08/21/2026
"Nothing by mouth." You may have heard those words in a hospital labor setting — or you may know them by their medical term: NPO, from the Latin nil per os. 🤍
Here's where that policy came from — and why it doesn't hold up in 2026.
The NPO policy began in the 1940s, when women in labor were routinely given inhaled anesthetics like ether and chloroform, or Twilight Sleep — a combination of morphine and scopolamine that caused unconsciousness and no memory of the birth. In that era, aspiration — inhaling stomach contents under general anesthesia — was a genuine risk. The tools to protect the airway simply didn't exist yet.
But we are not in the 1940s anymore.
Anesthesia has advanced dramatically. General anesthesia is now used in fewer than 6% of Cesareans. When it is used, modern airway management tools have reduced anesthesia-related maternal deaths by 60%. The original problem that created this policy has largely been solved — and yet the policy remains.
What does the research actually show?
A Cochrane review of five randomized trials found no evidence of harm from eating and drinking during low-risk labor. A larger review found that women laboring under less restrictive eating and drinking policies had shorter labors — and reported significantly higher satisfaction with their birth experience. Researchers have also noted that fasting can actually make stomach juices more acidic — meaning that if aspiration did occur, fasting could make it more dangerous, not less.
Labor is physical work. Your uterus is a muscle doing one of the hardest jobs of your life. Restricting food and water doesn't protect you — it depletes you.
In my practice, you eat. You drink. You fuel your body for the work it's doing. Because that's what the evidence supports, and because your body is not a liability to be managed — it's a force to be nourished. 🌿
Birth photography by Miranda Slaydon 📸
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