In many hospitals in the United States, women in labor are not allowed to eat or drink, engaging in what might be the most difficult physical effort of their lives with only the sustenance provided by a small plastic cup of ice chips. What is the reason for this rule, and how necessary is it?

The History

This policy of restricting food and drink during labor began in the 1940s, when anesthetics used (such as Twilight Sleep, ether or chloroform) were much less safe and were more likely than today’s methods to result in aspiration, or the stomach’s contents being inhaled into the lungs, a serious problem that can lead to lung disease or even death. Doctors realized this was a risk and began implementing the “nothing by mouth” policy.

Today, aspiration is rare; few mothers require general anesthesia, even when undergoing a Cesarean section, and airway protections can be put in place. A study of the United Kingdom, where no such food and drink restrictions are in place, found only one aspiration-related death out of six million births.

Weigh the Risks v Benefits

What is the benefit of eating and drinking during labor, anyway? Even if the risk is so small, why not just restrict it just in case? Many studies of women in labor do not even consider the question of “maternal satisfaction,” something that most of us would like to consider, actually! Labor is difficult, and laboring until exhausted may necessitate interventions that could be undesirable. People under stress feel pain more acutely, and being barred food and drink adds stress to an already-stressful situation. A review of several studies found that women who were not restricted food and drink during labor labored for a shorter period and reported more satisfaction in their experience.

If you’re planning on a hospital birth, your hospital may have the common “nothing by mouth” policy in place. That doesn’t have to be the final word on your labor. Do your own research on the risks and benefits and discuss it with your doctor or midwife. And if you decide to just stick with the ice chips, chew away and think thoughts of the first food you want to bite into once the baby is here!

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