GETTING LABOUR STARTED
“When will my baby come?”
It’s kind of like the weather report. We gather all the information, our watchful eyes looking for clues and signs, we compile the knowledge and the wisdom, and we paint an idea. But we still don’t usually get it right.
Although there is no “date” they’re coming, what we do know, is that they will be born: one way or another, at one point or another. For some people, it is a slightly more urgent matter that labour starts on its own, or sooner. It may be for the benefit of a healthy mum and baby. It may be for the benefit of mum’s sanity. It may be that you just want to give your body a helping hand.
It may also be important to avoid a medical induction of labour, whether it's a personal preference or for medical reasons.
It is always wise to start from the least harmful, risky, and perhaps impactful tool and slowly up the ante.There are rarely downsides to it!
Of course, unless you’re short on time and need the baby out ASAP...but even if it seems like this is the case, there is usually more time than it is made out to be.
This is where careful preparation and communication can change the course of your labour dramatically.
NATURAL REMEDIES FOR LABOUR
There are simple lifestyle activities that could encourage our bodies for labour, like walking and sitting on the birth ball, but sometimes we can’t help but want to take matters more into our own hands.
Here are some natural remedies for encouraging labour, or if you find yourself choosing an induction, suggestions you could try before the medications:
While writing these methods down, we realized even some commonly used remedies have very little evidence, but may be based more on anecdotal experiences of success. We have listed the few tricks you could try with a brief description.
Taking our own advice, we have started with the easier to try, gentler methods, slowly moving up the ladder as you scroll down.
This post is pretty long and not all the methods may be interesting to you, so here’s a shortlist:
I have never seen someone walk themselves into labour. Actually, most of the time I hear people have walked all day or the day before trying to start labour.
This one is more of a lifestyle then a “tool” to get labour started. It is healthy for the body and the baby, it helps apply pressure to all the areas you want to pressure, and adds mobility in all the places we want to wiggle around so your baby can find the right fit through your pelvic bones to wiggle down. That’s why we recommend it.
RASPBERRY LEAF TEA
Tea made from raspberry leaves. Caffeine free.
The working theory:
Raspberry leaf tea (RLFT) helps increase blood flow to the uterine muscle and increase the coordination of contractions. This is why it is also used in alternative medicine and historically to help ease menstrual cramps. In my practice as a midwife, I have and seen other midwives recommend this to shorten pregnancy, not labour. Research I found all tested RLFT to shorten the labour, why? I do not know. And it did not seem to work. I think it was a bit of an ambitious search.
You can purchase raspberry leaf tea from most supermarkets. Make a pot, drink it hot, or drink it cold. There are lots of different regimes out there about when to start, how much to drink, and how to increase each week...but really, drink as much or little as you want.
You can also take it in tablet form.
Personal Experience: Writing this made me think hard back on my experiences. I am not too sure how well this one works, although we do use it often! This is probably because raspberry leaf tea is one of those “slow brew” remedies that is usually started around 37 weeks of pregnancy to be drunk in the last few weeks, hopefully slowly helping the body start to think about labour. By the time labour starts, it’s hard to say if it’s because of the tea, or simply because it’s time!
Precautions: As the idea of RLFT is to make your uterus muscles start cramping and contracting, it may cause some worries if consumed in early pregnancy. This concern, however, is theoretical and RLFT is safe to drink in pregnancy.
EVENING PRIMROSE OIL
Oenothera biennis - a plant native to North America. The flowers open in the evening, hence evening primrose. Evening primrose oil is produced from the seed of this flower.
The idea is that this oil contains ingredients that mimic the action of prostaglandins (hormone-like substances in the body). They soften the cervix to become mushy like butter and prepare it for dilation.
Evening Primrose oil is commonly used in capsules. It can be taken by mouth, or inserted vaginally at bedtime after poking a hole in the capsule and letting the oil seep out overnight and do its magic. The capsule will melt.
Personal Experience: Like the raspberry leaf tea, evening primrose oil is generally started around 37 weeks and used in the last few weeks of pregnancy, making it difficult to tell anecdotally if there is indeed an impact.
There is a mixture of ways this could help start labour:
Oxytocin - During sex oxytocin is produced from intimacy with a partner. Oxytocin is the hormone that causes orgasms, and contractions.
There are prostaglandins in the semen, which may help soften the cervix.
Cuddling - post sex cuddling also produces an oxytocin-rich environment to help you feel connected, safe, and start contractions.
Personal Experience: No one’s really given me feedback on this one.
Precautions: There are no real dangers to this remedy. Be mindful that you might have some spotting or cramping after, both normal. If your waters have already broken, then refrain from this one as it is best to not introduce any bacteria into the birth canal.
This works similarly to intercourse, minus the prostaglandins. Nipple stimulation tried to promote natural release of oxytocin in the body to start the contractions.
Manual stimulation, you can do it yourself, or by a partner. You could also use a breast pump.
Personal Experience: I have used it during labour when contractions slow down and space a part to increase the contraction pattern again.
STRETCH AND SWEEP
This is one most people have heard about but know little about what it actually is.
