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induce labor naturally Esali Birth

Are you curious how to induce labor naturally and safely at home?  This is probably one of the biggest questions in the maternity industry... 

How do I Induce Labor Naturally?

In most cases, mom is either trying to avoid a medical induction that has been coerced on her by her providers or she's ready for the baby to come out now for various reasons – some medical, most personal.

Well, if you've stumbled upon this post early in pregnancy, wonderful - you have time to comfortably make the choices for provider and birth location that support the biology of birth.  On the other hand, even if you're late in pregnancy - you still have plenty of time to politely say, "No thanks" or any other rendition of that statement that allows you to practice your legal right to make your own decisions for your body and birth.  Oh, and of course, time to read this post and see how you can encourage baby into this world.

STEP 1 – How to Induce Labor Naturally

Learn what your body and baby need to move from the gestating phase of the childbearing year into the birthing phase.  What is that?  Well, beyond the obvious need of the baby to be fully developed - which takes somewhere around 37-43 weeks... give or take depending on your luteal phase of your cycle, when you conceived, and simple biology - there is an immense need for moms to feel safe.

If you don't feel safe, supported... i.e. RELAXED... then your mind is basically the one telling baby, "Stay in, it isn't safe to come out yet."  So, get that support.  Relax.  Take a bath.  Take a walk.  Listen to happy music.  Get a massage in all the tense places, including your uterus.  Most of all, TALK to someone about ANY questions you have.

While ideally your provider AND educator/doula would have prepared you so well during pregnancy that darn near all of these questions and concerns are ancient history, that may not be the case or there may be new questions that have come up.  You need to talk with your TRUSTED birth team about all of these - or you need to speak with the individual that these concerns are hinting.  If there is stress at work, take some time off... or ask for a different task... or ask for help... or take some meditation music to work with you and use all of your breaks to listen, pray, and just breathe.  YOU can MAKE this WORK.  You having gotten here in this life, you can get to the next step, too.

Step 1 Recap to Induce Labor Naturally:

  • Learn – Join a Birth Series or Schedule Mentoring Sessions (online or locally)
  • Relax
  • Reduce the must-do’s and want-to’s

STEP 2 – How to Induce Labor Naturally

Build oxytocin.  This goes along with relaxation, in a sense, but let's think about this a little deeper for a moment.

During your pregnancy, building oxytocin is THE relaxation "method" that I encourage here at Esali Birth.  It is the safest most natural and productive relaxation method.  Why?  Because not every technique works for every mom and because it is with oxytocin that our uterus will contract and progress labor (provided baby is ready).

Keeping STEP 1 in mind, do more eye-gazing, skin to skin touching and abdominal massaging, flirting with/loving our birth partner, building a RELATIONSHIP with our birth team. Stay intimate with your partner throughout pregnancy and in the end.  This doesn't have to mean sex - it just means keeping that relationship strong - or making it stronger - so that it is enhanced during birth and mind blowing through the parenting stages.  At the same time, intercourse does increase oxytocin - especially when it includes breast stimulation and results with orgasm (high levels of oxytocin are created to orgasm) and ejaculation internally.  Semen is an incredible prostaglandin (i.e. something that "ripens" the cervix, or makes the cervix soft and stretchy to encourage dilation) and orgasm creates the highest amounts of oxytocin in our body, apart from the moment after a biological birth.  Yea... biological birth is that amazing.  This does NOT mean just go have sex.  This is more about the connection - the relationship - the joy - the trust that you're creating with this person you've chosen to spend your life with and be a 50/50 partner on parenting.  You NEED that trust and building this relationship now makes you that much more confident to bring a baby into this world.

Therefore, we are increasing our oxytocin naturally by the trust.  THEN, we are getting adequate sunshine (for Vitamin D and all that hormone-balancing and happiness it creates as well as building stores for our baby during the first year of their life).  We are eating balanced wholesome and whole foods meals and snacks that have been properly balanced.  We are getting enough water and of course enough physical activity.  We are going to bed at a decent hour and ensuring we are sleeping well.

You see, oxytocin isn't the only player in the labor game.  There are so many hormones, but particularly with this contracting-hormone, we need dopamine (our happy hormone) and melatonin (our sleep hormone) to be at their peak.  These hormones are at their correct levels with all of the mentioned above.  Yes, yes, this is often why we see so many labors peaking at night.  Sometimes this is because the only time a mom relaxes is during the night.  This brings me to our next step.

