The Midwifery Dilemma: to fast or feed the labouring woman makes a few interesting comments that you might find helpful. Basically, "it is believed that the decline in the general anaethesia rate for obstetric patients and the improvements in anaesthetic drugs and techniques over the past 50 years have made an aspiration episode extremely rare". In 1946 Mendelson recommended employing regional anaesthetic (epidural) rather than general anaesthetic to help prevent morbidity and mortality from gastric aspiration in labouring women.
It has been found that despite prolonged fasting time "a majority of patients had large gastric volumes" prior to general anaesthetics. Guyton (19860 found that 500 millilitres of gastric secretion per hour was produced when associated with hunger. The stomach may produce 50 millilitres of highly acidic fluid at times of stress and fasting. Phillips et al (1993) stated that "fasting only increased the amount of acid secretion in the stomach, while food and fluid reduce the production and dilute the pH level of the gastric contents". Basically epidural rather than general anaesthetic is considered the most effective way to minimise the risk of aspiration. An interesting finishing quote in the article from Sleatel & Golden (1999) comments "when the risk of death from aspiration is put into perspective, it can be seen that a woman has a three times greater chance of dying from a lightening strike than dying from aspiration during childbirth" I hope this helps. kathy ----- Original Message ----- From: "Jen Semple" <[EMAIL PROTECTED]> To: <[EMAIL PROTECTED]> Sent: Monday, March 01, 2004 6:57 PM Subject: [ozmidwifery] Eating In Labour- evidence! > Wow, it's interesting that women are even restricted from eating solid foods while they're labouring... the Cochrane folks, Enkin et al. (2000) Guide to Effective Care in Pregnancy & Childbirth. (3rd ed, Oxford University Press) have a whole section on nutrition in labour (pp. 259- 263). It can be downloaded from http://maternitywise.org/pdfs/gecpc3ch29.pdf > > The gist is "...except for women at high risk of needing general anaesthesia, the benefits of nourishment in accordance with women's wishes far outweigh the possible benefits of more restrictive policies." (p. 259). > > In the two hospitals I've done my clinical placements, women have been encouraged to drink to thirst & eat to hunger (lightly). > > Here's to evidence-based practice! > > Jen > 3rd year BMid student, Melbourne > JoFromOz <[EMAIL PROTECTED]> wrote: > > @page Section1 {size: 595.3pt 841.9pt; margin: 72.0pt 90.0pt 72.0pt 90.0pt; }P.MsoNormal { FONT-SIZE: 12pt; MARGIN: 0cm 0cm 0pt; FONT-FAMILY: "Times New Roman"}LI.MsoNormal { FONT-SIZE: 12pt; MARGIN: 0cm 0cm 0pt; FONT-FAMILY: "Times New Roman"}DIV.MsoNormal { FONT-SIZE: 12pt; MARGIN: 0cm 0cm 0pt; FONT-FAMILY: "Times New Roman"}A:link { COLOR: blue; TEXT-DECORATION: underline}SPAN.MsoHyperlink { COLOR: blue; TEXT-DECORATION: underline}A:visited { COLOR: purple; TEXT-DECORATION: underline}SPAN.MsoHyperlinkFollowed { COLOR: purple; TEXT-DECORATION: underline}SPAN.EmailStyle17 { COLOR: windowtext; FONT-FAMILY: Arial}DIV.Section1 { page: Section1}Women are allowed water, black tea, that kind of thing. Whether epidural or not. Inductions are more strict though, water only. I had to beg a doc to let my labouring woman have a barley sugar... > > Jo > > > > --------------------------------- > Find local movie times and trailers on Yahoo! Movies. > -- This mailing list is sponsored by ACE Graphics. Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe.
