Oral Hydration and Food During Labour - Is Restriction Necessary?

Hospital labour room policies restrict oral intake of women in labour to clear liquids, due to fears of pulmonary aspiration in cases of emergency C-sections under general anesthesia. Professional organizations have provided varying recommendations for oral intake in labour with some advocating clear fluids alone, which are unlikely to meet the 50-100 kcal/hour energy requirements of labour; and others recommending ad-lib intake. The objective was to explore intra partum food choices and compare the effect of ad-lib oral calorific clear fluid intake vs solids and calorific clear liquids on obstetric and neonatal outcomes. A prospective observational study was conducted in low-risk pregnant women >18 years of age with 36+ gestational age in the labour wards of urban maternity tertiary centres in Hyderabad (N=211). Women were given the option of eating and drinking from a standardised low residue menu. 72.2, 22.4 and 5.38 % of the women consumed liquids, a combination of liquids and solids, and fasted respectively. Women consuming solids and fluids consumed 350.5 ± 171.9 kcal whereas those consuming only calorific clear liquids consumed 168.35 ± 106.2 kcal during the intra partum period (p<0.001). No significant differences were observed in obstetric or neonatal outcomes between groups. Eating during labour is safe in low-risk pregnancies and women who consume both solids and liquids are able to meet the calorie requirements of labour. Obstetricians should give women greater freedom in their choice of oral intake.