Doula Fresno

The following article was a very helpful read for me as a doula in fresno where most women are limited to drinking clear fluids once they are admitted to the hospital.  I thought it was worth sharing here:

The Birth Marathon: Food & Drink for Labor & Birth

By Patty Brennan, BA, CD(DONA), PCD(DONA)
Excerpted from Brennan’s cookbook, “Whole Family Recipes:  For the Childbearing Year & Beyond” © 2007

Women birthing in most hospitals are told that they cannot eat during labor and can only drink clear liquids once they are admitted.  The reason behind these instructions is to prevent aspiration of stomach contents in the rare instance that the mother requires general anesthesia for an emergency.  The following are tips to enhance energy and progress in a mother if her labor goes longer than her blood sugar can hold out.

Strategies

Some women experience an urge to load up on carbohydrates in the 24-hour period before the onset of active labor, similar to what an athlete may do in preparation for running a marathon on the following day. Go for it! (I had a bread, salad and pasta dinner at a local restaurant 12 hours before my second child was born and never felt nauseated in labor, which started about five hours after the meal.) This strategy is especially recommended for women facing a scheduled induction. Avoid having the hard work to hit after essentially fasting for 24 hours or more.

EAT IN EARLY LABOR. This is essential and must be maintained throughout the day. Don’t just settle for breakfast and stop there. Eat every 2–3 hours, whatever is appealing. You may want to avoid heavy, greasy foods such as pizza or fast food (which don’t digest easily under the best of circumstances).

Avoid substances that will cause a blood sugar level spike, such as soda and other forms of concentrated sugar (read labels!). These are dehydrating and ultimately lead to blood sugar crashing.

If planning a hospital birth, eat a banana on the way to the hospital. Despite most TV depictions of how women go into labor (i.e., a sudden contraction alerts her to the need to rush to the hospital where she gives birth soon after on her back, typically involving various emergencies for dramatic effect), most women have plenty of time to take care of themselves with little need for high drama.

During labor, try a variety of the suggestions below, alternating them. A little protein here, some electrolytes there, something sweet to boost your energy, the Pregnancy Tea—you get the idea. That will keep a mom going if the labor is long.  This is especially important for women who might be admitted to the hospital early in labor or whose labor is being induced.

Drink lots of water, at least 4 oz per hour throughout labor, more if it’s a hot day and you’re sweating a lot. Have your support team help you with this. (Note to all attendants: Your job is to encourage the mom to drink throughout her labor. If she is willing to drink, asking for liquids and consistently taking several gulps when offered, then just keep the supply coming and keep an eye on her to ensure she doesn’t stop drinking at some point. However, if the mom is disinterested in drinking and reluctant to do so, then frequent small sips will be necessary. Keep offering!)

Finally, don’t hesitate to accept IV fluids if you can’t keep anything down over a long period of time and are getting dehydrated. While healthy women will not need routine IV fluids, dehydration can cause your labor to be dysfunctional and non-productive. An IV can turn the picture around and is an appropriate use of medical intervention.

Recipes for Nutritious Clear Fluids

Raspberry leaf tea labor cubes. Before labor begins, make up a very strong tea (two quarts of boiling water with two cups of dried red raspberry leaves added).  Simmer with the lid off for at least 20 to 30 minutes as the volume reduces considerably. Strain and add one quarter cup of honey (raw is best if possible).  Pour into ice cube trays and freeze, adding water if necessary for at least one tray’s worth.  Store in a zippy bag at home or take with you to the birth center/hospital.  (Usually you can store them in the freezer of the small room refrigerator or in the common nutrition room refrigerator).  The honey gives mom a boost of energy, while the concentrated raspberry leaves provide minerals and may assist in bringing back strong contractions.  In between the contractions, mom can easily crunch the cubes into a satisfying slush.

Electrolyte-balanced sports drinks. There are a large variety of sports drinks on the market these days.  Avoid the overly-sweet, chemically-generated metallic blue and other colored products not found in nature.  Encourage mom to see what is available at her local health food store and experiment until she finds one she likes.  Recharge is my personal favorite and is available in several flavors. Have two to three quarts on hand for labor.

Miso broth. If you are unfamiliar, miso is a paste made from fermented soybeans.  It is high in protein and tastes salty.  If you haven’t tried miso, there are a number of different flavors available in the refrigerated section of your local health food store.  Give them a try and find one you like.  The paste can be brought with you to the hospital and kept in the refrigerator.  Mix one tablespoon of miso into one cup of hot water.  Avoid boiling miso as it kills may of the nutrients.  There are also packets of instant miso soup on the market.

Concentrated homemade chicken or beef broth. Place one whole (preferably organic) chicken or a couple of beef bones in a large soup pot.  Bring to a boil and spoon off the scum that will rise to the surface over a 10 minute period and discard.  Roughly cut up one onion, three carrots (washed, with skins on) and three stalks of celery, including tops.  Chop up two to three garlic cloves and throw those in too (you can even leave the skins on as a timesaver).  Cover and reduce heat, simmering for one and a half hours or more.  Cool and strain out the solids (make chicken salad with the meat).  Put the broth in the refrigerator overnight so that the layer of fat on top solidifies.  In the morning, remove and discard the fat layer.  Return the broth to the stove, uncovered and bring to a boil, allowing the liquid to reduce to a rich-colored (and tasty!) broth.  Add in Celtic sea salt (for the extra minerals) to taste at the very end.  Freeze in small containers to have on hand for labor.

Herb tea and honey. Encourage mom to bring a variety of her favorite herbal teas and some raw honey with her to the hospital.  When energy flags, especially in the second stage of labor, a cup of tea with a generous spoonful of honey can give her the boost she needs to get the job done.  Ginger tea may help settle the stomach if nausea is an issue.

Hot drinks. Americans are big on iced drinks, but in many parts of the world, ingesting iced drinks is not recommended.  An number of cultures, from China to South America, have prohibitions against iced drinks for women in labor or postpartum.  The wise women grandmas-to-be will not allow it.  Feed the fire.  Women are supposed to get hot in labor!  She will sweat.  She will be uncomfortable.  It’s okay.  It’s more efficient.

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