Eating pineapple or drinking
pineapple juice is said to be an old wive's tale to bring on labour for woman past their due date. Large amounts of pineapple juice can in fact cause uterine contractions. It's for this reason that in early pregnancy, it's often suggested that you don't drink pineapple juice in excess amounts.
Why pineapple can cause contractions
Fresh pineapple contains Bromelain which can also soften the cervix but it is said that it takes large quantities to have any effect which can also result in diarrhea. Some women say that they've had zero problems having plenty of pineapple and pineapple juice during pregnancy and others claim it brought on labour. The verdict on pineapple during pregnancy? Some would say that you should eat it in moderation and watch for any signs of problems before your due date. If you're at or past your due date, it might help you.
Natural ways to bring on labour: a guide
For the past 40 weeks you have been waiting for this moment. Your birth plan is written, your bag is packed, your belly feels like it is about to burst and you are sure that any minute now you will feel your first contraction. And then... nothing. Not even a twinge.
Now there is something to be said for being patient. Your baby will come out when he is good and ready and some just like to take their time. But if an induction date is looming, you might feel like you want to give him a gentle nudge. Here are some of the alternative methods of bringing on labour.
Before you proceed, we should warn you that there is very little hard scientific evidence relating to either the effectiveness, or the safety, of any of these methods. The studies that have been done tend to be small and evidence is difficult to verify: if labour is due anyway, how do you know whether it was the curry you ate last night that actually brought it on?
On the safety side, talk to your doctor or midwife at your next check-up before you try any of these methods. This is particularly important if there are any complications in your pregnancy, as there is even less evidence about the safety of these methods in a high-risk pregnancy.
Nipple stimulation
Nipple stimulation is the gentle rubbing or rolling of the nipple to encourage the start of contractions. The theory is that oxytocin, a hormone that causes contractions, is released in the body when the breasts are stimulated.
Is it safe?
A review of studies found that contractions after nipple stimulation did not over-stimulate the uterus, which could be dangerous for the baby (Kavanagh et al 2005). There is a lack of research on the safety of this technique in high-risk pregnancy, so currently it is only recommended in normal pregnancies.
Does it work?
The review mentioned above showed a significant benefit from nipple stimulation in women whose cervix had already started to soften, thin and open ready for labour. 37 per cent women who had tried it went into labour within 72 hours as compared to just 6 per cent of those who had not.
How do I try it?
The idea is to simulate the suckling of a baby so you need to massage the whole areola (the dark area around the nipple), not just tweak the nipple. Place your palm over the areola and move in a circular motion, applying a firm but gentle pressure. This may need to be continued for some time. The usual recommendation is to stimulate the breasts for an hour, three times a day, spending 15 minutes continually stimulating one breast and then alternating to the other breast for 15 minutes until the hour is up.
Castor oil
There are reports of castor oil being used to bring on labour as far back as the Egyptians, though how it works is poorly understood. The most commonly given explanation is that it acts as a powerful laxative, and when it stimulates the gut it also stimulates the uterus and so "kick starts" labour.
Is it safe?
Nausea is likely to be the immediate effect, followed by a bad case of diarrhoea and there is a risk that you will become dehydrated. For this reason, we would NOT recommend taking castor oil.
Does it work?
A study of 100 overdue women found that 57.7 per cent began active labour after a single dose of 60ml of castor oil, as opposed to 4.2 per cent who received no treatment (Garry et al 2000). A review of this study reported no adverse affects on mother or baby but that all the women who took it felt nauseous (Kelly et al 2001). The study was not large enough to be conclusive.
How do I try it?
This is one we would NOT recommend but, according to a survey of midwives, 4 fl oz of castor oil mixed with orange juice is the usual dose. It is revolting (very oily) to drink though some suggest that making it fizzy by adding half a teaspoon of bicarbonate of soda helps. A second dose can be given 12 hours later.
Sex
Sex as a means of getting labour started is thought to work in three ways: firstly orgasm may help to stimulate the uterus into action; secondly, sex can trigger the release of oxytocin, the "contraction" hormone; thirdly, semen contains a high concentration of prostaglandins which may help to ripen, or soften, the neck of the womb (cervix) ready for it to dilate when labour starts.
Is it safe?
Sex is safe as long as your waters have not broken. Once this has happened, making love may increase the risk of infection. You should also avoid sex if you have a low-lying placenta (placenta praevia) or have had vaginal bleeding (von Sydow 1999; Aston 1997 cited by Jackson 2004: 106). Men often feel uncomfortable making love to their partners with a baby so obviously present but the baby will not know what is happening and will not be harmed.
Does it work?
There's not much evidence that it does work. Of the small studies that have been carried out all but one (Tan et al 2006) suggest that sex neither helps to ripen the cervix nor to start labour earlier (Kavanagh et al 2001; Tan et al 2007; Schaffir 2006). If nothing else, it will take your mind off the waiting!
How do I try it?
At this stage in your pregnancy sex is easier said than done. Try spoons, with your partner entering from behind or use the bed as a prop: your bulge isn't an obstacle if you lie on your back at the side or foot of the bed with your knees bent, and your bottom and feet perched at the edge of the mattress. Your partner can either kneel or stand in front of you. Alternatively, giving your partner oral sex may work better. It is thought that prostaglandins are absorbed more efficiently through the gut than through the vagina. (Note: you may prefer to keep this piece of information to yourself!)
Eating pineapple
Pineapple contains the enzyme bromelain which is thought to help to soften the cervix and so bring on labour.
