Tuesday, September 1, 2009

ACOG Revises Position on Fluids During Labor

ACOG recently released new guidelines on fluid intake during labor, loosening the restriction on ice chips only to "modest amounts of clear liquids".

The full news release can be seen at http://www.acog.org/from_home/publications/press_releases/nr08-21-09-2.cfm

The new recommendations include:

According to ACOG, 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. Fluids with solid particles, such as soup, should be avoided, however. Women who have uncomplicated pregnancies and are scheduled for a cesarean delivery may also drink these clear liquids up to two hours before anesthesia is administered.

My favorite part of the release is this:

"Allowing laboring women more than a plastic cup of ice is going to be welcome news for many," Dr. Barth said. "As for the continued restriction on food, the reality is that eating is the last thing most women are going to want to do since nausea and vomiting during labor is quite common."

Tsk, tsk Dr. Barth. Leave it to a man to tell all pregnant, laboring women what they "will want", and to speak for all of us as if we're not worthy of individual consideration.

What he also fails to realize is that nausea and vomiting typically occur during transition, the shortest and latest part of labor.

Since labor can (and often does) last 12+ hours, his rationale is that because at some point 12+ hours down the road a woman may feel nauseous and possibly vomit, she shouldn't be allowed to eat at all during labor.

Instead he should consider that starving a laboring woman for 12+ hours could in fact cause the nausea and vomiting, independent of labor.

ACOG (and Dr. Barth) also fail to realize that digestion usually slows to a near-stop during labor as the hormones of birth build within the woman's body. While remaining largely undigested for hours, this food serves to provide critical energy to the birthing mother to help stabilize her and her baby's blood sugars. Robbing her of nutrients puts unnecessary risk of upsetting this delicate balance and increasing the risk of a "dysfunctional" labor pattern or fetal distress in the baby.

Although the relaxed guidelines are a small step in the right direction, they still shows the persistent lack of understanding that physicians have about labor and in considering individual differences. As long as they try to make modern obstetrics about a "one-size-fits-all" approach, we won't see the change women and babies deserve.

Perhaps the greater goals would be to train caregivers who could think independently, recognize normal birth, expect birth to progress normally, intervene only when necessary (and in the least intrusive, evidence-based ways first) and understand that a woman's body knows how to birth a baby, when it is allowed to do so.


Anonymous said...

does this work?

© 2007-2011 | All Rights Reserved | GivingBirthNaturally.com | No Reproduction without Written Permission