Eating during Labour

Ez - posted on 01/02/2011 ( 46 moms have responded )

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The debate rages: food vs fluids vs NPO

I was backing up a fellow RN on labor and delivery in her conversation with an OB resident about the other nurse's patient. The woman was having baby #4, she wasn't in labor yet, and they were unsuccessfully (thus far) inducing her labor. It was day #2 of her induction. Things were winding down for the night: everything for her induction was stopped.

What would you want to do, if it's been a two day process, so far, and you were pregnant? You'd want to be able to eat and drink, right? That was what this other nurse was advocating for her patient. Let her eat a light dinner, and let her rest for the night, before restarting her induction in the morning.

The OB resident (who I admit is still very green behind the gills) was arguing with the nurse about it -- saying no, this woman can just have ice chips and maybe a Popsicle or two. The doc was mumbling about aspiration risk, blah blah blah.

I piped in: well, since she's a G4 who has given birth vaginally before, just how do you think she's an aspiration risk? Chances are extremely low that she'll need a c/section, and even lower that she'll need general anesthesia for a c/section --- which is precisely where the "worry" for aspiration of stomach acid lies.

How many times do women need general anesthesia for a c/section? I can count on one hand per month how often that we do general anesthesia. How often are c/sections under dire emergency conditions requiring general anesthesia actually seen on labor and delivery? Even less than the one handed count of cases of G.A. we see per month.

This patient? Extremely low risk for G.A., much less the need for a c/section, even less of a chance of aspiration of stomach acid.

I argued the fact that aspirating pure stomach acid will actually do more damage versus aspirating fluid/food laced stomach contents, which will be less acidic.

Both of us nurses also brought up the fact that even ACOG recommends liberal fluid intake during labor ---- and this woman wasn't even in LABOR!!! So, you want to continue to starve her for another day, putting her body into a further ketotic state? (The resulting symptom is the lovely ketotic breath that laboring women in longer labor tend to get - the body isn't being nourished, so it starts burning it's sugar stores to maintain some kind of energy level --- and energy required for labor is higher than not being in labor.)

I brought up - how about practicing some evidence-based medicine here? Let the poor woman eat something light, if you're so worried. How about some chicken noodle soup and some saltines? Something to help hold her over, but yet makes her feel like she's actually "eating" something, versus a simple Popsicle?

In the end, the resident gave up arguing back with us, and told the nurse taking care of the patient to get the order if she wants it, from the attending MD about a light food diet for this non-laboring woman.

We're trying folks. We're trying hard (as nurses) to help the newer doctors see the light about evidenced-based practice. However, even when ACOG backs up our arguments, the doctors still refuse to listen.

Oh, and the NPO in the title of the post? That's one particular doctor who is notorious for making every single woman under his care NPO. Even when not in labor.

http://atyourcervix.blogspot.com/2011/01...

Did you eat during labour? If not, was it because you were not 'allowed' to or were you simply not hungry? If you were hungry and medical staff were preventing you from eating, would you abide by their protocols or listen to your body?

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[deleted account]

@Cathy: NPO is an acronym for Nil/Non/Nulla Per Os, Latin for Nothing by Mouth. Also Nil Per Orally.

~♥Little Miss - posted on 01/03/2011

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During labor eating? Hell no, you couldn't force it down me...but dude!! She wasn't even in labor! Give the mom to be some ENERGY!

Jess - posted on 01/03/2011

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Cathy - Thanks heaps for asking what NPO stood for because I had no idea ! I've only ever heard it called Nill By Mouth, so I was mighty lost.

Mary - posted on 01/03/2011

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There is no power on earth that could have made me eat during labor - I threw up pretty much hourly. No big surprise there, since I'd been doing that the whole pregnancy. I did, however, drink liberally throughout. I also ate ice chips like a fiend...something about those hospital ice chips...I'd been chomping on them my entire pregnancy, since I work where I delivered.

I will say this...the NPO rule was abandoned by my hospital a few years ago. Unless someone is particularly high risk (i.e. pre-eclamptic on mag sulfate), all laboring patients (including inductions) are allowed clear liquids. This includes juices, jello, broth and popsicles. Truth is, very few women in ACTIVE labor want anything more than that, and if you're still in early labor and wanting to eat a burger, you ass should still be home.

