Healthy women not at risk for aspiration may be permitted to eat a light meal during labor, suggests research presented at the 2015 Annual Meeting of the American Society of Anesthesiologists.
“A change in practice makes sense,” said Christopher Harty, BN, study co-author and medical student at Memorial University, in St. John’s, Newfoundland, Canada.
The researchers analyzed 385 studies, which were published after 1990 and focused on women who gave birth in a hospital setting, and found that aspiration is nearly nonexistent today, particularly in healthy patients. One case of aspiration was reported in the United States between 2005 and 2013, and no cases of aspiration were reported in the United Kingdom between 2000 and 2005.
Childbirth research suggests that the energy required and caloric demands of laboring women are similar to those of marathon runners. Without the option to replenish calories, women’s bodies will begin to use fat as an energy source, leading to increased blood acidity in both mother and baby, reduced uterine contractions, longer labor, and lower health scores in newborns. Fasting can also lead to emotional distress in the mother, potentially moving blood flow away from the uterus and contributing to the distress of the fetus.
For women in labor, a light meal could include fruit, light soups, toast, juice, water, and light sandwiches without large slices of meat.
“[Clinicians] should work together to assess each patient individually,” said Mr. Harty. “Those they determine are at a low risk for aspiration can likely eat a light meal during labor. This gives expectant mothers more choices in their birthing experience and prevents them from being calorie deficient.”
However, there are exceptions to this new rule. “Certain factors increase a laboring patient’s risk of aspiration, which outweighs the risk of withholding nutrition,” cautioned Erin Sproul, BN, study co-author and a medical student at Memorial University, citing factors such as eclampsia, pre-eclampsia, obesity, and the use of opioids to manage labor pain.
The study authors suggest that pregnant woman should discuss the possibility of eating a light meal during labor with their clinicians.
- Harty C, Sproul E, Bautista MJ, et al. A review of fasting and the risk of aspiration in labor. Presented at: Anesthesiology 2015, the annual meeting of the American Society of Anesthesiologists; October 24-28, 2015; San Diego, CA.