Why Ice Chips Can Chip Away at a Healthy Birth

newborn one minute old, photo by Allison CooperDuring one of the most physically intense events of their lives, women are still routinely limited to ice chips and sips of water during labor, despite strong research showing no benefit, and possible harm to women and their babies. Lamaze is urging women to think twice about the effect that fasting might have on the birth of their baby.

Lamaze educators have long taught that eating and especially drinking freely in labor sets women up for healthier and safer births. A recent research review featured in the Cochrane Library -- a publication of the Cochrane Collaboration, an international organization that evaluates medical research -- reinforces this finding that women at low risk of potentially requiring a general anesthetic should be free to eat and drink in labor, if they wish.1

"Women should be allowed to eat or drink while undertaking one of the body's most physically demanding tasks," said Sharon Dalrymple, president of Lamaze International. "Marathon runners keep themselves well hydrated by drinking fluids during their races and so should most laboring women. Every system in a woman's body is taxed during labor and all that effort takes fuel. When women are deprived of food and drink, it's no surprise when those systems don't work as intended."

The practice of restricting a woman"s oral intake during labor originally stemmed from concerns about safety. The reasoning was that if a woman needed to have cesarean surgery, there was an increased risk of the stomach contents entering the lungs while under general anesthesia.2 To help minimize this risk, most hospitals began to require surgery patients and women in labor to fast and administer intravenous (IV) fluids instead. However, the use of IV fluids increases a patient's chances of overhydration and swelling (edema), as well as restricts women's movement which can impede the birth of the baby.

Newer research has demonstrated that even for women who ultimately require surgery, modern anesthesia protocols minimize risk. Other research suggests that fasting instructions even for patients with planned surgeries are too stringent3 and can actually translate into weakened immunity and slower recovery time for surgical patients.4, 5 In fact, recommendations from European countries encourage patients to drink clear, carbohydrate-rich liquids before an operation.6

"Depriving women of food and drink also raises a 'chicken and the egg' argument," said Elizabeth Day, a Lamaze childbirth educator from Centerton, Ark. "Does treating every woman like a candidate for surgery increase her risk of ending up with surgery? In my experience the answer is likely 'yes.'"

Giving women the freedom to eat and drink as they like is part of Lamaze International's Six Healthy Birth Practices. Based on recommendations by the World Health Organization and backed by extensive research that supports a woman's natural ability to give birth, these practices are:

  1. Let labor begin on its own
  2. Walk, move around and change positions throughout labor
  3. Bring a loved one, friend or doula for continuous support
  4. Avoid interventions that are not medically necessary
  5. Avoid giving birth on your back and follow your body's urges to push
  6. Keep mother and baby together; it's best for mother, baby and breastfeeding

Restricting women from eating and drinking freely is one of many routine interventions that has not proven a medical benefit to mothers and babies, and can impose harm. Other common routine interventions include continuous fetal monitoring, coached pushing, being positioned on your back in labor, and requiring repeat cesarean surgeries for women with a prior cesarean.

To learn more about the Lamaze Six Healthy Birth Practices, please enroll in a Lamaze childbirth education class and visit their website.

About Lamaze International: Lamaze International promotes a natural, healthy and safe approach to pregnancy, childbirth and early parenting practices. Knowing that pregnancy and childbirth can be demanding on a woman’s body and mind, Lamaze serves as a resource for information about what to expect and what choices are available during the childbearing years. Lamaze education and practices are based on the best and most current medical evidence available. Working closely with their families, health care providers and Lamaze educators, millions of pregnant women have achieved their desired childbirth outcomes using Lamaze practices. The best way to learn about Lamaze's steps to a safe and healthy birth is to take a class with a Lamaze certified instructor.

[1] Singata M, Tranmer J, Gyte GML. Restricting oral fluid and food intake during labour. Cochrane Database of Systematic Reviews, 2010, Issue 1. http://mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD003930/frame.html

[2] Maltby, MR. Fasting from midnight – the history behind the dogma. Best Practice & Research Clinical Anaesthesiology, 2006, Vol. 20, No. 3, pp. 363-378.

[3] Crenshaw, JT, Winslow EH. Actual Versus Instructed Fasting Times and Associated Discomforts in Women Having Schedule Cesarean Birth. Journal of Obstetrics, Gynecologic, & Neonatal Nursing, 2006, Vol. 25, No. 2, pp. 257-264.

[4] Melis, GC, van Leeuwen, PAM, Bloomberg-van der Flier, AC, et al. A carbohydrate-rich beverage prior to surgery prevents surgery-induced immunodepression: A randomized, controlled, clinical trial. Journal of Parenteral & Enteral Nutrition, 2006, Vol. 30, No. 1, pp. 21-26.

[5] Nygren, J. The metabolic effects of fasting and surgery. Best Practice & Research Clinical Anaesthesiology, 2006, Vol. 20, No. 3, pp. 429-438.

[6] Nygren, J, Soop, M, Thorell, A, et al. Preoperative oral carbohydrate administration reduces postoperative insulin resistance. Clinical Nutrition, 1998, Vol. 17, No. 2, pp. 65-71.

Copyright © Lamaze International. Permission to republish granted to Pregnancy.org, LLC. Photo credit: Allison Cooper.