Step 2 Recap to Induce Labor Naturally:

  • Build Oxytocin
  • Be Intimate & Connected
  • Get sunshine
  • Eat wholesome whole foods with a variety of colors
  • Stay hydrated
  • Move
  • Sleep

STEP 3 – How to Induce Labor Naturally

Your gestating and laboring body craves a quiet, calm, and dark space.  Dark allows those labor hormones to work.  Dark mimics your night - relaxed - state.  Dark makes everyone walk a little quieter and speak a little softer.  Quiet allows your logical brain to rest and your instinctual brain to take over and work with your baby.  Sometimes most importantly, calm, allows you to feel safe which is key to reducing adrenaline.

Adrenalin and oxytocin are antagonistic hormones.  When one is high, the other is low.  So when stress and particularly caution, question, and distrust is high then adrenaline will be high and labor will not progress.  I don't know how many moms I've talked with that have convinced themselves that they're "such a calm person" or "totally relaxed" or any rendition of being at peace with birth when their actions, schedules, and questions clearly show otherwise.  A kiss can be "stressful" - as stress is not simply a negative feeling, it is the body exerting more energy routinely without balanced rest that causes hormonal stress - whether you're happy with your life or not.  The great thing is, though, they're talking about it.  Sometimes, it does help to admit that to your birth team, however.

When a provider scares you, questions your birth, changes your EDD because of an [often inaccurate] ultrasound scan, or has routine practices you don't agree with - adrenaline will constantly be higher than it should be, even if you aren't feeling completely stressed.  Whether hospital or home, don't convince yourself your choices are the best when they aren't jiving with your birth view or you're not receiving support from your birth team.  This is especially prevalent in births where many moms may actually be friends with their birth team, used that team or provider for a previous birth, or in the case of home birth they assume "home" and "midwife" actually mean they're receiving the best care they should simply because of the title - same goes with an obstetrician.  Titles are irrelevant here.  You have to be honest with yourself.  Every ounce of question, concern, or confusion might be one more day baby stays in when they're actually ready.  But all this has to come naturally  - you can't stress yourself into relaxation!  Let it be.

Likewise, any projects that are ongoing, filled-schedules, and various things that "need done" will not allow this progression.  Get away for a bit.  Put the screens away.  Put the work down.  Let it all go for long enough to feel a sense of release.  At some point during pregnancy, closer to 41-42 weeks for most, mom's brain does tend to override these thoughts and goes. "OK, enough of that, get all this stuff together we need to have this baby."  This is otherwise referred to as the nesting instinct.  Often in our culture with all of our modern technologies and house cleaning help...etc., this is seen in mom as having a surge of energy where she feels amazing and totally different from the last few weeks of complaints and ready to be done with pregnancy thoughts.  But, those little thoughts of complaints - that little doubt that someone may be giving you in the back of your mind is saying, "Stay in there baby."  So, if this is the case, refer back to STEP 1 and read a little about the Art of Relaxation.

Step 3 Recap to Induce Labor Naturally:

  • Be quiet
  • Be calm
  • Be in dark spaces (keep it balanced, of course) – but definitely during labor
  • Be honest about your comfort level and make decisions that support it

 

STEP 4

Get baby and body aligned.  Now, ideally we would be doing this constantly through pregnancy with our physically-oriented lifestyles.  Our shoulders would stack over our hips and our hips would stack over our ankles and our pelvis wouldn't be tilted and... and... our entire body would be aligned.  Our core would be toned and ligaments flexible and myofacia supple to properly support our body structure and uterus and growing baby.  We wouldn't have a lot of back pain because of this physical health.  We wouldn't be sitting at a desk 20-40 hours a week rocking our pelvis in the wrong position and shortening our leg muscles causing pelvic tilt.  We wouldn't be leaning back on the couch with our feet up.

We likewise wouldn't be overworking ourselves physically in any way.  We would naturally walk a lot, maybe gathering foods or just for relaxation.  We would have quality social time with positive people in our lives that help us feel empowered and don't add stress to our body.  We would be barefoot and squatting (with our glutes, not a tucked pelvis) in the garden and the woods pulling [edible] weeds and nurturing our growing plants.  We would be eating well and feeling energized.  We’d also be receiving abdominal massages that encourage oxytocin release comfort and baby’s position while enhancing the tone of the uterus.

