The Hardest Work with No Food

In 1946, Dr. Curtis Mendelson hypothesized that the cause of pneumonia following general anesthesia was aspiration of the stomach’s contents. He noted in his study that food can be vomited 24-48 hours after being eaten.

When his theory was tested on rabbits, aspiration of undigested food could not cause aspiration pneumonia, it only caused obstructions. And they only died when aspirated materials containing hydrochloric acid.

Since his hypothesis was incorrect, he said that by forbidding food and drink in labor, you reduce stomach volume, thereby reducing risk of problems from acid aspiration while under general anesthesia.

In the 1940’s and 1950’s, general anesthesia was used all the time. Gases were given by an opaque face mask, which hid the airway from view. Now that we use clear masks, the anesthesiologist can keep an eye out and see if anything is going to come up to prevent it from being inhaled.

In 1950, Dr. Robert Parker largely blamed aspiration on poor anesthetic technique and poor practitioner quality.

Now, general anesthesia is only used 3.5-13% of the time. And since the technique has greatly improved, aspiration pneumonia rarely ever happens.

One of my very good friends had general anesthesia when her daughter was born. She was in labor a very short time, and by this study, it wouldn’t have mattered if she had eaten or drank at the hospital. She was only there a few hours. Limiting her intake would not have done anything had something gone wrong.

Not eating or drinking in labor can cause dehydration and ketosis, which can make the woman tired, drop her blood sugar, make her labor stall or stop completely, and make her unable to push properly, all of which now lead to interventions and cesareans.

Eating and drinking in labor has actually been shown to shorten labor by 90 minutes or more, make less need for pitocin augmentation, fewer pain medications, and the babies had much higher apgar scores than the control group.

It is offered that only low risk women should eat, since high risk women are more able to turn bad at any time.

Some hospitals have suggested a laboring woman have a diet of tea, fruit juice, lightly cooked eggs, crisp toast and butter, plain biscuits, clear broth, and cooked fruits. They all contain high amounts of sugars and things a woman needs to keep her energy up.

When I was pregnant, my midwife said I could drink fruit drinks, but couldn’t eat anything except popcycles.

People that have their babies at home or in a birthing center are allowed to eat any time they want in labor. It is understood that a woman has to keep her strength up, since this is the hardest work her body will ever do.

Would you run a marathon without proper hydration and nutrition?

I understand the risks of not eating and drinking, but can you truly deny your body something that it needs daily? It makes you wonder if hospitals let women eat and drink, would their intervention rates drop and would our mortality rate drop along with it?

Interesting food for thought…

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2 Responses

  1. Yeah, that whole no-food thing is totally ridiculous. Our midwives completely encourage eating at will, and they actively push liquids. When I was in labor I didn't end up wanting to eat, but I was free to do so according to whatever I wanted, and that's a wonderful freedom. Nice article!

  2. That is funny that you would mention running a marathon. That is the very thing my doctor compared birth to. He said that women who are unprepared for birth are about as smart as someone running a marathon without a day of training. (So sad he isn't around to deliver my future babies! He was a great doctor.) I think fortifying your energy with nutritious food is important in labor. I am anxious to see more doctors and hospitals recognize that.

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