A stretch and sweep is where the midwife or doctor or nurse performs an internal exam by inserting two fingers into the vagina.
They try to reach for the cervix. If they can, they will try to:
Stretch the cervix - either the external opening, or the internal opening if your cervix is open and they can reach it.
Sweep between the bag of waters and the cervix - the bag that holds the water around your baby, and your baby, is called the membrane. That’s why this is sometimes also called a membrane sweep. This bag is not attached to the uterus or the cervix, but it is pressing right up against it. So sometimes you might hear “separating” the membranes from the cervix. But essentially, the care provider will sweep their finger around in this space, hoping this action will release prostaglandins to help make your cervix softer and shorter.
If they can’t reach your cervix, don’t worry about it, your body needs some more time. Or your cervix just doesn’t want to be touched.
Personal Experience: How comfortable or not this procedure is, depends highly on the person. But however sensitive your cervix may be, the experience should always be okay for you...because if it isn’t you simply say stop and it should stop immediately. You could take as many deep breaths and as many breaks as you want.
How well this one works depends on how ready we find the cervix when we do the internal exam. But in experience, when the cervix is ready and a proper sweep has been done, labour tends to start soon (the next day or two). Of course, there have been and always will be odd balls that fall out of our predictions.
There is something called cervical ripening acupuncture. Using the theories of traditional Chinese medicine, there are certain acupressure points in the body that stimulate cervical change and contractions. You can start this around 37 weeks if it is something you are interested in.
Personal Experience: There is good research that acupuncture for labour shortens the length of pregnancy.
*CASTOR OIL - need to consult care provider
Castor oil is oil from the castor plant seed. It has traditionally been used for constipation by its ability to stimulate the smooth muscles of the intestine. Funny thing, the uterus is also a smooth muscle. They tend to be stimulated together. This oil can trigger the body to start contractions.
Talk to your care provider before trying this method. This method is more potent. It is good for them to be aware that you are trying this method for safety and for planning purposes.
Precautions: It can also trigger diarrhea. Talk to your midwife or care provider before trying this, especially if it’s not your first baby. It could be very effective, so it is sometimes used as a last try before a medical induction.
Personal Experience: If it’s going to work, it works. Fast. But if your body’s just not ready, then you might just give yourself some frequent trips to the bathroom.
*FOLEY CATHER INDUCTION - need to consult care provider, can be requested when a medical induction is needed (when there is a clinical reason, not for starting spontaneous labour)
A foley catheter is a silicone tube that is typically inserted into the bladder through the urethra to drain the bladder. It is held in place by a small balloon that is blown up once the tube is in the bladder. For inducing labour, this little tool is put in the cervix. This means your cervix needs to be open, but not yet very dilated (in this case less than 4cm or so). The catheter is inserted into the vagina, and once it is inside the uterus, the tiny balloon gets blown up and sits right there wedged between the cervix and the bag of waters, applying some pressure.
This pressure pushes down onto the cervix, and up around the entire uterus. Now that the bag of waters is pushing more strongly against the uterine walls and the little balloon is pressing down onto the cervix, we hope it will kick start some contractions and make some cervical changes.
This is a nice method to avoid medications while prompting your body to start labour.
*ARTIFICIAL RUPTURE OF MEMBRANES - need to consult care provider, need a clinical reason for inducing labour
...also known as, breaking the waters.
This is where we take a large, plastic, crochet-hook like tool and break the bag holding in the water and containing the baby.
This takes the cushion in front of baby’s head away to apply more direct and more intense pressure on the cervix. This increased pressure can trigger the body to start contractions. The series of biochemical changes that follow the water breaking might allow the uterine muscle to be more sensitive to the signals in the body for labour.
Precautions: After you water breaks there is a higher chance for infection, but it is still relatively safe and there is no need to worry if you are mindful, such as: nothing in the vagina. No sex, no baths, no tampons. Just wear a pad and leave it be.
Sometimes the water breaks and we discover that the baby has pooped inside, this is called meconium. It’s not as gross as one’s imagination might make it because your baby hasn’t even eaten anything yet! This is just body waste from mostly amniotic fluid.
Sometimes breaking the water doesn’t start labour but now you’re walking around with your waters broken.
Bottom line is it puts the labour on a map and you on a timeline. It can be a good option to try before more powerful medications but is also not as without consequences as it may seem.
FOODS - without much scientific evidence. Can try for interest to encourage spontaneous labour!
Eating Spicy foods
There are no harms to eating these foods, so by all means try them if you like them! But there is little evidence to how well these methods work, so don’t force yourself to eat dates if you don’t like them for the singular hope of starting labour!
CALM YOUR MIND AND REST YOUR BODY: PATIENCE.
Tried and tested method.
Works most of the time.
Sometimes you don’t really need labour to start, you just need to be reassured that it’s okay for your baby and your body to take their time. Here is a little something to help reassure you.
Precautions: Easier said than done. Might be annoying to hear.
A Friendly Note:
This is especially for anyone who feels that they have a had a traumatic experience, would like to debrief with a clarity of mind to gain more insight on their birth management, and to find closure and strength in their experience.