Are "Natural Induction Methods" truly Natural?
I know those last few weeks of pregnancy are hard. Your body is worn out. You're more tired than you've ever been in your life and you can't get any sleep between needing to pee and trying to find a comfortable position to rest. You're desperate to end the discomfort and can hardly wait to finally meet your baby.
You've undoubtedly heard about a variety of ‘natural' induction methods. About the same time everyone you know starts calling and texting you asking if you've had your baby, they also start offering suggestions for how you can kick start labor and see your baby sooner.
The thing is, trying to force labor is not natural, and it reduces the likelihood of an unmedicated birth. Your baby and your body know when birth is supposed to happen. They've been working together seamlessly for nine months, creating a miracle. Your body and baby hold the real wisdom of when labor should begin. You've been preparing for natural childbirth for this long, it may be worth the wait to keep things as natural as possible.
Many of these so called natural labor induction methods have just as many dangerous risks as a medical induction and haven't even been proven effective for starting labor.
I’m not saying there is never a reason for induction. In some cases, there are real medical reasons that labor needs to begin sooner. Sometimes, to protect your baby's health as well as your own, labor needs to start sooner than nature intends. Pre-eclampsia, high blood pressure, uncontrolled gestational diabetes, and other complications are legitimate reasons to induce labor. In these cases, some non-medical induction methods may have fewer risks than your care providers protocol, so you may want to try them first. But to induce labor because you're uncomfortable, or your partner will be away, or the timing would be better for you, probably isn’t worth the risk.
Inducing labor in any way always carries the risk of your baby being born prematurely. Ultrasounds and LMP (Last Menstrual Period) dating are not always accurate. Even if you know what day you conceived, sperm can remain alive and well for up to 6 days waiting for a late egg, so you may still be off by several crucial days. Some babies just need more time than others.
Drinking Castor Oil
There are a variety of suggested ways to use castor oil to start labor. Castor oil is an age old remedy for starting labor, made from the Ricinus Communis plant seeds.
Some people take it straight, and others add it to orange juice to make it more palatable. It's quite disgusting on its own. Castor oil stimulates your bowels and your uterus causing both to contract, therefore potentially inducing labor.
At least one study has shown ingesting castor oil to have a 50% effectiveness rate, meaning that 50% of women will go into labor within 24 hours of being dosed with castor oil. (See study here) On the flip side, it also comes with a high rate of causing intestinal cramping, diarrhea, nausea, and even dehydration. Studies have shown the risks of complications for the mother might be lower when castor oil is used, but for the baby, the risks significantly increase. (study) Castor oil may result in a higher risk of suffocation, increased heart rate, and respiratory distress in infants. Babies whose births were stimulated by castor oil may also be more likely to have a bowel movement (meconium) in utero, a common symptom of fetal distress that increases the risk to the baby.
After all that, it might not even work. If you're lucky when it doesn't work you get some mild nausea and diarrhea. For the unlucky it can mean dehydration and severe stomach upset combined with many hours of irregular contractions and still no real labor.
So, should you try castor oil to induce labor?
It's your body and your baby, but you need to weigh the risks and compare them to the benefits. Most people would suggest you discuss it with your health care provider. If you do decide to go for it and try castor oil to induce labor, be sure to stay hydrated and well rested.
Black or Blue Cohosh
Another ancient plant preparation for inducing labor, a tincture of black cohosh and blue cohosh together is said to start labor. The herbs may also be taken in capsules or tea form. They're bitter, so tea is not the preferred modern way to administer black and blue cohosh.
The two herbs are unrelated, but both have been used by North American Native Peoples for a variety of gynecological treatments including labor augmentation.
Black and blue cohosh do appear to cause labor, but there is insufficient information on either herb and no reliable studies to confirm the safety or dangers of using black cohosh or blue cohosh during pregnancy.
Many herbalists and traditional midwives would agree that these herbs are safe as long as a woman is at least 40 weeks along. The traditional midwives I have studied with suggest the use of certain tinctures, such as B&B Labor Formula by Wishgarden that include blue and black cohosh only when contractions have already started, but are somewhat weak and/or irregular. These are signs that your body is already "ripe" and has begun the early stages of labor. The tinctures can act as a "boost" in this case. Using these tinctures under the supervision of an experienced midwife and / or herbalist can be helpful in certain situations.
