Eating during the birth process

THE wheels of progress seem to turn excruciatingly slowly over at ACOG. The powers that be over there have just come out with official policy that reverses their position on withholding beverages from birthing women. The light bulb has come on. Nothing is helped by completely starving a woman and her unborn baby.

Midwives needn’t worry that this will send homebirthers rushing into the hospital for their births. It will take another 30 years to come up with a policy about what kind of drink might be most helpful and how to get it out of food services at 3:00 a.m.

The homebirth experience allows a window into what happens with the human mammal who is not told what to eat or drink, and can open her own fridge or cupboards anytime she wants. When a woman eats to her own taste in the early birthing hours, that food does not digest the way it does normally. Digestion usually slows to a crawl with the hormones of birth. However, the food in the stomach provides energy (sugars) to the birthing woman/baby dyad. The reason that a woman vomits when nearing the pushing stage is that the body is automatically calibrating how much sugar should or shouldn’t be in her body and, at transition, the levels drop dramatically in order to protect the baby’s brain from a lactic acid buildup during the time the baby’s head is being compressed and pushed through the pelvis. How do I know this? An amazing article published in Scientific American many years ago.

There are so many things that are unknown about the birth process. An unmedicated birth is a very trustworthy process and wholesome nutrition taken in through the mouth (as opposed to I.V.) will be absorbed or ejected in the best interests of the baby and birther.

My personal experience when giving birth at home in 1976

I had a vision for my birth. I would be baking muffins, squat down to open the oven door, and push the baby out. My friends and attendant would say “You are amazing.” When I began having regular sensations at 8:00 a.m., I got up and began baking the muffins. I baked all day and there were muffins piled on every counter surface. I ate quite a few of them and washed them down with orange juice. At 2:00 a.m. the next day, all of that combo came out of me again completely undigested (vomited). I pushed the baby out about an hour later. Needless to say, my actual birth was a lot more down and dirty than my visionary birth.

Over the years, I’ve seen some unusual eating patterns with women birthing at home.
There is so much in birth work that defies the general rules that I feel rudderless at times and this leads to a temptation to make up rules to live by. I realized one day that I only knew one thing that was consistently true about birth “No one can eat during the pushing stage”. That rule was so comforting to me when everything else in obstetrics is chaotic. Then, during a homebirth of a second baby, the mother said “Do we still have some of those Rusk biscuits?” She was handed the dry, Dutch cracker and munched it down. I was appalled that she was defying my rule.
There went my nice theory. Of course, the mind abhors a vacuum so, then, I made up a new rule: “No one can eat when the baby’s head is crowning.” That, too, was good for quite a while but, then, a primip said at full crowning “Can I have a few raisins?” There went that rule, darn it.

I pity the powers that be at ACOG that they think they can make protocols, rules, and guidelines that will cover all births. A better goal would be to have clinicians who could think for themselves, distinguish complications from a normal birth, relax when things are taking a while, and really observe the consistently fascinating process of human birth.

17 thoughts on “Eating during the birth process

  1. I remember Ina May said in one of her books that she always wanted a little something (a watercress sandwich, iirc) during pushing. For myself, I didn’t want to eat or drink anything during my first labor (had had a large meal right before going into labor, and vomited it up; the mw made me drink apple juice, which I threw up within a ctx or two); but when I got to pushing, after about 20 minutes, I felt weak, like my blood sugar was dropping, and for the first time in 9 hours asked for something to eat/drink. I got a few sips of apple juice, and was good to go!

  2. I had a mom who demanded a slice of pizza (peperoni and green pepper) during second stage with her baby already showing!
    She’d take a few bites– give a push — take a few bites. Finally we could see a BIG contraction coming on and she hurriedly hands the pizza to her husband (literally throws it at him), gives a huge push and brings baby right on out!
    First time mom. Didn’t need stitches either!
    She just needed her pizza!.
    So, THIS midwife says “eat in labor if ya want to”

  3. I wasn’t at all hungry with my first baby, just very thirsty. (Of course, being in a hospital, I recieved nothing but those damned ice chips.) With my next three babies, I was absolutely FAMISHED during labor and delivery. I felt like I needed to eat something very sugary, specifically a piece of white cake loaded with white icing. Again though, nothing by mouth as per hospital protocol. I remember it being very strange when, after my babies were born, I could not eat. I had been so hungry just moments before but once the baby was born, my appetite just vanished.
    This birth will be at home and while I’ll do my best to have something more nutritious than white cake, I make no gaurantees. After all, what’s a birthday without a little cake? 😀

  4. thanks for your comments. With my first homebirth, the helpers kept offering me ice chips. I was barely coping with the pain and I decided to imagine those ice chips were made of demerol. I’d ask for them between sensations and remember that thing they say about Demerol that “it takes the edge off the pain.” It got me through.

    I tell women to avoid takeout pizza and Chinese foods when they begin their births because it seems like the body reads MSG and nitrates as toxins in the birth process. Of course, no one feels like cooking when birth begins so it can be tempting to get one of these 2 choices. The other thing that seems to make people vomit excessively (to the point of dehydration) is smoking weed. Those are 3 things that smart women avoid in birth.

