There is no such thing as a “natural induction” of labour.

Anything that is trying to make your baby come before it is ready is a risk.

So, you think it is time to evict your baby?

You have had enough.

You are tired, uncomfortable and just want to meet your little one…..NOW!

However, have you given thought that perhaps your baby is just not ready to come out into the world. Perhaps your “due date” is not the date your baby has chosen to enter the outside world and they just need that extra time to progress.

The other thing to consider is that your dating scan may not be quite right (as studies have recently shown scans are not an accurate way of determining due dates).

http://www.sarawickham.com/research-updates/womens-lmp-dates-are-just-as-accurate-as-scans/

We become so focused on “due dates” that are just not accurate, but the added stress of phone calls and messages from well-meaning loved ones asking if you have had the baby yet just tips the scales that little bit more.

On average only 4% of babies are born on their “due dates” and women are constantly trying to evict them either before this date (from 38 weeks), or after 40 weeks due to being threatened with medical induction by their health care providers or for social reasons (partner is FIFO).

First time mums on average go into spontaneous labour around 41 weeks and 3 days (40 plus 10) so there is no need for women to be rushed into stretch and sweeps and being made to feel that their body is broken before 42 weeks. The World Health Organisation (WHO) states that you are not considered overdue until you go past 42 weeks as the gestation period for humans varies between 37 weeks and 42 weeks.

When healthcare providers are pressing women for induction, this puts unnecessary stress on both mother and sometimes baby as well, which can release catecholamines into the body, inhibiting oxytocin and other essential birthing hormones.

There are natural methods which may help to soften the cervix and stimulate the uterus, but when you start trying to make things happen more often than not you are preventing them from happening naturally. Even trying to induce naturally can be a form of “intervention” – meaning you are interrupting a normal, physiological process.

The last stages of pregnancy you should be giving yourself time to relax, getting into a great head space, easing any tension in the muscles and identifying any fears or concerns you may have and releasing them.

My belief is that women need to be balanced on all levels, which means that their mind, their body and their emotions need to be balanced and connected and ready and then the energetic body will also be in balance.

A study conducted by University of Texas showed that it is your baby that releases initial hormones to the placenta to trigger spontaneous labour. How does the baby know to do this? Apart from being a physiological process, just like your body created the baby in the first place, this is still unclear, but my belief is that baby recognises when mum is ready to give birth and activates those hormones.

http://www.pnas.org/content/101/14/4978.full?sid=addd2e9b-c5dc-49e7-9074-2480bad272fa

Evicting your baby before they are ready can set off a whole new set of circumstances; that could lead to complications, medical interventions, stress and uncertainty.

I have compiled a list of well-known “natural labour focus” methods, which may help to stimulate the cervix or uterus. This list is in no way the only methods available, there are so many, but these are the most commonly recommended.

But listen up, none of these methods are 100% successful, and let’s face it, like every pregnancy, every labour and birth is going to be different; it depends on the woman and her baby. Please note that most of the evidence supporting these methods are anecdotal, meaning they are based on testimonials from women who have used them, and there is little or no scientific evidence supporting or debunking them, or evidence on how safe they are either.

It is also really important that if you have a pre-existing condition, or you have been unwell or are considered high risk that you check with your health care provider before trying any of the methods.

Also make sure that you refer to a qualified therapist for techniques such as massage, acupressure, acupuncture, reflexology and homeopathy for example.

LABOUR FOCUS METHODS

Acupuncture

For over 3000 years Traditional Chinese Medicine (TCM) has promoted specialised treatment for women in pregnancy care and postpartum recovery. Today this care is becoming increasingly popular and is an opportunity to enhance the woman’s wellbeing.

Pre-birth treatment involves weekly acupuncture sessions from 36 or 37 weeks to prepare the body for labour. Acupuncture points are used according to a woman’s constitution and pregnancy history. This includes points used to assist in ripening the cervix, positioning the baby in the best presentation for labour and to promote optimal energy and stamina for women. The sessions also help clients to relax as the end stages of pregnancy often become stressful. Acupuncture to stimulate labour (induction acupuncture) should only be used near the end of the gestational period or if there is going to be medical intervention.

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In 2004 there was an observational study (Betts & Lenox) examining the effect of pre-birth acupuncture. This involved 169 women receiving pre-birth acupuncture who were compared to a local population for gestation at onset of labour, incidence of medical induction, length of labour, use of analgesia and type of delivery.

