(RxWiki News) Once a woman enters the stages of labor, there is no telling how long it might be before the baby arrives. If her labor lasts a long time, is it safe for the woman to eat or drink?
The answer has often been that eating or drinking during labor is discouraged in most hospital settings.
But a recent review of the research found that women with low-risk pregnancies may be fine to eat and drink during labor.
Women who ate or drank during labor were no more likely to have cesarean sections or other complications than women who fasted.
The results only apply to women with low-risk pregnancies because the research did not involve women at higher risk for complications.
"Ask your OB/GYN whether you can eat during labor."
This study, led by Mandisa Singata, RN, a PhD student at the University of the Witwatersrand/University of Fort Hare/East London Hospital complex in South Africa, looked at the benefits and harms of eating or drinking anything during labor.
The researchers looked at all the randomized controlled studies they could find related to women eating and drinking during labor.
Many women are discouraged from eating or drinking during labor because of research in the 1940s which appeared to show an increased risk of aspiration in patients with full stomachs.
Aspiration is when stomach contents are regurgitated up and into the trachea and lungs when a patient is under general anesthesia. General anesthesia impairs the natural cough and gag reflex which is usually protective of this process.
General anesthesia, which make patients unconscious and unable to feel pain, would only be necessary during a birth if a woman experienced complications and required a surgical procedure.
Of the 19 studies they found, the researchers included the five that involved a total of 3,130 women. Five of the excluded studies had not yet been completed and the others were excluded for poor quality.
All the participants were women in active labor who were at low risk of needing a general anesthetic for any reason.
The studies varied in what they compared and whether they allowed women to eat and drink at will or restricted women to specific liquids or carbohydrate drinks.
The researchers found that women who drank some liquids or ate some foods during labor were no more or less likely to need a cesarean section (C-section) or to require assistance with a vaginal birth (an operation or use of forceps, for example).
Women provided with some nutrition during labor were also no more likely to have babies with an Apgar score less than 7 at five minutes after birth, compared to women restricted to no food or liquids.
The Apgar score is a number on a scale from 0 to 10 that assesses the immediate health of a newborn.
No other outcomes included in the studies appeared different between the women who ate or drank during labor and the women who did not.
One study did find that women drinking carbohydrate drinks during labor had a slightly increased risk of needing a cesarean section, but the number of participants was very small, and this was the only study with that finding.
"Since the evidence shows no benefits or harms, there is no justification for the restriction of fluids and food in labor for women at low risk of complications," the authors wrote. "Thus, given these findings, women should be free to eat and drink in labor, or not, as they wish."
The authors added that this conclusion only applies to women with a low risk for complications since there was no evidence for women with a higher risk of possible complications.
"Conflicting evidence on carbohydrate solutions means further studies are needed and it is critical in any future studies to assess women’s views," the authors wrote.
Andre Hall, MD, an OB/GYN at Birth and Women's Care, PA in Fayetteville, NC, said it is true that eating and drinking during labor does not increase the risk of a C-section, but there is still reason for caution.
"The reason food and drinks are restricted during labor is because of the risk of aspiration if a cesarean section requiring general anesthesia is needed," Dr. Hall said.
"The implication in this study is that there are those who are at low risk of complications and therefore may be more suitable to eat and drink," he said. "I must emphasize, however, that low risk does not equal no risk. Further, in obstetrics low risk can become high risk very quickly."
"The potential catastrophic outcome to an otherwise healthy young woman who aspirates because she was allowed to eat, in my opinion, more than justifies keeping a patient on restricted measures to limit this risk," he said.
This study was published August 22 in The Cochrane Library. The research was funded by the University of Witwatersrand, the University of Liverpool in the UK, the World Health Organization (WHO) and the National Institute for Health Research in the UK.
One of the authors had also authored one of the studies being considered for inclusion in this review. She was not involved in deciding whether to include the data from that study for this review.