Wednesday, March 25, 2009

Eating for two in the delivery room

Throughout pregnancy, women are reminded that they are “eating for two.” But when they reach the labor and delivery suite, suddenly it’s nothing but ice chips. What gives?

A group of British researchers decided to find out.

Babies The prohibition of eating during labor dates to 1946, when doctors worried that moms-to-be could be at risk for acid pulmonary aspiration if they were given general anesthesia for emergency Cesarean sections with food in their stomachs. Although general anesthesia is rarely used for C-sections these days, the American Society of Anesthesiologists recommended as recently as 2007 that women in labor persist only on clear liquids such as water, tea, black coffee and sports drinks and avoid solid foods on the grounds that it “increases maternal complications.”

But the research team hypothesized that eating might actually be helpful in labor, which involves strenuous physical activity. They also noted that some European countries, such as the Netherlands, permit pregnant women to nosh during labor.

So they recruited 2,426 first-time moms-to-be who delivered singleton babies in a London hospital between 2001 and 2006. About half were invited to snack on cereal, biscuits, fruit, sandwiches, burgers, chicken, chocolate and other treats. The others were asked to restrict themselves to water.

As it happened, about 29% of the women in the eating group decided to fast, while 20% of the women in the water-only group broke protocol and ate. But it didn’t matter. In both groups, the rate of normal vaginal delivery was 44%, according to a study published online today by the BMJ, formerly the British Medical Journal.

There were slight differences, though none of them was statistically significant. Women who were allowed to eat spent 597 minutes in labor, compared to 612 minutes for those in the water-only group. The C-section rate was 29% for the eating group and 30% for the water-only group. The incidence of vomiting was 35% for women allowed to eat and 34% for those asked to limit themselves to water. The babies in both groups got the same Apgar scores, and about 5% of the infants in each group were admitted to ICUs or special baby care units, the study found.

In low-risk deliveries, “the consumption of a light diet could be left to the woman’s discretion,” the researchers concluded.

Bon appetit.

-- Karen Kaplan

Photo credit: Myung Chun / Los Angeles Times

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