ACOG says clear liquids acceptable during uncomplicated labor

Women in normal labor can safely drink modest amounts of clear liquids, and those undergoing cesarean delivery can do so for up to 2 hours before they are given anesthesia, according to a new opinion released by the American College of Obstetricians and Gynecologists’ Committee on Obstetric Practice and published in the September issue of Obstetrics and Gynecology.

The primary reason for the restrictions on liquid during labor had been to prevent aspiration in case women needed to be anesthetized for a cesarean section. However, there has been a steep reduction in cases of maternal death due to aspiration over the last 60 years, which has called into the question very restrictive oral intake policies.

Patients with uncomplicated labor should be allowed to have small amounts of clear liquids, such as water, fruit juice without pulp, carbonated drinks, sports drinks, and tea and coffee, the paper states. However, any drinks with particulates and solid food should be avoided during labor.

“There is insufficient evidence to address the safety of any particular fasting period for solids in obstetric patients. Expert opinion supports that patients undergoing either elective cesarean delivery or elective postpartum tubal ligation should undergo a fasting period of 6 to 8 hours,” the authors write. “Adherence to a predetermined fasting period before non-elective surgical procedures (i.e., cesarean delivery) is not possible. Therefore, solid foods should be avoided in laboring patients.”

ACOG Committee Opinion No. 441: Oral Intake During Labor. Obstet Gynecol. 2009;114:714. doi:10.1097/AOG.0b013e3181ba0649.