So do these folklore/ traditional remedies/old wives tales/ internet gossip “work” to start labor? What do they do? And are natural inductions safe?
As an important general warning for ANYTHING you find on the internet- if something is effective at altering your pregnancy, health or labor, then treat it like it’s going to work! So if you’re trying to get labor going, please keep your midwife, OBGYN or medical provider in the loop. Some of the techniques for natural induction do have cautions associated with them.
First, let’s discuss why labor begins.
While we don’t know for certain, here are the top three theories:
Traditionally it was thought mother’s body started labor. Specifically the thought was that when it was time, the birth person’s pituitary gland secreted oxytocin, which causes contractions and results in cervical change.
Newer research suggests that the fetus’s lungs start the process, since the baby’s lungs are the last organ to develop in utero. When they are formed, they send a signal that begins labor.
Some scientists believe that a baby’s adrenal gland sends a signal when their brain activity reaches full development, and the fetal release of cortisol disrupts the maternal hormone balance, which triggers labor.
When is a normal time period for labor to start?
Anything from 37 weeks gestation, to 42 weeks is considered normal. Going beyond 40 weeks in pregnancy is very common and normal, and even more so for first time mothers.
When is it “too long” to be pregnancy? After 42 weeks, there may be concerns about fetal size, amniotic fluid, age of placenta and “post-maturity syndrome”.
I compiled a list based on what I’ve learned over the years as a labor doula, and also dive into the mommy forums. Some of these techniques encourage labor to begin which is a natural labor induction. Other techniques are suggested to make labor easier or faster- which is considered an augmentation. It matters because if you’re wanting to get labor started, there are different approaches than if you need to encourage a labor that’s already happening.
Red Raspberry Leaf Tea for Natural Labor Augmentation
This herbal tea’s goal is to tone the uterus. The uterus is a muscle, and so a stronger toned uterus is more effective. The theory is that when contractions begin, they will be stronger, resulted in a shorter labor.
A study published in 2001 in 108 mothers found it to be effective at shortening labor. https://pubmed.ncbi.nlm.nih.gov/10754818/
Another study, a systematic review including studies published between 1941 and 2016 found neither benefits nor harm- https://pubmed.ncbi.nlm.nih.gov/33563275/
Research suggests that drinking 1-2 cups of red raspberry leaf tea beginning at 32 weeks of pregnancy may help, and is unlikely to cause harm.
Okra Water for Pregnancy
I first saw okra water for induction on tik tok. Mostly I’ve seen Black women discussing it, and it sounds Black and southern to me, but I’ve not found the roots of it. The idea is that you soak okra in water, and the sliminess improves vaginal lubrication. As a childbirth educator, I’m not sure about the effectiveness of this method. More than lube, what we need for labor is dilation.
But okra is high in folate, which can help prevent brain defects and that’s a positive. You would want to eat okra during conception and the first trimester to receive folate benefits.
Eating Dates
Eating dates during pregnancy to improve labor has recently grown more popular. A study was published in 2011 of 69 women, who consumed 6 dates per day in the 4 weeks prior to EDD. They were more dilated than the 45 who’d consumed no dates, and more likely to experience spontaneous labor.
Please note two things- this was a small study and not a randomized control trial. Also, dates are high in sugar so if you’re controlling gestational diabetes through diet, be aware of that and consult your medical provider. But if you’d like to follow the study, begin consuming 6 dates per day in week 36 to encourage natural induction and a shorter labor.
Evening Primrose Oil
Gamma linolenic acid is thought to be the active ingredient in this plant and evening primrose oil is often recommended for cervical ripening. Cervical ripening can improve your body’s readiness for labor (and is often the first step in an induction done in the hospital).
I’ve heard this recommended throughout my doula career, and often by midwives. There’s recently been research on both oral and vaginal use of EPO, include randomized controlled trials. Evidence Based Birth did a great podcast episode on this, which I’ll link, that dived into the studies on both oral, and vaginal use.
While the jury is still out- the studies are small, it seems like the evidence is primarily in favor of oral insertion of EPO.
This is something that should be discussed with your provider, as there may be risks if you take anti-platelet and anticoagulant drugs, both of which are commonly recommended for Black women since we have higher rates of pregnancy induced hypertension and pre-eclampsia.
