Labor and delivery is often a grueling ordeal for many women, and current guidelines rule out eating.
But new Canadian research suggests that a light meal during labor could be a good idea for most healthy women.
“Our findings suggest a change in practice makes sense,” study co-author Christopher Harty, a medical student at Memorial University, St. John’s, Newfoundland, said in an news release from the American Society of Anesthesiologists.
He was slated to present the findings Saturday at the society’s annual meeting in San Diego.
Traditionally, women have been told to avoid eating or drinking during labor due to concerns they might inhale food or liquid into their lungs — a condition known as aspiration. Aspiration, in turn, can sometimes lead to pneumonia, the researchers said
But they noted that medical advances have now made this problem highly unlikely in modern settings. According to the researchers, aspiration during labor is extremely rare: In the United States, there was only one case of aspiration during labor and delivery between 2005 and 2013.
The low risk of aspiration is likely due to advances in anesthesia care, such as increased use of epidurals and spinal blocks instead of delivering anesthesia through a mask over the nose and mouth, the researchers said.
In the new study, Harty’s team revisited the issue. They reviewed 385 studies published since 1990 and concluded that avoiding food and liquids during labor may be unnecessary for many women.
In fact, having a light meal may be beneficial because the energy and caloric demands of labor are so high for women — similar to running a marathon, according to the researchers.
Instead of setting a “no eating” rule, “anesthesiologists and obstetricians should work together to assess each patient individually,” Harty said. “Those they determine are at low risk for aspiration can likely eat a light meal during labor. This gives expectant mothers more choices in their birthing experience and prevents them from being calorie-deficient, helping to provide energy during labor.”
Two experts agreed with the notion, but added that identifying patients at “low risk” for aspiration is key.
“A light meal during labor may be beneficial for most low-risk pregnant women, especially those who wish to have early, continuous regional [pain control],” said Dr. Anthony Vintzileos, chair of obstetrics and gynecology at Winthrop-University Hospital in Mineola, N.Y.
But he pointed out that aspiration can be an issue if an emergency Cesarean section is required due to fetal distress. In those cases, general anesthesia may be used, and “a recent maternal meal may place the woman at risk for aspiration,” Vintzileos explained.
Therefore, “the anesthesiologist and obstetricians should exercise good judgment to assess each patient individually for having a light or liquid meal during labor,” he said.
Dr. Francine Hippolyte is an obstetrician/gynecologist at Long Island Jewish Medical Center in New Hyde Park, N.Y. She agreed with the study authors that “low-risk moms benefit significantly when allowed to eat in labor — It’s an important consideration, given the unpredictable duration of labor and delivery in addition to all the energy and effort that is needed during and after the labor experience.”
“Once a patient is correctly identified as low risk, she should at minimum be allowed to have a clear liquid diet, especially given the advances in anesthesia and the results from recent studies,” Hippolyte said.
Experts note that findings presented at medical meetings should be considered preliminary until published in a peer-reviewed journal.
The U.S. Office on Women’s Health has more on labor and birth.
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