Can Labor Be Induced Naturally?
Childbirth experts don't think most at-home methods work.
It's just a week until your due date. You're scouring the Internet for some way to coax baby out on time -- or maybe even a couple of days early. The message boards are full of suggestions for inducing labor "naturally." They range from eating spicy foods to spooning down castor oil.
But does anything really work? Childbirth experts say there's no good proof.
"There are no proven non-medical ways for inducing labor naturally," says New York midwife Elizabeth Stein, CNM. The only safe and reliable methods for starting labor involve medications given at the hospital. Most other techniques are rumors, unlikely to help at best and potentially harmful. Only a couple show any promise, and the jury is still out on those.
Inducing Labor With Acupuncture
Acupuncture might help bring on labor, but it's too soon to say. In parts of Asia, it has been used for centuries to jump-start labor.
One small study at the University of North Carolina found that women who got acupuncture were more likely to go into labor without a medical "push."
The study included 56 women who were 39.5 to 41 weeks pregnant. (Forty weeks is full term.) Half of the women got three acupuncture sessions, while the other half did not.
Seventy percent of the women who got acupuncture went into labor on their own, compared to 50% who received standard care. The women who got acupuncture were also less likely to deliver by cesarean section -- 39% compared to 17%.
"We had almost a 50% reduction in the C-section rate," says researcher Terry Harper, MD. Harper, who now practices maternal fetal medicine in Albuquerque, says the small size of her study means more research is needed. She hopes acupuncture might one day help more women give birth vaginally.
Can Sex Bring on Labor?
Another strategy that gets positive reviews from doctors and midwives is inducing labor the same way you started your pregnancy -- by having sex.
"I tell my patients to do that all the time," Harper says. Although there's no proof sex can start labor, there is a good reason why it might. Harper says sex releases prostaglandins, hormone-like substances that are like the medications used to induce labor. And it won't hurt to try!
"I think sex is a great idea," Stein agrees. Make sure your water has not broken and your doctor or midwife has given you the green light. She adds that it's important for the man to ejaculate inside the vagina. "This ejaculate contains prostaglandins which stimulate the cervix ... possibly leading to contractions."
Other Methods to Induce Labor
When it comes to inducing labor, the following methods draw mixed reviews from childbirth experts. Either there's no evidence to support them or they might work but carry risks. If you plan to try any of them, consult your doctor or midwife first.
- Long walks: Going for a long walk is "good exercise," Harper says, "but I don't think that it helps bring on labor." Stein is more critical. "Short walks are OK, but I'm not a fan of long, tiring walks. Exhaustion is not a good way to go into labor."
- Spicy foods: It's a popular theory, but there's no direct connection between the stomach and the uterus. So, there's no reason to think a particular type of food will bring on contractions. "I have never seen anything that supports [spicy foods] one way or another," Harper says.
- Castor oil: Stein sometimes recommends taking a small amount of castor oil after the 38th week. "There's no direct action on the uterus. It's indirect via stimulation of the bowels, which lean on the uterus. This only seems to work when the body is ready to go into labor." But Harper says there's "no good evidence" for inducing labor with castor oil. "Castor oil brings on horrific diarrhea. I don't recommend it, because you could get moms dehydrated."
- Cohosh: Some women try starting labor with cohosh, but doctors caution that this herb contains plant-based chemicals that may act like estrogen in the body. "I'm actually pretty nervous about it," Harper tells WebMD. "It's not well enough studied."
- Evening primrose oil: Harper is more positive about another herb, evening primrose oil. It has substances that your body changes into prostaglandins, which soften the cervix and get it ready for labor. "Evening primrose oil does supposedly release prostaglandins," Harper says. "But it needs more study."
Inducing Labor in the Hospital
If you pass your due date, your doctor or midwife may recommend inducing labor in the hospital. For women with high-risk pregnancies, Harper says they may be induced very close to or just before the due date. Some risks of complications require induction well before the due date. For low-risk pregnancies, she says, 42 weeks is "the absolute cut-off" for allowing pregnancy to continue.
Inducing labor usually starts with taking prostaglandins as pills or applying them inside the vagina near the cervix. Sometimes this is enough to start contractions.
If that's not enough to induce labor, the next step is Pitocin, a man-made form of the hormone oxytocin. It stimulates uterine contractions. Harper says it's vital that Pitocin only be given once the cervix is open and ready for labor. " Most people recommend starting out with prostaglandins for preparation of the cervix."
The Waiting Game
As the due date approaches, many couples are eager for labor to begin so they can finally meet their little one.
And though that's the most exciting moment of your life, you might want to slow down and not rush through things. Stein recommends saving your energy, rather than wearing yourself out with schemes for starting labor sooner.
In other words, get some sleep while you can!