Is it safe?
There is no evidence to say whether it is safe or not. Each pineapple contains only very small amounts of bromelain so you would need to eat as many as seven to have any effect. The most likely side-effect of eating large amounts of pineapple would be a severe case of the runs.
Does it work?
Some cultures swear by it but there is a lack of research into whether it really works. Regardless of this, eating large quantities of pineapple is likely to stimulate the gut and bowel and, as with castor oil, could kick-start the uterus into action by that means.
How do I try it?
The pineapple must be fresh: bromelain is destroyed by the process of canning or juicing.
Homeopathy
Homoeopathic remedies use highly diluted versions of more potent substances to treat the body. Pulsatilla and Caulophyllum are two commonly used homeopathic remedies used to stimulate labour.
Is it safe?
Homeopathic remedies appear to be safe. The Faculty of Homeopathy have researched their use in labour and not found any incidents of damage caused by them (Dantas and Rampes 2000). The worst damage homeopathy can do is nothing.
Does it work?
There is plenty of anecdotal evidence from patients who found that homeopathy is helpful, but this has not been researched in a systematic way. One trial into caulophyllum found no difference between the women who took it and those who didn't, but the method of the trial was not thought to be reliable (Smith 2003).
How do I try it?
Contact a registered homeopath (The Society of Homeopaths has a list). A Homeopathic Birth Kit is available from Helios Pharmacy which includes 18 remedies and a mini-guide.
Herbal: blue cohosh and black cohosh
Blue cohosh (Caulophyllum thalictroides) and black cohosh (Cimicifuga racemosus) are herbs which should not be used in early pregnancy but are often cited as useful in bringing on labour.
Are they safe?
Two Canadian reviews of studies on their use have concluded that they should be used with caution in the case of black cohosh and extreme caution in the case of blue cohosh (Dugoua et al 2008; Dugoua et al 2006). Blue cohosh in particular has been linked with severe complications for the baby at birth. In either case, there is not enough evidence that they are safe to use. Herbals are much stronger than homeopathic remedies and so should always be used under professional guidance. Given that there is a question mark hanging over them, you may decide that it is better to avoid these herbs entirely.
Do they work?
Anecdotal evidence suggests that they do, but there are no scientific studies to back this up.
How do I try them?
The National Institute of Medical Herbalists can help you to locate a qualified, registered herbalist near you.
Eating curry
Spicy food is often suggested as a means of bringing on labour. There are no scientific theories relating to this, but it may be that it stimulates the gut and bowel and so encourages the uterus to get going by that means.
Is it safe?
Spicy foods can cause heartburn (CKS 2008) and, if you are not used to them, irritate the bowel. For this reason you should probably not order a vindaloo if you are usually more of a korma girl.
Does it work?
There is no evidence either way though many women swear by it.
How do I try it?
Order a takeaway. This is not the time to be slaving over a hot stove.
Acupuncture
Acupuncture involves the insertion of very fine needles into specific points of the body. According to traditional Chinese philosophy, this stimulates the energy within the body to act on a specific organ function or system.
Is it safe?
Studies into this are limited but none have shown any ill-effects from the use of acupuncture for mother and baby. Acupuncture is generally considered safe at this stage of pregnancy (Harper et al 2006; Smith and Crowther 2004).
Does it work?
The limited studies that have been carried out so far suggest that acupuncture may be effective (Smith and Crowther 2004).
How do I try it?
You need to find a qualified practitioner. The British Acupuncture Council has a searchable list. You will probably need treatment daily until you give birth.
Red raspberry leaf
Raspberry leaf can be taken as a tea or in tablet form. It is often mentioned alongside other methods for bringing on labour. This is a myth.
Is it safe?
It is very important not to use raspberry leaves until the last two months of pregnancy because of their stimulating effect on the uterus.
Does it work?
There is no evidence to show that red raspberry leaf will encourage labour to begin. However, an Australian study has shown that it speeded up the second stage of labour and reduced the need for a forceps delivery (Simpson et al 2001).
How do I try it?
If you want to help to prepare the uterine muscles for labour start with one cup of tea a day or one tablet and build up gradually to a maximum of four cups of tea or tablets daily. The tea can be sipped freely during labour, too. The tea and tablets are available from health food stores or from herbal suppliers.
Walking
The explanation appears to be that the pressure of your baby's head pressing down on the cervix from the inside stimulates the release of oxytocin, hopefully bringing on labour. Also, just being upright gets the forces of gravity working for you, encouraging the baby to move down onto the cervix.
Is it safe?
Yes, but you should be careful not to wear yourself out. Labour can be exhausting and you don't want to use up all your energy before you have begun.
Does it work?
There is, as yet, no evidence. If your baby has not "dropped" or is still high in the pelvis, walking is thought to encourage your baby into a better position so that labour is more likely to start on its own.
How do I try it?
This is not the moment to take up power walking, particularly if you have not done much exercise earlier on in your pregnancy. A gentle stroll is probably the best you will be able to manage.
And finally:
Here is a selection of other methods (some of them a little bizarre) that other mums are said to have found helpful. There is no evidence for any of these and frankly we are not convinced!
€ Blowing up balloons: the theory is that the build up of abdominal pressure encourages labour to start.
€ Bouncing on your birth ball or driving your car down a bumpy road would seem to put the same faith in shaking things up a little
€ Get a weepy video and have a good cry
€ Wear your best knickers (sod's law will ensure that your waters break in them).