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46 Comments

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Vegemite - posted on 01/04/2011

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With the first the nurse got me a sandwich somewhere at the beginning, she said soon my contractions would get too strong and close together to eat so I should eat something. Ended up having an emergency c-section with no problems. No time with the second but was eating about two minutes after while baby breast fed for the first time. It was great.

Sharon - posted on 01/03/2011

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oh man - Yeah I'd have been fucking PISSED. But then mine were hidden away. God knows they left me alone enough to sneak a bite here and there. My mother was spazzing "they said to not eat! you're gonna die!' One nurse caught on but just giggled.

Lacye - posted on 01/03/2011

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Sharon, I actually took snacks to the hospital with me, but the nurses took them away when they saw that I had them and didn't give them back until I was being wheeled up to my room. I was cussing them for a long while!

Sharon - posted on 01/03/2011

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I actually took snacks with me and made certain to eat before I got to the hospital because of horror stories like the ones you ladies have related here.

Johnny - posted on 01/03/2011

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I was encouraged to eat during my labor. I wasn't hungry for the first 12 hours, but after that I started to get the munchies and frankly, I was getting a bit weak from lack of food. My midwife told my husband to get me a soup and sandwich, which I ate slowly over the following 16 hours. Just before I started pushing, she had him get me a doughnut. I'd heard you were supposed to eat in labor from places like A Baby Story, but most people I know here have unless they were vomiting.

Lacye - posted on 01/03/2011

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I was told before I had even gone into labor, like the week before when I had gone to the hospital to have all of the paper work done, that I would be allowed ice chips. I get there, my mouth was really dry during one part of my labor and I asked for ice chips and the nurse told me that I wasn't allowed to have any at all because they had to induce my labor (my labor was induced because my water broke but I was only 1 cm dilated and my body was refusing to go past that!) So not only was I in labor but I had really bad cotton mouth. I was in labor 17 hours (which is not really as bad compared to some) and I was not allowed to have anything to eat or drink until an hour after my daughter was born. Yes, I was super pissed!

Lady Heather - posted on 01/03/2011

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My midwife advocates for eating during labour if desired, but also suggested that I probably shouldn't eat too much because I was extremely high risk for a c-section and in fact was scheduled to have one but ended up having my daughter naturally three days before the surgery.

I REALLY wanted a cheeseburger about halfway through my 3 hour labour. It's one of the only things I remember saying. "I want a cheeseburger". "Heather, you are about to start pushing so I don't think now is a good time." "But I'm huuuuuungry!!!!" Yeah, it pissed me off. Next time I will make sure I have a cheeseburger in the fridge at all times that I can just grab on my way out the door. I would have happily eaten a cold one.

Nichole - posted on 01/03/2011

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I was only allowed clear liquids, jellos, & popcicles. And after the nurse shift change, one nurse overheard me telling my husband how I was starving. She brought me 2 smalls cups of ice cream & 2 little packs of crackers. She said she couldn't get permission for anything else or more, but hoped that helped me feel a little fuller than the liquid only diet. Definately was nice to have some food even if it wasn't much.

Kylie - posted on 01/03/2011

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I had long labors and i ate during both - first baby i grapes, apples and sandwiches, second i ate cake and chocolates. When i hit transition I threw up until my stomach was empty.

[deleted account]

I didn't eat but I had barely eaten for days before my labour, due to be so ill (hence my induction). I continued being sick throughout my induction until I was literally empty and had nothing left to throw up, at least the black sick ended (bloody iron tablets, my iron levels were great when I was at home eating my own food - I go into hospital and end up needing iron tablets stupid hospital food).

My appetite didn't return until around 9 ish after I had Ethan and then I could only eat one round of toast- I had him at 5.11pm, after a 45 min labour.

