Women in labour not restricted to ice chips
February 2, 2010
Nancy J. White
LIVING REPORTER
Low-risk women in labour should be able to eat and drink if they wish, instead of being restricted to ice chips, according to a new review of studies.
"Based on the evidence available, there's no harm and no benefit in allowing her to eat and drink," says Joan Tranmer, associate professor of nursing at Queen's University. "Given there's no harm or risk, women should be given the choice."
Tranmer is a co-author of the review published by the Cochrane Collaboration.
The traditional labour room prohibition against oral intake is to reduce the risk of food being regurgitated into the lungs while the patient is under general anesthesia. That is known as Mendelson syndrome, after Curtis Mendelson, the obstetrician who first reported it in the 1940s. The acidity of the stomach liquid and particles of food could lead to respiratory problems, even death.
Tranmer points out that obstetrical practices have changed since the 1940s, with far more use of regional anesthesia, even for caesarean sections. Should a patient require general anesthesia, she says, doctors have techniques for preventing regurgitation of stomach contents.
In her clinical experience, she has seen women in labour become uncomfortably thirsty and some have asked for food.
The review identified five studies involving 3,130 women and looked at the possibility of adverse outcomes for the mother and baby, length of labour and other issues.
"It's a balance between maintaining safe practices yet supporting a physiological, normal event," says Tranmer.
The Society of Obstetricians and Gynecologists of Canada's policy recommends that liquids and light meals be allowed during labour, although some hospitals may still prohibit it, says Andre Lalonde, executive vice-president of the organization.
At Mount Sinai Hospital, obstetrician Michele Farrugia says her patients in early labour can have a light meal, such as soup, maybe half a sandwich, to give them energy and a sense of control and comfort. A woman headed for a C-section should not eat.
At Sunnybrook hospital, the nothing-by-mouth policy changed about five years ago to allow easy-to-digest foods and clear fluids. "The issue now is how much and what," says Dr. Jon Barrett, chief of maternal fetal medicine.
He remembers one patient asking for McDonald's. That was not allowed.
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