The diet permitted a laboring woman varies between cultures and eras. Here, cross-cultural practices regarding food and drink during labor are reviewed, with particular attention to historical and present-day American medical advice. In most American hospitals women are prohibited from eating or drinking in labor. This custom started in the middle of the twentieth century when general anesthesia was widely used for ordinary childbirth, creating risks of aspiration pneumonia and maternal death. Despite marked improvements in obstetric care, anesthetic agents, and anesthesia administration, women are still prohibited from eating and drinking in labor. It is posited that this reflects the phenomenon of culture lag. (BIRTH 15:2, June 1988)Although a few obstetricians and some nurse-midwives permit women to have light meals of clear liquids in early labor, many prohibit eating and drinking once labor has progressed to the active phase. In most hospitals prohibition of food and beverage continues until after delivery, an average of 12.1 hours in nulliparas and 7.6 in multiparas (1). In 5 percent of nulliparas, labor lasted longer than 34.7 hours, and the corresponding number for multiparas was 19.9 hours (1). Thus, for some women, the period of deprivation of food and drink is very long.Proponents of withholding food and drink note that catastrophes during labor that mandate the use of general anesthesia may occur without warning. The danger lies in the possibility of women vomiting and aspirating the vomitus into their lungs, since all protective reflexes are abolished under general anesthesia (2-5). Such aspiration can cause severe pulmonary complications and death.This paper recounts customs regarding the ingestion of food and liquid in labor from other cultures and eras. As Mead and Newton (6) pointed out, "All known human societies pattern the be-Jeannine Broach is a maternal-child nurse currently completing
Giving intravenous (IV) fluids in labor is currently an accepted custom in United States hospitals, although most indications for this practice have not been validated by adequate outcome research. This paper discusses the following questions: I) Does IV therapy add pain to the woman in labor? 2) Does it have an adverse impact on the attitudes of health care workers and on the laboring woman? 3) Does partial immobilization caused by IV lines have adverse effects? 4) Does the practice introduce a possible route of infection and overdose of fluids? 5 ) Do IV fluids give adequate nutrition in labor? 6) Does glucose administered intravenously sometimes cause psychophysical and neurologic complications? 7) Might forced feeding with glucose in IV fluids in late labor sometimes be harmful? The need for individualized treatment and much more research is emphasized. (BIRTH 15:2, June 1988)
Since the 1940s women have been prohibited from eating and drinking during labor because of the danger of aspirating stomach contents should general anesthesia be necessary. This is a critical review of the research on which prohibiting oral intake during labor has been based and includes studies demonstrating delay of gastric emptying in pregnant and laboring women. Problems in defining the scope of maternal mortality from aspiration during anesthesia are discussed, as well as other effects of prohibiting women from eating and drinking during labor. These include physiologic effects from short-term deprivation of oral intake which has been largely overlooked in the literature and requires further investigation. Psychologic effects have been neglected altogether and should also be examined. (BIRTH 15:2, June 1988)
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