In the acupuncture group there was an overall 35% reduction in the number of inductions (for women having their first baby this was a 43% reduction) and 31% reduction in the epidural rate.

When comparing midwifery-only care, there was a 32% reduction in emergency caesarean delivery and a 9% increase in normal vaginal births.

The conclusion was that pre-birth acupuncture appeared to provide some promising therapeutic benefits in assisting women to have normal vaginal births and that a further randomised controlled study was warranted.

Midwives in the Wellington region of New Zealand have been using pre-birth acupuncture since 1997. It is taught as part of a series of specifically adapted workshops for midwives on the use of acupuncture in pregnancy and childbirth.

In clinical practice, pre-birth acupuncture is offered to women as part of routine midwifery care, commencing around 36 or 37 weeks and given once weekly until delivery.

This information was provided by Ian Russell of East Meets West Traditional Chinese Medicine.
www.eastmeetswestmed.com.au

Labour Focus Massage (also known as Induction Massage)

As with acupuncture, labour focus massage can be given on or after your estimated due date. The massage therapist should be trained and qualified in pregnancy and maternity care and experienced in performing this type of massage.

A labour focus massage helps to relax and calm your body, easing tension and helping to create a clear and grounded space. The therapist may also use essential oils such as clary sage, which will help you to become deeply relaxing as it works on the central nervous system.

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If your body and baby are ready for labour, a labour focus massage can help to move things along because again, the mother becomes balanced mentally, physically and emotionally which may then encourage the release of labour hormones.

Having regular pregnancy massage will also provide many more benefits for your labour and birth.

http://vickihobbs.com/pregnant-and-in-pain-need-help-2/

I am a registered remedial massage therapist who has undertaken additional specialised training to qualify as a Nurturelife Practitioner with Pregnancy Massage Australia. This means that I have advanced level training in pregnancy massage and labour focus points. In my experience I have seen women who have gone into labour within 24 hours after having a labour focus massage. Was it the massage? Or was it that the massage helped bring them into that balanced triangle of mind, body and emotions where baby felt mum was ready and initiated labour to start?

Acupressure

Using acupressure on the “labour focus points” of the body can help to stimulate or increase whatever is already happening in your body.

I love using this technique as it is based on our chi and energy centres. When the pressure points are stimulated it may also help to stimulate the uterus to start contracting. These pressure points can also be used during labour to increase the intensity of those contractions, and help mum to be more relaxed or even relieve some of the intensity of the contractions she may be experiencing.

Acupressure is a great way to work with your body for relaxation, energy balancing and stimulation. I regularly show women and their partners how to use these acupressure points effectively and safely, but again if your body is not ready to go into labour, then this is not going to “induce labour” but will help to promote relaxation and prepare the body.

Sex

Semen contains prostaglandins, which helps to soften the cervix, so it is quite often suggested for couples to have regular sex to try and induce labour. When you have sex you release the oxytocin hormone often called the “love hormone”, but it is very much the labour inducing hormone.

If you are going to have sex then it is important for the woman to elevate her hips and legs after ejaculation to allow the semen to remain around the cervix for it to have any benefits.

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It is safe to have sex unless your membranes have released (waters have broken) as you increase the risk of infection. It is also not recommended to have sex if you have a low lying placenta (placenta praevia) or have experienced vaginal bleeding.

I noticed on quite a few American websites they claim that giving your partner oral sex may work a lot more effectively as it is thought the prostaglandins are absorbed more easily through the gut than through the vagina. This may be a lot easier than trying to find a comfortable position for vaginal sex and then keep your hips elevated, but how will you get that orgasm?

I was unable to substantiate these claims even though I did manage to find one source, a Professor of Obstetrics & Gynaecology at the McMaster University in Canada who would suggest the following in his lectures:

“Oral Application of Semen

About fellatio: It would probably be beneficial, if the idea is to get the labour started. The concept is that prostaglandins are absorbed 10X more efficiently through the gut than through the vaginal mucosa, with respect to semen and labour onset.”

However, when I contacted this Professor by email, he replied that he is now retired and no longer has any of his articles as it was before electronic files, so was unable to help me, so who knows, but I will keep digging – there has to be something out there, right?

Anyway, oral sex performed on you might be the better way to go, so that you have multiple orgasms, which may release oxytocin (the love and labour hormone), stimulate the uterus and fill you with good old fashion loving, while also lubricating the birth canal at the same time. Remember this is your time to be pampered and attended to as the birthing goddess that you are, so I shall leave that up to your own discretion.

