Why don't they let women drink water during labor and ask them to chew on ice chips instead?

The responses to this question are really interesting to me because it seems there either was a time or there is currently the practice of this in wherever these answers are coming from. As a midwife in a large hospital in Sydney I have to say that I actively encourage labouring women to drink water (or juice, or whatever they like) during their labour. Labour is hard work, kind of like running a marathon. I wouldn't expect someone to run a marathon dry and so I wouldn't expect a labouring woman to not drink water. We don't put up IV fluids unless we have a reason and in many cases women don't have a IV cannula anyway. Even though we deal with the risk that a Caeserean Section might need to be performed for whatever reason, if a woman has been eating and drinking near that time (or even if they haven't) we give them 30mls of sodium citrate to raise the pH (decrease the acidity) of their stomach contents which lowers the risk of aspiration. I give ice to women who request it, not to avoid drinking water but because they are generally pretty hot and some like it.

Short answer: Actually, there is no good medical reason for this outdated and obsolete policy. Long anwer: This old habit is actually based on obsolete premise:  the aim of keeping the women birthing on nil by mouth is not because after drinking water one would vomit and aspirate so causing aspiration of stomach contents in the lungs causing http://en.wikipedia.org/wiki/Aspiration_pneumonia, but because if during delivery things would go wrong like the deceleration of the fetal heart rate during contractions seen on http://en.wikipedia.org/wiki/Cardiotocography as a sign of http://en.wikipedia.org/wiki/Fetal_distress, needing immediate Cesarian section, in these cases they fear the imagined aspiration risk. So when thirsty one is given ice-chips to give one the feel of wetting the mouth without swallowing a lot of water. We now know that keeping the patient on nil by mouth for 12 hours before surgery is obsolete, outdated, but old habits die hard.  See: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2991655/ It has been known for ages that in the http://en.wikipedia.org/wiki/Lesser_curvature_of_the_stomach two longitudinal folds form a canal the Germans call the gastric canal (Magenrinne) through which when taken on an empty stomach fluids will pass directly from the http://en.wikipedia.org/wiki/Esophagus into the http://en.wikipedia.org/wiki/Duodenum without first collecting in the stomach: Diagram from http://training.seer.cancer.gov/ss_module07_ugi/unit02_sec02_anatomy.html: * 1. http://en.wikipedia.org/wiki/Body_of_stomach * 2. http://en.wikipedia.org/wiki/Fundus_%28stomach%29 * 3. http://en.wikipedia.org/wiki/Anterior_wall * 4. http://en.wikipedia.org/wiki/Greater_curvature * 5. Lesser curvature * 6. http://en.wikipedia.org/wiki/Cardia * 9. http://en.wikipedia.org/wiki/Pyloric_sphincter * 10. http://en.wikipedia.org/wiki/Pyloric_antrum * 11. http://en.wikipedia.org/wiki/Pyloric_canal * 12. http://en.wikipedia.org/wiki/Angular_notch * 13. http://en.wikipedia.org/wiki/Gastric_canal * 14. http://en.wikipedia.org/wiki/Rugal_folds We now permit people without stomach or intestinal passage problems to drink on the morning before abdominal surgery, a drink containing enough calories and proteins has been proven to be beneficial when given 2 hours before surgery, preventing http://en.wikipedia.org/wiki/Insulin_resistance and http://en.wikipedia.org/wiki/Catabolism induced by the surgery. See: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2999216/

If there are problems during delivery, there may be a need to progress to Caesarian section. This is most commonly undertaken under regional anaesthesia (spinal, epidural or combined spinal+epidural), which is the preferred technique. If however the regional technique is contraindicated or fails then a general anaesthetic is required. During a general anaesthetic the conscious level is so depressed that the airway is unprotected. One major problem is regurgitation of stomach contents which can be aspirated, which is a contributing reason for the preference for regional anaesthesia with an awake patient. Preventing women from drinking is designed to minimise the volume of residual stomach contents. Women in labour have increased risk of delayed gastric emptying, due to the mass effect of the uterus, the effect of circulating stress hormones and any opiate analgesia she might have had prior during labour. Progesterones are believed to relax the lower oesophageal sphincter tone, and increased intra abdominal pressures cause increased risk of regurgitation. Additionally there is an increased incidence of difficult intubation (and thus airway protection) in pregnant women compared to the general population. Due to the above, the conventional wisdom therefore is to keep all women nil by mouth during labour "just in case" they need an emergency Caesarian under general anaesthesia (which of course is a small fraction of all women) Eating ice chips is supposed to help keep the mouth moist for comfort, but the same effect could be gained by using wet sponges or even rinsing the mouth with water and spitting. Intravenous fluids can be given, but shouldn't really be required by most healthy women. The problem (as Liang-Hai Sie alluded to) is that people are often unwilling to try new techniques or experiment on pregnant women (or children) due to ethical considerations (eg "what if something went wrong, why would we risk X when we know Y works?" even if Y is rubbish or outdated)

The major medical organization of obstetricians and anesthesiologists feel it's safe to drink water and clear fluids in labor.

Hopefully your birth went well! There is new research out and since I was very low risk for complications (other than needing to be induced at 12 days overdue), I specifically asked my doctor for written permission to eat and drink during the early stages of labor.  I live in Indiana and have a very holistic-minded OB, so we agreed that I would snack slowly but would not have to labor with no fuel. (that just seems cruel....)