It is common practice to withhold food and the majority of liquids from women in labor in most medical facilities.
The rationale for this practice has been that, should the woman need general anesthetic, the stomach contents may be aspirated into the lungs resulting in the danger of such complications as choking, pulmonary edema, partial lung collapse, and even death.
There is some evidence that, when the administration of general anesthesia was common during childbirth, this complication was associated with a substantial number of maternal deaths.
Therefore, it stands to reason that the initiation of the practice of withholding food and liquids from the laboring mother may have been warranted.
However, advances in anesthetic administration and the lean toward unmedicated birthing have indicated a need for the reexamination of this practice.
Studies have indicated that digestion is slowed during labor.
This slowing is further exacerbated by narcotic analgesics.
Therefore, anything ingested during labor may remain in the stomach longer than normal.
However, the majority of laboring women no longer need general anesthesia during labor and delivery, and those who do need some form of pain control fare well with the administration of regional anesthesia.
Additionally, even older studies indicated that, although aspiration may once have been a cause of maternal death, medical advances reduced the majority of the complications of aspiration to pneumonia.
Few, if any, deaths were reported by the mid 1970's as a result of aspiration.
What once may have been a significant danger for laboring women, in time became responsible for less than 2% of maternal deaths.
It was thought that the majority of these deaths could have been prevented by the use of regional anesthesia.
Current studies have failed to find any maternal deaths at all that can be directly linked to aspiration under general anesthesia.
One source asserts that the practice of withholding food and liquids from women during labor may be more harmful than the reverse.
The woman who labors with no food or drink may build up gastric juices that are more acidic than normal which may be more harmful to the lungs if aspirated than had she been permitted oral intake.
Additionally, women who receive general anesthesia are likely to be lying flat on their backs which further increases the dangers of aspiration.
The majority of modern research has already indicated that the lithotomy position during labor and delivery may not be the most desired.
It was the 1946 groundbreaking study entitled The Aspiration of Stomach Contents into the Lungs During Obstetric Anesthesia, by C.
L.
Mendelson, which was the source of the practice of ensuring an empty stomach for anesthesiologists by restricting the intake of food and liquids for laboring women As a short-term solution, nothing by mouth (NPO), may have been warranted until medical techniques regarding the administration of anesthesia and the management of pain during childbirth advanced to the point that oral intake by laboring mothers was no longer an issue.
However, since it appears that the solution may have well outlived the problem, a reconsideration of the practice of NPO for laboring mothers may long overdue.
The rationale for this practice has been that, should the woman need general anesthetic, the stomach contents may be aspirated into the lungs resulting in the danger of such complications as choking, pulmonary edema, partial lung collapse, and even death.
There is some evidence that, when the administration of general anesthesia was common during childbirth, this complication was associated with a substantial number of maternal deaths.
Therefore, it stands to reason that the initiation of the practice of withholding food and liquids from the laboring mother may have been warranted.
However, advances in anesthetic administration and the lean toward unmedicated birthing have indicated a need for the reexamination of this practice.
Studies have indicated that digestion is slowed during labor.
This slowing is further exacerbated by narcotic analgesics.
Therefore, anything ingested during labor may remain in the stomach longer than normal.
However, the majority of laboring women no longer need general anesthesia during labor and delivery, and those who do need some form of pain control fare well with the administration of regional anesthesia.
Additionally, even older studies indicated that, although aspiration may once have been a cause of maternal death, medical advances reduced the majority of the complications of aspiration to pneumonia.
Few, if any, deaths were reported by the mid 1970's as a result of aspiration.
What once may have been a significant danger for laboring women, in time became responsible for less than 2% of maternal deaths.
It was thought that the majority of these deaths could have been prevented by the use of regional anesthesia.
Current studies have failed to find any maternal deaths at all that can be directly linked to aspiration under general anesthesia.
One source asserts that the practice of withholding food and liquids from women during labor may be more harmful than the reverse.
The woman who labors with no food or drink may build up gastric juices that are more acidic than normal which may be more harmful to the lungs if aspirated than had she been permitted oral intake.
Additionally, women who receive general anesthesia are likely to be lying flat on their backs which further increases the dangers of aspiration.
The majority of modern research has already indicated that the lithotomy position during labor and delivery may not be the most desired.
It was the 1946 groundbreaking study entitled The Aspiration of Stomach Contents into the Lungs During Obstetric Anesthesia, by C.
L.
Mendelson, which was the source of the practice of ensuring an empty stomach for anesthesiologists by restricting the intake of food and liquids for laboring women As a short-term solution, nothing by mouth (NPO), may have been warranted until medical techniques regarding the administration of anesthesia and the management of pain during childbirth advanced to the point that oral intake by laboring mothers was no longer an issue.
However, since it appears that the solution may have well outlived the problem, a reconsideration of the practice of NPO for laboring mothers may long overdue.
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