The The New York Times picked up on the recent Cochrane review that concluded eating and drinking during labor is not harmful (or helpful, although satiating hunger seems helpful to me).  Historically hospitals restricted food and fluids to laboring moms, due to the possible risk of being put under general anesthesia, and vomiting and aspirating during the surgery.  This is such a rare risk that making all labor patients NPO (Nothing By Mouth) does not make sense.  I won’t go over the debate (I personally believe it is A-OK to eat during labor.  Heck, I snuck food into my own delivery, and ended up with a C-Section, and survived to blog about it!) because I do not want to beat a dead horse.  What I found interesting in the NYT’s article were some of the quotes embedded in the article.  They actually made me laugh, and I do not think this was a comedy piece.  Here is what I thought was funny, in a not-so-funny kind of way:

• Dr. Tranmer, (a nursing professor…yeah!) who said she had seen all too many women in labor complaining of thirst and dry mouth resort to sucking wet washcloths. This just makes me sad.  The thing is, I believe her!  The image of laboring moms sucking on washcloths seems so pathetic and demeaning.  Thankfully I have not witnessed this.  I have furiously spooned ice chips into laboring women’s dry mouths, but never had them suck on a wet washcloth.  Jeez!

• “My own view of this has always been that you could say one shouldn’t eat or drink anything before getting into a car on the same basis, because you could be in an automobile accident and you might require general anesthesia,” said Dr. Marcie Richardson, an obstetrician and gynecologist at Harvard Vanguard Medical Associates in Boston, who was not connected to the new study. I have never heard of this analogy, and I like it.  I may use it at work!  It’s funny because I have heard of (she who will not be named) some anti-home birth advocates saying things like delivering at home is like driving without a seat-belt, or some weird  sh*t like that, so I like when the car analogies are U-turned (tee hee) around.

• “From an anesthesiologist’s perspective, they missed the boat on this one,” said Dr. Craig M. Palmer, chairman of the committee on obstetrical anesthesia for the American Society of Anesthesiologists. They looked at the impact on the progression of labor, but to be honest, that’s not an issue for anesthesiologists. Our primary concern is patient safety.” Oh Craig,  you are my hero.  I completely agree with you.  The researchers did ignore you, and that was mean!  We can never predict who may need an emergency C-Section.  I have seen women walk in off the street who have eaten, gasp, and have needed a crash C-Section right on the spot.  So I propose that ALL pregnant women with a viable gestation, become NPO  until they deliver.  This is the safest way.  We can insert central or PICC lines at around 23 weeks gestation, and have home health nurses hang total parental nutrition once a day.  At around 36 weeks,  all pregnant women should have Foley catheters inserted, so we are not futzing around in the OR and wasting time, in case she needs that emergency C.  Let’s see, is there anything else I’m forgetting?  How about weekly  abdominal shaves?  Sounds about right.

The NYT article was an enjoyable read.  Not so enjoyable was reading the comments.  I should know better!

RR