Let women eat and drink in labour - new analysis

Wednesday January 20th, 2010

There is no good reason to prevent women from eating and drinking while giving birth, experts say today.

For many decades, it has been common practice to stop women eating during labour to reduce the risk of "Mendelson's syndrome", or pulmonary aspiration (breathing food into the lungs), if an emergency caesarean is needed under general anaesthetic.

But the rate of pulmonary aspiration has declined, and fears have been raised that preventing food intake during labour can be detrimental for the mother and baby.

To investigate the costs and benefits of the policy, Dr Mandisa Singata of the East London Hospital Complex, South Africa, and colleagues carried out a systematic review.

Their Cochrane review included five studies and a total of 3,130 women. The studies looked at the evidence for and against restricting food and drink in women who were considered unlikely to need anaesthesia.

The team found no evidence for any risk or benefit among these women.

Dr Singata said: "Since the evidence shows no benefits or harms, there is no justification for nil by mouth policies during labour, provided women are at low risk of complications. Women should be able to make their own decisions about whether they want to eat or drink during labour."

But she added: "While it is important to try to prevent Mendelson's syndrome, it is very rare and not the best way to assess whether eating and drinking during labour is beneficial for the majority of patients. It might be better to look at ways of preventing regurgitation during anaesthesia for those patients who do require it."

Further research is need before specific recommendations can be made for women with a increased risk of needing anaesthesia, the researchers say.

* A second study today warns of the risk from growing numbers of pregnant women who are obese.

Both mother and baby face a range of increased risks, according to a report in BJOG: An International Journal of Obstetrics and Gynaecology.

The study of 23,000 women in nine countries found that caesarean section and the dangerous condition pre-eclampsia were among the complications linked to obesity. And babies were likely to be overweight and at a risk of developing diabetes.

Researcher Professor Boyd Metzger, of the Northwestern University Feinberg School of Medicine, Chicago, said: "On a worldwide scale, the increasing prevalence of obesity is likely to strain health care resources, with increased rates of caesarean section and hypertension.

"Effects on the next generation due to the association of increased foetal adiposity with future diabetes and obesity may well compound the future effects of the epidemic of obesity."

Louise Silverton, deputy general secretary of the UK Royal College of Midwives, said: "The links between obesity in pregnancy and poor outcomes for mother and child are becoming more and more apparent.

"The health of both can be affected in potentially very serious ways, and there is no doubt that this needs addressing as a matter of urgency."

* An expert group yesterday warned that obese women might be refused treatment for infertility along with smokers. The task force of the European Society of Human Reproduction and Embryology, writing ahead of today's publication, said more information was needed.

They said that previous research suggested an increased risk to infants born to obese women of heart anomalies and of neural tube defects such as spina bifida.

Women who drink too much alcohol should definitely be refused treatment - because of the risks to the child, they say.

Singata, M., Tranmer, J. and Gyte, G. M. L. Restricting oral fluid and food intake during labour. Cochrane Database of Systematic Reviews 2010, Issue 1.

BJOG: An International Journal of Obstetrics and Gynaecology January 19 2010

Human Reproduction Journal doi: 10.1093/humrep/dep458

Tags: Africa | Childbirth and Pregnancy | Diet & Food | Europe | Fitness | UK News | Women’s Health & Gynaecology

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