Birthing guru Ina May Gaskin says “If a woman doesn’t look like a goddess during labour, then someone isn’t treating her right.”

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My beautiful friend Angela Gallo who is a doula and birth photographer based in Melbourne, recently wrote a blog that went viral on her experience of masturbating and having orgasms during labour to increase the oxytocin flow and those amazing pain relieving hormones while at the same time allowing her to really enjoy the whole experience – orgasmic birth!

You can read her blog here:

Why I touched myself in labour – here’s 3 reasons you should consider it too!

Nipple stimulation

When you stimulate the nipples gently by rubbing, sucking or licking you are likely to release the hormone oxytocin, which may stimulate the uterus to start contracting.

You do need to stimulate the whole area around the areola firmly but gently, so you are sort of imitating the actions of a suckling baby. This method can take a long time, for up to an hour three times a day, with little or no results, but you might be the lucky one that has success, so no harm in trying.

The feedback I have had from women who have tried this is that it is not always that pleasant playing around with your nipples that are already sensitive, and you may cause them to be dry and too sensitive for breastfeeding when your baby does come.

Many women are now also being encouraged to pump their breast to initiate labour.

Hypnosis

I am a big advocate of hypnosis to help prepare pregnant women for labour and birth. Again, this forms part of my belief that the mind, body and emotions all need to be in balance. If the mum is concerned, fearful or there is a lot of stress surrounding her, then she is less likely to go into spontaneous labour.

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I perform fear release hypnosis in my hypnobirthing classes, and also offer this to women on an individual basis, where I have experienced really good results. A woman who is worried about her other children for instance, or still working right up to the end of her pregnancy, or is the partner of a FIFO worker who runs the risk of missing the birth, or there has been a traumatic incident recently can all play an enormous role in inhibiting labour.

http://www.researchgate.net/publication/258894224_Hypnosis_for_induction_of_labour_(Protocol)

Again there was very little “evidence” to support that hypnosis could help to induce labour, however the Cochrane Review suggested the following: “A complementary and alternative medicine method, such as hypnosis, may provide a safe alternative method for inducing labour.”

http://www.cochrane.org/CD010852/PREG_hypnosis-for-induction-of-labour

Clary Sage

Many are told that they can use clary sage to induce labour. Clary sage cannot be used to induce labour unless your body is ready to go into labour.

What clary sage does do is help you to have more effective contractions once you do start having them as it relaxes the mind, body and muscles. This is what is needed for mums to go into labour in the first place – eliminating catecholamines (adrenaline) and stimulating endorphins and oxytocin. By using the clary sage for relaxing and calming the mind, body and muscles you are more inclined to go into labour spontaneously.

You can read more about the effects of clary sage and labour by going to my article on clary sage:

Clary Sage – Can it be used to induce labour?

Evening Primrose Oil (EPO)

Evening Primrose Oil (EPO) is oil from the seed of the evening primrose plant. It is a rich source of omega 6 essential fatty acids and gamma-linoleic acid (GLA).

However, there are some concerns with using EPO and the main ones are that it could trigger seizures for those with a history of seizures; it is contraindicated in those who are taking mental health drugs particularly for schizophrenia and depression, and the GLA in EPO is the part of the evening primrose oil that might slow blood clotting and could cause an increase in bleeding during or after surgery, which would be a concern during a caesarean section or post-partum haemorrhage.

For those with low blood pressure Evening Primrose Oil has been known to lower blood pressure even more, and can affect other medications that a person is taking.

Evening Primrose may also cause a person to have seizures while under anaesthetic, so it is extremely important to let your anaethetist know if you have been using it prior to surgery.

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It has also been shown that EPO may cause bleeding and premature contractions, so if you are thinking of taking EPO then make sure it is from 38 weeks onwards and only 1000mg or less per day.

Other side effects that are considered to be mild include an upset stomach, nausea, diarrhea and headaches.

Pregnant women should not take Evening Primrose Oil because of the risks mentioned associated with it.

Personally, I would leave this one alone even though it is one of the most readily available and highly recommended forms of labour focus techniques by midwives, forums and pregnant women who have used it.

Here is a link to the Evidence Based Birth research on using Evening Primrose Oil:

CLICK HERE FOR LINK

Homeopathy

Homeopathy is a form of alternative medicine that helps to stimulate the body’s own healing response to conditions using highly diluted preparations. Homeopathic medicines can be in the form of liquid, granules, powder or tablets.

