Fasting in labor: relic or requirement.

Area of Science:

• Obstetrics and Gynecology
• Perinatal Care
• Evidence-Based Medicine

Background:

• Historically, laboring women were restricted from eating and drinking due to concerns about gastric aspiration.
• This practice has persisted despite a lack of robust scientific evidence supporting its efficacy.

Purpose of the Study:

• To critically evaluate the scientific literature regarding the practice of restricting oral intake during labor.
• To determine the evidence supporting or refuting the need for fasting during childbirth.

Main Methods:

• Comprehensive literature search of MEDLINE and CINAHL databases.
• Inclusion of historical articles, texts, and cited references, excluding single-person case studies.
• Data extraction focused on historical context, effects of fasting, aspiration risks, gastric emptying, and hydration.

Main Results:

• Scientific literature does not support restricting food and fluids during labor to prevent gastric aspiration.
• Evidence suggests that restricting oral intake during labor can lead to unexpected negative outcomes.
• The risk of maternal aspiration mortality is very low (approximately 7 in 10 million births).

Conclusions:

• There is insufficient research on the effects of consuming food/fluids versus fasting during labor on labor progress, birth outcomes, and neonatal status.
• Further research is needed on the impact of epidural analgesia on gastric emptying and the physiological implications of fasting during labor.
• Fasting during labor is a tradition lacking evidence of improved maternal or newborn outcomes; many facilities are moving away from these restrictions.