In Countries With Better Birth Outcomes, Laboring Women Encouraged to Eat and Drink

Countries with the best birth outcomes encourage laboring women to eat and drink. Ready why from Jennifer Margulis, Ph.D.

Would you run a marathon without water or food?

Would you climb a mountain?

Would you have a baby?

Women giving birth expend a tremendous amount of energy. They sweat, urinate, defecate, and generally lose bodily fluids of all kinds.

Yet many hospitals in America continue to restrict what a laboring woman can eat or drink.

“It’s against hospital policy,” a laboring woman is told when she begs for some nutritious food.

These restrictions are a holdover from the late 1940s when Dr. Curtis Mendelson, a New York obstetrician, posited that food could be vomited and then aspirated into the lungs if a patient was under general anesthesia. Today the relevance of Mendelson’s findings, mostly done on experiments with rabbits, is disputed. And the fact is that the vast majority of pregnant women, even those who end up delivering via Cesarean section, will not be under general anesthesia.

A systematic review of the scientific literature, published by the Cochrane Institute in 2009, found no benefit to restricting eating or drinking during labor.

Despite these findings, the American College of Obstetricians and Gynecologists (ACOG), continues to recommend restricting food.

“Allowing laboring women more than a plastic cup of ice is going to be welcome news for many,” William H. Barth, Jr, MD, of Massachusetts General Hospital in Boston and chair of ACOG’s Committee on Obstetric Practice, is reported as saying in a press release about ACOG’s updated guidelines. “As for the continued restriction on food, the reality is that eating is the last thing most women are going to want to do since nausea and vomiting during labor is quite common.”

Eating is the last thing a pregnant woman is going to want to do?

Ah, Dr. Barth, one sees you have never been in labor or given birth to a baby.

Yes, women sometimes vomit. Yes, they sometimes feel nauseous. But they also feel hungry. Sometimes tremendously hungry. And a woman’s body knows what it needs.

If you have a baby in a hospital in Norway, the doctors won’t restrict your food intake.

At the Ullevål Delivery Department at the Oslo University Hospital in Norway, which I visited twice this September, the obstetricians or the midwives (midwives oversee 70 percent of the births in Norway) may even send you downstairs to the cafeteria to get something nourishing to eat.

If you don’t have the energy to walk that far, there are snacks on hand. In a window-lined room for laboring women and their families in the ABC (Alternative Birth Center) at Ullevål, which has a kitchen, table and chairs, toaster, and microwave, there’s a nice big refrigerator. Tubs of liver paste, tubes of caviar, butter, fruit juice, and frozen whole grain bread are available to anyone — the laboring woman, the eager spouse, or the hungry journalist.

Food for laboring women is not discouraged at the hospital in Norway, it is actually provided

Caviar is a popular food in Norway, available for free on the labor ward to anyone’s who’s hungry

It strikes me as ironic that in countries that have the best birth practices (and the best maternal and fetal outcomes), the evidence used often comes from studies done partially or entirely in the United States.

In Iceland a baby is not washed after birth, because science has shown that this does more harm than good and that the fluids on a baby’s body are actually good for her skin. Continuous fetal monitoring is not used during low-risk pregnancies, because studies have shown that this kind of monitoring only leads to more unnecessary C-section and other intervention, not to better outcomes. And women are allowed to eat what they want when they want it.

Is it naive or clairvoyant to imagine that one day our birth system will be more like Scandinavia’s — that in America we, too, will start paying attention to the science and best evidence? That we will try to empower a woman to have the best birth she can? That we will treat her with dignity and respect as she does the hard work of birthing a child? And let her eat and drink what she wants when she wants it?

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Categories: pregnancy and childbirth.

Comments

  1. George Denniston MD

    Chalk up one more reason why the case can be made that American obstetricians should not be permitted anywhere near a laboring woman. Far too many c-sections, episiotomies doing the exact opposite of what obstetricians thought they were doing, cutting the cord before it stops pulsating, removing half of the normal skin from the normal penis of a newborn healthy boy, and preventing women from getting empowerment from their births are among the reasons. We must bring humans into the world better if they are to evolve into the type of people who can live sustainably, and possibly keep us from extinction.

  2. Kimberly Ford

    The worst part about my 36-hour labor-turned-c-section-turned-3-days-on-clear-liquids was how HUNGRY I was. Okay, that was totally not the worst part. There were WAY worse parts. But it was really dispiriting. I would have given my eye teeth for a ham and cheese croissant while I was laboring away.

  3. Natalie

    I was surprised that I did not want to eat while in labor. I’m the type of person that’s hungry all the time, and I assumed that I would want to eat during labor. My hospital does not have a policy against eating and drinking, but they certainly don’t have tubes of caviar in the fridge. I threw up a number of times during labor with my first child, so I actively avoided food when I was in labor with my second. I still threw up, but it wasn’t as bad. After I’d given birth, however, I was starving. I managed to get food twice each time directly after delivery. I’d get one meal in labor and delivery, and another meal up in postpartum. My hospital, by the time I had my second, also changed how patient meals were served. I could order as much as I wanted from a very large menu. And I did! Ultimately, it’s important for hospitals to support a woman’s decision about what she wants to eat and drink and when.

  4. Jerri Swan

    Thank you for posting this. THIRST was what overcame me during my first labor, which was a very dehydrating 36 hours long. Even though I had IV fluids, I was so desperately thirsty I had trouble concentrating on birthing. I begged for a cup of water, and was given only a few ice chips by the nurse. It was horrible and I felt abused to be denied a drink of water for so long. The baby wasn’t coming down and when I could stand it no longer, I screamed for my husband to give me water and he grabbed his cup and gave it to me. Then I could finally concentrate, and minutes later I delivered my baby boy.

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