Permitting a laboring mother to consume light snacks and liquids has been shown to provide several physiological and psychological benefits. Parsons’ (2004b) study reinforces the knowledge that “glucose is the principal source of energy for the fetus and is diffused rapidly across the placenta (p.7).” The metabolism of glucose during pregnancy occurs at nearly twice the normal rate because of the demands of the fetus. Therefore, it makes sense to encourage laboring women to maintain these levels by eating and drinking small amounts nutritious foods and liquids. In addition, ketosis occurs in pregnant women after only short periods of fasting and has been indicated as a factor in prolonged labor. It has also been suggested that women who choose what they eat and drink during labor experience an increased sense of control and improved moral during their labor (Parsons 2004b). In summary, it is possible that encouraging women to eat and drink while in labor may present more benefits than drawbacks.
Scope of the Problem
In 2003, 4,089,950 live births were reported in the United States, of which 27.5 percent were delivered by Cesarean section. Of these, 2,965,213 women gave vaginal birth and were affected by the delivering practitioners’ recommendations on whether to eat or drink during labor. The practice of allowing women to eat and drink during labor is highly-debated. These debates and well-designed research studies may eventually challenge the 1946 study that brought the NPO policy into the medical practice (O’Sullivan, Liu, & Shennan, 2007). In an effort to resolve the issue, there are medical associations which are conducting their own studies. These studies have shown to provide inconsistent results. Yet, studies that present evidence to the contrary must be heeded despite any desire to do otherwise (Polit & Beck, 2004). Review of the literature offers insight into the problem and invites healthy discussion among doctors, anesthetists, midwives, nurses, and other healthcare service providers. Viewpoints and practice regarding offering eating and drinking to laboring mothers vary largely due to profession (Parsons, Bidewell, & Griffiths, 2007). Women are, for the most part, receiving conflicting advice and information and being permitted to eat and drink during labor based on the type of provider and birth environment rather than well-researched and evidence-based medical practice.
With the amount of information available, many women find themselves overwhelmed or confused by conflicting guidelines related to eating and drinking during labor. Even if the laboring women requests food and fluids their health care provider or birth facility protocols may require that she be NPO or given ice chips only. Pregnant and laboring women need straightforward guidelines based on solid research that will guide them and their health care provider. Since the prevailing tradition is to restrict food and fluid during labor, most women follow the policy of the provider or clinical environment. According to Scheepers, Jong, Essed, and Kanhai (2001) although most women are not given any advice regarding eating and drinking in labor, those who are offered advice generally follow it. Women who are told not to eat generally refrain from doing so, and women who are offered light food and drink during labor are often eager to do so. Since the prevailing tradition is to restrict food and drink to laboring women, most women consume nothing other than clear liquids once labor begins or once they have entered the clinical environment. It may be advisable to restrict the intake of certain women who are known to be high-risk deliveries, yet the restriction policy extends to all women regardless of risk.