"They didn't let me eat or drink during childbirth"

A phrase that many recent (or not so recent) mothers often say when they remember the day they gave birth, related to food or drink in the birth process, is: “They didn't let me eat or drink during childbirth“.

This restriction has been part of the birth protocols for many years and is motivated by a "What if ...", which in this case is about the possibility of having to do general anesthesia to the mother, then having risk of aspiration gastric (which passes stomach contents to the lungs).

However, limiting the intake of liquids and solids does not always guarantee the reduction of stomach content (it does not always empty completely, despite not eating) and also affects the well-being of women, which in addition to being tired, sleepy and perhaps hungry , see how he is denied a simple glass of water.

To this we must add that currently, less and less general anesthesia is used, for the benefit of neuroaxial anesthesia, much more localized and with less side effects (and the mother wakes up) and the knowledge that WHO promotes offering oral fluids during childbirth.

What do the scientific studies say?

Well, not much. In a practical guide for obstetric anesthesia published in 2007 by the American Society of Anesthetists, it was published that there was no evidence to assess the time of safe fasting after the intake of solids in women. In other words, nobody knows for sure how much time has to pass since the last time a pregnant woman took something solid until the time of anesthesia was administered to make it safe.

With this doubt in mind, the effects produced by the presence of food in the mother's stomach at the time of giving birth have been observed and it has not been found that the fact that the woman has eaten solid food during childbirth influences either type of delivery (caesarean section or vaginal) or the duration thereof.

Regarding more serious complications in which Mendelson's syndrome could occur (gastric aspiration by anesthesia) there are no studies that can assess the safety of the mother in such situations, although it can be said that these are extremely rare complications.

What is recommended

Since we are talking about solids above all and there is no evidence to advise against them (or advise them), we focus on talking about liquids that will always be less dangerous. The fact that a woman drinks clear liquids (water, filtered broths, strained fruit juices, infusions, tea or coffee alone and drinks without bubbles) does not influence the evolution of labor, that is, it does not affect the type of delivery, the duration, the use of oxytocin, nor does it affect the newborn in any way.

If in addition to all this we take into account that it improves the comfort of the woman and her satisfaction in the birth process it is advisable to allow the mother who wishes to drink clear liquids during childbirth (We talk mostly about the dilation phase).

Decreasing the risk of ketosis

During labor the woman may suffer ketosis (elevation of ketone bodies in the blood) secondary to physical exertion and stress, accompanied by a decrease in oral intake. This happens because, in the absence of energy that comes from food, the liver begins to metabolize its own fat, giving rise to ketone bodies, which transport that energy to other organs.

It is not clear the effect that ketosis can have on the mother or the baby, but it is believed that it can cause nausea, vomiting and headache and therefore cause more tiredness and less general comfort.

To avoid it, it is suggested then what has already been commented, a light diet or carbohydrate fluid intake (isotonic drinks), provided that the increase in gastric volume (filling the stomach) does not cause discomfort.

Summarizing

There are women who do not want to hear about liquids or solids during labor, however there are others who, in the middle of labor, feel the need to replenish fluid and drink something. In order to improve the comfort of the mother and observing that there is no evidence to contraindicate it and that it can be useful to avoid ketosis Women are recommended to drink some clear liquid from time to time.
I remember that for our first birth he was strictly forbidden, despite my wife, who would have drunk some good taste. For the second, however, they did offer him a juice that suited him quite well.

To you,they let you drink something in your births?