The appropriate oral intake for labouring women has long been a controversial issue among midwives and anaesthetists. Anaesthetists argue that any type of food and, to some extent, fluid consumption during labour, will increase a woman’s risk of gastric content aspiration if general anaesthesia is required. Many midwives believe that aspiration, being such a rare event with contemporary medical practice, is unlikely in the hands of a skilled obstetric anaesthetist. These midwives believe that labouring without any form of sustenance other than water or clear fluids may be detrimental for the woman, her baby and the progress of labour. To date, research has been unable to provide reliable information to support either side of this debate. This thesis presents a series of studies (three surveys and a comparative trial) designed to enhance the body of knowledge available for decisions about labouring women’s oral requirements. The surveys were conducted to describe the policies of hospitals in New South Wales, Australia, and the views and practices of anaesthetists and midwives regarding the oral intake of labouring women. The main findings of this thesis come from a comparative study conducted to explore the effect of eating or not eating food on labour and birth outcomes of 217 nulliparous women with low risk pregnancies, (Eating group = 123; Non-eating group = 94). The study employed a naturalistic approach to its design in order to capture the actual eating behaviour of labouring women rather than the manipulated approach used in a randomised control trial. The findings from this series of studies suggest women should be informed of the lack of evidence to support any dietary regime for labour, along with the possible risks and benefits, and allowed to make their own decisions about their oral intake needs for labour. Although this thesis has augmented knowledge, it has been unable to demonstrate that eating food during labour improves labour and birth outcomes. However, it did not find this practice to be harmful for mothers or babies. The lack of reliable research evidence on which to base practice decreases the ability of midwives to be assured of the ‘best practice’ for labouring women’s oral intake. Further research is essential to ascertain ‘best practice’ for this aspect of care. / Doctor of Philosophy (PhD)
| Identifer | oai:union.ndltd.org:ADTP/185831 |
| Date | January 2005 |
| Creators | Parsons, Myra, University of Western Sydney, College of Health and Science, School of Nursing |
| Source Sets | Australiasian Digital Theses Program |
| Language | English |
| Detected Language | English |
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