Women have long been told to avoid eating or drinking during labour due to concerns around the risk of vomiting or aspiration, in case general anesthesia and surgery are required. But a new study, published in the American Journal of Nursing, which found no increase in risks for women who were allowed to eat and drink during labour, suggests the advice may be outdated.
"In keeping with current guidelines, most obstetricians and anesthesiologists in the United States continue to recommend restrictions on oral intake for labouring women," lead author Anne Shea-Lewis and her colleagues write. "The findings of this study support relaxing the restrictions on oral intake in cases of uncomplicated labour."
As part of the research, the team analysed the medical records of approximately 2,800 women who went into labour in the same hospital between 2008 and 2012. Some of the women were allowed to eat and drink as they pleased while others were nil by mouth. Researchers then compared outcomes for both mums and bubs in the two groups.
Interestingly, while there were fewer pre-existing medical issues in the group who didn't eat or drink, (14 per cent versus 20 per cent) these women had a higher incidence of complications during labour and birth. They were also more likely to undergo an unplanned caesarean section.
When it came to the health of the newborns, there were no significant differences between bubs in the two groups as measured by Apgar scores, or the need for a higher level of care after birth.
"Our findings support permitting women who are at low risk for an operative birth to self-regulate their intake of both solid food and liquids during labor," the authors write, adding that restricting food and drink to a woman in labour who is hungry or thirsty "may intensify her stress".
"Conversely, allowing her to eat and drink ad lib during labour can contribute to both her comfort and her sense of autonomy," the authors note.
Last year, a study published in the journal Obstetrics and Gynaecology found that women who were allowed to eat, had labours 16 mins shorter than those whose food intake was restricted. "If we're well hydrated and have adequate carbohydrate in our body, our muscles work better," the researchers noted at the time.
Terri Barrett, president of the Australian College of Midwives (ACM) told Fairfax Media, that the ACM notes the increasing body of evidence that supports women being able to eat and drink as they wish during labour.
"The practice of fasting or limiting women to sips of water is outdated and not relevant to contemporary maternity care," Ms Barrett said. "Obviously there are individual situations where a more cautious approach is required but for women at low risk of complication they should be encouraged to stay hydrated and nourished, following their instincts in relation to what they eat and drink whilst in labour."
So, what exactly should women in labour be consuming?
According to Ms Barrett, there is no current evidence informing which food and drink is best. "Women should determine what they would like to eat and drink and be supported in this choice not only by their maternity care provider but also through hospital policies that are based on best evidence."
Ms Barrett adds that it is also important to consider that for some women there may be cultural considerations in relation to their intake. "Maternity care providers should work with women to determine what the woman's preferences are based on individual needs," she says. "The most important thing is that a caregiver talks to the woman and asks 'what's right for you?'"
And not everyone, says Ms Barrett, will feel like eating.
"What we know from experience is that in early labour women often feel like eating small amounts but as labour becomes more advanced they are less likely to want to eat," she notes.