Often as women approach the end of their pregnancy, the question of inducing labour comes up. Usually this conversation happens in the context of your pregnancy going over 40 weeks, which is sometimes referred to as “post dates”. The important thing to remember is that even though we often get fixated on the length of a pregnancy being 40 weeks, a normal human pregnancy can be anywhere between 37 to 42 weeks in length. So where one woman might have her baby at 37 weeks and this is a perfectly normal pregnancy length for her, her next door neighbour mightn’t go into labour until 41 weeks plus 5 days, for example, and this is also perfectly normal for her.
Technically you’re not considered “overdue” until your pregnancy is 42 weeks plus 1 day in length. Also interesting to know is that less than 5% of women give birth on their estimated due date. So there are no hard and fast rules about the exact length of a pregnancy.
Natural induction methods
Sometimes when induction for being “post dates” is being discussed, women like to try a number of “natural” induction methods to see if labour can begin on its own, rather than having to be chemically induced in hospital. Some of the methods that women try to get labour started include:
- Drinking raspberry leaf tea
- Eating pineapples
- Eating hot curries
- Taking hot baths
- Drinking castor oil
- Breast stimulation
- Eating dates
- Applying evening primrose oil (EPO) vaginally and consuming it orally
That’s a pretty long list! And it’s certainly not a complete one. There’s plenty of other methods that people try too. But how effective are these methods? The honest answer is that in the main, we really don’t know.
This is because evidence of their effectiveness is either thin on the ground or not of very good quality. This of course does not mean that they definitely don’t work, it just means that there isn’t enough good quality research done to prove or disprove their effectiveness.
What does the evidence say?
While there is some suggestion that consuming castor oil may help to get labour started, the side effects are more than unpleasant with all women in studies reporting that drinking castor oil, usually with orange juice, made them vomit and often caused diarrhoea and stomach cramps. If this is an option you’re considering, it’s certainly worth weighing up the side effects versus feeling well, strong and having enough energy to get you through labour in the first place. A dose of induced vomiting or diarrhoea might just put you on the back foot!
The theory behind eating pineapples is that they contain bromelain which is an mixture of enzymes thought to aid implantation but also induce labour. Unfortunately there is no evidence to support this and some sources suggest that you need to eat 7 to 15 pineapples to get enough bromelain in your system in the first place! The good thing about fresh pineapple though is that its absolutely delicious so at the very least you can enjoy some tasty fruit while also crossing your fingers that it might help get things moving.
Let’s talk about sex!
Women past their guess date can often find complete strangers or people they don’t know very well suggest to them that maybe a roll in the hay might help to get things started! Believe it or not, some studies have been done to investigate the effectiveness of having sex to induce labour. The hormone prostaglandin, which helps your cervix to soften and thin out before labour begins, is also present in semen. The theory goes that by having sex at the end of pregnancy, the prostaglandin in your partner’s semen will help to get things moving. Unfortunately, studies haven’t been able to prove this. But where sex might play a part is if you find it enjoyable and have an orgasm. We do know that orgasms trigger the release of oxytocin, which is the hormone that starts your uterus contracting and keeps your surges moving throughout the birth process. So if having sex sounds like something you might both enjoy, then that aspect of it is definitely something worth pursuing! It is important to remember though that for some women – and indeed their partners – sex towards the end of pregnancy may not be something that they are interested in so don’t feel it’s something you need to cross off a list if you’re worried about having a chemical induction. If you won’t enjoy it, it’s unlikely to do the job!
Take aways (not the kind you order!)
For me the two biggest take aways from engaging in natural induction methods is that firstly it is absolutely worth your while researching their effectiveness as well as their side effects in advance; and secondly, make sure that its something that you enjoy doing. Forcing yourself through a checklist of items that make you miserable is not a great way to end your pregnancy.
Researching your options
In terms of where to get started on your research, the NICE Guidelines on the Induction of Labour have a great summary of the evidence on sweeps, acupuncture, homeopathy, sex, hot baths, anemas, castor oil and breast stimulation in Chapter 5.2, which begins on page 59. I’ve also included a number of study summaries and links below to help get you started. It’s important to read the details of studies as well as the executive summary because sometimes its easy to take the summaries out of context or miss an important result that might be relevant to you.
What really works
My number one tip for getting labour started is deeply unpopular but I’m convinced its the only thing that works. Here it is:
Relax, rest, be kind to yourself and do nothing. Your baby will come when its ready.
Any kind of induction, whether chemical or “natural” is still an intervention. Interventions come with both pros and cons. Once you’re fully informed about what they are, then your gut is the best decision maker on the right choice for you. If something makes you feel good – be it acupuncture, reflexology, eating curries, having sex, whatever it might be – enjoy them as often as you like. Good luck!
© Sylda Dwyer, AlphaBirth 2015. Unauthorised use and/or duplication of this material without express and written permission from the owner is strictly prohibited.
“Most complementary and alternative medicines used for induction of labour are recommended on the basis of traditional knowledge, rather than scientific research. Currently, the clinical evidence is sparse and it is not possible to make firm conclusions regarding the effectiveness of these therapies. There is however some data to support the use of breast stimulation for induction of labour. Acupuncture and raspberry leaf may also be beneficial. Castor oil and evening primrose oil might not be effective and possibly increase the incidence of complications. There is no evidence from clinical trails to support homeopathy however, some women have found these remedies helpful. Blue cohosh may be harmful during pregnancy and should not be recommended for induction. Other complementary and alternative medicine (CAM) therapies may be useful but further investigation is needed.”
“Evening primrose oil is widely used by many midwives to hasten cervical ripening in an effort to shorten labor and decrease the incidence of postdates pregnancies. Although its efficacy has been studied in the relief of symptoms of a number of medical conditions, its use has not been well studied, if at all, for the purpose of cervical ripening. The purpose of this study was to investigate the effect of oral evening primrose oil on the length of pregnancy and selected intrapartum outcomes in low-risk nulliparous women. A two group retrospective quasi-experimental design conducted on a sample of women who received care in a birth center, compared selected outcomes of 54 women taking evening primrose oil in their pregnancy with a control group of 54 women who did not. Findings suggest that the oral administration of evening primrose oil from the 37th gestational week until birth does not shorten gestation or decrease the overall length of labor. Further, the use of orally administered evening primrose oil may be associated with an increase in the incidence of prolonged rupture of membranes, oxytocin augmentation, arrest of descent, and vacuum extraction.”