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.