d like anytime during a normal labor.
Wrapping it Up
I hope this was helpful!
I would genuinely love to hear your experiences with NPO policies and hospital births. Please let me know in the comments. 🙂
Until next time,
Lynette