  5. Common sense and wisdom derived from the experiences of life would easily dictate we are not all the same. Not rocket science. So, why does ACOG and academic medicine keep doing this? It reminds me of a person who picks up some lint and fluffs the pillows on the sofa while ignoring the 300 pound gorilla on the coffee table. All these guidelines are for the purpose of litigation mitigation. They may even mean well but seemingly are unaware that every new micromanaging “guideline” limits freedom and individuality. They stubbornly refuse to take on the 300 pound gorilla that is behind all this absurdity. That is the medical malpractice tort system. Whether by design or accidental idiocy this new guideline will not improve outcomes. It will only restrict patients rights and increase tension in hospitals whose lawyers and insurers mandate new policies. None of this good news for the laboring woman who best knows her body and its needs. ACOG even admits there is not enough evidence to really make a scientific recommnedation. So why so much distrust of nature’s process? Write them a letter and ask! Maybe there is a good explanation. Then again, common sense and experience would say not.

  6. Last year I attended a hospital birth as a doula. My client was a petite, beautiful lady from France and it was her second birth. She had no qualms about pulling out her granola bars…to which the nurse said, “You aren’t supposed to eat, but I guess I can’t stop you.”

    Just had my 3rd baby last night and I can’t imagine NOT eating during labour, although I definitely thought I was going to throw up before I started pushing.

    I just can’t believe that there still needs to be discussion about this, you can’t put out that kind of energy without food, food, food!!

  7. Interestingly I don’t recall eating anything for the 100+ hours I was in labor, glo. Maybe you remember… I remember being handed a popsicle at some point it but not wanting it. And maybe some herbal tea… I definitely had very little appetite.

  8. Amy, you had your baby girl! CONGRATULATIONS. Now go read my post about the therapeutic power of rest 🙂
    Thanks for commenting and I’m so pleased that you have a little daughter.

    April, I don’t remember what you ate during that marathon. It’s funny because people always say things to me like, “Don’t you remember, I had that funny tear? or Do you remember that my mother in law phoned in birth?, etc” I always say “No, I don’t remember that but I remember we had pizza with pine nuts after your birth” or (whatever food we ate). I guess it’s bizarre to have food be the big memorable event after a birth but usually the attendant’s are really hungry, too. I don’t leave the woman’s house after the birth until I know she’s had a big protein meal.

  9. Hey Gloria,

    A colleague of mine just asked if you have the citation for the Scientific American article. Or even just the title so we can dig around for it. She’s teaching the obstetrical interventions course at SBGI and will put it to good use. This is priceless information about how the body (of course!) knows exactly what’s needed during birth and I’m delighted that there’s science behind women’s knowing of their needs. Sometimes valuable research just isn’t replicated because people go off on other tangents, or there is no funding for it and we lose the opportunity for obtaining some solid evidence for what we know to be true.

    Meanwhile I’m all in favor of the latest way of challenging ACOG’s new pronouncement (since they password-protected the questionnaire page asking for documentation of bad homebirth outcomes): sending a pizza to them for every successful homebirth!

  10. I find this to be fascinating! I love it every time scientists discover something about why the body works the way it does, so I would love to see which Scientific American that was in, too! I also think that it’s a bit funny that once some scientist finds that something is true, it’s suddenly labelled as TRUE, or treated as though it’s just started occurring, even though natural-oriented birth attendants may have known it at some level for decades, or even centuries. 🙂

    Just FYI, the only thing that I’ve suggested over the years that laboring mothers might want to avoid ingesting during labor is orange juice, or any juice blend that contains orange juice. I’ve found that whenever they do, they’re guaranteed to throw up. (And now there will probably be some mother who says that it did not happen to her) 🙂

    Also, I’ve found that the one thing that mothers can usually ingest during those labors when absolutely nothing else will go down is a baked potato with nothing on it but salt. If a labor is going well and the mother doesn’t want to eat, that’s one thing. But if the contractions are spacing apart and weakening, where it was quite active before, I’ve found that it often means that her blood sugar is dropping and the uterine muscle just doesn’t have the carbs to work properly any more. So in those cases, I start being a little more assertive with the suggestions for food and drink.

    But I absolutely love it that there is this wonderful reason for throwing up sometimss during labor!


  11. It also makes no sense to me that ACOG is so inflexible on this issue of solid food during labor. If a non-pregnant person has a huge dinner at a restaurant and then is severely injured in a car accident on the way home, does the surgeon refuse to save his/her life because s/he has a full stomach?! I don’t think so! They have protocols to deal with that situation. So why shouldn’t a laboring woman be afforded the same protocols and technology as any non-pregnant person needing emergency surgery?!


  12. Hi Claire, I don’t have the reference but just “googled” it and found this ref.
    Eating and drinking in labor: Should it be allowed?
    European Journal of Obstetrics & Gynecology and Reproductive Biology, Volume 146, Issue 1, Page 3
    D. Maharaj
    I have asked my research maven to find the whole article for me and see if the Scientific American reference is there. Thanks for asking because I was being lazy and I do like to have everything on this blog cross-ref’d. Gloria

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  14. During my first birth I was not allowed to eat. I was so hungry and finally stalled out at about 8 cm where I continued to sit for hours while intervention after intervention was applied. And a little fuel was not one of them. What did they expect? Around about dinner time, somehow someone must have thought I’d had my baby and brought me a tray of food. Finally! They had come to their senses! But no, I was informed that I would not be able to eat it after all. It was all a mistake. So my poor husband who was also starving (we had been at the hospital since that morning, and the day was wearing on into night) got to eat it. At least one of us did! So on we went until about 2 AM. The doctor it seemed was busily giving cesareans to several women whose bodies didn’t work (NOT! Well–without food certainly not as well as they could anyway). I was soon in line with the other mothers for a cesarean. I was almost glad because it would mean I could finally eat something. I’ve since had four vaginal births and the last took about 1/2 an hour from the time things really got going. These were all homebirths and you can bet I did not do them without being nourished and hydrated! Listening to and taking care of your body–in labor too (especially in labor!)–matters!

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