Like any other method of induction, it's important to weigh the risks and benefits based on your circumstances. A safer alternative to the herbs would be to include Red Raspberry Leaf Tea to strengthen and tone your uterus in the last 4 weeks of your pregnancy, something I recommend to all women.
Evening Primrose Oil
There are many anecdotes about evening primrose oil or EPO, being helpful for ripening the cervix. At least one study has shown that EPO is effective at increasing Bishops Score (a calculation of how prepared for labor the body is based mainly on cervical ripeness, whereby the higher the number, the more favorable the cervix is for labor). But this study also found no significant decrease in the length of labor or how soon it began between women who were assigned to take EPO and those who received a placebo. (study)
There is no reliable data on whether Evening Primrose Oil is safe to consume during pregnancy, but as always, we keep in mind that no research doesn’t make something safe or unsafe, it only means that there hasn’t been enough information gathered.
EPO can be ingested orally, massaged onto the cervix, or capsules may be inserted into the vagina or neck of the cervix. At this point any evidence that EPO is effective for cervical ripening is anecdotal. More research is needed.
Spicy Food
There no evidence that eating spicy food is helpful for inducing labor and unless you usually eat spicy food and enjoy it, I'm going to take the liberty of advising against it. If spicy food is not a dietary staple for you, it’s more likely you’ll end up with heartburn or burning diarrhea than labor.
Acupuncture
Acupuncture is an ancient Chinese medicine practice where tiny needles are inserted into the skin at specific acupuncture points. An herb called mugwort may be burned at the end of the needles to enhance the effects.
Thought to be helpful for most ailments of pregnancy, including morning sickness, back pain, heartburn, pelvic pain, and constipation, acupuncture is considered a safe way to induce labor. Personally I find acupuncture to be extremely effective at balancing and nourishing my system, so I recommend it regardless of wanting to induce labor! Many practitioners and mamas swear by acupuncture for inducing labor. No adverse outcomes from using acupuncture to initiate labor have been recorded.
The downside, even the most die hard acupuncture fanatics say it won't start labor unless your body and your baby are ready. But maybe that isn't a downside at all.
Acupressure
Similar to acupuncture only without the needles, acupressure may stimulate labor if your body and baby are ready. There are several points on the body that are commonly used including the webbing between your thumb and index finger and a spot about four inches above your ankle. Some people suggest a deep calf muscle massage with a pedicure once you’re full term just might do the trick-if not, at least you’ll have pretty toes for your baby’s birth.
To find the correct acupressure points, see this video:
https://www.youtube.com/watch?v=wnEcLSHTI0s
Nipple Stimulation
When your nipples are stimulated it triggers the release of the hormone oxytocin, that's responsible for feelings of love, and your milk let down. Oxytocin also causes contractions and is used in its synthetic form (Syntocin or Pitocin) to induce labor medically. Nipple Stimulation can cause long and intense contractions that stress your baby, but it's also a very effective way to start or augment labor. It is suggested you do it under the watch of your care practitioner to monitor your baby. It's one of the more truly natural methods of inducing labor.
Sex
The theory is that orgasm stimulating the uterus combined with the prostaglandins in semen helping to ripen the cervix and the oxytocin you release when you are intimate with someone you love can jump start labor. Of course, there are plenty of people who have lots and lots of sex and still have a postdates pregnancy. Sex is surely the most fun way to start labor, whether it works or not!
The Safest Way To Induce Labor
Want to get things started without any guilt or risk? Massage, meditation, intimacy with your partner and relaxation, in general, are thought to be helpful for getting labor started. Massage may stimulate oxytocin production and so will intimacy with your partner. Meditation and relaxation will relieve stress that could be causing your body to feel like it isn’t the right time and place for your baby to be born. These methods are truly safe and have nothing but positive benefits, even if labor doesn't start as soon as you hope.
The reality is, inducing labor is an intervention, even if it's done with natural herbs and ancient wisdom. Intervention has its place, but it's always important to weigh the risks and benefits and listen to your intuition about the interventions you are considering. If staying pregnant puts you and your baby at a greater risk than the induction method you'd like to use and it feels right for you… Well, only you can decide what is best for your body and your baby. No one but you should be making decisions about how your labor is augmented.
Your body took a couple of tiny cells and created a complex human being. Trust its wisdom. I know it's hard to stay focused when you're tired and anxious and uncomfortable, but you've got this. You're growing and learning and preparing for the mental challenges ahead. Do your best to find pleasure in these final days. Stay focused on an empowered birth experience, and soon enough your baby will be in your arms.