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The past week, I have been invited as a speaker at a major medical conference in Oslo (held digitally). However, the Norwegians were physically present at the Grand Hotel in Oslo. The Norwegians are about to start a large study on inducing labor (the SAINT study).
What's exciting is that I was invited to speak because they have read and reviewed my studies on bicarbonate during childbirth.
When we conducted the "Samarin study" and the "Giving Birth project," we used bicarbonate (Samarin) as a treatment for stalled labor progress and weak contractions.
The Norwegians have a different approach. They will attempt to administer bicarbonate as a preventive treatment every four hours during induced labor. It's fascinating!
Do you remember how I came up with the idea of using bicarbonate? This post is a little reminder!
The Swedish Olympic Committee's advice on how athletes should prepare for intense exertion:
Bicarbonate can be found in the spice aisle of your regular grocery store, and the cost is just a few kronor.
During high-intensity exercise, the muscles work anaerobically, meaning without oxygen. During anaerobic energy production, lactic acid accumulates in the muscles, causing acidification that limits performance.
One way to improve the body's ability to counteract acidification is to supplement with plain bicarbonate (the main ingredient in baking soda, but baking soda should NOT be used instead). By consuming bicarbonate (0.3 grams per kilogram of body weight) approximately 60-90 minutes before training/competition, one can enhance the ability to perform at a high intensity and produce lactate.
Bicarbonate should be taken with a few deciliters of water.
The Story Behind the Study (drink bicarbonate)
I often have medical students who come to me to do their final projects to complete their medical studies. This means that they work in some of my research projects for a semester and then write a report that needs to be approved by KI (Karolinska Institutet).
This time, a guy came to do his student project. Besides being a student, he was a javelin thrower in the national team and perhaps one of the top 4-5 in Sweden.
Fatigued uterus - weak contractions
When I explain the concept of a fatigued uterus and lactic acid to athletes, they often understand immediately what I'm talking about. In the world of sports, lactic acid is something that is measured and used in training.
Everyone has an individual threshold that they want to stay just below for efficient muscle work. My student told me that his girlfriend also runs 400 meters, representing the national team. His question was, "Why don't you give your patients bicarbonate when they have high lactate levels during childbirth?"
That was the first time I heard about bicarbonate in this context.
"My girlfriend mixes baking soda in water and drinks it before competing to avoid high levels of lactate."
I wondered if that wasn't doping. The answer was no (see the note from the Olympic Committee).
That's when I started thinking. Could this be something for us in childbirth care? I couldn't give women baking soda to drink during labor. That would be super gross.
That's when the idea of Samarin was born.
I happened to have a woman in our delivery ward who drank Samarin because she had an upset stomach. I borrowed the package insert from her Samarin packaging.
It turns out that a small sachet of Samarin contains 2.3g of bicarbonate. We decided to give the women 2 packages, which amounted to approximately 5g. Athletes consume up to 20g, but the disadvantage would be an unsettled and noisy stomach, and possibly nausea.
Therefore, we stuck to the lower dose.
The Samarin Study
The study included 200 women, all in need of labor stimulation (oxytocin) due to stalled labor. With 100 women, we did things "as usual," meaning we connected an oxytocin drip and increased it to an adequate dose of contractions.
The other 100 women drank two packets of Samarin, waited for 1 hour, and then received their drip. The difference was incredible!
The lactate levels in the amniotic fluid significantly decreased in those who drank Samarin, and a larger proportion of the women who consumed Samarin had normal deliveries. Moreover, their newborns were in better condition!
This has spread like wildfire around the world.
Today, when I attend conferences, people from all corners of the world come up to me, wanting to talk and take selfies. I have become a bit of a "Samarin celebrity" 😊.
Now the Norwegians have picked up on this concept and are planning to do things a bit differently. It will be incredibly exciting to see their results!
The Olympic Committee's website on nitrate
Beetroots, broccoli, arugula, and spinach are examples of crops that contain a high amount of nitrate, a substance that has shown positive effects during long-duration and high-intensity exercise. In the body, nitrate is converted into nitric oxide, which affects blood vessels in a way that facilitates oxygen supply to the muscles during exercise.
Oxygen uptake capacity often limits how long one can sustain high-intensity work. Swedish researchers have shown that trained cyclists and triathletes who load up on nitrate for three days consume three to four percent less oxygen when performing a cycling exercise at 200 watts.
A British research group documented that subjects could cycle, at a constant workload, 16 percent longer after six days of nitrate loading. To achieve the performance-enhancing effects of nitrate, no unrealistic amounts are needed—approximately half a liter of beetroot juice or an equivalent amount of concentrate.
However, it's a shame that beetroot juice tastes so awful, in my opinion! It tastes like an old cellar!
It's worth noting that many sports drinks today contain bicarbonate. Perhaps something to consider bringing for childbirth when the time comes to give birth?
/Dr. Eva