Saturday, June 25, 2011
As one of my writing assignments, I researched the history of NPO (nothing by mouth) after midnight before heading into surgery. To give you a brief over view...It started in the 1940's when an obstetrician (Curtis Mendelson) took note of a couple deaths (out of 44,016 cases) related to aspiration during labor and delivery while under general anesthesia. These deaths were related to food and liquid intake, so he recommended fasting during labor for everyone (Crenshaw & Winslow, 2008, p.963).
Fast forward 60 years... Few laboring women under go general anesthesia for C-sections and of those who rarely do, they are at a greater risk of death associated with intubation difficulty rather then aspiration (Sharts-Hopko, 2010, p.198). Not to mention the quality of anesthesia has greatly improved along with the expertise in administration. Soooooo... based on research, eating popsicles and ice chips is no longer an acceptable practice. If your doctor says this is what you should follow, challenge it AND bring your own bag of snacks to the hospital to eat as you feel up to it.
There have been numerous studies on oral intake during labor and the conclusion is that "no adverse maternal or infant outcomes were associated with food ingestion" (Sharts-Hopko, p.202). In fact, numerous studies revealed that those who drank water up to two hours prior to surgery exhibited lower gastric volumes than those who followed a nothing by mouth diet (miller, 2009, p. 16). More stomach acid equals a greater risk for nausea/vomiting. Fluids taken two hours pre-operatively actually stimulated peristalsis (digestion) and emptying (Crenshaw & Winslow, p.967).
Here's a link to the benefits and suggestions of light foods to eat during labor:
Crenshaw, J. & Winslow, E. (2008). Preoperative fasting duration and medical instruction: Are we improving? AORN Journal, 88(6), 963-976.
Sharts-Hopko, N. (2010). Oral intake during labor: A review of the evidence. American Journal of Maternal Child Nursing, 35(4), 197-203.