Water and food fasting during labour: Tunisian midwife's perspective

 

Objective:

Since the 1940s, strict fasting of women in labour has rapidly gained acceptance throughout the

the world. However, this dogma has been challenged by learned societies and official recommendations have evolved in favour of an oral intake in women with low risk of general anaesthesia. The objective of this work was to evaluate the practices and knowledge of Tunisian midwives concerning peripartum fasting.

 

Design :

This was a prospective cross-sectional and descriptive study.

 

Methods:

Our study extended from February 1, 2022 until March 15, 2022. It was conducted online via a self-administrated questionnaire distributed in the format of a "Google Forms". We gathered 68 responds from midwives who worked in the delivery room

 

Results:

Most midwives were older than 40 years. Regarding oral hydration, midwives were permissive in the latent phase (64%). Regarding the active phase, most participants had forbidden any oral hydration (76%). The attitude of the midwives regarding feeding was rather restrictive: restriction was systematic in the active phase for 91% of them and more than half had forbidden it in the latent phase, while 62% had authorised feeding in the immediate post-partum period.

This attitude was most often explained by the fear of the risk of vomiting and inhalation.

More than half of midwives (58.5%) considered they had good knowledge of the current recommendations for fasting in the delivery room.

However, in detail, this knowledge seems fragile and insufficient.

When asked about the indications for fasting in the delivery room, the answers were disparate: fear of general anaesthesia was cited as the main indication.

The risk of vomiting during labour and a previous caesarean section were listed on the second and third place.

Conclusions:

The recommendations of the learned societies are in favour of a permissive attitude concerning water intake in delivery rooms and to a lesser degree for food intake, particularly in the active phase. The midwife has an essential role in monitoring the progress of labour, but also in ensuring the physical and psychological well-being of the mother-to-be.