WebMD Medical News
Louise Chang, MD
Jan. 20, 2010 -- There is little medical justification for telling women in
labor not to eat or drink, a review of the research finds.
For many decades, the prevailing practice in childbirth has been to restrict
food and fluids during labor to little more than ice chips. This was largely
due to concerns about aspiration of stomach contents into the lungs of women
given general anesthesia during delivery.
But very few women receive general anesthesia during childbirth these days,
even when they deliver by cesarean section. And changes in anesthesia practices
over the years have reduced the vomiting risk.
As a result, doctors have begun to relax once-strict policies about eating
and drinking during labor.
"We are, as we speak, in the process of re-evaluating our practice, as I
believe other hospitals are," high-risk obstetrician Jeffrey Ecker, MD, of
Massachusetts General Hospital tells WebMD. "We are trying to find a balance
between what makes patients happy and comfortable and what makes the
In the newly published review, conducted for the nonprofit Cochrane
Collaboration, researchers examined five studies in which a total of 3,130
women were followed through childbirth.
All of the women were considered to have a low risk for needing general
anesthesia when they entered labor.
Taken as a whole, the studies showed no evidence of any risk or benefit
associated with eating or drinking during labor.
One of the largest studies included in the analysis was published just last
Researchers followed 2,426 women with a low risk of obstetric complications
through delivery and found that those who ate lightly during labor and those
who only had water had similar lengths of labor and rate of C-section
The women who ate were no more likely to vomit than women who did not.
"Since the evidence shows no benefit or harms, there is no justification for
[prohibiting eating and drinking] during labor, provided women have a low risk
for complications," study researcher Mandisa Singata, MD, of South Africa's
East London Hospital Complex, says in a news release. "Women should be able to
make their own decisions about whether they want to eat or drink during labor
Last summer, the nation's largest group representing obstetricians
officially relaxed its restrictions on fluid intake during labor.
According to the American College of Obstetricians and Gynecologists (ACOG),
women with uncomplicated pregnancies may now drink "modest' amounts of clear
liquids such as water, juices, carbonated beverages, tea, black coffee, or
But the group still recommends against eating solid food during labor.
"Allowing laboring women more than a plastic cup of ice is going to be
welcome news for many," Massachusetts General Hospital ob-gyn William Barth
Jr., MD, said in a news release at the time. "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."
Ecker agrees that most of his patients have no interest in food during
labor, but he says some do.
"A light meal early in labor may be appropriate for women with a low risk
for obstetric complications," he says. "But nobody should be ordering a double
cheeseburger from the cafeteria during labor."
The Cochrane Collaboration is an international, nonprofit group that
assesses health care policy by reviewing the best available research.
SOURCES:Singata, M. The Cochrane Collaboration, Jan. 19, 2010.Jeffrey Ecker, MD, maternal and fetal medicine, Massachusetts General
Hospital; associate professor of obstetrics and gynecology, Harvard School of
Medicine.News release, Cochrane Review.American College of Obstetricians and Gynecologists: "Recommendations Relax
on Liquid Intake During Labor," Aug. 21, 2009.O'Sullivan, G. BMJ, March 24, 2009; vol 338.
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