I have had several clients use homeopathic remedies to help during their pregnancy, labour and birth with awesome results.

Again there have not been many studies undertaken on this form of treatment, yet it appears to be safe. You will need to do your own research and find someone who is qualified and who specialises in pregnancy, labour and birth.

Contact the Australian Homeopathic Association for a practitioner near you.
http://www.homeopathyoz.org/

Stretch & Sweep

I have heard health care providers and other women suggest that this is a natural form of induction, and so this is why I am including this practice here, but only to educate women on what it is. In my opinion, anything that is trying to “make you go into labour before you are ready” is not natural.

The “stretch” refers to the process of your health care provider inserting their finger into your vagina and “stretching” the cervix so it opens. The “sweep” refers to separating the membranes from where they rest against the cervix.

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The cervix needs to have softened and at least a little open to enable the health care provider to be able to get the finger inside the cervix. If your cervix is soft and slightly open, then your body is already preparing you for labour, so why not just leave it alone?

When a cervix is not ready the texture will be similar to the tip of your nose, hard and grisly. If your cervix is softening it will feel like your lips, soft and flexible and easily moveable.

It can be really uncomfortable, even painful and may cause bleeding or even rupture of membranes, which then puts you on the clock. Depending on your hospital and their policies at some point you will then have to be administered with antibiotics. These days hospitals are making women go straight in when their membranes have broken and this can cause stress and anxiety, rather than being at home in a comfortable and safe space.

Sometimes you may get a few contractions and you start to get really hopeful, but then they may not progress into labour, causing disappointment and stress.

This method can be really effective for some, and then useless for others. I know one woman who had seven stretch and sweeps, and when I asked her why she said that she really felt with so many women saying that it worked for them, it would have to work at some point for her.

Here is one of my biggest catch phrases….

”What works for one woman may not work for the next.”

Raspberry Leaf Tea

Raspberry Leaf is a uterine tonic to help your uterus work more efficiently during labour. It is not designed to induce or speed up labour but to help your contractions be more effective when you are in labour.

The uterus becomes more relaxed, which causes the contractions to work more efficiently; therefore it may help to shorten the length of time a woman may be in labour, or it may not, and in some instances women who have used Raspberry Leaf Tea have found their labours very long.

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It is suggested that women commence taking raspberry leaf from 32 weeks and then continue through to birth. Again, not enough research has been conducted on the safety and side-effects of using raspberry leaf tea during early pregnancy. We do know that raspberry leaves are high in tannins, which can cause constipation.

Always refer to your health care provider if you are unsure or arrange to discuss further with your naturopath or Doctor of Traditional Chinese Medicine to find out your individual needs.

Here is a link to the Evidence Based Birth research:

CLICK HERE FOR LINK

Dates

A recent study concluded that eating 6 dates daily during the last four weeks of pregnancy significantly reduced the need for induction and augmentation of labour and produced more favourable birth outcomes.

Containing at least 15 minerals such as potassium, calcium, iron, magnesium and zinc, 23 types of amino acids, vitamins, carbohydrates, protein, 14 types of fatty acids, dietary fibre and a lot more, these sweet little fruits are a nutritional powerhouse.

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Here is a “small” study published by Pubmed that confirms that women who consumed date fruit had significantly higher mean cervical dilatation upon admission compared with the non-date fruit consumers.

http://www.ncbi.nlm.nih.gov/pubmed/21280989

Here is a link to the Evidence Based Birth research:

CLICK HERE FOR LINK

Spicy Food / Curry

Again, spicy food and curry gives some people the runs, so another one to think twice about particularly if you have a sensitive stomach and you are not used to eating hot and spicy foods. It can also cause dehydration, which may cause the uterus to start contracting, however these generally subside once the body is hydrated again, and therefore may cause mums to become distressed when labour doesn’t progress. There is also a suggestion that the “capsacam” in some spices could also work to inhibit the release of endorphins – your pain relieving hormones.

Eating pineapple

Pineapple and other tropical fruits such as kiwi and papaya contain the enzyme bromelain. This is thought to stimulate the release of prostaglandins to help soften the cervix and stimulate the uterus. The process of canning or juicing destroys the bromelain so the fruit has to be fresh.

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However, don’t get too excited. Each pineapple only contains very small amounts of bromelain so you would need to eat as many as seven or more pineapple in one sitting to have any effect. The most likely side-effect of eating large amounts of pineapple would be a severe case of diarrhoea, cramping, tummy upset and heartburn.

