Five years ago, when Elizabeth Gulledge was in labour with her first son, Alex, her doctor told her to go for a walk and have some lunch after she was induced. That surprised her. “You’re programmed to believe you shouldn’t eat anything in case you need an emergency C-section,” she says. She ended up grabbing a sandwich from Subway and was glad she did, since her labour lasted eight hours.
But when she went into labour with Max and, most recently, Hank, she was too nervous to eat. “Nobody ever said anything to me about food, but the last thing I wanted to do was eat,” she says. And yet, some women do want to eat during labour and, depending on where they deliver, often get conflicting advice about what they can and can’t have. In many delivery rooms, women are permitted only ice chips or small amounts of clear fluids. “I was just given water and told to take little sips,” says Gulledge, who was in labour for about five hours with her second and third sons. “I don’t know what would have happened if I’d had longer labours—it makes sense that you have to fuel your body.”
Labour is work, agrees Sharon Dore, a registered nurse and associate clinical professor at McMaster University. “Any other time you’re doing work, you can’t just not eat. You need something to keep you going.”
According to the Society of Obstetricians and Gynaecologists of Canada (SOGC), “In the very early stages of labour, eating and drinking small amounts prevents you from getting dehydrated and helps you keep up your strength.” But the SOGC warns that if you’re at high risk for a C-section—your baby is breech or you’re expecting twins, for example—you might not be allowed any food or drink. Guidelines depend on the particular rules of the hospital or caregiver. And many maternity wards still have a no-food policy during labour.
Anaesthesiologists worry about pregnant women having food in their stomachs in the event that they need general anaesthesia for a C-section. That’s because general anaesthesia brings a risk of vomiting. “If a person vomits while under general anaesthetic, the contents of their stomach could go back down the ‘wrong tube’ and block the airway [this], leading to breathing issues and possible infection,” says Kathryn Walton, a registered dietitian in Toronto who specializes in pregnancy.
Most C-sections are done with an epidural, which is a regional anaesthetic and doesn’t carry the same risks of vomiting. But if you’re scheduled for a C-section, you’ll be restricted to no food for about eight hours prior to surgery and no clear fluids for up to four hours beforehand. That’s because, while the use of general anaesthetic for C-sections is less common nowadays, there is still a risk that a labouring patient might need it, says Amanda Selk, an OB/GYN at Women’s College Hospital in Toronto. For example, if a localized anaesthetic isn’t working, a woman might undergo a general one.
Still, the cases where general anaesthesia is needed are rare, and there have been numerous studies to support relaxing some hospital rules around eating. A 2017 study in the journal Obstetrics and Gynecology found no benefit to restricting food and drink for women with a low risk of complications in the delivery room, and determined that women who were allowed to eat freely had shorter labours.
When Abbey Sharp was in labour, she had no appetite, but she forced herself to eat a few bites of bagel between contractions to keep her strength up. “I was glad I did, because I was starving by the time I had an epidural, and then they only let me have Popsicles and hard candies,” she says. Sharp, a Toronto-based registered dietitian who specializes in pregnancy, says the question of when and what you should eat really comes down to how you feel and what the hospital will let you do. “Labour, particularly pushing, is a marathon, so you’ll be grateful for any fast-carb energy source you can get,” she says. In early labour, Sharp recommends protein and carbs, with a little fibre thrown in (this might include a turkey sandwich, fruit, soup with noodles, granola, or pasta or rice with chicken) to help sustain you in case you don’t feel like eating later on.
“As you get into the thick of it, cold foods may feel refreshing, so smoothies, ice pops and watermelon may be good options,” Sharp says. For a quick jolt of energy in the pushing stage, she recommends dates or other dried fruits, candies or juice. “Anything heavier or fattier may upset your tummy and divert blood away from the working muscles to your digestion—and you need all the strength you can get.”
Don’t forget to pack snacks in case you find yourself in labour in the wee hours, when the cafeteria is closed. Even if you don’t eat during labour, those snacks you stash in your hospital bag will come in handy afterwards, when the marathon is over.