As it stands, the labour process and how and when it starts is still quite the mystery of nature. The latest research points to an intricate dance of hormones, including prostaglandins and oxytocin, which is initiated by the baby when their lungs and brain are mature and they are ready for life outside of the womb. It thus stands to reason that it’s probably best to patiently wait it out until baby gets things going, but sometimes things happen (or don’t happen!) and you would like to try and give the labour process a little kickstart. It could be that an induction will soon be medically indicated, or you could just be getting tired of pregnancy (those last few weeks can sure feel like months!) and baby doesn’t seem to have got the eviction memo.
So, should you try inducing labour?
The answer to this depends greatly on your individual circumstances. Remember that any form of induction (even using natural methods) is still an induction and an intervention, so always check in first with your care provider to find out if you should be trying any form of induction.
When is it safe to induce labour naturally?
Your baby is considered early term from only 37 weeks of gestation, so it’s not recommended to try inducing labour before then. We also see from the latest research that baby’s lungs and brain undergo exponential growth and development during the last few weeks of pregnancy, so it may not be a good idea to try inducing naturally until baby is at least term, which is around 39–40 weeks – unless given the go-ahead from your care provider under special circumstances.
Many of the methods we’ll cover below won’t really work unless your baby and body are on the brink of spontaneous labour anyway, but it is best to avoid introducing any unnecessary risk that would come along with trying to induce early, for example at 35 weeks. When babies are born prematurely (before 37 weeks) there is a strong chance that they will need extra care, for example in the neonatal ICU, so it is best to leave well enough alone until a later point in your pregnancy.
Let’s take a look at some methods of inducing labour naturally …
Natural induction methods supported by some evidence
Eating date palm fruit (Phoenix dactylifera plant) –
Dates are very nutritious, and it’s believed that their nutritional and biochemical properties are effective in shortening pregnancy and improving labour and birth outcomes. Recent studies show that eating about 70–100 grams of pitted dates (so about 3–4 medjool dates or 6–10 smaller dates) daily from 36 weeks of pregnancy helps ripen (soften and open) the cervix, reduce the length of pregnancy, and shorten the length of labour. As the studies did not apply to pregnant people with diabetes or gestational diabetes, please check in with your healthcare provider before consuming dates if you have concerns about blood sugar levels.
You may have heard it said before: “What gets the baby in, gets the baby out.” Let’s take a look at how and why sex may be a natural induction method, and when it’s not recommended. Firstly, human semen contains prostaglandins, which we know play an important role in ripening the cervix and starting labour. Secondly, oxytocin is released when you orgasm (your uterus actually contracts, which can also be a mechanical kickstart to labour contractions) and when your clitoris and/or nipples are stimulated. Sex is generally considered safe for most pregnancies, some of the only exceptions being when you have a low-lying placenta, are at risk for pre-term labour, or your waters have broken.
Acupressure, shiatsu, and acupuncture –
Acupressure and shiatsu are techniques that use the application of manual pressure to certain points on the body. Research looking at acupressure for labour initiation doesn’t show much benefit; however, there was one study carried out that looked at the effect of acupressure (applied to spleen six, the pressure point on the inside of the leg above the ankle for 20 minutes per day) on cervical ripening, and they found that the participants’ Bishop’s scores (level of cervical ripening) increased significantly. There were also a couple of low-quality studies done on using shiatsu (applied to gallbladder 21, large intestine four, and spleen six), and they found lower rates of artificial oxytocin use in the study groups. Looking at acupuncture, which involves fine needles being inserted into specific acupuncture points, two studies found an increase in cervical ripeness when the technique was performed by a trained professional. So, overall, these techniques probably won’t induce labour, per se, but may ripen the cervix.
Some natural induction methods that lack sufficient evidence, but may be worth a try
Pineapple contains an enzyme called bromelain that is thought to help ripen the cervix. Pineapple has been used to terminate pregnancies and induce labour in many cultures throughout the world, including Fiji, the Philippines, Indonesia, Malaysia, India, and Trinidad. Little research on pineapple for induction of labour has been conducted in humans. In animal studies, and when applied directly to uterine tissue from humans, pineapple juice caused contractions, but this same effect was not seen when it was consumed orally. We therefore don’t have much evidence to support eating pineapples or drinking pineapple juice to induce labour, but unless the pregnant parent has diabetes or the pineapple gives her a sore mouth, it is likely not harmful, either.
