A Healthy Pregnancy

Eating During Labor

Many hospitals currently restrict food intake during labor. A few hospitals allow laboring women to have only ice chips, others allow clear liquids only. These policies are based on work by Dr. Mendelson in the 1940s that indicated that under general anesthesia there was a possibility of acidic stomach contents entering the lungs and causing damage.

Even though the cesarean rate in the United States is an alarming 32%, most cesareans are performed under spinal anesthesia, not general anesthesia. Many women express that restricting food during labor made labor more unpleasant and have asked if these restrictions are still valid.

Labor IS physically hard work. Some birth advocacy groups claim that restricting food intake may be contributing to an increasing cesarean rate. They suggest that withholding food and water decreases a woman's energy level and contributes to cesareans for "failure to progress" (the medical term for a labor that "stalls" at a certain level of dilation) and so say that women should be encouraged to eat in labor.

Which is correct? Food restrictions or encouraging eating?

A recent review of research (Cochrane D Sys Rev 2010: Issue 1. Art. No.: CD003930. DOI: 10.1002/14651858.CD003930.pub2.) found no evidence of harm in allowing women to eat during labor or no evidence of benefit of encouraging them to eat if they do not wish to do so. Consequently, the reviewers stated that a woman should be allowed to follow her own desires as far as eating and drinking in labor.

Note: The researchers did not review studies pertaining to women who were at high risk of having a cesarean section. It is possible these types of studies may indicate a need to restrict eating and drinking. The design of the studies did not assess the length of labor, amounts eaten, and the progress of labor. It is possible that these types of studies might indicate the value of eating during labor.

Talk to your obstetrician about eating during labor. Your physician may be willing to write an order that differs from traditional eating/drinking policy in certain cases. If being able to eat or drink during labor is important to you, call various hospitals or birthing centers in your area and ask about their policies. They may vary considerably. Ask what food is available at the hospital. If you don't like the food that is available, bring your choices in a cooler.

If you choose to eat during labor, here are some foods that work for many women during labor.

Broth or stock
"Broth" in many hospitals is bullion (lots of sodium and not many nutrients). Take a can of broth with you to the hospital and warm it in a microwave (but not in the can!). Even better, make homemade stock and freeze it in small quantities, such as an ice cube tray, and warm only what you want at the time. Stock takes more planning but has better flavor, consistency, and nutrition.

Miso soup
If you aren't familiar with Miso, you can find this soybean based soup at Japanese stores and many health food stores. It is light and very digestible.

Fruit smoothies, shakes, drinkable yogurt
Sip on these beverages instead of drinking them quickly. If you don't feel like drinking the whole beverage, ask your nurse to put it in the freezer and eat small bites of the frozen beverage later in labor.

Italian ice, ice cream, bites of popsicles, or other "slushy" foods
Labor can be hard work; small bites of something cold can be very refreshing.

Non-caffeine beverages
Fruit juices, non caffeine teas, lemonade, sports drinks (like Gatorade) can all be good choices. Skip the energy drinks. Most of them have caffeine. You want to be able to relax between contractions. Caffeine can leave both you and baby jittery and may raise baby's heart rate.

Applesauce or fruit in small chunks
Fruit is easily digestible. Stick with fruits where you can have a bite or two at a time. Frozen (slushy) applesauce gets high marks from my patients.

Granola bars or nutrition bars
These are easy to eat and can be enjoyed a bite or two at a time.

Honey
If you don't feel much like eating but are worn out or exhausted, a couple of spoonfuls of honey may make a difference. I have seen this be especially effective when mom has had a long labor and is preparing to push.

Cheese and crackers or peanut butter crackers
A combination of carbohydrate and protein (in small quantities) is helpful. Caution: Some women find peanut butter is too strong a flavor for them.

When and how to eat

Early labor is a good time to eat. If you can easily walk and talk through contractions, it is a good time to have a nutritious snack. Eat something with some protein and some carbohydrate. Stay away from highly spicy food or anything that causes you heartburn. You don't want to taste that chili all through labor!

Eat lightly throughout labor as desired. Pay attention to what YOUR body is telling you. If you are feeling nauseous, wait awhile. Rinse your mouth with water if you are getting a dry mouth or try a few ice chips. The nausea will likely pass soon. If you are feeling exhausted or discouraged, try some food. Start with just a few bites. You can always have more later.

After birth

Many women are hungry after baby is born. (You will have been working very hard!) Check out the food at the hospital where you plan to give birth. Hospital food is much better than it was years ago, but if it doesn't match your palate ask a close friend to bring you food from your favorite restaurant after the birth.

Don't forget the coach! Whether it's baby's Dad or your best friend, having someone with you in labor can be very helpful. You may not want your support person to leave long enough to go to the cafeteria, so include healthy snacks for them.

Be flexible. If you pack a cooler of nutritious gourmet food and don't feel like eating, it's ok. Know that you were well-prepared. You will want the food later.

Nourish yourself and your child!