hmm - it's as if they are using their brains!

Many hospitals have been advising all laboring women to not eat or drink during labor in case they need emergency surgery with general anesthesia. But isn't that kind of like advising everyone to skip breakfast in case they get hit by a bus? There's a 100% chance that women will need energy for labor...

Well, finally a well-respected organization is calling BS on this (read the full article here) for low risk women:

NEW YORK (Reuters Health) - There is no reason why pregnant women at low risk for complications during delivery should be denied fluids and food during labor, a new Cochrane research review concludes.

..."Women should be free to eat and drink in labor, or not, as they wish," the authors of the review wrote in the Cochrane Library, a publication of the Cochrane Collaboration, an international organization that evaluates medical research....

...Standard hospital policy for many decades has been to allow only tiny sips of water or ice chips for pregnant women in labor if they were thirsty. Why? It was feared, and some studies in the 1940s showed, that if a woman needed to undergo general anesthesia for a cesarean delivery, she might inhale regurgitated liquids or food particles that could lead to pneumonia and other lung damage.

But anesthesia practices have changed and improved since the 1940s, with more use of regional anesthesia and safer general anesthesia...

...And recently, attitudes on food and drink during labor have begun to relax. Last September, the American College of Obstetricians and Gynecologists (ACOG) released a "Committee Opinion" advising doctors that women with a normal, uncomplicated labor may drink modest amounts of clear liquids such as water, fruit juice without pulp, carbonated beverages, clear tea, black coffee, and sports drinks. They fell short of saying food was okay, however, advising that women should avoid fluids with solid particles, such as soup...

...Singata and colleagues systematically reviewed five studies involving more than 3100 pregnant that looked at the evidence for restricting food and drink in women who were considered unlikely to need anesthesia. One study looked at complete restriction versus giving women the freedom to eat and drink at will; two studies looked at water only versus giving women specific fluids and foods and two studies looked at water only versus giving women carbohydrate drinks.

The evidence showed no benefits or harms of restricting foods and fluids during labor in women at low risk of needing anesthesia.

...Singata and colleagues acknowledge that many women may not feel like eating or drinking during labor. However, research has shown that some women find the food and drink restriction unpleasant. Poor nutritional balance may be also associated with longer and more painful labors. Drinking clear liquids in limited quantities has been found to bring comfort to women in labor and does not increase labor complications.

skin-to-skin

little actions, big payoffs

Often we do things a certain way because, well, that's the way we do them. We have good reasons and don't really question whether there is a better way. But maybe we should...

An example: after a baby is born in a hospital (where most babies in the US are born), the baby might be put on its mom's chest for a minute, though usually on a blanket. That blanket is used to dry off & stimulate babies. That makes sense, though I know plenty of midwives who feel we overdo the stimulating via drying.
But soon after, usually while the birth of the placenta is being medically managed (which is what usually happens in a hospital birth & may be wise - read more here***), the baby is taken to a corner of the room & looked over & then wrapped up and given a hat before being handed back to the mom. A baby burrito...cute, but should we be doing this?

Randomized studies detailed in The Cochrane Library say no...you can read the whole abstract, or this plain language summary (the bolding of the conclusion is mine):

Early skin-to-skin contact for mothers and their healthy newborn infants
Skin-to-skin contact between mother and baby at birth reduces crying, improves mother-baby interaction, keeps the baby warmer, and helps women breastfeed successfully.

In many cultures, babies are generally cradled naked on their mother's bare chest at birth. Historically, this was necessary for the baby's survival. In recent times, in some societies as more babies are born in hospital, babies are separated or dressed before being given to their mothers. It has been suggested that in industrialized societies, hospital routines may significantly disrupt early mother-infant interactions and have harmful effects. The review was done to see if there was any impact of early skin-to-skin contact between the mother and her newborn baby on infant health, behavior and breastfeeding. The review included 30 studies involving 1925 mothers and their babies. It showed that babies interacted more with their mothers, stayed warmer, and cried less. Babies were more likely to be breastfed, and to breastfeed for longer, if they had early skin-to-skin contact. Babies were also, possibly, more likely to have a good early relationship with their mothers, but this was difficult to measure.

If you are pregnant or if you work with birthing women and new babies, think about this and really consider making skin-to-skin happen if at all possible. Certainly any skin-to-skin, at any time in the early days or weeks is important...but we do not get these first moments and hours back.

***regarding the medically managed third stage, I wish the study/ies had looked at whether it contributed to issues with retained membranes, need for D&Cs, related complications and extended lochia (bleeding for the weeks following birth)