Nipple Stimulation to Begin Contractions
We know exactly why nipple stimulation would work to encourage contractions.
Oxytocin is a hormone that causes lots of things, most relevant to labor- contractions. It’s released during many activities, one of which is when babies feed directly at the breast. Oxytocin causes your milk to let down, and so nipple stimulation is using this well established way that we know your body works to produce oxytocin.
In a recent study published in 2022, women were assigned to nipple stimulation therapy were asked to stimulate with an electric breast pump or by hand for periods of at least 30 minutes, with breaks as needed for up to 15 minutes at a time, for at least a cumulative 2 hours before considering initiation of oxytocin, and to complete intrapartum diaries. These women required on average 69 minutes of stimulation before contractions reached a frequency and intensity compared to those using pitocin.
In my opinion, because it’s not an instant gratification remedy, and does require some effort, it’s best used for what we call labor augmentation- increase how frequent and effective your contractions are. And it can be an alternative to pitocin (which is artificial oxytocin used as a medication).
Pineapple for Induction
Traditional recommendations in some cultures, including those of Trinidad and India to terminate pregnancy (by causing contractions). The idea is that bromelain would be the active ingredient in pineapple, and it would contribute to cervical ripening, that can help start a natural induction. However the research has primarily been performed on rats, and didn’t find good evidence. I would caution folks with gestational diabetes to consult their provider first.
Sex
Sex for induction is another instance where we’re using the body’s ability to produce oxytocin. For clarity: when I say sex, the most effective kind for the purposes of labor induction is penetrative sex that involves a penis and vagina, without a condom or other barrier method. (That all sounds so clinical, but clarity matters more than sexiness in this case!)
Even without a penis, orgasms will produce oxytocin, which can lead to contractions. But there is an added benefit of semen, because semen has a lot of prostaglandins, which are a hormone known to induce labor.
A 2019 meta-analysis which looked at lots of studies on the subject, did not find that intercourse was effective, but they did not find any harm.
My recommendation is that if you want to have sex, or an orgasm, go for it. It won’t hurt, as long as your water has not broken (in which case avoid inserting anything into your vagina). But if you’re not feeling it, avoid this method.
Yoga Ball Bouncing/Pelvic Mobility
Using a birth ball (which is the same as a yoga ball or exercise ball) is a common recommendation. On social media, I often see if described as bouncing. As a doula, I typically tell clients to do hip circles, or figure 8s (imagine moving your hips like you are keeping a hula hoop up).
According to a study published in 2021, the use of a birthing ball was found to be effective for women who were already undergoing induction.
Walking/ Curb Walking /Exercise
According to a study published in 2021, “Walking during late pregnancy could improve Bishop score, increase spontaneous onset of labor, and decrease induction, cesarean, and instrumental delivery without having any adverse effect on the neonate’s Apgar score.”
Staying active with light exercise like walking is great for most pregnant women. My caution with walking is always NOT to wear yourself out. Labor is typically a marathon, not a sprint (and sprinting labors are tough anyway.) So light activity is a great idea as a consistent practice. Trying to cram all the walking in during early labor might exhaust you.
Spicy Food
When it comes to spicy food, I say eat what you like. Spicy food may get your bowels going, and stimulating bowels could stimulate contractions, but not necessarily the sort of contractions that produce labor, and get your baby to you.
If you do think you’re going into labor, I don’t recommend eating new foods, things likely to cause nausea, or that would hurt if you vomited or pooped them out, because ALL of those things are a normal part of labor.
Chiropractors and Acupuncturists
Based on my own experience as a doula, I think more pregnant folks should consider getting help from a professional to encourage labor, or create conditions for their baby to encourage labor.
I’ve seen acupuncture work very effectively for clients, and know moms who swear by induction massage. Chiropractic care can also aid in smooth labors.
Midwives Brew/Castor Oil
Some people report that a drink called Midwives Brew helped induce their labor. Ingredients vary, and there’s no research to support that these drinks work. To be safe, always consult your healthcare professional before consuming any concoction while pregnant.
