"Don't eat... the #1 Cause of Death During Labor is Aspiration!"

(Title taken from one of my most loved/loathed blogs, www.myobsaidwhat.com)

The New York Times recently summarized the results of a study on eating and drinking during labor. Conventional practice forbids eating and drinking everything, except some ice chips here and there. Reason for this: if Mama has a full stomach (even of liquid), she could vomit and choke while under general anesthesia during a c-section. But general anesthesia is only used for emergency c-sections, because it is the fastest acting type of anesthesia. Most c-sections are not emergent, however- the nice thing about labor is that it usually lets you know something's wrong well in advance. Mama usually has at least an hour, usually many more, of bad signs (irregular fetal heart rate, meconium, weaker and spaced out contractions, stalled dilation) before the decision of a section is even brought up. And in that hour, maybe you transfer from home or birth center to the hospital, and in the hospital, your doctor or midwife starts taking some necessary interventions to avoid that section. So if you do make the decision for a section, you get a regional anesthesia, mosey on over to the operating room fully aware and not nauseous, without the danger of aspiration. But given this usual c-section course of events, mamas are still forbidden to eat or drink.

(I HATE ice-chips. Some people like them but I despise them. When I'm thirsty, I drink, I don't chew and hurt my teeth with stupid, useless ice chips. When I'm in labor, even if I'm in a hospital and they don't let me have anything but ice chips, as soon as that nurse leaves my room, hand me my liter of coconut water and I'll be a happy girl.)

In the Times article, a doctor spoke about this antiquated reasoning using a great parallel: ' “My own view of this has always been that you could say one shouldn’t eat or drink anything before getting into a car on the same basis, because you could be in an automobile accident and you might require general anesthesia,” said Dr. Marcie Richardson, an obstetrician and gynecologist at Harvard Vanguard Medical Associates in Boston.'

Thankfully, the study found that there is NO harm or benefit to eating or drinking during labor. Some hospitals are finally lifting the ban on drinking, so women can drink if they want to. Yay!

But I'm interested in the study's claim that there is no benefit to eating and drinking during labor. The uterus is a muscle, and muscles need hydration and energy in the form of carbohydrates in order to work effectively. I've heard a number of doctors and midwives say that proper hydration is crucial to the effectiveness of contractions and mamas' energy when pushing time comes. And I've seen that when contractions slow and become less effective, midwives and doctors blame dehydration and push liquids or IV fluids. I couldn't read the whole study, unfortunately, so I couldn't tell if every woman in the study had an IV- I have a feeling that they must have, if eating and drinking had no benefit. With an IV, extra liquid is indeed unnecessary, for the mama's purely physiological functioning.

But what about her emotional functioning? I believe so fully that labor is the most intense example of the mind-body connection. When women feel strong, they birth strong. Their emotional state sends cues to their body, telling their body whether the environment is safe enough for a vulnerable baby to enter. If mama feels out of control, can't make decisions for herself, feels trapped, her body is going to read that and slow its birth process, because there must be some danger in her environment causing her to feel that way, and her body won't risk allowing a baby to enter into that environment.

Imagine: you've been laboring for 15 hours without anything to drink. Your mouth and throat feels like cotton and all you get is three or four ice chips every twenty minutes. Forget about plain old discomfort in your mouth- what about some compassion? Someone to actually listen to you, validate your frustrations, instead of threatening you with death during an emergency c-section, when the question of a c-section, nonetheless an emergency c-section, hasn't even been raised. Before, you were thirsty and tired. Now, you're worrying about an emergency c-section and vomiting into your lungs. What kind of message does that send to your body? Maybe your body says- there's way too much anxiety here for a baby to be born. Then you've got a self-fulfilling prophecy (well, nurse or doctor or midwife self-fulfilling prophecy): they say c-section, and a few hours later, you get c-section. Not necessarily because they forced it on you when they decided, but maybe because that one tiny remark set off a chain of events in your body, preventing the birth of your baby in any way except surgically.

So, enough with the pessimism, because the results of this study are wonderfully promising. I promise, my next post will be a happy one- just like more births will be if women eat and drink as they please.