What are natural ways to induce labour?
By the end of the third trimester pregnant people are more often than not ready to get the ball rolling when it comes to birth. While medical induction is a common practice, clients often present in my office wanting to try acupuncture to induce labour. Moreover, they’re also looking for other evidence-based natural ways to induce labour and promote cervical ripening (because I don’t know about you, but I couldn’t handle spicy foods at the end of pregnancy!).
Cervical ripening is incredibly important when it comes to the success of induction and labour. A ripe cervix increases the likelihood of a vaginal birth, while an unripe cervix increases the risk of a prolonged labour and C-section.
How to assess a cervix using the Bishop Score
Your OB or Midwife will assess your cervix using the Bishop score to determine its favourability and readiness for labour. They’ll take a look at:
Dilation: The cervix is normally closed in most of pregnant, but can begin to open/dilate towards the end of pregnancy. Having a dilated cervix doesn’t equate to an early labour though - you may be dilated for several weeks before going into labour.
Length: Towards the end of pregnancy, the cervix begins to thin and effaces. Once the cervix is completely thin, it is 100% effaced.
Position: A posterior cervix means it’s far back in the vaginal canal, where an anterior cervix means it’s close and easy to assess. As the cervix effaces, it will normally become more anterior.
Consistency: A cervix typically feels like the tip of your nose (you’re touching your nose now, aren’t you?). As pregnancy progresses, the cervix will become softer like the skin of your cheek (did you touch that too?)
Station of the fetal head: This is assessing if the fetal head is engaged in the pelvis. Normally care providers will assess this during your prenatal visits. I recall during one of my pregnancies, my baby’s head was engaged starting at 32 weeks!
A high Bishop score is associated with a favourable cervix, meaning that you’ll possibly experience an easier and shorter induction. A low Bishop score is indicative of an unfavourable cervix, which means that induction can take a longer time and has a higher chance of failing.
The Bishop Score is measured by a cervical membrane sweep otherwise known as a “Stretch and Sweep.” These are commonly offered during the last few weeks of pregnancy depending on your care provider. In my experience, I was offered one at 40+ weeks pregnant with my Midwife. However, I’ve had clients have them done at 38+ weeks with their OBs.
Evening Primrose Oil to Induce Labour
Evening Primrose Oil (EPO) has been shown to improve the Bishop Score and reduce the time between taking EPO and birth. Ideally, the capsules should be inserted vaginal to have a local effect on the cervix.
While there have been studies to assess its effectiveness when taken orally, it does come with more side effects such as nausea and vomiting, diarrhea and hyperthermia. There was even a study that showed prolonged rupture of the membranes and stopping the descent of the fetus in the vaginal canal.
This is one of the treatments that I would talk to your care provider about and determine what their experience with it was.
I’ve personally used EPO in my past pregnancies, but at the very end and inserted vaginally.
Castor Oil to Induce Labour
Castor oil (the oil from the castor bean, not motor oil) has been shown to increase labour induction. Drinking a specified amount of castor oil (in juice and usually paired with a nut butter) increased the Bishop score. There are some reported side effects though - they include nausea and diarrhea.
In my experience, castor oil is often used as a last resort mostly because of the side effects.
Dates to Induce Labour
Eating dates is associated with increased cervical dilation and a decreased need for labour induction. You can begin eating about 3-4 Medjool dates around 36 weeks of pregnancy. When I was pregnant, I liked blending them into a smoothie with 1 banana, 1 scoop of both protein powder and almond butter, and finishing it off with nut milk. You can also pair dates with pecans and dark chocolate for a very offbrand turtles.
If you have gestational diabetes, this may not the the appropriate treatment for you.
Acupuncture to Induce Labour
Check out my blog post about acupuncture to induce labour.
Contraindications to Labour Induction
The following are contraindications to labour induction:
A history of classical or high-risk cesarean section
Uterine rupture
Transmural incision entering the uterine cavity
Active genital herpes infection
Placenta previa
Umbilical cord prolapse
Transverse fetal lie
Invasive cervical cancer
Category III fetal heart rate tracing due to associated risks
Next Steps
If you’re looking for a tailored plan on natural ways to induce labour, or begin acupuncture treatments at 37 weeks, please feel free to book an appointment with me. Wishing you a wonderful birth experience!