If you need to eat during labour eat, your body would not want it if it didn't need it or couldn't take it, and as a few ladies have said I would rather throw up food than bile (my morning sickness for this pregnancy seems to occur first thing before I have a chance to eat anything, it was actually a relief the day I managed to eat breakfast and throw that up instead of dry heaving and throwing up tiny amounts of bile yuk).

Ez - posted on 01/03/2011

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Just to clarify.. I didn't write the OP. The link to the blog I got it from is included at the bottom :)

[deleted account]

W/ my 1st I went in having contractions and they stalled and sent me home to eat :( I ate some beef/barley soup and cantelope...when I'd gone back 5 hrs later I puked up all the soup :( The cantelope apparently vanished, but the soup was the worst thing to puke up...it was sooo gross! I was in labor for another 25 hrs AFTER that! I may have been hungry but there was NO WAY i was going to eat after that!!!

#2 I was induced, came in @ 7 the nurse told me to finish my breakfast (I'd brought a bagel) I don't think I ate half of it before losing interest... total it lasted 7 hrs and I was fine with no food. I got to eat after having him and that was fine for me!

If you can stomach food then whatever I guess? I thought we weren't supposed to eat because the body stops digesting food when it is in labor? But if your body is telling you it wants food then I'd probably listen! After my 1st labor I had such low blood sugar that I passed out after delivery! Scared the crap out of everyone! I had been drinking 7-up & cranberry juice the whole time but I needed food! I just didn't feel like eating for nothing!!!

Sharon - posted on 01/03/2011

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My labor lasted minutes, not hours. I ate before going to the hospital and had snacks with me.

Screw them. I dunno about now but back then I had a really hyper metabolism. Not eating sent my body into this weird twitchy state. I wasn't going to go through that while shoving a 7lbs watermelon out my vagina.

Rosie - posted on 01/03/2011

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i was starving and pissed that i couldn't eat during labor. my first labor was around 20 hours, and during pregnancy i NEED to eat almost constantly, lol, or else i feel like i will puke. i can't imagine 2-3 days of no eating, i go fucking bonkers. i'd have people sneak food in for me lol!

i've always thought it was a stupid rule especially for people who had epidurals in. i'm pretty positive i wouldn't need general anesthesia with an epidural in already. gah!

Laura - posted on 01/03/2011

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I was in labor for 4 hrs for my first and didn't even think about food until after he came out. My second I was induced at 8am and he was born a little after 2 pm and I really didn't even think about food then either. I think after 2 days I would have gotten a little irate with out any food. I think if I had longer labors I would probably want something, I mean seriously labor is not easy and you need all the energy you can get.

Tara - posted on 01/03/2011

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I was told when I was induced with number 3, that I couldn't eat, I sent my ex out to get me some chili and a whole wheat roll. He brought them in, I ate them. The nurse freaked out, I told her off...
End of story. I refused to be hungry while in labour.
I had the last 3 babies at home, where I was free to eat whatever and whenever I chose.
I always throw up during transition and it is very unpleasant to throw up bile, I would rather toss my dinner and snacks that dry heave only to have burning acid make it's way up and out my mouth.
Good for you, keep educating the butthead doctors who think they know better...
:)

Bonnie - posted on 01/03/2011

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I didn't eat during either of my labours, but my first was just under 10 hours and my second was 4.5 hours. I don't recall being asked if I wanted to eat anything. When I was induced for my second labour, I remember early in my husband asked my nurse if it would be okay for me to have candy. I remember her saying, as long as she doesn't chew it, it is fine. So I am guessing I wasn't allowed to eat. Although, I wouldn't have even wanted to try eating while in pain. Perhaps once I had my epidural and time to relax maybe I could have asked, but food wasn't even on my mind.

Jenn - posted on 01/03/2011

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I didn't eat anything during labour with my first but that's because I was ralphing my guts out, and with my twins it all happened so fast I didn't need to eat as I had something eat just before they started the induction (3 hours later I was hold my babies). With my son I had a similar situation as what you described though and stayed the night so they could retry in the morning but they most certainly let me eat that night, and after he was born they brought me in a big tray of food and you better believe I ate all of it!

Tracey - posted on 01/03/2011

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I was encouraged to eat during labour as the midwife said I needed the food to give me the energy to push, but that was 14 years ago.

