| Labouring with food?
During labour most hospitals insist on ‘nil by mouth’ but alternative and complimentary therapist, Pat Thomas, says women should be able to eat and deliver You are anticipating the hardest, most intensely physical event of your life. An event that will challenge you mind body and soul. An event where the energy you will be expending will be equivalent to running a full marathon. And then your midwife gives you the bad news. You are expected to achieve all this on an empty stomach because the hospital does not 'allow' labouring women to eat or drink. If it sounds barbaric, it is. But don’t despair because throughout the country, attitudes to eating and drinking in labour are beginning to change. Enforced fasting, the practice of routinely withholding food and drink from women during labour, is without scientific merit. Despite this, most hospitals still refuse women food and drink in labour - preferring instead to keep them artificially hydrated and maintain their blood sugar levels by using an intravenous drip of water and glucose (also known as dextrose). There are several traditional reasons for a 'nil by mouth' policy in labour. Hospitals like to keep the birth environment as clean as possible. Some fear that if a woman eats during labour, she may vomit or have diarrhoea. OK, it’s not a very nice thought, but there is no scientific evidence that refusing women food prevents either of these problems. The other reason is surprisingly controversial. Physicians argue that if a general anaesthetic is needed and a woman has been eating during labour, there is a risk that she might inhale her own vomit, resulting in respiratory problems and occasionally death. While this is a frightening scenario there is a growing body of evidence which shows that on the rare occasions when aspiration has occurred, (when the contents of the stomach are regurgitated and inhaled into the lungs) eating in labour has not been the cause of the problem. In most cases the cause has been improperly administered anaesthesia. Running on empty For women in labour the benefits of eating and drinking as they wish, outweigh any risks. Denied proper fuel, your muscles cannot work efficiently. The uterus is a muscle and glucose provides the energy, which it needs to work so hard. If the body is short of glucose because of fasting it will burn other fuel such as fat. If this goes on for some time you become ketotic. When ketones - the toxic products of fat metabolism - accumulate in the blood it is a sign of profound exhaustion and one that can put you and your baby at risk. Denying labouring women food may also adversely affect labour. Research carried out in Belfast's Jubilee Hospital found that women who were allowed to take light food, such as toast, scrambled eggs, sandwiches, ice cream, yoghurt, jelly or fresh fruit, had shorter labours and required less pain relief compared to women who did not eat during labour. In addition, babies born to mothers who ate during labour tended to be more vigorous and healthy. This may be because the dextrose solutions used in labour can cross the placenta resulting in abnormally high blood sugar levels in newborn babies. If these blood sugar levels cannot be maintained after birth, the baby then experiences the shock of hypoglycaemia (a drop in blood sugar to abnormally low levels), which leaves them floppy and cranky. Although many women do not want to eat, particularly in the later stages of labour, the choice, especially early on, should be theirs. If you are at home the choice is already yours. If you are planning to give birth in hospital you may be lucky enough to be in one that offers a menu of suitable food and drink for labouring women. But if you are not and feel strongly about this issue, you don’t have to sneak food in and eat it when no one is looking. You have the right to bring your own food from home. Suitable choices include the same sort of light foods you would eat when recovering from a stomach upset or flu. These include:
Armstrong, T and Johnston, I, Which women want food during labour? Results of an audit in a Scottish DGH, Health Bulletin, 2000; 58: 141-144 |