Curry/spicy food –
Eating spicy food can irritate your gastrointestinal tract, which leads to an irritated uterus and possible contractions. If you are on the brink of labour already, that curry may just tip you over the edge – but there is no hard evidence supporting the use of spicy food for labour induction.
Gravity is your friend! You may have heard that climbing stairs, walking, washing the floors on hands and knees, and bouncing on a birth ball can help kickstart labour. Indeed, gravity can help by nudging baby deeper into the pelvis, and the increased pressure on your cervix may aid in opening it up. This can help initiate labour or ramp things up if you’re already in active labour. To date, though, no actual studies have been carried out on the effects of exercising to induce labour.
Effective natural induction methods that should only be used under direct guidance from your healthcare provider
Evening primrose oil –
Gamma linolenic acid, which is a precursor to prostaglandins E1 and E2, is thought to be the active ingredient in evening primrose oil. These prostaglandins ripen the cervix, thereby preparing it for labour. The latest evidence showed that inserting 1000mg of evening primrose oil vaginally from 38 weeks of pregnancy significantly increased the average study participant’s Bishop’s score and shortened the length of their early labour. Fewer caesarean births also occurred in the group who used evening primrose oil. No side effects were reported. Because all study participants were healthy with no pregnancy complications, and the evidence that has come out is quite new, it is recommended to first speak with your healthcare provider before using evening primrose oil.
Castor oil (Oleum Palma Christi) –
From studies that have been done and anecdotal evidence amongst healthcare providers, it appears that castor oil ripens the cervix and stimulates uterine contractions, especially in pregnancies that go beyond 40 weeks. This effect is more pronounced in mothers who have had previous vaginal births. Reported side effects include nausea and diarrhoea. Because of the wide range of dosages and possible side effects, it is recommended that pregnant parents ask for guidance from their healthcare provider before consuming any amount of castor oil to induce labour.
Nipple stimulation –
Breast and nipple stimulation has been used all over the world as a way of inducing and augmenting labour. Research has shown that nipple and breast stimulation increases cervical ripeness, improves the likelihood of going into labour sooner, reduces postpartum haemorrhaging, and reduces the likelihood of needing a caesarean birth. This is a result of oxytocin being released. However, this is also where some risk comes in: There is no way of controlling the amount of oxytocin being released during the stimulation, and the stimulation can lead to excessively frequent uterine stimulations and foetal heart rate decelerations. Because of this, it is best to speak with your healthcare provider before attempting breast/nipple stimulation as an induction method. Pregnant mothers who are breastfeeding an older baby or toddler may be concerned about the risk of breastfeeding leading to pre-term labour, but from the studies we have, this is not seen to be an issue. The authors of the studies believe that all of the oxytocin receptors need to be fully present in the uterus before nipple stimulation may induce labour, and this usually only happens later on in pregnancy.
Natural induction methods that lack sufficient evidence and safety data
Red raspberry leaf (Rubus idaeus) –
Red raspberry leaf contains fragarine compounds that are thought to help tone and tighten the muscles of the uterus and shorten labour. Due to a lack of evidence on efficacy and safety, though, it is not known whether or not it is safe to consume red raspberry leaf tea or extract during pregnancy, and it is best to speak with your healthcare provider before trying it out.
Blue cohosh (Caulophyllum thalictroides) and black cohosh (Actaea racemosa or Cimicifuga racemosa) –
Black and blue cohosh have been used traditionally to induce labour and abortion and reduce labour pain. Due to a lack of evidence on safety (and some concerning case reports), though, it is unknown whether or not they are safe to consume these herbs during pregnancy (especially early pregnancy), and they are best avoided.
Are there any other ways to prepare your body for labour or get things going sooner?
Certain toning techniques, including perineal massage and pelvic floor exercises, can be useful in preparing the body for labour. Although they won’t initiate labour, they can make the labour process more efficient.
Finally, if you have run out of options and baby needs to make their appearance sooner rather than later, for whatever reason, you can ask your healthcare provider about massaging your cervix or stripping your membranes – also known as a stretch and sweep. The procedure causes the body to release hormones such as prostaglandins (thereby softening the cervix) and, occasionally, oxytocin. The method can be quite uncomfortable, and it carries a small risk of accidentally breaking your waters, but it has been shown to reduce the need for chemical induction for post-term pregnancy.