A midwifery practice dichotomy on oral intake in labour

Abstract

Objective: to assess the views and practices of midwives regarding oral intake in labour for women with low-risk pregnancies. Design: an exploratory survey design including open- and closed-ended questions. Setting: four hospitals in Sydney, Australia. Participants: 89 practising midwives who provided care for labouring women. Findings: midwives were divided on the issue of what and when labouring women should, or should not, be allowed to eat and drink. The views and practices of these midwives were influenced by the accepted practice in the hospital in which they were employed and the types of midwifery models in which they have practised. Key conclusions: there is insufficient conclusive research evidence to support any stance on oral intake for labouring women. Most information purported by supporters of oral intake is based on anecdotal evidence and assumptions based on the physiology of the body. ‘Nil by mouth’ policies have never been researched while clear fluid policies are based on research performed with non-obstetric patients. Implications for practice: without reliable research evidence for the management of oral intake for labouring women no hospital practice or policy is valid. This leaves midwives with the responsibility of deciding what they believe is the best management for the oral intake of labouring women in their care.