[deleted account]

I went in to the hospital on a thursday to be induced. I got all my meals. BUT i got meals for a diabetic, not a GD no no they gave me a diabetics meals. I was starving. They took me down to be induced at 12ish just before lunch was served. After they had broken my water i asked if i could eat something as i was starving, they said no. I even asked for a cup of tea and some chewy to try and tide me over until the baby was born. They said no, i couldn't have anything other than ice chips. I was furious but couldn't leave the delivery room as i was hooked up to a glucose drip and 3 others because they were afraid of my sugars dropping. Yep thats right i wasn't allowed to eat but they were giving me sugar via a drip so that i could get through it. Even with the stupid drip my sugar levels dropped drastically and they still wouldn't let me have anything to get them back up claiming the drip was enough. I should have gotten my hubby to go up to our room and get me something to eat because it was the most stupid thing ever.

This was my 3rd birth and all have been vaginally.

Next baby i have ( last baby) If i have to be induced then i will be eating i will never be left that exhausted after a 5 hour birth when i had more energy after a 6 hour labor with a broken leg and drugs.

I guess it also dpeends on the hospital and i could not be more negative towards the hospital i gave birth in. :(



Edited to add : with my 1st they were trying to get me to eat or drink anything. i was sick with her and i didn't want to eat but with my other 2 i think the GD had something to do with it because about 2 hours before my 2nd was born ( at home by accident) i had the biggest craving for apples and oranges.

Jess - posted on 01/02/2011

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I was allowed to eat during my labour. They brought me a huge meal and snacks, I tried to eat my breakfast but I wasn't that hungry. They kept offering me juice and water and milk. It wasn't until after I had Ava that I took them up on their offer at which point they practically threw the food and drink at me. I think they thought I was going to starve to death from 4 hours labour !!!

[deleted account]

I think in the case of the woman you're talking about, she should be allowed to eat something light. I mean, she's not even in labor yet so I think starving her will only weaken her and possibly cause her to "need" a c-section when really, it doesn't sound like she would normally need one.

I was induced at 7am on a Wednesday. At my doctor's appointment the day before, I was told no food or liquids after midnight and I abided by their rule, minus a few sips of water after brushing my teeth before we left to go to the hospital. After I was checked in and they had the pill on my cervix (I can never remember the name of that pill), I was allowed small amounts of water, some jello and some saltine crackers through out the day. I was induced at 7am, walked the halls until 3:30, when my water broke. From then on out, it was only ice chips. The nurse was adamant about me ONLY HAVING ICE. I got sick a few times once the contractions started getting worse. The first time I got sick, the nurses had just done a shift change and somewhere in between, while they were exchanging info on my labor, I begged the new nurse for something liquid so she gave me a red Gatorade and told me "small sips only". The first nurse came in just after I had thrown up and saw that it was red and she freaked out and asked Steve, "Where did she get something red to drink???" He told her the other nurse had "allowed" me to have it and then she and the new nurse proceeded to have a heated conversation about it in the hall. First nurse went home (boy was I glad to see her go...she was awful, not just about the ice) and the second nurse allowed me to drink if I felt I needed it but didn't want me eating anything, which was ok by me because I really didn't want any food. I just knew that the pain was making me throw up and I'd rather have something come up than to dry heave or just have stomach acid so I guess you could say I listened to my body and did what I felt was best. But the second nurse was awesome and "allowed" me to drink water. And even though she said she didn't recommend I eat anything, she did bring me some saltines, just in case I wanted them. She was amazing....I had her sign my baby book instead of the doctor. He was an asshole, but that's a whole other story.

Becky - posted on 01/02/2011

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With my first, I was induced with Cervadil in the late afternoon. By the time they moved me from triage to a bed on the antepartum unit, I'd missed supper, so they found me a couple of sandwhiches. I was in early labor by the next morning, but was allowed to have breakfast. They brought me a lunch tray too, but by that time, I was nauseous and didn't want to eat. I'm not sure they realized I was in active labor when I was brought the lunch tray, but anyway, no one ever tried to stop me from eating.
With my second, I went into labor at 5:30 am and did most of my labor at home. So I could have eaten if I'd wanted to, but it was too early and I was a little nauseous, so I didn't want to. He was born at 8:30 am, so I just had breakfast afterwards.
Not allowing a low-risk woman who isn't even in labor to eat is ridiculous!

