oral fluids in labor

[kouklakis]

Our anesthesia department has come out with a directive that anyone with an epidural or wanting one in labor be restricted to 30 ml per hour po fluids. The reason behind this is that if the labor moves to an operative delivery, there will be less probability of an aspiration pneumonia and the morbidity/mortality associated with it. Since many of our patients get epidurals early in labor, it may mean they would be on this fluid restriction for 12-24 hours. I have found that not only does this make women uncomfortably thirsty, it inhibits the progress of labor by decreasing the efficiency and strength of their contractions. The uterus needs to be fed to contract well. Does anyone know of any research in support this thought, or should I let anesthesia take us back into the dark ages again?

[aura_of_laura]

Medscape had an interesting article about this topic earlier this month...

http://www.medscape.com/viewarticle/715472

[LDRNMOMMY, BSN, RN]

I worked at a hospital that only allowed women ice chips once they were admitted for labor. Where I work now our ladies get clear liquid trays for breakfast, lunch, and dinner when they are admitted for labor.

[shortstuff31117]

Unfortunately anesthesia seems to be like this in a lot of places. It totally goes against research and I find it cruel to starve a woman whose body is working so hard. But anyway...

We have an ice/water only policy, not as restrictive as yours but still annoying. The way that I get around this is to explain exactly what the risks are to the mom, tell her it's a hospital policy/recommendation, not a law, and that she can make her own decision. I never give her anything to eat or drink and I don't worry about it.

How many people throw up during a c-section even when they haven't eaten in a long time? I know I did...so how is it better to throw up stomach acid, than to at least throw up some juice or something? I will never get that...

[sethmctenn]

Your question came within a day of me seeing this article...

http://www.scienceandsensibility.org/?p=930

[spunky1281]

I received an epidural during my labor and was never restricted on fluids. It was very dry in there and I felt like no matter how much I drank, it was never enough. Something mad me so thirsty I was sucking down water like there was no tomorrow. Never once did they restrict my water. I think had I had juice or something else, there would have been issues.

[RNBelle]

only 30 ml?! geez. But we allow only ice chips. As longs as your pts have iv's and are getting iv fluids that should hydrate them even though they might be craving something to drink.