Single‐centre survey of women reflecting on recent experiences and preferences of oral intake during labour

Abstract

Background: Consensus-based recommendations guiding oral intake during labour are lacking. Aims:We surveyed women at a tertiary women's hospital about preferences for and experiences of oral intake during labour, gastrointestinal symptoms during labour and recalled advice about oral intake. Materials and methods:Women who experienced labour completed a postpartum survey with responses as free text, yes-no questions and five-point Likert scales. We identified demographic data and risk factors for surgical or anaesthetic intervention at delivery from medical records. We summarised free text comments using conventional content analysis.Results: One hundred and forty-nine women completed the survey (47% response rate). Their mean (SD) age was 31 (four) years, birthing at median gestation of 39 weeks (interquartile range: 38-40). One hundred and twenty-two (83%) and 44 (30%) women strongly agreed or agreed they felt like drinking and eating respectively during labour. Ninety women (61%) reported nausea and 47 women (32%) reported vomiting in labour. Forty-one women (28%) did not receive advice on oral intake during labour. Maternal risk factors for surgical intervention were identified in 72 (48%) women and fetal risk factors in 27 (18%) women. Thirty-one women (21%) delivered by emergency caesarean section. Conclusion:Pregnant women received variable advice regarding oral intake during labour, from variable sources. Most women felt like drinking but not eating during labour. Guidelines on oral intake in labour may be beneficial to women, balancing the preferences of women with risks of surgical intervention.

The effects of intravenous hydration regimens in nulliparous women undergoing induction of labor: A systematic review and meta‐analysis

“… 28 These issues can be resolved through isotonic IVT types; however, it warrants the question as to whether women can be adequately hydrated via the oral route during labor? Current guidance is that women should not be routinely fasted during labor and birth 6 and studies highlight that women prefer having control over what they ingest during labor and birth, 12 yet this occurs within a context of conflicting advice and information.…”

“… 11 However, cesarean section was not reduced in women with unrestricted oral intake in their review. Oral intake during labor is preferred by women 12 during labor and there is no evidence of harm when they self‐regulate oral intake for nourishment, comfort, and hydration. 8 Consistent with this, international guidelines recommend oral intake in labor 6 and this is the usual practice in many maternity units internationally.…”

Evidence‐based guidelines for intrapartum maternal hydration assessment and management: A scoping review

“…10 More recently, advances in regional anesthesia and concurrent reduction in rates of general anesthesia, means routine fasting, especially for women at low risk of complications in spontaneous labor, has become less common. 11 Subsequently, international intrapartum guidelines now encourage oral fluid intake during labor. 12,13 International intrapartum care guidelines, for a positive birth experience 12 recommend that maternal hydration should be managed by way of oral fluid and food intake during labor.…”

“…birth, clinical variation, fasting in labor, hydration, hyponatremia, intrapartum care, intravenous therapy, labor, labor and birth management or care systematic review (seven trials) found that IVT therapy did not reduce the duration of labor. 24 Notably, the control groups fasted intrapartum-a practice now discouraged by international intrapartum guidelines 12 or maternal preference 11 and therefore limiting applicability to current practice.…”

“…However, during the 1940s, fasting during labor emerged due to concerns about pulmonary aspiration during general anesthesia should a cesarean birth be required 10 . More recently, advances in regional anesthesia and concurrent reduction in rates of general anesthesia, means routine fasting, especially for women at low risk of complications in spontaneous labor, has become less common 11 . Subsequently, international intrapartum guidelines now encourage oral fluid intake during labor 12,13 .…”