Your body needs to have already begun to prepare for labour in order for a natural induction to work, explains obstetrician and gynaecologist Dr Elmarie Basson.
Obstetricians and midwives can gauge this ‘readiness’ by measuring how soft your cervix is. They give it a Bishop’s score – a score of six or less is unfavourable, whereas a score of eight or more is seen as favourable with a better chance of bringing on labour. Other factors weigh in too, including whether or not this is your first vaginal delivery.
Inducing labour without medication
1. Membrane stripping
Your obstetrician or midwife will insert a gloved finger into your vagina to the part of your cervix closest to the uterus and rotate her finger along the lower segment of your uterus to gently separate the amniotic sac from the wall of your uterus. This releases hormones that can trigger contractions and bring on the spontaneous onset of labour within 48 hours, explains Elmarie. It can also cause discomfort and cramping.
2. Balloon catheter
This works by inserting a balloon catheter through the cervical os (the part of the cervix that can be seen during a gynaecological exam), inflating the balloon on the inside of the cervical os and in the vagina. It’s a method that’s been proven to ripen the cervix, says Elmarie, but does increase the risks of infection for the mother and the foetus.
Sex, close to your due date, may well work to bring on labour, suggest Elmarie and Annette. Although there’s not much supporting, research-based, evidence for this, the theory is that since semen contains prostaglandins, the hormone used in induction vaginal gel, it’s likely to be effective. Our bodies release the hormone oxytocin during sex, which is found in Pitocin, the drug given intravenously to induce pregnant mothers or strengthen their contractions if labour isn’t progressing. Likewise, nipple stimulation and masturbation will also flood your system with oxytocin.
There’s little evidence-based research to support reaching for a homeopathic remedy to bring on labour. As a method of treatment, homeopaths prescribe remedies according to an individual’s unique constitutional make-up, which makes the study of the efficacy of generic remedies difficult to gauge. For any chance of success, you’d need to see a qualified and experienced homeopath who could work with your obstetrician or midwife, says Annette.
5. Vigorous exercise
Walking up and down a steep hill isn’t going to ripen your cervix in any way, says Annette. If you’re close to your due date and your cervix is already beginning to soften, and your baby’s head is well applied to the cervix, then being in an upright position can encourage labour.
There are no significant statistics to give acupuncture a thumbs up, says Elmarie. But, if your cervix is already beginning to ripen and your body is preparing for labour slowly, Annette recommends acupuncture as a natural way to speed things along. It can take three to four treatments for results to show, so it’s best started four days prior to a scheduled induction, she says.
7. Castor oil
This natural induction aid that was touted in your grandmother’s era is one to be avoided, says Elmarie. “It causes potassium abnormalities that can interfere with your baby’s heart rate and is considered dangerous.”
8. Blue cohosh
Another one to be avoided, says Annette. There’s been insufficient research on this herb, but one study linked blue cohosh to foetal heart malformation, she says.
9. Black cohosh
This herb has a long traditional use and appears to strengthen and regulate uterine contractions. It may be helpful for women who are already having irregular uterine activity, but needs to be used with extreme caution under professional supervision as overstimulation of uterine contractions can lead to foetal distress, says Annette.
10. Evening primrose oil
You’ll find a fair amount of information online touting evening primrose oil as a natural, gentle means to induce labour. But both Elmarie and Annette say there is little evidence-based research on its efficacy. One study published in 1999 in the Journal of Nurse-Midwifery found that it did nothing to shorten gestation, but was, instead, associated with an increase in the premature rupture of membranes, an increase in synthetic oxytocin to augment labour, arrested descent of babies down the birth canal and increased vacuum extraction.
11. Spicy food, dates, laxatives
There may be some truth in the joke that a curry could bring on labour. Both spicy food and laxatives like cod liver oil may irritate your colon, bringing on diarrhoea that can, in turn, irritate the uterus, explains Annette.
Any plans to induce labour naturally need to be discussed with your healthcare provider, who will take the following into consideration:
- Your obstetric history. A previous C-section may increase the risk of uterine rupture.
- Low levels of amniotic fluid around the foetus can lead to severe foetal distress in an induced labour.
- Whether you have a medical condition that may require that you have a C-section.
- The position of the baby and whether you are carrying more than one.
Know the risks
- Moms considering induction, using natural or non-medical methods, also need to know that when labour is induced there is an increased chance of uterine rupture, infection and haemorrhage.
- Inducing labour also increases the risk of a C-section, especially if you are delivering for the first time and your cervix isn’t ready.
- Natural induction may be especially helpful in avoiding an orthodox induction when the cervix is unfavourable, says Annette. This can lead to a prolonged induction with Pitocin administered intravenously, which not only results in a more painful labour, but increases the chances of foetal distress and emergency C-section. This is often what makes moms panic and prompts them to take matters into their own hands. However, bringing on labour, even with natural methods, is still best done with the guidance of your obstetrician or midwife.
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