There are different recipes for midwives brew, but most include some combination of:
castor oil
lemon verbena oil
almond butter
apricot juice
It’s important to use this midwives brew (or similar) only with the support of your medical professional (we can’t emphasize this enough), so before attempting to make and consume it, check with your OB or midwife. They can suggest or approve a specific recipe for you.
That said, though it’s popular in certain circles, not all midwives have heard of a “midwives brew” concoction specifically. You may be introducing the recipe to your healthcare professional!
Also, keep in mind that for many women, this drink doesn’t stay down — taste isn’t usually the selling point!
To consider the overall safety of midwives brew, let’s take a look at the individual ingredients. Of note, castor oil is likely the labor-inducing ingredient, while the others are there primarily to mask the taste of, well, the castor oil.
Castor oil
One of castor oil’s most common uses is as a laxative. This is because castor oil can cause little spasms in the intestines. Similarly, it can cause spasming of the uterine muscles, which can lead to contractions and induce labor.
But consuming castor oil can also lead to severe diarrhea, nausea, and vomiting. In a word, it can be unpleasant.
It’s very important to watch out for dehydration if taking castor oil. Additionally, castor oil may cause contractions that stay irregular or become extremely painful. This can cause exhaustion or additional stress on mom and baby. This is one reason why castor oil shouldn’t be used during pregnancy without a healthcare professional’s guidance and supervision.
One more important note: Castor oil should never be consumed earlier than full term in pregnancy, as it can be dangerous for baby.
Lemon verbena oil
There isn’t a lot of research around the use of lemon verbena oil in pregnancy and labor. Speak with your doctor or midwife about their views on you ingesting it.
Almond butter
If you have a nut allergy, this is certainly an ingredient to be aware of. But for others, it’s generally safe.
If you have an almond allergy, it may be possible to substitute another type of nut butter. Speak to your doctor or midwife about another ingredient that can replace this.
Apricot juice
Apricot juice is a great source of vitamins and minerals. Unless you have a specific allergy to apricots, it’s probably safe to consume apricots throughout your pregnancy. (Though like everything, consumption in moderation is key!)
When do you drink it?
It’s important not to try to induce labor before a date when it would be safe to have your baby. You may be eager to see your little one (and get out of your pregnant bod, already!), but the longer they can stay safely in the womb, the better. It’s important to carry baby until at least 39 weeks if possible.
Additionally, an induction is more likely to be successful when the body is already ready to go into labor.
The combination of both of these facts means that for most women, midwives brew shouldn’t be consumed until at least full term (between 39 weeks and 40 weeks, 6 days).
There may be cases where you doctor would like to induce labor before your due date. This is a medical decision generally made with specific concerns for the safety of you and your baby in mind.
If your doctor is planning a medical induction before your due date and you’d like to try midwives brew, it’s important that you discuss it with them. Midwives brew may not be appropriate to use in these situations, and your doctor should be aware of any actions you’re taking to try to induce labor yourself.
Is it effective?
Although there are a lot of anecdotal reports on the success of midwives brew, there’s a lack of research behind it. Looking at the scientific effectiveness of castor oil is equally confusing, since there aren’t a lot of studies on it — and the results vary.
In one older studyTrusted Source of 103 women who were at least 40 weeks pregnant, half were given castor oil and half had no treatment. Of those given castor oil, nearly 60 percent were in active labor within 24 hours. (And for those who had castor oil–induced labor, more than 80 percent gave birth vaginally.)
But another studyTrusted Source, published in 2009, gave a less enthusiastic finding for castor oil. It suggested the oil’s effects are neither particularly helpful nor harmful in inducing labors.
And a 2013 review of studiesTrusted Source noted the effectiveness of castor oil for inducing labor, but cautioned that the quality of the studies may make results questionable. Also of note: Researchers found that all women who took castor oil felt nauseous.
So, for the time being, the formal scientific jury still appears to be out. Basically, more research is needed — especially when it comes to the ingredients other than castor oil, but for castor oil, too.
For people citing the effectiveness of both midwives brew and castor oil in inducing their labors, the results are quick — usually under 24 hours later. One 2012 study even suggested that post-term women were three times more likely to go into labor within 12 hours when they consumed castor oil. Talk about instant gratification.
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