Drinking in Labour
If you’ve seen a lot of births in the movies, you might have the impression that once you’re in the hospital, you’re no longer allowed to drink water. We’ve all seen film scenes where women are limited to crunching ice chips to quench their thirst. In reality, this is not true. Drinking fluids is not only permitted during labour, but important.
Labour is an intense, physical experience, with extended, demanding muscle work. Like any sport, it can be very dehydrating. And just like in any sport, it is beneficial to stay hydrated.
When muscles get dehydrated, they can cramp up. This can be very uncomfortable. But in labour, the feeling of a cramped muscle can become confused with the sensations of the contractions, so that the contractions are more painful than they would otherwise be. A labouring person wouldn’t know that dehydration is causing additional and unnecessary pain, but would likely assume that contractions are just always that bad. Needless to say, this can make labour more difficult, more uncomfortable, and less manageable. It can lead to more requests for medical forms of pain relief, and a misleading impression about what labour usually feels like. This alone is a pretty good reason to stay hydrated.
But it’s not the only reason. A cramped muscle does not work very well. The uterine muscle has to do an impressive amount of work during labour, flexing and pushing for many hours if not days. Like any muscle, it needs to be well tended, nourished, and lubricated. It cannot run on empty. If dehydrated, labours often dwindle, slow down, sputter, and stall. Or even if the uterus keeps contracting, the efforts become fatigued, less effective, and dilation often slows to a crawl or stalls altogether.
If your care providers suspect you are dehydrated, a urine test will often be proposed, and if it’s confirmed, an IV of fluids will usually be recommended. While an IV of fluids does indeed hydrate, it also comes with a few downsides, such as limited mobility, less access to comfort measures such as bathtub immersion or stair climbing, and the discomfort of the needle itself. As well, fluids entering your veins can sometimes exacerbate an oedema effect that some people experience after the birth, such as swollen ankles or feet. Even babies are sometimes more puffy from the intravenous fluids the mother has received during labour, which might give them an artificially high birth weight, and cause concern when they shed the weight over the next several days. Sometimes this can lead to advice for unnecessary supplementation, which can then pave the way towards breastfeeding/chestfeeding challenges.
So staying hydrated is important. But how much fluid does one need in labour? How does one calculate the amount since labours can vary so much in length and intensity? Here’s an easy formula to remember that applies across the board: on average, people need a minimum of one sip after every contraction. This will result in continuous hydration, and the total volume of fluids will be greater or lesser depending on the length of the labour. The “one sip” is the minimum–if she takes several sips, that is perfectly fine.
The labouring person will become increasingly focused on coping, and may not remember to drink liquids. Or more to the point, she will get deeper and deeper into the hormone-infused trance-state of labour, and may lose the capacity to think about anything else–and nor should she have to. It is very helpful for partners and attendants to take on all support tasks, including remembering to hydrate. This allows her to sink into the oxytocin-rich mental state that is wordless and timeless, without the aggravation of having to identify or verbalise her thirst.
The wordless part is also important. Rather than ask if she’s thirsty, it is more helpful for partners and support people to simply hold the drink in front of her between contractions, which invites her to have a sip without any talking. Finding words is an effort, and it can interrupt her labour trance. Even interpreting words can be disruptive to her focus, so best to offer fluids with silent gestures.
This is easiest if you have some bendy straws. The kind that hold their shape when you bend them are particularly useful, because you can offer the straw regardless of her position. If her hands are under her head, or she is leaning on something, or if she is on her hands and knees, you can position the straw in front of her with minimal disruption. You don’t have to ask her to move, or even to open her eyes.
As for what to drink, water is obviously important. We all need water during physical activity, and labour is no exception. But water alone isn’t always enough. It can be beneficial to alternate water with beverages containing electrolytes. This might include sports drinks, coconut water, clear juice, or “labour-ade”, which is a labour-specific drink you can make yourself. Here are some recipes. Generally, offer water for a while, and then switch to electrolyte beverages for a while, and then back to water. If she turns her head away, switch to a different drink. It’s unlikely that she’s not thirsty, but she may be tired of that particular flavour.
Some people vomit during labour. While this may sound atrocious, it’s not usually your main focus. Often, people don’t even feel particularly nauseous, they just suddenly realise they’re about to throw up–they do–and then they don’t think about it again. Many people throw up once or twice during transition, and some people throw up every few hours throughout the entire labour. It’s caused by the rising hormones, and is not a reason to limit food or beverages. Quite the opposite. It is a cause to increase fluids. The formula now becomes: One sip after every contraction AND one sip after every vomit. Or several sips–again, one sip is the minimum.
The final thing to know about labour hydration is that it needs to continue through second stage labour as well. Even while she’s pushing, you can continue to offer one sip after every contraction right until the baby is born. Pushing is even sweatier work than first-stage labour, so the need for hydration is as important as ever.
People often wonder what they can do to be as supportive as possible while their loved one is in labour. Being right by her side, holding her hand and wordlessly offering a beverage after every contraction, is a pretty good way to help. It supports the physical and hormonal experience, and it shows attentiveness and care. Bodies work better when sufficiently hydrated, and labouring people feel better when someone is right beside them, tending to their needs.
Stephanie Ondrack has been a member of the Childbearing Society since 2003.
She lives in East Van with her partner, 4 kids, 5 cats, 3 chickens, and 2 rats. You can read her thoughts on child development and learning at www.thesmallsteph.com