Posted by My OB said WHAT?!?.
Jan
30
Posted by My OB said WHAT?!?.
“You Cannot Eat In Labor. If You Aspirate & Die, Someone Is Going To Sue Me.”
“You cannot eat in labor. If you aspirate and die, someone is going to sue me.” – OB to mother when the mother listed “be able to eat and drink” on her birth plan.
There are 41 comments to this post.
And there you have it. The truth at last. Policies formed by fear of litigation, and for no other valid reason.
If I allow X to go on, my chance of getting sued is higher, so I will forbid X from being allowed. No other reason needed.
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Christine Reply:
January 30th, 2012 at 11:38 am (Quote)
Isn’t is crazy how warped a health care provider can become that they don’t even ATTEMPT to provide a medical reason? But instead think throwing “litigation” out there is going to swing a woman’s thinking? I mean, seriously, this is just dumb.
To follow your questions from above I would add “And of those who ate, aspirated, and died, how many families sued and WON a lawsuit in which the doc had clearly documented in the medical record advising the pt on the risks of eating while in labor?”
(. . . .crickets . . . .)
Thought so.
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Grrr. What they *really* mean is that if they let you eat and drink during labor, you would be too strong to be bullied into the beginnings of the cascade of interventions that make you into a sheeple and boost their profits.
Oh. Wait. Was I too honest just now?
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Well, as unbelievably rare as it is for a laboring mother to end up dead of aspiration, and as misguided as the OB is, you have to give the doc credit for some refreshing empathy.
“If you aspirate and die, it would be a horrible tragedy for you and your family, and I could never forgive mys…”
Oh, wait.
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Alyson Miers had this to say,
Jan 30, 2012 @ 11:57 am (Quote)
Rather than, you know, “If you aspirate and die, your child will grow up without a mother.”
So, what are the odds that a woman who eats during labor will have to be put under for surgery and aspirate?
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Jane Reply:
January 30th, 2012 at 12:29 pm (Quote)
The last time I checked, 1 in 10000 laboring women aspirated. Because most laboring women aren’t put under general anesthesia.
The irony is that if you do aspirate, straight stomach acid is the worst possible thing to aspirate. So they’re pretty much assuring that if there’s a failure, it’s going to be catastrophic.
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And yet my OB (gasp!) let me eat during labor. She even ordered me a dinner tray when it looked like things were going to be slow going. I ate when I felt like eating, and stopped eating a few hours before I delivered because I just didn’t have an appetite. But I was still drinking juice. Start practicing evidence based medicine, for heavens sake,
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Thats funny. My wife ate and drank whatever she wanted (granted she didn’t want anything for about the last 45 minutes), the WHOLE time she was in labor and she didn’t aspirate and die … that I know of
o.O
*whispers* zombie wife
Time to go check her pulse!
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As someone who has actually gone through that scenerio, I understand why the doc would say NOT to eat.
With my first child, I had an epi and was told not to eat. I said to myself, “Yeah right!!”. I learned my lesson quite quickly. Ten minutes after eating, I was throwing up. My stomach couldn’t digest while frozen. Luckily, I was sitting up when it happened, so there was no chance of asperating while vomiting. It doesn’t happen to every woman, I just know that this was my experience.
Now, for this OB to be worried about being sued is dumb. He should be more worried about mom.
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Jane Reply:
January 30th, 2012 at 12:31 pm (Quote)
Many women vomit during labor.
Aspiration is different, though. You’ve probably vomited a hundred times during your life but never aspirated. Aspiration tends to only happen when someone is anesthetized. And it also depends on the skill of the anesthesiologist.
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Olivia Reply:
January 30th, 2012 at 4:37 pm (Quote)
I’ve actually breathed in my own vomit once (non-pregnancy related). It scared the crap out of me because I thought I was going to die. On one of the heaves, I breathed in and there was still some in my mouth. Thank god that has never happened again. *shudder*
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SculptorAlison Reply:
February 6th, 2012 at 7:26 pm (Quote)
I have too and it was incredibly painful. However, it was only a little bit and I don’t think I’m dead.
Brains?
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kbdidit Reply:
January 30th, 2012 at 1:34 pm (Quote)
It’s pretty normal for women to vomit during labor. Ina May Gaskin actually stated that it can be helpful for dilation. It’s not harmful at all, just yet another natural bodily function. It’s unpleasant but it happens. Even women who don’t eat during labor will vomit occasionally but it doesn’t hurt them and certainly wouldn’t be an occasion for a law suit for the doctor.
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Alyson Miers Reply:
January 30th, 2012 at 2:07 pm (Quote)
I think it’s more likely than not that the OP was hoping to avoid an epidural, and wanted to eat during labor so she’d feel better in general.
