The obstetric textbook Midwifery by Ten Teachers, published in 1931, states that “the patient should be encouraged to take light food during the first stage of labour.”1 In 2000, the Guide to Effective Care in Pregnancy and Childbirth noted, “that food and drink should be withheld once labour has commenced is almost universally accepted in hospital care.”2

In the linked randomised controlled trial (doi:10.1136/bmj.b784), O’Sullivan and colleagues assess the effect of allowing women to eat a light diet during labour on the spontaneous vaginal delivery rate.3 The authors provide evidence in their introduction that professional attitudes and clinical practices in relation to eating during labour still vary greatly within and between countries. Some maternity units limit oral intake to ice chips and drinks of water for all women in labour. This is to minimise the risk of pulmonary aspiration (Mendelson’s syndrome) …