[deleted account]

I ate during early labour (some tea and toast for breakfast) but had no appetite during active labour. I had to be reminded to even drink. I was in labour for 8 hours and didn't eat that whole time but that was my choice. And I was ravenous afterwards, ate two banana muffins, half a bag of jelly beans, two juice boxes, a bag of grapes, an apple, both of the hospital meals they bought for me and my partner and numerous cups of tea in about the space of two hours.

Good on you for advocating for the woman's rights, wants and needs and for backing your arguments with evidence-based practice. I hope you contributed to the doctors continuing education and that they will incorporate the information you have passed on to them in their future practice in considering the effects of their clinical decisions and hospital policies on the people they are 'treating' and whether certain policies are actually necessary in all applications of their practice.

Jodi - posted on 01/02/2011

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I had midwives who brought me snacks around lunchtime (I had been in labor since 8 a.m.) to help keep my energy levels up. I was low risk for my entire pregnancy, things were going exactly on schedule and they allowed me to eat what I wanted pretty much until it was close to pushing.

On the otherhand, my sister went through an OB. Her water broke and so went to the hospital and was told not eat anything other than ice chips and she could have a jello every couple of hours. It was her third pregnancy, all vaginal, all perfectly normal and healthy. She ended up eating her post-delivery snacks she brought with behind the nurses back.

If you're high risk for a c-section or for complications, then it may be wise to follow doctor's orders, but if all is normal and healthy and you're low risk, well, your body needs energy to go through all that work right?

[deleted account]

When I went in to be induced w/ the girls it was 8am. I was told I could eat light if I ate early.... so I had some peanut butter toast for breakfast at around 5. They were delivered by c-section at 1:02 and 1:07pm.... I was starving and apparently spent the whole procedure begging for jello and applesauce (the 2 things they told me I could eat once I was done). I was also od'ed on my epi though, so have NO recollection of begging for anything. ;)

My son was a scheduled c-section at 8am.... no food after a bedtime snack the night before.

Neither one of those experiences were a problem compared to when I went in for my D&C. My ex was 'starving' as we drove to the hospital (w/ me practically bleeding to death), so we drove through McD's on the way. I ate some fries and stuff, so when it was discovered that I had to have a D&C they asked if I wanted it done awake right then or asleep first thing in the morning. I voted for asleep. They were SUPPOSED to give me dinner in the hospital, but I got forgotten about. OR was unexpectedly packed the next morning, so by the time I ended up getting the D&C I hadn't eaten for 24 hours. REALLY bad for someone who normally needs to eat every 2-4 hours during the day!

Stifler's - posted on 01/02/2011

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I ate during my labour. I was in labour for 26 hours and not dilating that much or getting closer together and my water had broken. I finally got into the labour ward as I was disturbing people in the normal ward. I was in the first stage of labour and not progressing very fast when they brang me fish with parsley sauce and mashed potatoes. We were encouraged to bring energy foods (lollies and juice) I ate gummy bears the entire way through labour and they kept pushing fluids but I forgot about food when the contractions got closer together. God that fish and parsley sauce was delicious, it still goes down in history as one of the best meals ever even though it was hospital food. Public hospital food. I love Australia.

Meghan - posted on 01/02/2011

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I don't think I could have eaten anything. My contractions started around 11am and on our way to the hospital my ex thought I should eat, so he stopped at McDonalds- WORST chicken nuggets EVER!

Jennifer - posted on 01/02/2011

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my induction (pitocin) started at 7am, and as they were hooking up my IV told me that i could no longer have food, or fluids...i could have ice chips and that was it. they didn't consider me to be "in labor" until 11am when they broke my water. i delivered at 6:55pm that same day and i was told right away that i could eat whenever i wanted to now that my son was born. my labor was pretty short so while i would have liked to have been able to eat, i did fine without food.



whenever we have our next babe, i plan on having a homebirth so hospital rules be damned! if i'm hungry, i absolutely will listen to my body.



edit to add: in regards to the OP, that woman absolutely should have been allowed to eat.