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Kim Reply:
January 30th, 2012 at 3:04 pm (Quote)
The only time I’ve ever thrown up while pregnant was when I was in labor with baby #3 and I did it about 20 times (even before my epidural) I was starving with my first baby though, I had my husband run out to Wendy’s and get me a baked potato because the food at the hospital was barely edible 
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Rachel Reply:
January 30th, 2012 at 4:40 pm (Quote)
how often is hospital food edible? I spent 2 weeks in hospital before they induced me with my first… and the food was a horror… every meal… (shuddering at the memory)
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Darsy Reply:
January 31st, 2012 at 6:29 am (Quote)
Actually when I was in the hospital after the birth of my first child, the hospital food was so good that I was really sad when I went home and had to make my own stuff on such little sleep and energy, hehe. Then again, this was a women’s hospital, the primary purpose of which was for childbirth, so their food might have been better on purpose?
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Serene Reply:
January 31st, 2012 at 5:37 am (Quote)
Usually the risk of aspiration from vomitting is because a/ theyre getting a general (or doc thinks he might score a CS on them…), or b/ they will be made to birth on their back. Now me, I LIKE to birth on my back. I spend the final pushing on my back. No idea why, but I like it. As for the rest, no way. Nope. Nuh-uh. I will stay upright. Part of this is because its a protective mechanism. If we are upright when we vomit, we wont inhale it (or are much less likely anyhow). This is atop the normal “labour upright” benefits, mind you. So eating and drinking do not harm anyone in labour, and preventing it is just a doctors way of minimising clinical risk. Nutritional intake in labour is actually quite beneficial, particularly in a prolonged labour or in a diabetic mother. Your stomach will eject any excess when its ready, its quite normal.
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I puke a lot when I get too hungry. Would you rather let me eat and maaaaybe throw up or guarantee it?
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I can’t remember where I read this, but one physician made the compelling point that we may as well tell everyone to fast before driving. If you get in an accident and go to the hospital and have to go under…you could aspirate your lunch from Arctic Circle and die.
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JulietsButterfly Reply:
January 30th, 2012 at 3:41 pm (Quote)
Very true Wendy! If I were to eat lunch and get hit by a car on the way home and be rushed to the ER, what are they going to do if I need surgery? Hopefully they’ll tube me and put me under and monitor me for aspiration. Any hospital that can’t handle emergency anesthesia procedures isn’t one that I think I’d want to deliver my baby at (in the rare case that I actually need their services).
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Bethany Reply:
January 31st, 2012 at 5:51 am (Quote)
I remember reading this too…as a nurse who has worked ER, I know no one waits to find out if the patient’s stomach is empty before intubating PRIOR TO the paralysis & “final knock-out”. Intubating protects against aspiration and provides a relatively closed system of airway and ventilator, if I’m not mistaken. Therefore, if the anesthesiologist or CRNA does their job correctly, aspiration is a moot point.
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Details Reply:
February 1st, 2012 at 5:18 am (Quote)
Thank you Bethany. Right here is the meat of the problem. Aspiration is only a problem when they do a general and you are stuck on your back and can’t help yourself if you do begin to vomit. Therefore the correct preventative is intubation. Secondly siince most women get an epidural if they need a c-section now aspiration shouldn’t even an issue. In the case where the epidrual doesn’t take they should be intubating anyway. Non-issue and not even the OB’s specialty!
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This is one of *the* most basackward things doctors spout. I have a medical issue that causes me to asperate on occassion. Maybe once a month or a little less I end up with stomach acid sucked into my lungs. 1) even when you *do* asperate (say mom did have a general and did asperate) asperation pnemonia is a rare outcome. Far more common is your breathing is a bit messed up for a few days and your chest hurts (I know!) And 2) it is *WAY* worse to asperate undiluted stomach acid. My asperation attacks are scary, painful, and knock me off my feet for a couple of days…the few times my stomch has been *empty* and I’ve asperated undiluted acid I thought I was going to die(reaching for the phone trying to figure out how to call 911 when I can’t breath when my lungs finally started coughing) and it was 100 times worse! Some doc says he’s worried about me asperating my response will be a resounding “then I better eat something!”
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Heather had this to say,
Jan 30, 2012 @ 6:38 pm (Quote)
I almost vomited in labor one time, but vomiting is different than aspiration.
Aspiration carries a risk of: no harm, Pneumonia or death. All depends. If you’re under general with a oxygen mask on you’re more likely to aspirate when you vomit. When laboring normally you can vomit without aspiration easily.
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With my first child, I had 18 hours of labor and they wouldn’t let me eat at all. However, the same hospital with my second allowed me to eat as much as I wanted during my induction. I ate dinner and then an hour and a half later had my daughter. At the time I really wanted that epidural but in hindsight…yeah I preferred getting that last hit of Chick Fil’ A.
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Add Your Comment.
Really? When was the last time you performed a C-Section with the patient under a general? What percentage of your C-sections are done with general anesthesia? And how many patients under general anesthesia for any procedure in this hospital have aspirated, much less died, in the last year?
And during a C-section would a patient not be under observation by at least the anesthesiologist, if not also their birth partner, and perhaps a nurse?
So yes, if a patient aspirated and died, someone might get sued, but that would be because it would only happen due to extreme negligence, not my desire to eat this PB&J.
*Munch!*
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