Why You Can't Eat During Labor—But Maybe Should

Labor isn't typically a pleasant experience—obviously, there's pain involved, and you're usually asked to fast through the process, so you may also experience a few hunger pangs.

But a critical literature review of 70 years of research suggests eating a light meal while in the beginning stages of labor might not be dangerous. It may even be beneficial.

Michael Bautista, M.D., an associate professor of anesthesiology at Memorial University, St. John's, Newfoundland, Canada, became interested in this topic when he was asked why birthing parents are told to fast during labor.

"I realized I didn't have a good answer [to that question,]" he said. So Dr. Bautista assembled a team of researchers to study whether or not fasting during labor is truly necessary, and they found that the advice to fast during labor and delivery may be outdated.

The Reason for Fasting During Labor

People have long been told they should fast during labor because of the risk of aspiration, which happens when food or liquid is inhaled into the lungs.

But according to Dr. Bautista and his team, there's minimal risk of aspiration in healthy, low-risk people. There was only one case of aspiration during labor between 2005 and 2013 in the United States—and the patient involved was high-risk, according to the research team.

"When a woman is in labor, it's like she's running a marathon, and you need a lot of energy to run a marathon," Dr. Bautista says. "Having calories—glucose, sugar, something—to keep them going would be very beneficial."

What the Review of Studies Says

First, it is important to understand that scientists cannot ethically conduct experiments or research on pregnant people that could potentially harm the pregnancy, which is why there is still a lot we don't know about pregnancy and birthing.

So, while Dr. Bautista's team did not include a study of pregnant participants to monitor fasting versus eating during labor—which could be dangerous—they did comb through 385 studies published since 1990 that followed female birthing parents as they labored in hospital settings.

Here are a few interesting takeaways that Dr. Bautista and his team discovered:

• Labor is comparable to running a marathon in terms of calories and nutrition needed to sustain energy levels.
• Fasting during labor forces a person's body to burn fat as an energy source, causing acidity in the blood for both parent and baby to rise.
• Rising acidity in the blood can reduce contractions in the uterus, which can make labor last even longer, which can lower health scores in a newborn.
• Fasting can impact a person emotionally, triggering stress to divert blood away from the uterus and placenta, making labor last longer and possibly causing stress on the baby.
• Low-risk people can safely eat small meals during the early stages of labor. By the time later active stages of labor are in full swing, the parent's appetite is usually decreased or gone.
  

What You Should Eat During Labor

Of course, it's still important to be careful about what you eat since science is still divided on the reasons behind the rule.

"The risk of aspiration is much lower than it was four years ago, but maybe it's much lower because we don't allow people to eat," says Cynthia Wong, M.D., professor of anesthesiology at Northwestern University's Feinberg School of Medicine. Still, Dr. Wong agrees that consuming something light is safe for low-risk people.

"I think that the research supports that women can drink clear liquids during labor without adverse consequences. I don't think there's a lot of evidence out there to suggest that women can actually eat a whole meal while in labor. It might be true, but it has not been well-studied," she says.

Wong suggests sticking to clear items—think jello, popsicles, broth, and clear juice. Dr. Bautista and his team recommended the following:

• Fruit
• Light Soups
• Toast
• Light sandwiches (no large slices of meat)
• Juice and water

Dr. Batista also notes that most birthing parents lose their appetites during active labor, but they can still safely consume water and clear juices.

Who Shouldn't Eat During Labor

With that being said, the experts agreed that some parents should avoid eating while in labor.

"Certain factors increase a laboring patient's risk of aspiration which outweigh the risks of withholding nutrition," Erin Sprout, co-author of the study and a medical student at Memorial University, said in a news release from the American Society of Anesthesiologists. "These factors include eclampsia, pre-eclampsia, obesity, and the use of opioids to manage labor pain, which delays stomach emptying."

Dr. Wong echoes this suggestion, adding that the rules surrounding fasting during labor have changed quite a bit. "I would say it was considered a no-no ten years ago. Over the last ten years, there's been significant liberalization of the fasting policies during labor. I think if you ask most anesthesiologists, they will tell you that women are often allowed to drink," she says.

Ultimately, according to Dr. Bautista, the question of whether or not a patient can take solid foods during labor comes down to the particulars of that patient's health and pregnancy. "Each patient should be looked at on a case-by-case basis," he says.