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NPO means “nothing by mouth”, from the Latin nil per os. Our guidelines for food intake during labor have integrated the recommendations from the American Society of Anesthesiologists practice guidelines for obstetric anesthesia and the Society for Obstetric Anesthesia and Perinatology task force.1–3


  • Moderate amounts of clear liquids for uncomplicated laboring women. Clear liquids must be nonparticulate, e.g., water, carbonated beverages, sports drinks, fruit juices (no pulps), tea, and black coffee.

  • Avoid milk, cream in the tea and coffee.

  • Solid food should be avoided.

  • Patients with increased risks for operative delivery have further restrictions on food intake.


  • Last regular meal up to 8 hours prior.

  • Light, low-fat snacks (e.g., crackers, one slice of dry toast) up to 6 hours prior.

  • Clear liquids (carbonated, nonparticulate 45-g carbohydrate beverage) up to 2 hours prior.

  • Patients with increased aspiration risks (morbid obesity, long-standing diabetes, difficult airway) may have further restrictions on food intake.


  • NPO as soon as the decision for cesarean delivery is made.

  • Depending on the urgency of delivery, anesthesia and obstetric team decide timing based on last intake.

  • May utilize ultrasound to assess gastric content.


1. +
Practice Guidelines for Obstetric Anesthesia: An Updated Report by the American Society of Anesthesiologists Task Force on Obstetric Anesthesia and the Society for Obstetric Anesthesia and Perinatology. Anesthesiology. 2016;124(2):270–300.  [PubMed: 26580836]
2. +
Considerations for NPO Guidelines and Gastric Emptying during Labor. SOAP Task Force for OB/GYN Continuing Education; 2019.
3. +
Beth Israel Deaconess Medical Center. PPGD CP-PP 22 enhanced recovery after cesarean delivery (CarePath). Accessed April 2022. Use with permission.

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