By East Bay Homebirth Midwifery
There are many things that influence when labor begins. Hormonal changes, fetal development, stress, lifestyle, and even your own sense of readiness all contribute to determining when your baby will make its way into the world.
To improve your likelihood of going into labor “on time,” is important that you begin with the right due date. This is something you want to establish with the help of your provider during your first prenatal visit. Familiarize yourself with how your due date can be affected by both the date of the first day of your last period and the length of your menstrual cycle, and be aware that your provider may be using a calculation method that does not take these factors into account. You may find it useful to do your own calculation in advance, and to bring your calculation to your first visit.
Ultrasounds can never date a pregnancy exactly, and depending on when they are done, have a greater or lesser margin of error. Therefore, an estimated due date based on your last menstruation could be much more accurate than an ultrasound estimate. Avoid agreeing to a due date that seems wrong to you with the idea of clarifying it later on, as providers may base their recommendation to induce labor on the due date that was assigned at the beginning of your care.
Whether your body will respond to nudges towards labor and birth will depend primarily on the readiness of your cervix. Before labor begins, the cervix goes through a process of “ripening” or softening. A soft, buttery cervix can open more easily than a relatively firm cervix that has yet to ripen. This ripening process is influenced by prostaglandins, a hormone naturally produced by women’s bodies in late pregnancy. Exposing your cervix to semen, which is prostaglandin-laden, as often as possible during the last four weeks before your due date can make a big difference in readiness for labor.[i] Make sure that you remain in a supine position (lying on your back) to allow the semen to stay in contact with your cervix. (Please note that any kind of penetration should be avoided after your bag of water breaks to avoid increasing risk of infection.)
Your provider can get a sense of where your body is in the process of getting ready for labor by judging cervical effacement, dilation, and softening, as well as the location of your baby’s head. If, at 36 weeks of pregnancy, your provider finds that your cervix has not started to get ready yet you may want to use evening primrose oil, another rich source of prostaglandins, to help ripen it. Take two capsules daily by mouth, and at bedtime insert two capsules vaginally after first piercing them with a pin. You can also begin to take one of the late pregnancy (pre-labor) herbal tinctures that are available online, following the instructions on the bottle.
The use of acupuncture in late pregnancy is very valuable in preparing the body for labor. Find a practitioner who has experience with induction points, and expect that it will take about three treatments around your estimated due date to have an effect.
Sweeping or stripping of the membranes can be used to encourage labor. One of the risks of this procedure is spontaneous rupture of the membranes (breaking the bag of water, thereby creating a pathway for infection).[ii] This procedure must be done by your provider and it is important that it’s only done after careful evaluation of its benefits versus risks.
There is controversy about the use of castor oil to induce labor. In our practice we have used castor oil for over 20 years with great results if the cervix is ripe. Some practitioners claim that they have seen an increase in meconium (baby’s first stool) in the amniotic fluid when using castor oil, but that has not been our experience.
We have also had great outcomes with the use of a homeopathic spray solution called Birth Ease available in some herbal stores.
These are tools in our baskets. We often use a combination of several of them to induce a labor successfully. Make sure that you consult with your provider before deciding on your plan of action.
–Blessings from the midwives of East Bay Homebirth Midwifery
The information in this column is not intended to be used for medical diagnosis or treatment. Talk with your healthcare provider about any questions you may have regarding a medical condition.
[i] A study found that 6% of women who had sex an average of four times after 36 weeks were still pregnant beyond 41 weeks as compared to 29% of women who did not have sex during this time. See “Effect of Coitus at Term on Length of Gestation, Induction of Labor, and Mode of Delivery,” Obstetrics & Gynecology, July 2006.
[ii] According to one study, membrane sweeping increased the likelihood of prelabor rupture of membranes (breaking water) for women who were dilated 1cm or more at the time of the membrane sweep, but did not decrease the likelihood of induction or the average age of babies at birth. See “The Effect of Membrane Sweeping on Prelabor Rupture of Membranes: A Randomized Controlled Trial,” Obstetrics & Gynecology, June 2008.
