The Effect of Oral Honey- Date Syrup Intake during Labor on Labor Progress of Nulliparous Women

Document Type : Original Article


1 Lecturer, Faculty of Nursing & Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.

2 M.Sc. in Midwifery, Emam Sajad Hospital, Shahriyar, Tehran, Iran.

3 Assistant Professor of Biochemistry & Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

4 Associate Professor of Biostatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

5 Gynecologist, Emam Sajad Hospital, Shahriyar, Tehran, Iran


Introduction:Poor progress of labor is the most common leading cause of cesarean section. Oral intake during labor is one of the strategies to prevent dystocia among low-risk nulliparous women. To date, little is known about the influence of oral intake on labor progress and the most appropriate foodstuff during labor. The purpose of this study was to determine the effect of oral honey date syrup during on labor progress in nulliparous women.
Methods: In a double-blind randomized clinical trial, 90 low-risk nulliparous women aged 18-35, between 37-42 week gestation, singleton fetus, vertex presentation and spontaneous beginning of uterine contractions were enrolled at Sajad hospital in Shahriyar Tehran in 2007 .They were randomized to the intervention, placebo or usual care groups. At labor, after a cervical dilatation of 4 cm to delivery, women in the intervention and placebo groups received honey-date syrup and placebo; respectively. The women in the usual care group were restricted to small quantities of water as desired. Labor progress was compared among the groups using ANOVA, Kruskal Wallis and Chi-Square tests.
Results: Normal labor progression rate was higher among honey-date group than two other groups (96.7% vs. 66.7% in placebo and 60.0% in usual care group p<0.002). Labor duration was also shorter in the group taking honey date syrup than two other groups (351.0 minutes vs. 484.2 in placebo and 475.7 in usual care groups, p<0.001).
Conclusion: In our study oral honey-date syrup induced high rate of normal labor progress. It may be used during labor to prevent prolonged labors but more research is warranted to clarify these associations.


1. World  Health  Organization. Evidence  and  information  for policy. Available  at: Accessed Jul 23, 2006. 2. Hofmeyr GJ. Obstructed labor: using better technologies to reduce mortality. Int J Gynecol Obstet 2004 
Jun;85 Suppl1:S62­72.
3. Lowe NK. A review of factors of associated with dystocia and cesarean section in nulliparous women. J 
Midwifery Womens Health 2007 May­Jun;52(3):216­28.
4. Hammamy E, Arulkumarans S. Poor progress of labour. Curr Obstet Gynaecol 2005;15(1):1­8.
5. Simkin P, Ancheta RS. The labor progress handbook: early interventions to prevent and treat dystocia. 2nd ed. Oxford: Blackwell; 2005. 6. Tranmer JE, Hodnett ED, Hannah ME, Stevens BJ. The effect of unrestricted oral carbohydrate intake on 
labor progress. J Obstet Gynecol Neonatal Nurs 2005 May­Jun;34(3):319–28. 7. Enkin M, Keirse MJ, Neilson  J, Crowther C, Duley L, Hodnett E, et al. A guide to effective  care in  pregnancy and childbirth.3rded. New York: Oxford,2000. 8. American  College  of Nurse Midwives. Intrapartum nutrition: clinical bulletin 1999;3. Available at: Accessed Jun 8, 2007. 9. WHO. General aspects  of care in  labour(part2): nutrition. Available at: normal_ birth_ Practical_  guide. Accessed Mar 7, 2006.
10. Sleutel M, Golden SS. Fasting in labor: relic or requirment. J Obstet Gynecol Neonatal Nurs 1999 Sep– 
Oct;28(5):507–12. 11. Oral Intake During Labour3. Available  at: http//Library.uws.Edu.Au/adt–NUWS/uploads/approved/adt­ NUWS20060706. 131824/ public /04 chapter3. Pdf. 12. Scheepers HCJ, de Jong PA, Essd GGM ,Saskia LC,Kanhai HHH. Carbohydrate solution intake during 
just before the start of the second stage:A double­blind study on metabolic effect and clinical outcome. BJOG 2004 Dec;111(12):1382­7.
13. Hawkins J. Aspiration  risk  and NPO status  during labor. 2003. Available  at: Accessed Jun 8, 2007. 14. Lamaze Institue for Normal Birth. Care practices that promote normal birth(4: No Routine Intraventions). 2003. Available at: Jun 8,2007.
15. World Health Organization. Pregnancy, childbirth, postpartum and newborn care:A guide for essential
practice:Integral manangment of pregnancy and childbirth.Geneva;2003:D6­10.
16. Scheepers HC, Thans MC, de Jong PA, Essed GG, Le Cessie S, Kanhai HH. Eating and drinking in labor:
the influence of caregiver advice on women,s behavior. Birth 2001 Jun;28(2):119­23.
17. Kubli M,  Scrutton MJ,  Seed PT, O'Sullivan  G.An  evaluation  of isotonic “sportdrinks”  during labor. Anesth Analg 2002 Feb;94(2):404­8.
18. O'Sullivan G, Liu B, Hart D, Seed P, Shennan A. Effect of food  intake during labour on  obstetric  outcome: randomized controlled trial. BMJ 2009 Mar 24;338:b784.
19. Seeds N.The importance of eating and drinking in  labour. 2005. Avaliable at: Accessed Jun 8, 2007. 20. Klein S, Miller S, Thomson F .A book for midwives: care for pregnancy, birth, and  women’s health, new ed. Available at: Accessed Dec 30, 2005.
21. Amer WM.  Alckemy in Islamic times: history of botany Part1". Available at: http://www.Levity.Com/alckemy/islam08.html­36k. Accessed Jun 5, 2006.
22. Aliaghaei M, Mirnezamizeiabary SH. Honey therapy. .3nded. Tehran:Nourpardazan Publisher; 2000: 17­
21.[Persian]. 23. McArdle WD, Katch FL, Katch VL. Exercise physiology: energy, nutrition and human performance. 5th 
ed. Philadelphia:Lippincott Williams & Wilkins;2001: 21.
24. Morgan G, Hamilton C. Practice guidelines for obstetrics & gynecology.2nd ed. Philadelphia:Lippincott
Williams & Wilkins;2003: 59.
25. Scrutton MJ, Metcalfe GA, Lowy C, Seed PT, O'Sullivan G. Eating in labour. A randomised controlled 
trial assessing the risks and benefits. Anaesthesia  1999 Apr;54(4):329­34.