Should women be eating more carbohydrates during labour? Study casts doubt

Until very recently it was common practice to starve pregnant women during labour, a tradition dating back to the mid-20th century.  But a new joint study from the United Kingdom, Belgium, Norway and Canada investigates the potential benefits of providing women with carbohydrates during labour and finds there to be no effect on labour outcome.

The study reviewed four sets of data concerning carbohydrate supplementation during labour and found that considering mode of delivery, length of labour and various other factors such as the frequency of use of epidural anaesthesia, the adding of extra carbohydrates to dietary intake produced no noticeable impact. Researchers determined, however, that more study is necessary before drawing a firm conclusion.

“The potential effect of this intervention cannot be fully assessed on the current evidence. We recommend further research, beginning carbohydrate supplementation in the latent phase of labour,” say the joint study’s authors.

Researchers had postulated that food and fluid intake during labour may prove to be beneficial since it had already been shown that for general surgery, the use of oral carbohydrate supplementation during operation improved outcomes. And, analogously, trained athletes have been shown to improve their results by consuming carbohydrates before, during and after training and competition.

The issue of food and fluid consumption during labour has been a contentious topic of late. Until very recently it was common practice to starve pregnant women during labour, a tradition dating back to the mid-20th century when research suggested that under general anaesthesia there was a risk of gastric fluids and food particles entering the lungs, a condition which could lead to serious complications and sometimes resulting in death. This led to severe restrictions on a women’s intake during the labour process, which averages eight hours and can sometimes take up to 20 hours. Hospitals would often provide ice chips for labouring women to chew but nothing more. But advances in anaesthesia over the past decades, combined with new research on the topic have led health care professionals in many countries to begin to reevaluate their approach.

Last fall, the American Society of Anesthesiologists (ASA) issued a press release noting that research had been conducted which suggested that most women would benefit from a light meal during labour. A study co-author Christopher Harty of memorial University in St. John’s, Newfoundland, said that the actual risks of aspiration during labour are very low (only one case was documented in the United States between 2005 and 2013.

“Anesthesiologists and obstetricians should work together to assess each patient individually. Those they determine are at low risk for aspiration can likely eat a light meal during labor. This gives expectant mothers more choices in their birthing experience and prevents them from being calorie-deficient, helping to provide energy during labor,” said Harty.

Nevertheless, the wheels of traditional medicine (and, some would say those of patriarchy in medicine as well) are slow to turn: the ASA’s current guidelines for food intake during labour still recommend that women avoid solid foods during labour.

The joint study was published this month in the journal BJOG, an international journal of obstetrics and gynaecology.

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