Overview

Eating during labor is a topic with conflicting advice. In this episode, we respond to a listener whose doctor advised against eating during labor, while her doula encouraged her to pack snacks in her hospital bag. Explore the reasoning behind restrictions on eating during labor and the official recommendations from medical organizations. Learn whether the evidence supports restricting food during labor and the latest research on how food can impact labor outcomes. If you decide to eat during labor, find out what foods are best and practical tips for staying fueled and hydrated.

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Hi Vanessa,

I had an appointment today where we were talking about what to pack in my hospital bag, and I mentioned that I was planning to bring snacks. My OB told me that once I’m admitted, I won’t be allowed to eat anything. But my doula recommended packing snacks because I’ll need the energy during labor. Now I’m feeling a little confused. Am I supposed to eat a meal before heading to the hospital? What happens if I’m in labor for more than a day? Can you really not eat anything at all? Are there any risks to eating during labor?

I obviously want to follow my OB’s advice and avoid doing anything that could make my labor more difficult, but I also want to be as prepared as possible, especially in case my labor is long. I’d love to hear your thoughts on this.

Thanks so much,
Emily

Thank you so much for your email. It is great you are planning for labor, and having some key items in your hospital bag can make your labor more comfortable. It can be very frustrating to get conflicting advice. Hopefully, this episode will help you understand where your OB and doula are coming from and better help you decide which course of action is best for you.

Why Eating is Discouraged

The primary reason food and drink were historically discouraged during labor was to prevent aspiration. The concern was that if a laboring woman required an emergency cesarean under general anesthesia, she could vomit and inhale the contents into her lungs, potentially leading to serious complications or even death. In the 1940s, a doctor proposed that restricting oral intake during labor could reduce the risk of aspiration by keeping the stomach empty, lowering the chances of vomiting under anesthesia. Since then, food and drink have been restricted during labor, and it wasn’t until fairly recently that consuming fluids was allowed or even encouraged.

Cesareans and General Anesthesia

The majority of cesarean births are performed using an epidural rather than general anesthesia. If you already have an epidural in place during labor, your doctor can adjust the medication to provide pain relief for a cesarean. General anesthesia is typically reserved for situations where an epidural is not an option, such as certain neurological or spinal conditions, or if there are complications with epidural placement. Most often, it is used in emergencies when there isn’t enough time to administer an epidural. In the United States, general anesthesia is estimated to be used in approximately 6% of cesarean deliveries.

Risk of Aspiration

When general anesthesia is used, strict safety measures are in place to prevent aspiration, making it an extremely rare occurrence today. According to the American Society for Anesthesiologists, there was only one reported case of aspiration during labor in the U.S. between 2005 and 2013. This involved a complex case of a woman with obesity and pre-eclampsia. This statistic highlights how uncommon aspiration is during labor.

A study analyzing 48,609 cesarean deliveries examined the incidence of aspiration under both general anesthesia and an epidural. Of the cesareans studied, 22,690 were performed under general anesthesia. Three patients were admitted to intensive care due to suspected pulmonary aspiration—two during emergency cesareans involving difficult intubation and one under deep sedation with an epidural. The incidence of aspiration during general anesthesia was 0.009% (1 in 11,345) with general anesthesia versus 0.004% (1 in 25,920) with an epidural. No deaths due to aspiration were reported during the study period.

Official Recommendations Against Eating During Labor

As a result of the risk of aspiration, although it is small, the American College of Obstetricians and Gynecologists and the American Society for Anesthesiologists officially recommend that you should not eat food during active labor. ACOG states that current guidance supports the oral intake of moderate amounts of clear liquids by women in labor who do not have complications. However, particulate-containing fluids and solid food should be avoided. According to the American Society for Anethesiologists, there is insufficient scientific evidence to support the consumption of solid food during active labor. The committee on obstetric anesthesia recommends no change to the guidelines set forth by the American College of Obstetricians and Gynecologists (ACOG), stating that consumption of solid food during active labor should be avoided. These guidelines explain why your OB recommends not eating after you get to the hospital.

Official Recommendations In Favor of Eating During Labor

Why might your doula recommend you pack snacks in your hospital bag? The guidelines from the American College of Nurse Midwives differ from ACOG. The ACNM breaks down the history of restricting food and drinks and the current evidence that is the basis for their current recommendations. They state that care providers should discuss the very small risk of aspiration during birth and that anesthesia should be identified as the causal factor that increases the risk for aspiration, not oral intake. They go on to recommend that providers should also discuss the benefits of oral intake during labor. This is an excellent example of informed consent. You should be given all of the information, risks, and benefits, and have the autonomy to make the right decision for you.

