Inducing Labor

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The following is a student blog post by Rebecca Kuzman

Inducing Labor

                Whether due to concerns about medical professionals wanting to push induction, or due to the feeling of being “done” as pregnancy becomes increasingly uncomfortable, or due to just being ready to meet their new little ones, it is common for soon-to-be-moms to seek ways to get labor moving.  Oftentimes, an anecdotal suggestion from a friend or an old wives’ tale makes up the basis for attempting various induction methods.  Many women may feel like they are ready to try anything as long as labor starts.  However, before trying way number seventeen to induce labor at home, it would be prudent to look into the evidence behind some of these practices to see if they really are beneficial or not and whether they are safe or unsafe.

                Unfortunately, for most of the alternative ways to induce labor, there is little research that is conclusive.  This limits our ability to really know if a method could be helpful or safe or not, but it is still worth looking at the studies which do exist.  Information from these studies, along with discussions with trusted care providers, can help women make informed decisions about what methods to try.  While not comprehensive, this article will look at some of the more commonly suggested labor induction practices and summarize what is known about their efficacy and safety.

                Castor Oil – Research indicates that taking one dose is linked to the induction of labor within 24 hours, along with an increase in cervical ripening.  No differences were found in birth outcomes, such as C-section rates, APGAR scores, etc.  It is thought that castor oil works by stimulating intestinal and uterine contractions.  This causes some undesirable side effects – increased nausea and diarrhea – so it is important for women to maintain a healthy level of hydration if using castor oil. (Dekker, 2017d; Mama Natural, n.d.a)

                Breast Stimulation – Because nipple stimulation helps oxytocin to release, a hormone which stimulates the uterus and which is mimicked in medicinal induction, this is a common technique utilized to start labor or help stalled labor.  The evidence shows that it is more effective if the cervix is already ripe, so it may not be as useful to initiate labor unless the body is ready.  Another potential benefit is that breast stimulation may reduce the risk of postpartum hemorrhage.  However, there is risk involved as the uterus could be overstimulated by the extra oxytocin released, so this method should be discussed with the care provider to ensure proper usage.  (Dekker, 2017c)

                Evening Primrose Oil (EPO) – There is very little research on this, and what does exist is mostly anecdotal, so it is difficult to make an informed recommendation one way or the other.  There are some indications that EPO may be linked to cervical ripening but not necessarily to the initiation of labor.  The reports have conflicting viewpoints on the safety of EPO during pregnancy, with some stating concerns linked to bleeding while others indicated no difference found between women who used EPO and those who did not. (Dekker, 2017f)

                Pineapple – Eating pineapple is often suggested as women share pregnancy and labor stories with each other.  There are some studies which showed pineapple extract causing contractions, and the enzyme bromelain that is found in pineapple may help cervical ripening.  However, this method is not actually evidenced based.  On the other hand, there is no evidence that it is harmful other than the potential effects on mouth tissue from eating large quantities of pineapple, so it may be a good excuse to enjoy this sweet fruit. (Dekker, 2017h)

                Red Raspberry Leaf Tea – There is little research on the effects of red raspberry leaf tea on labor induction, and what is there does not show statistically significant results.  One study did show that the raspberry leaf was able to stimulate contractions in uterine tissue, but it is unclear why this might be.  Also, those studies, conducted on rats, indicated some negative effects for future generations, but it is difficult to apply these findings to women.  While red raspberry leaf tea may not have much effect on labor induction, it is high in vitamins and minerals (mamanatural) and may have other positive benefits on the actual labor process as it is thought to help tone the uterus. (Dekker, 2017i)

                Blue or Black Cohosh – The research evidence for this substance does indicate that consuming it might induce contractions.  However, there are significant concerns with safety.  Cohosh was linked to negative outcomes in birth, which no mama wants to experience, therefore, it is best to avoid this method. (Dekker, 2017b)

newborn

                Sex – The thought process behind this natural induction method is multifaceted.  The human prostaglandins from the semen could help ripen the cervix, similar to medicinal means of softening the cervix.  Orgasm is linked to uterine activity which might stimulate contractions.  Also, the natural release of oxytocin that occurs could lead to contractions, again similar to what induction drugs seek to mimic.  However, there is no solid research that can definitively point to evidenced based practice with this strategy, although there are links to reduction in being overdue.  Consensus is that it is probably safe to attempt as long as there are no other health concerns which would make doing so unsafe. (Dekker, 2017g)

                Acupuncture – At this point, the research indicates that acupuncture can help ripen the cervix and have beneficial effects on initiating labor.  However, the various studies did not examine a set standard; rather, there were variations in how the acupuncture was performed.  This makes it difficult to determine the efficacy of this treatment from the studies.  There needs to be more research and standards of care to validate the potential benefit.  Fortunately, it does not seem to be harmful, so it may be a method worth trying if working with a competent practitioner. (Dekker, 2017a)

                Eating Dates – Although more rigorous studies would solidify the findings, there does seem to be evidence that eating dates does have benefits for labor.  At the proper dosage, dates are linked to increased cervical ripening, less need for labor augmentations, and potential benefits with postpartum bleeding.  It is recommended that a woman consume 60 to 80 milligrams a day to see these results.  While this is a fairly straightforward method to improve outcomes, caution may need to be exercised among women with Gestational Diabetes due to the high sugar content of eating that quantity of dates.  (Dekker, 2017e)

References

R Dekker. (20017, July 26). Natural labor induction series: Acupuncture. Retrieved from

R Dekker. (20017, July 5). Natural labor induction series: Blue cohosh or black cohosh. Retrieved from https://evidencebasedbirth.com/evidence-taking-blue-cohosh-black-cohosh-induce-labor/

R Dekker. (20017, June 14). Natural labor induction series: Breast stimulation. Retrieved from https://evidencebasedbirth.com/evidence-using-breast-stimulation-to-naturally-induce-labor/

R Dekker. (20017, June 7). Natural labor induction series: Castor oil. Retrieved from https://evidencebasedbirth.com/evidence-using-castor-oil-to-induce-labor/

R Dekker. (20017, June 21). Natural labor induction series: Eating dates. Retrieved from https://evidencebasedbirth.com/evidence-eating-dates-to-start-labor/

R Dekker. (20017, May 17). Natural labor induction series: Evidence on evening primrose oil. Retrieved from https://evidencebasedbirth.com/evidence-using-evening-primrose-oil-for-natural-labor-induction/

R Dekker. (20017, May 3). Natural labor induction series: Evidence on sex. Retrieved from https://evidencebasedbirth.com/evidence-using-sex-for-natural-labor-induction/

R Dekker. (20017, May 10). Natural labor induction series: Evidence on using pineapple to naturally induce labor. Retrieved from https://evidencebasedbirth.com/evidence-using-pineapple-naturally-induce-labor/

R Dekker. (20017, July 19). Natural labor induction series: Red raspberry leaf. Retrieved from https://evidencebasedbirth.com/natural-labor-induction-series-raspberry-leaf/

Mama Natural. (n.d.). How to induce labor naturally – labor induction tips. Retrieved from https://www.mamanatural.com/labor-induction/

Mama Natural. (n.d.). The truth about red raspberry leaf tea during pregnancy. Retrieved from https://www.mamanatural.com/red-raspberry-leaf-tea/

All student article posts are the expressions of the student who wrote them. We do not take responsibility for the content, these are done as part of the educational experience and we try to encourage students to use their voice and learn to connect with clients through blogging and social media.
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