Birth & Labour

Care in normal birth: a practical guide (WHO 1996)

Care in normal birth: a practical guide

Authors: World Health Organization, Maternal and Newborn Health/Safe Motherhood Unit

Publication date: 1996

WHO reference number: WHO/FRH/MSM/96.24 (English and French)

This report identifies the most common practices used throughout labour and attempts to establish some norms of good practice for the conduct of non-complicated labour and delivery. You can read it here.

Food During Labour

Eating and drinking in labour—Cochrane Review

Restricting oral fluid and food intake during labour

Singata M, Tranmer J, Gyte GML

Cochrane Database of Systematic Reviews 2010, Issue 1. Art. No.: CD003930. DOI: 10.1002/14651858.CD003930.pub2.

“In some cultures, food and drinks are consumed during labour for nourishment and comfort to help meet the demands of labour. However, in many birth settings, oral intake is restricted in response to work by Mendelson in the 1940s. Mendelson reported that during general anaesthesia, there was an increased risk of the stomach contents entering the lungs. The acid nature of the stomach liquid and the presence of food particles were particularly dangerous, and potentially could lead to severe lung disease or death. Since the 1940s, obstetrical anaesthesia has changed considerably, with better general anaesthetic techniques and a greater use of regional anaesthesia. These advances, and the reports by women that they found the restrictions unpleasant, have led to research looking at these restrictions. In addition, poor nutritional balance may be associated with longer and more painful labours, and fasting does not guarantee an empty stomach or less acidity.

This review looked at any restriction of fluids and food in labour compared with women able to eat and drink. The review identified five studies involving 3130 women. Most studies had looked at specific foods being recommended, though one study let women to choose what they wished to eat and drink. The review identified no benefits or harms of restricting foods and fluids during labour in women at low risk of needing anaesthesia. There were no studies identified on women at increased risk of needing anaesthesia. None of the studies looked at women’s views of restricting fluids and foods during labour. Thus, given these findings, women should be free to eat and drink in labour, or not, as they wish.”

Read the Cochrane Review here.

Restricting Food and Fluid Intake During Labor May Not Be Helpful

Laurie Barclay, MD

Medscape Medical News

‘January 20, 2010 — Restricting food and fluid intake during labor may not be helpful or necessary for women at low risk for complications, according to the results of a systematic review reported online January 20 in the Cochrane Database of Systematic Reviews.’

Read full article here.

Effect of food intake during labour on obstetric outcome

British Medical Journal Online

Published 24 March 2009, doi:10.1136/bmj.b784

Ref:BMJ 2009;338:b784

Research: Effect of food intake during labour on obstetric outcome: randomised control trial

Conclusions: ‘Consumption of a light diet during labour did not influence obstetric or neonatal outcomes in participants, nor did it increase the incidence of vomiting. Women who are allowed to eat in labour have similar lengths of labour and operative delivery rates to those allowed water only. ‘

Read full article here

Eating a light diet during labour does not seem to worsen obstetric outcomes

Editorial by Soo Downe

British Medical Journal Online

Published 24 March 2009, doi:10.1136/bmj.b732

CBMJ 2009;338:b732

Read full article here


Exercise ball used in delivery process decreases labor time, reduces number of C-sections

“According to a new study by nurse researchers at Banner Good Samaritan Medical Center, a Phoenix hospital part of Banner Health, a peanut-shaped exercise ball can be a highly effective tool to accelerate the labor process for women with an epidural. The research shows women utilizing the peanut ball were half as likely to undergo a cesarean surgery and delivered babies faster than those who did not use the ball. The results are published in the 2015 winter edition of the Journal of Perinatal Education.” 

Read more here:

Patience During Stalled Labor Can Avoid Many C-sections, Study Shows


Nov. 3, 2008

“Pregnant women whose labor stalls while in the active phase of childbirth can reduce health risks to themselves and their infants by waiting out the delivery process for an extra two hours, according to a new study by researchers at the University of California, San Francisco. By doing so, obstetricians could eliminate more than 130,000 cesarean deliveries—the more dangerous and expensive surgical approach— per year in the United States, the researchers conclude. The study examined the health outcomes of 1,014 pregnancies that involved active-phase arrest—two or more hours without cervical dilation during active labor— and found that one-third of the women achieved a normal delivery without harm to themselves or their child, with the rest proceeding with a cesarean delivery.

Read full article here


NICE Guidelines for Induction of labour

Membrane sweeping for induction of labour. Cochrane Database of Systematic Reviews


Immersion in water in labour and birth

Cluett ER, Burns E. Immersion in water in labour and birth. Cochrane Database of Systematic Reviews 2008, Issue 4. Art. No.: CD000111. DOI: 10.1002/14651858.CD000111.pub3


Immersion in water during the first stage of labour significantly reduces women’s perception of pain and use of epidural/spinal analgesia.

Author’s conclusions:

There is no evidence of increased adverse effects to the fetus/neonate or woman from labouring in water or waterbirth.

See full review here

Immersion in Water During Labour and Birth

RCOG/Royal College of Midwives – Joint statement number 1

April 2006

“All healthy women with uncomplicated pregnancies at term should have the option of water birth available to them and should be able to proceed to a water birth if they wish.”

Read full statement here