The Evidence on Eating During Labor 

The American College of Obstetricians and Gynecologists acknowledges that restrictions on eating during labor have been questioned, particularly given the low incidence of aspiration with modern obstetric anesthesia techniques. In addition to the risk of aspiration being low, research suggests potential benefits to eating during labor.

A systematic review of 19 studies found no justification for restricting fluids and food during labor for women at low risk of complications. Another study of 190 low-risk women examined the effects of consuming simple carbohydrates, such as dates and orange juice, during labor. It found that women who ate had a shorter second stage of labor than those who fasted. The average length of the pushing stage for those who consumed dates or orange juice was 12.6 minutes, compared to 19.7 minutes for those who fasted. Given the physically demanding pushing stage, even a few minutes can feel significant. The bottom line is that this study supports eating and drinking during labor and found no associated risks or harms for low-risk pregnancies.

Tips for Eating or Drinking During Labor

Now that you understand the different recommendations from your OB and doula, let’s review some practical tips in case you want to eat during labor or pack snacks in your hospital bag.

When to Eat and Drink 

You will likely feel more inclined to eat earlier in labor. As labor progresses and contractions intensify, you may lose interest in eating, which is normal. In general, eat if you are hungry. If not, focus on staying hydrated.

What to Eat 

Nausea and vomiting are common during the early stage of labor. As a result, it may help to stick to bland, easy-to-digest foods. The BRAT diet, which includes bananas, rice, applesauce, and toast, is a good guideline.

In any stage of labor, avoid foods high in fat or sugar with little nutritional value, and focus on foods that will fuel your body. Rather than eating one big meal, small frequent snacks may be more manageable. Many providers recommend carbohydrates since they are easy to digest and provide quick energy. Some good options include:

  • Smoothies
  • Bananas or fresh fruit
  • Rice
  • Honey sticks
  • Applesauce
  • Toast, bagels, or rice cakes (with jam or nut butter)
  • Oatmeal or cereal
  • Crackers or graham crackers
  • Granola bars or protein bars
  • Trail mix
  • Soup or broth
  • Eggs
  • Fruit juice
  • Popsicles  

Considerations for Your Birth Partner and Support Team

Your birth partner should also plan to eat during labor. While they won’t exert as much energy as you, they still need to stay fueled to support you effectively. It’s a good idea for them to bring snacks, but they may want to avoid strong-smelling foods like pizza, which could be overwhelming in the labor room.

Some expecting parents also bring snacks or small treats for the nurses and staff at the hospital or birth center as a token of appreciation. If you’re having a home birth, it’s a good idea to have extra snacks on hand for your midwife, doula, or other support.

What to Drink

Hydration is essential during labor. Any liquid can help, including broth, juice, tea, or popsicles. The official ACOG recommendation is to stick with clear fluids; water is always an excellent choice. Since labor is physically demanding, you may want to consider an isotonic drink, which contains electrolytes.

Some good options include:

  • Sports drinks (like Gatorade or Powerade)
  • Electrolyte powders mixed with water (e.g., Emergen-C)
  • Coconut water

A study found that drinking isotonic beverages during labor helped reduce ketone production compared to drinking only water. When your body needs energy, it first pulls from glycogen stores, which come from glucose (carbohydrates). If glycogen stores are depleted, such as when fasting, your body may enter ketosis. During ketosis, energy comes from ketone bodies. A mild state of ketosis during labor is normal, but care providers may monitor ketone levels to ensure adequate hydration and energy intake. It is also extremely common to administer IV fluids during labor.

Making the Right Choice for You

Emily, I hope this episode gives you more context on your doctor’s and your doula’s differing recommendations. You’ve also heard about the evidence on eating during labor, which can help you decide the right approach. Conflicting advice can be frustrating, but the benefit is that you can see both perspectives and make an informed choice based on your needs.

There is a small risk in the rare case that you eat during labor, require a cesarean under general anesthesia, and experience aspiration. The easiest way for doctors to minimize that risk is to restrict eating during labor. You may also want to consider any personal factors that could increase the likelihood of needing a cesarean or general anesthesia. In general, the research supports eating during labor for low-risk women.

A simple solution is to pack snacks in your hospital bag so you have that option. You may not feel like eating or be grateful to have something on hand. Whether you eat during labor or not, you will likely be hungry after birth, and having snacks for you, your partner, or other support staff can be helpful.

Additional Resources:

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