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Re: Chowing down during labor

From: anonymous@obgyn.net
Fri, 31 Aug 2001 09:09:31 -0500

I have read with interest this original question, Dr. Braun's response and the responses of others. As a physician, I read the original note about sneaking M&M's and the hehehe, as a statement by the individual to indicate that they knew that they were doing something wrong and are childlike snickering about getting away with it. but hte situation is more serious than that as Dr. Braun has pointed out and some of the other writers have experienced. In my practice, we do allow patients to suck on hard candy for the sugar and the tactile sensation. It should be pointed out that the gastrointestinal tract is sympathetic to the uterus and as uterine contractions increase, gastrointestinal motility decreases. Additionally, stimulus to the nose and mouth from food, increases gastric fluid contant secretion making the stomach contents more aciditic. As a result, the " food" does not leave the stomach. Many of you have been in labor and know of the nausea and the vomiting which may intiate labor or show up during labor or transition. Why take the chance? As Dr. Braun points out, the IV sugar can be given and the risk is just too great. What really offends physicians is the idea that a patient would do something that might affect their helath and then keep it a secret so that the physician is working without all of the information necessary. What chafes me even more, is a current trend that when a person is involved in a complication, whether it me pouring hot coffee on themselves, or their teenager acting up, somehow it has to be someone else's fault. I suggest that someone sneaking food to themselves in labor and suffering the, albeit, uncommon complication of Pulmonary damage from exposure to stomach acid contents, is likely the first one to sue their hospital and physican for making it easy for them to sneak the food.

Selman Welt, M.D. Maternal - Fetal Medicine -- Original Message --

>At Thu, 30 Aug 2001, Kristy wrote:
>>
>>21 years ago when I went into labor, the doc said DO NOT EAT A THING!!
>>DON'T DRINK A THING!! Same went for my son's labor eight years ago.
>>There is no way I could not eat - I get REALLY low blood sugar and I
>>shake, get dizzy, feel faint, get palpitations, severe weakness, etc.
>>With my daughter, my husband snuck me M&M's...hehehe. For my son, I
>>just ate things from my back pack and didn't tell anybody. I felt
>>guilty for breaking the rules, but there was no way I could handle
>>labor/birth without having my blood sugar regulated.
>
>That is why you have an IV.
>If your stomach is full and you have to have an emergency cesarean, you
>might need to have ageneral anesthetic. If your stomach is full and you
>vcomited before the endotracheal tube was put in place, you could
>aspirate the contents of your stomach into your lungs. This can cause
a >severe chemical pneumonia which frequently can lead to death of the
>mother.....hehehe.
>Many more women have died of this cause than from any of the problems
>with epidural.
>
>>
>>Are things still the same these days? Do they make you keep from eating?
>>If so, why? What can be done for patients like me who get super low
>>blood sugar? Can't I drink something clear or whatever? I don't see my
>>doc for two weeks, that's why I'm asking here.
>>Thanks...Kristy B.
>
>--
>R. Daniel Braun, MD FACOG FOG
>
>This is for educational purposes only, and is not intended to be replacement
>or substitute for consultation and examination by an appropriate medical
>professional. Due to time constraints, private e-mails cannot be answered.
>

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