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Medical anthropologist Robbie Davis-Floyd wrote extensively about the cultural myths about non per os and childbirth in the 1992 book, Birth as an American Rite of Passage. Mendelsohn’s original 1946 article reported several cases of aspiration and subsequent pneumonia, but no deaths. Davis-Floyd cites Baggish’s 1974 study which showed that at most 2 percent of maternal deaths were caused by aspiration under general anesthesia and Scott’s 1978 work that placed the risk of death at 1 in 200,000 women.

So what purpose would denying food and drink to all laboring women serve more than six decades after Mendelsohn’s work and with the great improvements made to regional anesthesia? Davis-Floyd wrote:

According to Feeley-Harnik, “persons undergoing rites of passage are usually prohibited from eating those highly valued foods that would identify them as full members of society” (1981:4). In rites of pregnancy and birth across cultures, food tabus serve the purpose of marking and intensifying the liminal status of the pregnant woman. The pseudo-foods (ice chips and lollipops have no nutritional value) allowed in the hospital are often fed to the laboring woman by her partner as if she herself were the baby, a symbolic process that can heighten her own sense of weakness and dependence.

In a recent article in Birth, Broach and Newton (1988) address the question of why laboring women are still prohibited from eating and drinking in labor in spite of mounting evidence that such prohibitions are medically contraindicated. Pointing out that this custom started in the 1940’s when general anesthesia was widely used for childbirth and the danger from aspiration was therefore higher, they posit that its continuance is the result of “culture lag”—that is, of “culturally patterned behavior that continues to be practiced long after the reasons for doing so have disappeared” (1988:84).

Davis-Floyd views denying food in labor as indicative of the confirmation of a woman’s initiate status as a dependent of the institution.

On the contrary, I would suggest that this custom forms an integral part of the technocratic tapestry of birth in the United States, continuing as routine procedure not because of culture lag but because it serves so well to legitimate and further necessitate the technocratic interventions we investigate here as transformative rituals. To deny a laboring woman access to her own choice of food and drink in the hospital is to confirm her initiatory status and consequent loss of autonomy, to increase the chances that she will require interventions, and to tell her that only the institution can provide the nourishment she needs—a message that is most forcefully conveyed through the “IV.”

Great article above and I just wanted to post because this is something I was thinking about the other day. I have never been able to understand the need to deny women food while they are in labor. It is LABOR!! It is hard work, our bodies are in need of nourishment, and not ice chips and popcicles. I have never understood the reason given about the risk of aspiration, if I am a low risk mother and am having a natural birth the chances of my needing a section are very low on top of that the chance of aspiration leading to my death during the unlikely event of a section are even lower.

So why deny my body what it needs to get me through my labor? Why lessen my chances at success with a natural birth by weakening my body, taking away my autonomy, and power as a woman?

Your stomach is never empty - it has acids in it when food is present or absent; the major difference between a stomach that is "empty" and one that is "full", is that it has only acids - which is far more damaging to aspirate.

When I was in labour with Lois, I asked my homebirth Midwife if I was allowed to have some lemonaide. She gently and firmly replied, "You can have whatever you want."

Love me some lemonaide in labour. MMMMMmmmm MMmmm.

Most people don't want a heavy meal, just light snacks. I brought snacks w/ me....no need to "ask" anyone. No, anesthesia people don't like patients to eat but should surgery become necessary it can be done. When a gun shot wound comes in an hour after eating a whole pizza do they not operate b/c the pt. ate? Of course not. When I had to tell them I ate an hour before my emergency section I got a look and I quickly and firmly said I was going natural and I can eat if I want to!

And then if you DO throw up on the table....can't they just tilt you to the side? ;) I would think very little would get in your lungs and they would notice the heaving before it truly came up and then back in... right?

J

I brought lots of food with me and ate like a pig when the nurses left the room! There was no way I was laboring all day without food!
Laura

With my first I didnot know to bring food with me to the hospital...I assumed I would be able to get something to eat there (afterall I was paying for my stay and just thought meals were going to be included). I was very hungry at one point, getting close to the end of a very long labor and had not eaten much at home that day so I asked for something to eat and drink. I was told no. I was offered a cherry popsicle. It was gross and not what I wanted or needed. I was denied water as well and told I could have ice chips, or they could go ahead and administer fluids through the IV. I opted for the IV when I started pushing because I was so dehydrated and weak and wasn't going to be allowed to get up anyway past that point.

I am going to look into this and ask local hospitals about it...Look for an article at Granola Rouge.

Thanks for posting this, Amy! Robbie Davis-Floyd is one of my heroes since grad school. She's da bomb. I highly recommend her writing. It's accessible but also very academically sound.

Amy

I am going to look into this and ask local hospitals about it...Look for an article at Granola Rouge.

Thanks for posting this, Amy! Robbie Davis-Floyd is one of my heroes since grad school. She's da bomb. I highly recommend her writing. It's accessible but also very academically sound.

Amy

GREAT IDEA AMY!! Evidence based care!