Oral intake during labor: a review of the evidence.
The purpose of this article is to review evidence and practices within and beyond the United States related to the practice of maternal fasting during labor. Fasting in labor became standard policy in the United States after findings of a 1946 study suggested that pulmonary aspiration during general anesthesia was an avoidable risk. Today general anesthesia is rarely used in childbirth and its associated maternal mortality usually results from difficulty in intubation. Healthcare professionals have debated the risks and benefits of restricting oral intake during labor for decades, and practice varies internationally. Research from the United States, Australia, and Europe suggests that oral intake may be beneficial, and adverse events associated with oral intake such as vomiting and prolongation of labor do not seem to be associated with alterations in maternal or infant outcomes. The World Health Organization recommends that healthcare providers should not interfere in women's eating and drinking during labor when no risk factors are evident. Nurses in intrapartum settings are encouraged to work in multidisciplinary teams to revise policies that are unnecessarily restrictive regarding oral intake during labor among low-risk women.
Sharts-Hopko
Nancy C
NC
Doctoral Program, Villanova University College of Nursing, Villanova, PA, USA. Nancy.sharts-hopko@villanova.edu
D000768:Anesthesia, General / Q000009:adverse effects; D004326:Drinking / Q000502:physiology; D004435:Eating / Q000502:physiology; D055317:Evidence-Based Practice / Q000458:organization & administration*; D005215:Fasting / Q000009:adverse effects / Q000502:physiology; D005260:Female; D006801:Humans; D007743:Labor, Obstetric / Q000502:physiology; D009721:Nurse Midwives / Q000458:organization & administration; D009773:Obstetric Nursing / Q000458:organization & administration; D009774:Obstetrics / Q000458:organization & administration*; D018743:Perinatal Care / Q000458:organization & administration; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000458:organization & administration; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology; D053120:Respiratory Aspiration / Q000209:etiology / Q000517:prevention & control; D012307:Risk Factors; D012449:Safety; D014481:United States / Q000453:epidemiology