What You Need To Know About Eating During Labor

Labor isn't typically a comfortable experience. There's often some pain involved, and your birthing experience may end up being totally different from what you expected. On top of that, you may be feeling hungry, especially if it's been hours since you started laboring.

Labor is hard work that requires both endurance and stamina. There's a reason it's often compared to running a marathon! But pregnant people have historically been told not to eat or drink during labor. This might leave you wondering: If marathoners routinely fuel up during a big race, why can't you eat during labor?

As it turns out, the rule may not apply to everyone. Here's what pregnant people need to know about eating and drinking during labor.

Why Fasting During Labor Started

People used to be told they should avoid eating and drinking during labor because of the risk of aspiration, which happens when food or liquid is inhaled into the lungs. This rule was popularized decades ago as a result of research conducted by Curtis Lester Mendelson, MD, an OB-GYN and cardiologist, who found patients were aspirating stomach acid during surgical delivery.

At the time, it was common for people to go under general anesthesia for C-section deliveries, which makes the person completely unconscious. What Dr. Mendelson's study found was that while general anesthesia increased the risk of aspiration, fasting decreased that risk. These findings eventually led in part to the pre-operative guidelines medical providers still follow today.

We also know now that pregnant people are also at higher risk for aspiration than nonpregnant people because the enlarged uterus puts more pressure on the stomach, and progesterone, which increases during pregnancy, relaxes the gastroesophageal sphincter, a valve that is meant to keep food and stomach acid in the stomach.

Today, however, pregnant people aren't routinely put under general anesthesia during C-section deliveries. In fact, only about 5% of pregnant people require general anesthesia. Advancements in local anesthesia, including epidurals, make aspiration unlikely, especially in healthy patients, which has led to some changes in the approach to food restrictions during labor.

New Research on Eating and Drinking During Labor

The rules today are loosening up. More recent, rigorous reviews of research show that eating a light meal while in the beginning stages of labor is likely safe—and may even be beneficial.

Michael Bautista, MD, an associate professor of anesthesiology at Memorial University, St. John's, Newfoundland, Canada, became interested in this topic when he was asked why birthing parents are told to fast during labor. "I realized I didn't have a good answer," he said.

Dr. Bautista assembled a team of researchers to study whether or not fasting during labor is truly necessary, and they found the advice to fast during labor and delivery may be outdated. According to Dr. Bautista and his team, there's minimal risk of aspiration during childbirth in healthy, low-risk people. There was only one case of aspiration during labor between 2005 and 2013 in the United States—and the patient involved was high-risk with preeclampsia.

Benefits of Eating During Labor

There could be benefits when people at low risk for pregnancy complications eat small meals during the early stages of labor.

When a person is in labor, it's like they're running a marathon, and you need a lot of energy to run a marathon, Dr. Bautista says. "Having calories—glucose, sugar, something—to keep them going would be very beneficial," he adds.

Research has also found that fasting during labor may stall labor. For one, it forces the body to burn fat as an energy source, causing acidity in the laboring person's blood that can cause contractions to slow down. Fasting can also trigger a stress response that diverts blood away from the uterus and placenta, prolonging the labor process.

What To Eat and Drink During Labor

While the most recent research suggests that most laboring people don't need to fast in the early stages, it's still important to be careful about what you eat during labor. Cynthia Wong, MD, professor of anesthesiology at Northwestern University's Feinberg School of Medicine, agrees that consuming something light is likely safe for low-risk people.

"I don't think there's a lot of evidence out there to suggest that [people] can actually eat a whole meal while in labor," says Dr. Wong. "It might be true, but it has not been well-studied."

Dr. Wong suggests sticking to clear items—think Jell-O, popsicles, broth, and clear juice. Dr. Bautista and his team recommended the following sources for nourishment:

• Fruit
• Light, broth-based soups
• Toast
• Light sandwiches (no large slices of meat)
• Juice and water

Other experts say that granola bars and drinks with electrolytes, such as coconut water, are also good options. The important thing is eating items that are easy to digest and not heavy. (In other words, labor isn't the time for double cheeseburgers.)

Dr. Batista also notes most birthing people lose their appetites during active labor, but they can still safely consume water and clear juices.

Who Shouldn't Eat During Labor

Experts agree, however, that some people should still avoid eating while in labor.

The researchers behind the Memorial University study concluded that a laboring person's risk of aspiration sometimes outweighs the risks of temporarily restricting food. People in this high-risk category include those with conditions like eclampsia, preeclampsia, or obesity. Food should also be restricted when opioids are used to manage labor pain, as these drugs delay stomach emptying.

Additionally, it may be safest to hold off on eating during labor if there is a high probability that you will require a surgical delivery. Factors your health care team may consider to assess this risk include whether you have a history of C-section or you are having multiples.