Eating During Labour Has No Effect On Delivery

Main Category: Pregnancy / Obstetrics
Article Date: 26 Mar 2009 - 0:00 PDT

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Eating during labour does not affect delivery, according to a study published on bmj.com. It also has no effect on the duration of labour, the need for assisted delivery (forceps or vacuum extraction), or caesarean rates.

Since the 1940s, it has been common practice to prevent women from eating during labour to minimise the risk of pulmonary aspiration (breathing food into the lungs) in women who may need an emergency caesarean under general anaesthetic.

But pulmonary aspiration has declined dramatically in recent years, mainly due to the increased use of local anaesthesia for caesarean deliveries. Furthermore, some doctors and midwives argue that preventing food intake during labour can be detrimental to the mother, her baby, and the progress of labour, so the policy of routine fasting is being increasingly challenged.

Results from five previous trials of food intake during labour have been inconclusive, so a research team led by Professor Andrew Shennan at King's College London set out to investigate the effect of eating during labour on delivery rates.

The study took place at Guy's and St Thomas' Hospital in London between June 2001 and April 2006 and involved 2,426 healthy women, having their first baby.

Women were randomly split into an "eating" group or a "water only" group. The eating group were advised to eat small regular amounts of food, such as bread, biscuits, fruits, low fat yoghurt, isotonic drinks, and fruit juice. The water only group were advised to have ice chips and water only.

Age, ethnicity, food intake for six hours before and during labour, vomiting and the need for intravenous fluids were recorded.

The spontaneous vaginal delivery rate was the same in both groups (44%). There were also no clinically significant differences in duration of labour (597 minutes for the eating group and 612 minutes for the water group), caesarean delivery rate (29% for the eating group and 30% for the water group), or vomiting (35% for the eating group and 34% for the water group).

There were also no differences in the condition of the babies at birth or admission to special care units.

These findings show that eating does not shorten labour, nor does it increase the chance of a normal delivery, so withholding food is not detrimental, say the authors. However, eating and drinking may allow mothers to feel normal and healthy, so the policy of routine fasting during labour is not justified, they conclude.

These results offer the best evidence yet in this area, and reinforce the most recent guidelines from the National Institute for Clinical Excellence (NICE) that low risk women in normal labour may eat and drink, says Professor Soo Downe from the University of Central Lancashire in an accompanying editorial.

Future research could investigate women's views and experiences of eating and drinking during labour, and the effect of a policy of a light diet on outcomes in other settings, she concludes.

Research: Effect of food intake during labour on obstetric outcome: randomised controlled trial
BMJ online

Editorial: Eating a light diet during labour
BMJ online

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