Not everyone in labor needs food and drink restrictions.
Slow labor isn’t automatically “bad.”
“Healthy mom, healthy baby” isn’t the only metric that matters.

Let’s talk through five opinions I hold, why I hold them, and how you can advocate for yourself with confidence.

1) Not everyone in labor needs restrictions on what they eat and drink

Policies vary widely—by country, hospital, and even provider. Some countries encourage fueling in labor (marathon, not sprint). In much of North America, the culture leans restrictive.

Here’s my stance: if a laboring person feels like eating, especially during a long labor, it should be a shared decision, not a blanket “no.” Your anesthesiologist (and provider) should explain risks vs. benefits and site policy. Once you understand the risks, bodily autonomy matters.

What are the risks?

Vomiting is common in active labor. If your stomach is full, it can come back up.
The rare but serious scenario is aspiration under general anesthesia (if you unexpectedly need an emergency cesarean and can’t have a spinal/epidural). That chain involves a lot of “ifs,” but it’s the root of many NPO (nothing by mouth) rules.

I’ve done a full breakdown in my Eating & Drinking in Labor video (linked in the YouTube description). The data often cited is old, the absolute risk is small, and informed choice matters.

Bottom line: If you understand the risks and your body is saying “I need fuel,” a universal restriction doesn’t fit everyone.

2) “Slow” labor isn’t automatically a problem

Somewhere along the way, a clock started the minute contractions began—and crossing invisible time lines became “bad.” Yes, sometimes time matters (if baby is not tolerating labor, there’s excessive bleeding, infection, or you’re exhausted and unwell). But arbitrary timelines don’t belong in every birth.

The term “failure to progress” has (thankfully) shifted to arrest of progress. Here’s the gist of current thinking:

Active-phase (first stage) arrest: ACOG suggests defining this as no cervical change at ≥6 cm with ruptured membranes after 4 hours of adequate contractions or 6 hours of inadequate contractions with oxytocin.
ACOG also notes this is a conditional recommendation with low-quality evidence—so individualized, shared decision-making is key.

What that means on the floor:

If you’re coping, baby looks good, and there is some progress (and remember, progress isn’t only dilation—it can be station, rotation, effacement), more time can be reasonable.
If you’re unwell or baby is in distress, the calculus changes.

ACOG does go on to recommend cesarean for active-phase arrest—but again, flags the evidence quality as low. Context matters.

Reality check: Units get busy; staffing ebbs; multiple examiners can interpret dilation differently. Don’t be afraid to ask:

“What specifically concerns you?”
“Can we reassess in an hour after position changes and rest?”
“What are the risks/benefits of more time vs. moving to the next step?”

3) Clichés can hurt: “Your body knows what to do,” “Babies come when they’re ready,” and even “Healthy mom, healthy baby”

I steer clear of these blanket phrases. Why?

I’ve cared for families with preeclampsia, preterm labor, PPROM, NICU stays, stillbirth, and loss. For them, “your body knows what to do” or “baby comes when they’re ready” can sting.
And “healthy mom, healthy baby” being the only goal? That’s the bare minimum, not the bar. It can dismiss birth experience, trauma, and autonomy.

Nuance matters. Read the room. For some, a grounding mantra helps. For many, thoughtful, specific support lands far better than a slogan.

4) Not everyone needs to be strapped to a monitor the entire time

I love intermittent auscultation (hands-on listening) for appropriate low-risk labors. It gives freedom to move, shower, tub, and change positions—often improving progress and comfort.

Three ways we monitor baby in labor:

Continuous external EFM (two belts: one for contractions, one for fetal heart rate).
Continuous internal (fetal scalp electrode), used when we need the most accurate tracing or the external signal is unreliable/concern is high.
Intermittent auscultation (doppler at set intervals, then off if reassuring).

Professional guidance (summarized):

SOGC (Canada): No evidence supports routine continuous EFM for low-risk; hands-on listening is preferred for low-risk term, singleton, spontaneous labor.
ACNM (US): Recommends hands-on listening as the preferred method for low-risk.
ACOG (US): Endorses hands-on listening as an appropriate and safe alternative to continuous EFM for uncomplicated labors. Multiple reviews also note no significant reduction in perinatal death/cerebral palsy with continuous EFM in low-risk—and higher rates of cesarean/assisted vaginal birth with routine continuous EFM.

So why the belts for everyone? Practical constraints: staffing, fewer dopplers, training comfort, and time. But if you’re low-risk, ask whether you qualify for intermittent monitoring.

5) Everyone should automatically see a pelvic floor physio and a lactation consultant after birth

This shouldn’t be controversial—and yet, here we are.

Pelvic floor physiotherapy can help with:

Strengthening and rehab
Urinary incontinence, prolapse, diastasis recti
Pain reduction and improved sexual function
Overall postpartum well-being

If we offer covered rehab for sports injuries, why not for bodies that just did the most?

Lactation support is similar. We say “breast is best” and “breastfeeding is natural,” then too often leave families to struggle alone. Imagine if every postpartum patient saw an IBCLC before discharge. If you don’t need them—great. If you do, help is right there, right then, when it’s most effective.

My take: Make pelvic floor PT and lactation consults standard postpartum care. Period.

Quick lightning-round opinions I stand by

Convenience is not a reason to require pushing flat on your back. If your clinical picture allows it, positions that use gravity (side-lying, hands-and-knees, supported squat) can help.
Your baby won’t “look like a name” at birth. They’ll look like… a baby. You’ll grow into the name you love—promise.
Pitocin isn’t always the answer. It can be helpful and life-saving when indicated, but it’s one tool among many (position changes, rest, hydration, bladder emptying, environmental support, and—yes—time).

How to advocate for yourself (scripts you can use)

“Can we review my risk level and whether I qualify for intermittent monitoring?”
“I understand the aspiration concern. Given my situation, what are reasonable options for light fuel?”
“What specific criteria are you using for arrest of progress, and can we try position changes and an hour of rest before deciding?”
“What are the benefits and risks of Pitocin for me right now, and what alternatives would you consider first?”

Sources & further reading

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Controversial (But Important) Opinions from a Labor & Delivery Nurse