Eating and Drinking in Labor: A Step toward Reclaiming Autonomy in Birth

Editor’s note: This article first appeared in Midwifery Today, Issue 129, Spring 2019.
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Traditionally, women in labor have been able to eat and drink as they desired. Most birthing women still eat and drink in parts of the world where Western medicine hasn’t yet transformed traditional birthing practices. In colonial times, as Lying-In: A History of Childbirth in America informs us, “female attendants provided food and drink for the laboring woman to keep up her strength, offering such things as toast, buckwheat gruel, mutton, broth, and eggs” (Wertz and Wertz 1989, 15).

Groaning beer is an English tradition that goes back centuries. Midwives and female attendants consumed the rich brew themselves and offered it to the new mother, whose milk production was meant to benefit. However, modern research tells us that beer won’t necessarily help with breastfeeding. Although hops promote relaxation and malted barley stimulates prolactin, alcohol consumption reduces milk production, possibly cancelling the other benefits.

Another ancient British birthing tradition, groaning cake, is always beneficial. A dark bread or cake, created with whatever combination of rich ingredients the household had on hand—molasses, eggs, honey, nuts, carrots, sprouted grains—and usually flavored with apples and spices, resulted in a delicious and nourishing refreshment for the birthing mother and anyone else present. Novelist Ami McKay’s The Birth House is a fictionalized account of the clash between a traditionally trained midwife and a medically minded physician in World War I-era Nova Scotia. The novel mentions groaning cake and the benefits of distracting the mother in early labor with a baking project that yields a nourishing treat for later, when she might really need the sustenance. (McKay’s website includes a recipe for a modern version:

Midwives may have been more adept at pulling together a groaning cake from ingredients on hand than doctors would have been, but even physicians in the nineteenth and early twentieth centuries acknowledged laboring women’s need for fuel and encouraged them to partake as they felt able. The Manner Born: Birth Rites in Cross-Cultural Perspective quotes an obstetrical text published in 1816 that advises, regarding the laboring mother, “She should be supplied from time to time with mild bland nourishment in moderate quantities. Tea, coffee, gruel, barley water, milk and water, broths, etc., may be safely allowed” (Dundes 2003, 18).

Anthropologist Brigitte Jordan’s Birth in Four Cultures is based in part on the author’s fieldwork shadowing a village midwife in rural Mexico in the 1970s. The Mayan mothers Jordan observed were encouraged to eat if they chose. “If initially it appears that progress might be slow, we might have time to go home briefly, or we might have a meal of frijoles and tortillas with the family in their cooking hut, possibly joined by the expectant mother” (Jordan 1993, 32).

Leading up to my own eight births, I read and re-read the labor and birth stories in the first half of Spiritual Midwifery. Always amazed by the variety of the women’s experiences, I was especially reassured by the normalcy of labor and birth for them and how easily many of the mothers integrated this momentous life passage into their daily lives. They cared for other children, cleaned, walked about, prepared food, and ate and drank during early labor, before the work of birthing a baby required their focused attention (Gaskin 2002). I was able to do all those things, as well, during early labor for my own homebirths.

Most American women who gave birth in a hospital from the late 1940s until very recently were prohibited from consuming any food or drink, with the possible exception of sucking on ice chips. That onerous, and often counter-productive, restriction was the result of the work of one man, Dr. Curtis Mendelson. Mendelson began attending births at Cornell-affiliated New York Hospital in the 1930s. He noticed a disturbing pattern after several occurrences of aspiration in his hospital and went on to examine the data for 44,016 births that took place between 1932 and 1945. Among the mothers were 66 cases—1 in 667, or 0.15 percent—of aspiration during surgery. Two of those mothers died. He concluded that we can inhale our stomach contents under general anesthesia, causing pneumonitis and possibly death. He presented his findings in a paper published in 1946 and his name became linked with the respiratory condition caused by such aspiration, Mendelson syndrome (Mendelson 1946).

Among the best choices are easily digested carbs and nourishing liquids:
toast with jam
crackers with nut butter
Jell-o, applesauce
frozen fruit, especially bananas or berries
coconut water
fruit juice
potatoes or sweet potatoes
granola bars

The policy of NPO—nothing by mouth, with IV lines used to maintain hydration—spread rapidly, quickly becoming a standard part of hospital culture. That policy continued for decades, while other aspects of hospital care changed. Mendelson’s original study looked at births during the 1930s and ’40s, when women who underwent obstetric surgery received general anesthesia and only rudimentary methods of airway protection existed. In recent decades, most birthing women who receive anesthesia, including those undergoing cesarean, receive regional or epidural anesthesia and hospital staff are adept at intubation and other sophisticated techniques to maintain an airway. The risk of Mendelson syndrome is vanishingly small these days.

A 2013 Cochrane review that looked at five studies and 3130 mothers concluded that “women should be free to eat and drink in labor, or not, as they wish” (Singata et al. 2013). In 2015 the American Society of Anesthesiologists reported only one, non-fatal, case of childbirth-related aspiration in the US between 2005 and 2013. They amended their official stance on nourishment during labor to recommend a light meal for healthy mothers.

Not being able to eat or drink can pose its own risks. Stress increases catecholamine levels and can prolong labor. The uterus is composed mostly of muscle and needs plenty of fuel to provide the energy to birth a baby. Food may not always appeal to a birthing mother, but the choice should be hers, with a range of options available.

Women who birth in hospitals often aren’t offered many real choices. The long-lingering restrictions on oral intake were part of a larger pattern of forcing women to conform to an authoritarian system that doesn’t always base policies on evidence or take individual needs into account. Redeeming the right to choose food and beverages during labor is one step toward reclaiming the sacred ground of birth as a woman-centered space. And for women laboring at home, eating and drinking is just one of many ways a new mother can integrate labor and birth into the routines of life in a natural way.


  • Dundes, Lauren, ed. 2003. The Manner Born: Birth Rites in Cross-Cultural Perspective. Walnut Creek, California: Altamira Press.
  • Gaskin, Ina May. 2002. Spiritual Midwifery. Summertown, Tennessee: Book Publishing.
  • Jordan, Brigitte. 1993. Birth in Four Cultures. Long Grove, Illinois: Waveland Press, 4th ed.
  • McKay, Ami. 2006. The Birth House. New York: William Morrow.
  • Mendelson, CL. 1946. “The Aspiration of Stomach Contents into the Lungs during Obstetric Anesthesia.” Anesthesiology 11(7): 694–95.
  • Singata, M, et al. 2013. “Restricting oral fluid and food intake during labour.” Cochrane Database of Syst Rev 8: CD003930. DOI: 10.1002/14651858.CD003930.pub3.
  • Wertz, Richard W, and Dorothy C Wertz. 1989. Lying-In: A History of Childbirth in America. New Haven: Yale University Press, expanded ed.

About Author: Mary Ann Lieser

Mary Ann Lieser is a freelance writer and doula, and sells used books in Wooster, Ohio. She is the mother of eight homebirthed children.

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