ACOG Relaxes Rules on Liquids During Labor

[KnoxvilleDoula]

Recommendations Relax On Liquid Intake During Labor

23 Aug 2009   

Women in labor may be allowed to quench their thirst with more than just the standard allowance of ice chips, according to a new Committee Opinion released today from The American College of Obstetricians and Gynecologists (ACOG) and published in the September issue of Obstetrics & Gynecology. Although the guidelines on prohibiting solid food while in labor or before scheduled cesarean surgery remain the same, ACOG says that women with uncomplicated labor, as well as uncomplicated patients undergoing a planned cesarean, may drink modest amounts of clear liquids during labor if they wish.

Standard hospital policy for many decades has been to allow only ice chips for pregnant women in labor if they were thirsty. Women are not allowed to eat any solid food during labor. "The reason for restrictions on food and water (or other liquids) during labor is to avoid aspiration in the event that a woman needs to be anesthetized for a cesarean delivery," said William H. Barth, Jr, MD, of Massachusetts General Hospital in Boston and chair of ACOG's Committee on Obstetric Practice. Aspiration, which is potentially fatal, can occur when the contents of the stomach are drawn into the lungs while under anesthesia. Over the past 60 years, however, the incidence of maternal death due to aspiration while under anesthesia has declined dramatically, mainly due to the prohibition on solid foods as well as improvements in obstetric anesthesia.

According to ACOG, women with a normal, uncomplicated labor may drink modest amounts of clear liquids such as water, fruit juice without pulp, carbonated beverages, clear tea, black coffee, and sports drinks. Fluids with solid particles, such as soup, should be avoided, however. Women who have uncomplicated pregnancies and are scheduled for a cesarean delivery may also drink these clear liquids up to two hours before anesthesia is administered.

"Allowing laboring women more than a plastic cup of ice is going to be welcome news for many," Dr. Barth said. "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."

According to ACOG, expert consensus supports the recommendation that women undergoing a planned cesarean delivery or elective postpartum tubal ligation after vaginal birth should have no solid food from six to eight hours prior to surgery. Pregnant women who have additional risk factors for aspiration, such as morbid obesity or diabetes, and those at high risk for operative delivery (ie, forceps, vacuum), may need to be restricted from fluid intake on a case-by-case basis.

Committee Opinion #441, "Oral Intake during Labor," is published in the September 2009 issue of Obstetrics & Gynecology.

Source
American College of Obstetricians and Gynecologists

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Article URL: http://www.medicalnewstoday.com/articles/161523.php

[Krystal.Ingalls]

Aug. 24, 2009 at 1:06 PM

Woohoo!!  I hope this news gets around fast and hospitals will lighten up a little on the whole no drinking during labor.  =) 

[Mary229]

Aug. 27, 2009 at 3:52 PM

This is the whole reason I waited so long before going to the hospital while in labor with my second child.  I was in labor/delivery for 42 hours with my first child and was denied food and drink the entire time.  How are you supposed to have the energy to push a baby out (which took 2 hours by the way) when you haven't eaten or drank anything in two days?

In any case, I went to the hospital less than 3 hours prior to the birth of my second child.  And I ate breakfast - oatmeal and gingerale (to calm my stomach) - 5 hours prior to giving birth.

[mommytobobby]

Aug. 28, 2009 at 1:18 PM

i stayed at home as long as i could. i ate ice cream, it was what i was craving. i guess i needed the sugar boost. and when i got to the hospital, they wouldn't even give me ice chips. granted, i had a fast active labor (my water broke at 230am, i got in the room at 3am and had my son at 344am), i was still thirsty. and they looked at me like i was crazy when after i told them that i had ice cream right before i left to go to the hospital.

i'm happy to say now that our next baby will be born at home. we're still ttc, but i've done research and have decided that this is the best decision for my family and me.