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The wheels of progress seem to turn excruciatingly slowly over at the American College of Obstetricians and Gynecologists (ACOG). The organization has just come out with official policy that reverses its position on withholding beverages from birthing women. The lightbulb has finally come on: Nothing is helped by completely starving a woman and her unborn baby.
Midwives needn’t worry that this will send homebirthers rushing into the hospital for their births. It will likely take another 30 years for ACOG to come up with a policy about what kind of drink might be most helpful and how to get it out of food services at 3:00 a.m.
The homebirth experience provides a window into what happens with the human mammal who is not told what to eat or drink, and who can open her own fridge or cupboard any time she wants. When a woman eats to her own satisfaction in the early birthing hours, that food does not digest in the usual way. The hormones of birth slow digestion to a crawl. However, the food in the stomach provides energy, via sugars, to the birthing woman and baby.
The reason that some women vomit when nearing the pushing stage is that the body automatically calibrates how much sugar is needed and, at transition, the levels drop dramatically in order to protect the baby’s brain from a lactic acid buildup while the baby’s head is being compressed and pushed through the pelvis. Where did I learn this? An amazing article published in Scientific American many years ago.
An unmedicated birth is a very trustworthy process. Wholesome nutrition taken in through the mouth (as opposed to through an IV) will be absorbed or ejected in the best interests of the baby and mother.
1976: My Personal Homebirth Experience
I had a vision for my birth. While baking muffins, I would squat down to open the oven door, and push the baby out. My friends and attendant would exclaim, “You are amazing!”
So when I began having regular sensations at 8 a.m., I got up and began baking the muffins. In labor, I baked all day. There were muffins piled on every counter surface. I ate quite a few of them, washing them down with orange juice. At 2 a.m. the next day, it all came out of me, vomited up completely undigested. I pushed the baby out about an hour later. Needless to say, my actual birth was a lot more down-and-dirty than the one I’d envisioned.
Over the years, I’ve seen some unusual eating patterns in women birthing at home. There is so much in birth work that defies the general rules that I feel rudderless at times, which leads to a temptation of making up rules to live by. I realized one day that I only knew one thing that was consistently true about birth: No one can eat during the pushing stage. That rule comforted me, even when everything else in obstetrics seemed chaotic. Then, during a home birth of a second baby, the mother asked, “Do we still have some of those Rusk biscuits?” She was handed the dry, Dutch cracker and munched it down. I was appalled! She was defying my rule!
So much for my nice theory. But since the mind abhors a vacuum, I made up a new rule: No one can eat when the baby’s head is crowning. That, too, was good for quite a while. Eventually, however, a first-time mom said at full crowning, “Can I have a few raisins?” There went that rule, too, darn it.
I pity the folks at ACOG who they think they can make protocols, rules and guidelines that will cover all births in all situations. A better goal would be to have clinicians who could think for themselves, distinguish complications from a normal birth, relax when things are taking a while, and marvel over the consistently fascinating process of human birth.
About the Author:
Gloria Lemay is a lecturer, midwifery educator and traditional birth attendant in Vancouver, BC, Canada. She specializes in VBAC and water birth. She has served birthing women since 1976 and is an advisory board member of ICAN and a contributing editor of Midwifery Today magazine. A mother and grandmother, Gloria wants her tombstone to read, “She spoke up for babies.”
01 December 2009