NPO for labor?

Specialties Ob/Gyn

Published

Specializes in NICU.

If this has been recently covered, I apologize.

What are your policies regarding eating/drinking in labor? I just heard it claimed that eating prevents exhaustion and speeds up labor. Haven't found any evidence of speeding up labor but maybe I'm not looking in the right scientific arenas.

I was allowed to eat during both labors until I got my epidurals. Not that I was very interested in eating.

Thoughts?

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

clear liquids only while in active labor, mostly due to anesthesia concerns.

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Clears when active; NPO once epidural is desired and ordered- for the same reason as above.

Never heard anything about po intake speeding up labor, by the way!

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Specializes in L&D.

My hospital has a pretty cruel policy--NPO during labor (exception to this is during Cervidil induction, then they can have regular diet until they're in real labor). We don't do epidurals at my hospital :( I think the moms should at least be allowed to drink clear liquids--this is usually all they want anyway.

Nikki

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When I was in labor with my 2nd, I was eating a peanut butter sandwich at 6 cm- and had no nausea or other problems- but I also had no meds and no epidural. Only the midwives at my facility allow this- all of the MD's order NPO except for ice chips.

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We do NPO x ice chips/ and occasional popsicles.. the reasoning behind this is in case of a stat c/s and general anesthesia... less risk of aspiration..

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Specializes in LDRP.

ice chips only (unless cervidil induction).

same reasons as mentioned above. sometimes, if okay with anesthesia, we give them popsicles.

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I'll look for some actual research, but in the meantime, IMO this is really one of the stranger "standard" policies in L&D. Of course, with a 29% C/S rate, maybe there's more of a reason... but a lot of those are planned c/s, so...

Why wouldn't eating speed up labor? Anything that keeps the mother doing what feels natural and helps her feel comfortable is going to make labor go faster than lying in bed, attached to machines with wires, only allowed to eat ice chips. Not to mention that she's going to have a lot more energy for labor. (Just think how tired many of us feel if we've been on seven hours and haven't been able to take a lunch break. A little peanut butter and crackers will do wonders.) Yes, some mothers will have zero interest in food, but many want something to eat.

I've also read (and will look for sources) that the whole NPO-before-surgery thing is less important than previously believed, anyway.

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

I think it's horrible to place laboring moms on NPO OR only ice chips for what could be hours or even more than a whole day and night; they need energy for labor and especially, pushing later on. This is why I tell women to wait as long as they can before coming in to us, because once they are with us, they get nothing but ice chips and that could be for a very long time.

Where I used to work, they got clear liquid trays during labor, which included the standard fare of jello, juice, broth, etc. Nothing too great, but I think it was much kinder and more humane than NPO. I think this is the way it should be everywhere. None of them aspirated or vomited anything that I could remember, not even once, except clear liquid or bile (which can't be any better to aspirate than clear liquid anyhow). Sadly, most places, it is not how it works, even though evidence seems not to support such practices as NPO for routine labor.

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Specializes in Orthosurgery, Rehab, Homecare.

I don't work in L&D or OB, but my question is: if the MD's stated reason is "in case of CS", what about those folks who come in through ER for trauma or such and need emergancy surgery. They haven't been NPO for their urgent/emergency procedure. If CS is truly used as it should be, as a last resort, emergency procedure (we all know it's not)then the same risk/benefit decision making should come into play as it does in any other emergency surgery. The risks or aspiration and harm to the mother/baby because of the procedure are outweighed by the benifit.

~Jen

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Specializes in NICU.

I looked up evidence for "speeding up labor" and didn't find any. I got a few "no statistical difference"s. Nor did I find evidence of it reducing instrumental delivery or c/s (as was also claimed by the person in the OP).

I was looking for stuff about aspiration and GI motility during labor. Anyone have any good resources for OB research?

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Specializes in NICU.

IIRC from my EMT training, sometimes it IS an issue. There is a lot of vomiting in the ED

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