Nikki - posted on 01/02/2011

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I didn't eat, I didn't even think about food. I vomited a lot and my labour was only 4.5 hours, so I didn't have much time to think about it.

Amanda - posted on 01/02/2011

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None of my 4 labors were really too long. My longest was 8hrs and that was with my first. By the time I was pregnant and in actual labor with my 4th it was 2am, and I had gotten my epidural and was starving!!! They told me no I couldn't eat... :( It sucked but she came by 4am and that was when I scarfed down on McDonalds...hahaha

[deleted account]

I ate in very early labor at about 3pm...homemade ice cream...oh so good! Hey, it was Mother's Day and I wasn't missing out on that treat! I didn't really want food during labor at the hospital. I was too distracted, and didn't get hungry. Baby was born right before mid-night via c-section (didn't realize she was breech until my water broke at 10 cm). I was incredibly thirsty after that, but they only let me have ice chips. Husband snuck me a glass of water at about 4am. Then I had a fluid breakfast and was eating real food again by lunch. Overall I wasn't displeased with the food situation. And I understand not being able to eat or drink after abdominal surgery, so while annoyed at the time, I'm not bothered by it in retrospect.

Nicole - posted on 01/02/2011

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Yes, I ate during both labour with both of my children. If I hadn't, I wouldn't have had the energy I had.



I should add, my first labour was 5 hours. My second was 3.

Kate CP - posted on 01/02/2011

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I ate when I was in early labor. When I got to the hospital and they had started the pitocin drip I didn't even want water. I was too busy. But yea, I ate when I was in labor and I plan to do it again.

Jodi - posted on 01/02/2011

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I was in and out of labour (very mild) with my daughter for a couple of days, so of course I ate. I didn't feel like anything heavy, but I snacked on light food. Once I was in hospital in labour, I was still hungry, so I asked for food. They were reluctant, but they let me have a light sandwich at around 4pm. I put my foot down and pretty much told them if they didn't get it for me, I would send my husband to get something. I delivered at 7:30pm. And of course I kept up the fluids as well (just water).

When I had my son, I went into labour in the middle of the night, I just wasn't hungry, and I was only in labour about 9 hours, so by the time a normal meal time came around I was in pretty hard labour and didn't feel like eating.

Joanna - posted on 01/02/2011

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I couldnt have eaten even if I wanted, the pain was too much. But I'd only gone without food for 16 hours though, wasn't too awful. After I had my daughter though the first thing I asked for was an In-n-Out double double :P

Ez - posted on 01/02/2011

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Sherri I was a vomiter too once things really got going. But I did eat a sandwich and some crackers at about 5cm (which coincided with dinner time) when my ctx were steadily 3-4mins apart, and the midwives had absolutely no problem with that. Even if they had, I would have still had them. It's not like I was chowing down on a Big Mac!



If a mother is at 8-9cm and pushy, I can understand advising her that eating is not a great idea (although I doubt many women feel hungry at that point anyway lol). But denying a woman food who is not even in labour yet seems ridiculous!

Sherri - posted on 01/02/2011

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No didn't eat during labor but my longest labor was only 12hrs, second 6hrs and 3rd 4hrs. So no need also once I go into heavy labor I am violently ill so no way do I want food.

Shauna - posted on 01/02/2011

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I was induced at 5 pm on a tues evening. I was told to stop eating at noon that same day and also to make it a very light meal. I didnt have the baby untill 6 pm next day. I was sooooo hungry, they finally let me eat b/c i was freaking out how hungry i was and had no energy. They said "your not going to need a c-section it will be fine" I did end up with a c-section and the epidural didnt work i was pumped full of narcotics during the epidural.

I tried to obide the "not eating" but i had my husband sneak my snacks :-/ --- nothing hapened from me doing so but i prob should have listened to the drs.

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