Your Pregnancy Matters
The truth about “natural” ways to induce labor
April 18, 2017
Toward the end of pregnancy, most women are tired and ready to meet their babies. As their due date nears, my patients often ask about natural ways to induce labor.
There are plenty of urban legends about natural remedies that supposedly move things along. Some of these methods are harmless; others may have risks or unpleasant side effects. Most don’t actually work at all.
Let’s look at the truth behind nine of these “natural” methods of inducing labor at home, and why you may or may not want to try them out:
1. Castor oil
Caster oil to induce labor is one of the more popular, supposedly “natural” suggestions. Because castor oil is a laxative, it does cause uterine irritation or contractions – but often as a result of GI upset and diarrhea, not labor. In randomized studies (the gold standard in medical research), women who ingested caster oil were no more likely to go into labor than women who had taken no castor oil.
There are some foods and recipes out there – such as this infamous salad or eggplant parmesan – that are rumored to cause labor and likely contain castor oil or something similar as their “active” ingredient.
But the oil itself has generally fallen out of favor given the significant side effects (again, GI upset and diarrhea) and its inability to induce true labor.
Moderate exercise is safe – and highly recommended – during pregnancy. Unfortunately, there aren’t any exercises that have been shown to induce labor. I have a friend who walked 40 city blocks unsuccessfully attempting to coax out her little one.
3. Acupuncture or pressure
Randomized trials have failed to show that acupuncture or pressure (like massage) will induce labor. Given this remedy can be quite pricey, I suggest you skip it and save that money for diapers.
Some people still buy into it, however, so don’t be surprised if your favorite pedicurist refuses to perform a foot massage when you’re pregnant. Many people believe massage of the inner leg above the ankle can cause miscarriage or preterm labor.
Fresh pineapple – the core, in particular – contains an enzyme called bromelain, which is commonly used as a meat tenderizer. This enzyme breaks down the proteins in tissue and is what makes your tongue tingle or mouth develop sores when you eat pineapple.
The popular theory is that somehow the bromelain from the pineapple makes its way to your cervix and causes the breakdown of tissue there, causing the cervix to soften and stimulating labor.
There is no evidence to support this theory, however. The enzyme is not active in your acidic stomach and is only partially absorbed by the body.
There’s no harm in enjoying a serving of pineapple at term – although the fruit is known to cause significant heartburn.
5. Sexual intercourse
It’s not clear whether or not sexual activity at term will help induce labor. One study has even shown that having sex might actually reduce the likelihood of going into labor.
Intercourse generally isn’t harmful during pregnancy. However, with certain conditions, such as placenta or vasa previa, your obstetric provider may recommend “pelvic rest” or “nothing per vagina.” Not following these recommendations could lead to hemorrhage and endanger your health and the health of your baby.
6. Herbal remedies
Herbs such as blue and black cohosh, raspberry leaf tea, and evening primrose oil have been sold as a way to “prepare” your uterus for labor.
Not so fast. Cohosh has been associated with fetal heart failure and stroke as well as maternal complications during labor. Randomized trials have shown no increase in likelihood of labor onset with any of these herbs, and the safety is unknown. Avoid these supposed remedies completely during pregnancy.
7. Nipple stimulation
Nipple stimulation causes oxytocin release, which in a lactating mother causes the “letdown” of breastmilk. It also causes uterine contractions and return to normal uterine size (called “involution”), which is why women who breastfeed generally have heavier bleeding for a shorter amount of time compared to women who bottle-feed their babies.
Nipple stimulation during pregnancy will also cause uterine contractions, although it may not cause the onset of true labor. It may also cause severe, prolonged contractions that cause fetal distress and harm. That’s why I don’t recommend using nipple stimulation to induce labor.
8. Spicy food
Spicy foods affect the body the same way as castor oil – GI upset leads to uterine irritation and contractions. As with castor oil, these contractions rarely result in true labor.
Spicy food can also lead to significant heartburn, which pregnant women are predisposed to anyway. Bottom line: you may regret those tacos later.
9. Membrane stripping
Your obstetric provider may begin membrane stripping about a week before your due date. This process – where a finger is inserted through the cervical opening and swept to the left and right in a clockwise motion to separate the lower part of the membranes from the uterine wall – may be uncomfortable for some women and is only possible if your cervix is dilated.
The available data does show an increase in spontaneous labor onset following this procedure – but it is also associated with vaginal bleeding, cramping, and occasional membrane rupture.
With my second child, I experienced heavy bleeding after membrane stripping that required a trip to labor and delivery to evaluate my baby – with my toddler in tow. This made me feel anxious, was inconvenient, and did not bring on labor.
If you are interested in membrane stripping to induce labor, discuss it with your provider, and he or she can help you decide if it is the right choice for you.
The medical community studies drugs and interventions (such as oxytocin for labor induction) both before and after implementation to ensure their safety and efficacy and to ensure no unexpected complications or side effects have occurred.
Many women swear by a certain natural method, but a woman close to her due date is extremely likely to go into labor no matter what she is doing – or eating – at the time.
Many of the above natural ways to induce labor are probably harmless. Others, however, may have unwanted side effects or could be unsafe for you or your baby. Talk to your obstetric provider beforehand about any method you intend to try and get his or her opinion on what is safest.
We recommend you take the true “natural” approach to labor – let it happen when it happens. After all, only about 2 percent of women remain pregnant more than 1 to 2 weeks past their due date.
Think of it as your first demonstration in patience – something you will undoubtedly require often as a mother!
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