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Food and Drink during Childbirth

  • Food and Drink during Childbirth

    Years ago, mothers-to-be had to follow a strict "no drink, no food" diet during childbirth. We look at why, and discuss what has (and hasn't) changed.

    Child birth used to be considered an operation – and you don't drink or eat when operated on, right? The patient/mother-to-be lies in bed and does not interfere with anything, leaving everything to her healthcare personnel.

    Should someone have argued that childbirth is NOT an operation but a natural phenomenon to which the female body is innately disposed, then the main objection against drinking and eating used to be (and still is): “And what if we need to perform an acute Cesarean?“ or “What if the placenta fails to separate and we end up having to perform manual placenta lysis?“ Thus the “no-drink” and “no-eat” rule stems from the concern that the birth might turn complicated and a surgery might become necessary.

    How to resolve this dilemma?

    Acute Cesarean section (a Cesarean whose necessity emerges unexpectedly during the delivery) is performed on no more than 5% of women giving birth to a term baby in healthy condition. Therefore a fundamental philosophical question arises as to whether obstetricians have the right to keep 95 out of 100 pregnant women hungry, and worse than that, thirsty – for many hours, for no reason.

    On the other hand, if every woman is allowed to drink, what should we do if the delivery indeed runs into problems and Cesarean section becomes necessary whilst the woman has a full stomach, vomits during narcosis, inhales vomitus and either chokes to death or develops pulmonitis… such is the catastrophic scenario frequently used as a counter-argument.

    Compromise is possible. As long as you have been admitted to the labor ward at the start of the delivery and are full term, with your foetus in a normal position, have a normal entry monitor result, and thus a high chance for a normal (vaginal) delivery – then in my opinion you can take small sips of pure non-carbonated still water throughout the entire labor (frequently and in small amounts).

    Should you feel like having some tea, we have no objection to warm, mildly sweetened weakish black or green tea. If your delivery proceeds at a fast rate which makes you dizzy and raises your stomach, you can gulp small bits of crushed ice. Ice in contact with stomach tissue has an anesthetic effect and can suppress the vomit reflex triggered by the pressure of the fetal head upon the pelvis floor and by dilation of the cervix and vagina by the fetal head, further contributed to by fatigue and low level of blood sugar.

    Throughout labor you may also use some ionic drinks, except that they always seem to have a bit of a chemical taste to them that might boost the tendency to vomit. Lack of ions and glucose accompanied by the compulsion to vomit can always be tackled by way of infusion with appropriate contents of minerals and glucose while at the same time gulping the crushed ice. You may not know that the vomit reflex is rarely manifested in any significant way during deliveries under well performed epidural analgesia, i.e. during such delivery it is enough to take sips of your favorite non-carbonated water or tea (with no need for the ice) and if the need for acute Cesarean arises it can be done under epidural anaesthesia which is an expanded epidural analgesia. In other countries, childbirth without local anaesthesia (epidural or spinal) is utterly exceptional, which minimizes potential risks of vomitus inhaling and thus eliminates the logical argument calling for restriction of drinking. If necessary, the stomach contents can always be sucked off by way of a nasogastric tube.

    As for food, let us take a reasonable approach. At the very start and mainly in case of slow-paced labor I can see no risk in having a fruit cocktail (concocted fruit without skin and stones, such that you have tested before as to having good tolerance for), it will satiate you for a while, give you vitamins and sugar and depart from the stomach within an hour, or you can use NUTRIDRINK – a commercially available liquid cocktail which contains proteins, sugar, fat, vitamins, minerals, trace elements and other important nutriments.

    During the further course of labor (mainly in the active phase of the first stage of labor – from approximately 5 cm dilation onwards) eating is by no means recommended – in the vast majority of cases the menu ends up on the floor or on the clothes of the delivery room staff. An exception may be a small bit of chocolate: let it melt in your mouth, thus raising the level of sugar in your blood. On behalf of delivery room personnel I beg you not to listen to your mum or your in-law encouraging you in good faith before your departure to hospital: “Go ahead and have the beef steak while you still can, darling – in the hospital they will starve you to death “.

    In the second stage of labor in between pushing you can gulp small bits of ice or take small sips of pure non carbonated water.

    The third stage of labor (through to birth of the placenta) is more or less a restful period during which it is better to restrain from drinking and eating – this phase normally does not take more than 10 minutes. Once the placenta has been birthed, after your muliebria have been checked, after your birth injury (if any) has been attended to, and having heard the final “everything is okay” statement, you can again resume intake if thirsty (in fact, every woman who has managed vaginal delivery should deserve a sip of champagne). This is when the nurse normally brings you the baby for breastfeeding and you will most likely have other things on your mind than food or drink.

    If, during some time after delivery (while still in the delivery room) you get desperately hungry, try to exercise moderation, eat rather slowly, taking small bites and thoroughly chewing your food. This is especially recommendable if you have toiled hard during the second stage of labor (the pushing stage) – in which case your stomach may remain sensitive for several more hours. Therefore, it's probably better not send your husband for that Big Mac... even though... sometimes there is no pleasure like grabbing a big bite to eat.

     
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