Episode 24: Eating in Labor

Eating in labor is still forbidden in some hospitals -- but it's an outdated policy that doesn't reflect current modern medical procedures AND doesn't take into account the need for pregnant people to nourish themselves and replenish their energy and endurance as they move through the physical intensity of labor. Lots of people assume laboring with an epidural would be easier, but the body is still working so hard even with an epidural!

You have the right to choose nourish yourself and eat during labor.

(Thanks to Evidence Based Birth for their summary of this research data that informed this video, and for all their data and research summaries and compilations. Evidence Based Birth is so cool and I'm so proud to be a professional member and support and benefit from their work.)

Full Transcript

Hello, and welcome to your next episode of the free weekly, Brave Journey, birth preparation videos, where I pick a topic related to birth and postpartum, and I talk about it for a few minutes. And this week I have decided to talk about eating and drinking and labor, and particularly why some hospitals still have outdated policies in place.

And why birthing people should have the right to eat during labor.

So I'm Cara Lee, I'm a birth doula, a childbirth educator, a mother of two. And I also have a background in organizational leadership. And today we're talking about eating and drinking and labor looking at the data perspective. And also logistics of what it is to be a human and a pregnant human who is hungry.

So if you are pregnant and perhaps you are in the later stage of the pregnancy, imagine being told you could not eat for 24 hours or 48 hours. Meanwhile, your body is working so hard. It's almost like you are running a marathon or just walking consistently for 24 hours straight. This is effectively what people are being asked to do when they are asked to fast during labor.

Even if you are using an epidural, when you are laboring, your body is expending a tremendous amount of energy, your muscles, when contracting, are working very hard. Your entire body is working very hard when you are in labor. And the way that we humans bring in energy as our body expels energy and uses energy is we eat.

We take in calories and nutrients and we nourish ourselves. Not only does eating bring us calories and energy eating can be very comforting and make us feel normal. So asking people to be in a situation where they're in labor and then asking them not to eat anything, but like weird frozen, like ice cubes or broth or things like that.

It just makes people feel even more like a patient and less just like a laboring person, which that's what they are. They're a laboring person.

In addition, it's really, when you're hungry, when you're pregnant, you are hungry and being asked not to eat it just it sucks. Also, it just makes it harder to maintain your energy.

So not being able to eat, it's sort of an issue. Now, there is, there was some research done. I'm going to look at my piece of paper. There was some research done, a study that came out in 2017 that looked at low risk people who, um, received more or less restrictive food. And this is, um, coming from a summary from Evidence-Based Birth.

And they did find that people who had less restrictive eating policies had slightly shorter labors by like 16 minutes. And there were no other differences in outcome. But I think we can all use common sense and recognize that if somebody wants to eat while they're in labor and then is told they cannot, it just is very uncomfortable and it's dehumanizing and unnecessary.

So why do some hospitals restrict eating in labor?. And this is an interesting question. In the 1940s, there were some noticed risks of aspiration during cesarean surgeries happening under general anesthetic. So there's a risk of aspirating- of the food contents in the stomach coming up and blocking the airways. And this was a potential risk of death for people under general anesthesia. General anesthesia is when you're completely asleep for a surgery.

So in these days in the 1940s, the only way to do a surgery was under general anesthesia. If a person fully asleep. Now in our modern medical world, most people who have sincerity and births are not put under general anesthesia, but are instead given epidural anesthesia or spinal anesthesia, which is where you are numbed from the breast down. But you're completely awake. In addition, there are been more advances in medicine and more ways of managing the airway. So even if as aspiration, just as less of a risk, generally, even under general anesthesia than it was in the 1940s.

And why hospitals still have these policies in places simply that they haven't done the work of updating. And it is outdated. And I want to be very clear that many, many, many really well-respected hospitals that pride themselves on being truly up to date on evidence and truly working closely with making the best experiences possible for birthing people. Absolutely allow low-risk birthing people to eat and drink during labor freely.

What is the actual risk of aspiration now with the modern ways of managing the airway and surgery, with the fact that very few cesarean surgeries happen under general anesthetic. And there was a research study that came out in 1997. They looked at more than a decade of data at that point.

And there was only one death for 1.4 million births, 1.4 million births. So it's a very, very, very small chance death by aspiration. It's a very, very, very small chance that somebody will aspirate and have the airway blocked And yet these policies are still in place in so many hospitals.

Now, are there some people who should still consider fasting during labor, perhaps. Perhaps people who are at higher risk of having an emergency surgery under general anesthetic, where there's not time to do a spinal epidural or excuse me, a spinal anesthesia aesthetic.

Um, and so perhaps if you were going into your labor and are in a high risk category that are more likely to have a very, um, fast. Emergency during your birth. Talk to your medical care provider, if that's you, or if you're concerned, that's you, but even if that is you, you still have the right to choose to eat, if you'd like, when you are laboring. It's your choice.

So, again, a lot of this summary of the data came from Evidence-Based Birth. And I, um, I think this is an excellent resource because this is just one of those policies that it just I'm going to be really blunt here. And this is personal opinion, but it irks me because it just is really, it's outdated. It's sort of like laziness on the part of the hospitals to keep implementing these policies for people.

When in fact low-risk laboring people should be, they have the right to choose to eat. Um, and eating fuels your body and makes you feel like a normal human being who's going through a normal human experience.

Which, birth is a normal physiological experience.

Even if it feels very, very new and very, very challenging when you're going to. So that is, those are my thoughts on eating and drinking and labor.

So to summarize, there are some hospitals that still to this day have outdated  policies, restricting people from eating in labor. They are leftover policies from the 1940s when the risk of aspirating during a surgery under general anesthesia, fully asleep, was a real risk. Now, very few. cesarean surgeries are done under general anesthetic. And even if they are, there are more advanced ways of managing airways, so the risk of aspiration is lower. There are benefits to eating in labor in studies. The benefits are slightly shorter labors, but these studies weren't looking at, did they feel more human? Did they feel more nourished? Did they feel more supported and normal? And were they not fighting with those feelings of hunger that someone can sometimes get when they are pregnant.

And final note. People who are giving birth should have the right to choose whether or not to eat.

Thank you for listening this week. I appreciate you. I will see you next week.