Nutrition and Nourishment During Labor
by Dorinda Mitchell
Anytime you are with a group of women who are sharing stories of birth you will hear at least one woman complain of how hungry she was! Some women will even say, " I would not have gotten sick if I could just have had something to eat!" As you think of the choices you have or your upcoming labor and birth have you thought about how you should nourish yourself? Did you know the research indicates withholding food and drink during labor is not beneficial? If this is the case, what should you be eating and drinking?
Let's look at nourishment just before labor and during early labor. During the last days of pregnancy a shift to a high carbohydrate diet can be beneficial. This is because our body needs something called glycogen. Carbohydrates increase glycogen levels. If we don't have these stored our body will convert fat into glycogen. When our body converts fat into glycogen we also produce a by-product called ketones. The production of ketones can result in slowing labor and fetal distress. To prevent ketosis IV's are administered. As you can see what you eat sets the beginning course for your labor. Some suggestions for foods that help build stores of glycogen are breads, cereal, crackers, corn, pasta, potatoes, rice, and fresh fruit. During early labor you want to be sure to drink plenty of water, fruit juices, and Gatorade or sports drinks. These will help to replace electrolytes and keep you hydrated. You want to continue eating high-carbohydrate foods that will digest easily. This will help to prevent excessive fatigue. It is important also to avoid products such as dairy, spicy foods, and heavy amounts of protein.
As your labor progresses you will want to switch to more simple carbohydrates that will give you bursts of energy but will leave your body quickly. Some suggestions of these are juices, honey, and fruits. You may want to make up some juice-sickles to have. Even if you are at the hospital at this point most hospitals have a nourishment room with a freezer where they can be stored. During this period you will want to eat smaller amounts more frequently.
During your labor you may come to a time when your body may tell you to "stop!" If you don't feel like eating now then don't. Your digestive system will slow down, and it is okay to trust your body and what it is telling you.
Some of you may be thinking "This sounds great, but is my care-provider going to go for this? He/she said 'No eating once labor begins!'" I can't make promises as to how your care-provider will respond, but I can give you some factual research behind why staying nourished in labor is important.
The thought behind withholding food and drink is that if a woman has to have general anesthesia and vomits she could aspirate. However, the level of this risk is and always has been low. The other problem with this line of thinking is that even if there is no food in our stomach we still have gastric fluids. Anesthesiologists are trained to prevent the aspiration of fluids or food particles. In a Guide to Effective Care in Pregnancy and Childbirth the routine withholding of food and drink from women in labor is classified as a form of care unlikely to be beneficial. At North Central Bronx Hospital the policy is to allow self-regulation of nourishment during a normal labor. This is what they have found in doing this. "Those women who nourished themselves at home during labor were likely to come to the hospital in more active labor than women who did not take nourishment. Women who do self-regulate their nourishment know what, or if, they need to eat and drink during labor."
This, as with all issues concerning labor and birth, is something you will have to discuss with your care-provider. They may or may not be very open to this initially. You are the captain of your ship, though. Come armed with factual, evidence-based research and discuss what can be done. While some may say no eating once you are at the hospital, others may be very open. If your care-provider is not so open maybe you can plan to stay home until labor is well underway. Remember this, as with everything, there is a middle ground. So, happy eating!
* A Guide to Effective Care in Pregnancy and Childbirth, Enkin, Murray, MD, Keirse, Marc, MD, Renfrew, Mary, CNM, Neilson, James, MD. Oxford University Press, Oxford England. Second Edition, 1996.
* A Good Birth, A Safe Birth. Choosing and Having the Childbirth Experience You Want. Korte, Diana, Scaer, Roberta. The Harvard Common Press, Boston, Massachusetts, 1992.