Pineapple is also very rich in natural sugars, so not very helpful for those with gestational diabetes, but is also really high in Vitamin C and can also help with constipation.

Here is a link to the Evidence Based Birth research:

CLICK HERE FOR LINK

Black / Blue Cohosh

The Black Cohosh and Blue Cohosh are two different herbs. Both of these herbs have been used for centuries to induce labour or increase contractions in a slow moving labour, and when used in a tincture together can be really effective.

They are more effective when used past your estimated due date, and again will not trigger labour if the body is not ready. The two herbs when used together help to strengthen and regulate the uterine contractions, and work with your body in a natural way.

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It is really important that you consult with a naturopath or a Doctor of Traditional Chinese Medicine, to ensure that you are using it correctly and at the right time.

Liquorice

Natural liquorice is not the same as the black lolly licorice you get from the shop. Liquorice contains glycyrrhizin, which stimulates prostaglandin levels and can trigger uterine contractions.

Again, eating a lot of liquorice can be like taking laxatives, and the stomach contractions you get could stimulate uterine contractions, however there is not research to support this idea.

A study published in the American Journal of Epidemiology in October 2009, suggested the ingredient found in liquorice called glycyrrhizin affected the placenta and allowed the glucocorticoid stress hormones to pass through to the unborn baby.

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Walking / Stairs

We know that being upright helps with gravity and may help to encourage baby further down into the pelvis, therefore putting pressure on the cervix, which may help to trigger the release of oxytocin.

One midwife suggested to a mum I was supporting as her doula that she could walk up and down the stairs sideways like a crab as it opens the pelvis a lot more than going up and down, but I think swaying your hips from side to side and forward and backwards could also do the same thing. If using the stairs, be aware of your safety and hold onto someone or a railing to ensure that you are not going to fall.

I suggest going for regular walks to be out in the sunshine, taking deep breathes, and soaking up some Vitamin D while you are outside, but don’t wear yourself out. You don’t know how long you are going to be in labour for, so you don’t want to exhaust yourself before you have even gotten started. Think again of a marathon runner, they don’t sprint out of the starting box like a 100m sprinter – they take it slow and steady, conserving their energy for the trek ahead.

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I couldn’t find any research to confirm that walking will induce labour or even encourage your baby into a better position. However, to me it just makes sense that as you are striding forward, or stepping sideways, even moving up and down stairs the movement and gravity will help to move baby down – the same with rocking, rotating and bouncing on a fit ball.

Again if your body and baby are not ready, then this is unlikely to induce labour.

Castor Oil

This method is one I would NOT recommend but many midwives and women in forums are still suggesting this to pregnant women to induce labour. I would be more concerned about the side-effects of this and possibly causing more complications for your birth.

I highly recommend you do your research and speak to your medical practitioner before even considering using castor oil.

Castor oil may cause vomiting, diarrhea and cramping for the mother, which is the last thing that you want when you go into labour. Diarrhea also causes dehydration and usually if a woman is dehydrated this can upset the uterus and start contractions, however it could also start contractions and then stop if the body is not ready.

Often in early labour you may have diarrhea or soft stools naturally and this is your body clearing out your bowels to make it easier for baby to move down.

Conclusion

The greatest gift you can give your baby is your patience.

Your number one priority is to keep your baby safe and supported even if it means that little bit longer. You can be sure that you are not designed to stay pregnant forever. Yes there are some circumstances where a mother may need to be induced for medical reasons, but until you are in that situation, be calm and nurture yourself and your baby.

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It doesn’t matter what you try to do to speed things up, if your baby and your body are not ready then you are going to be disappointed when these natural induction methods don’t work.

Dating / growth scans are rarely accurate so you may be stressing for no reason. I have seen many babies born who were told they were ahead of their time because of their size – suggesting a 9lb baby at birth, and then finding they are only 7lb.

http://evidencebasedbirth.com/evidence-on-inducing-labor-for-going-past-your-due-date/

So again, in conclusion, I suggest that when the mind and body and emotions are all balanced then that will be the stimulus for the hormones to be released to get things started.

My name is Vicki Hobbs and I am a Childbirth Educator, Hypnobirthing Practitioner, Pregnancy Massage & Pain Specialist, Birth & Postpartum Doula, Hypnotherapist and Life Coach. I am based in the northern suburbs of Perth and can be contacted on (08) 9303 9111 or feel free to send me an email [email protected]