Whether we've been doing this or not, making sure baby is in a good position for birth and our body is aligned to allow this good positioning will help us not only to encourage spontaneous labor but also create a smoother labor and birth for you and baby.  Often when all of the above is good to go but labor still isn't happening, doing optimal fetal positioning, seeing a physical therapist, visiting a massage therapist and maybe a chiropractor helps us to realign our spine and pelvis and get baby in the optimal LOA position.  There are of course so many births that are wonderful and smooth and amazing without this optimal fetal position, and that is typically because mom feels safe - which is why I place this down a little further on the list.

Step 4 Recap to Induce Labor Naturally:

  • Get aligned
  • Move aligned
  • Stay aligned
  • Stretch
  • Bellydance, get abdominal and whole-body massages and move the pelvis
  • Work with a doula prenatally for optimal fetal positioning, like spinning babies techniques

 

Final thoughts

 

There are incredible amounts of information for various herbal or OTC "natural" induction methods.  Though, the internet, particularly blogs, and most western medical providers are not always the best place for this information sharing with so much misinformation being shared.  But let's remember, an induction is an induction whether you do it at home or your midwife at home does it or your midwife or OB does it in the hospital or birth center.  Induction of any kind increases the risks of birth for you and baby.  In many cases, baby and mom aren't physically OR mentally ready for labor and herbal induction methods just cause some pretty significant uncomfortable side effects at best and increase risks like meconium staining for instance.  Take castor oil, for instance, which might work because it is a very strong laxative that causes diarrhea which can stimulate uterine contractions.  Not only would diarrhea be uncomfortable to experience during labor - but would also increase infection risks especially with a birth team really focused on vaginal exams.  At the same time, it often just causes diarrhea but not labor because in fact, mom and baby aren't ready.

Now, there are some herbal "tonic" teas that you may see around encouraged to be used as induction agents, such as Red Raspberry Leaf (RRL).  While we're not going to go into specifics here - I do want to talk about what a tonic herb means.  People think of RRL as "the" pregnancy herb.  If they don't drink it during pregnancy, they often drink it at the end.  The thing with tonic herbs is they don't actually contract, rather, they provide immense amounts of nutrients.  They are toning because they are a true statement of "let thy food be thy medicine."  If a mom has used a tonic herb to "induce" labor - it likely had nothing to do with an "induction," rather, she was likely providing her body with necessary vitaminerals like calcium, magnesium, and b vitamins to name a few that many of these tonic herbs contain.  Without adequate levels of [properly assimilated] vitamins and minerals in the body (which don't come from most Rx or OTC supplements), the body can't work as intended.  This is another common reason for prodromal labor aside from misalignment and stress (see above steps).

Now, this is not to say that herbs are not used to induce - they most certainly are, but these are herbs categorized as emmenagogues, abortifacients, and more specifically oxytocics - otherwise known as uterine contractors/menses promotors and strong uterine contractors.  Some oxytocic herbs like Black & Blue Cohosh, and various formulas from Wish Garden Herbs and other Midwifery supply stores should NEVER be used without the guidance of a knowledgeable herbal midwife.  Others, like castor oil, can pose a number of risks, such as hemorrhage, that I would especially discourage you from using at all, and especially not without the guidance of an educated herbalist midwife.  Likewise, you've now made your birth a medical event which now has no place at home (whether you were planning to birth at home or planning to avoid going into the hospital for a medical induction).  Remember that reading a list of "this herb is good for this" is nowhere near being an herbalist and often not at all explaining the way it should be used or if it would work with your situation and body type.  There is an incredible amount of misinformation about herbs on the internet and also in books.  From "do this" with herbs that need more caution to "this herb is poison" for herbs that have hundreds and hundreds of years of safety and herbalist usage but modern medicine extracted one constituent out to study it alone in copious amounts and often on animals, instead of with the other constituents in typical amounts with humans - and this totally changes the way something works.

So, if you're considering induction…  Remember that induction doubles your risk of cesarean.  If your risk of cesarean is 30%, for example, just by having a certain care provider or walking into a hospital - how could an induction change the course of labor for you and baby?  Have you researched induction and whether it is necessary and do you know that studies are pointing to the safety of cesarean over the long-term risks that induction may cause, like ADHD?  Is this induction actually necessary and do the risks of induction exceed the risks of not inducing?  Is your induction scheduled for days later or are you going in right now?  If it is scheduled days later, do you think this is really a true medical need or is waiting a good idea?

Lastly, I would love to talk to you!  If you have questions, concerns, or even a possible previous birth that you haven't quite worked through yet - I'd love to chat with you through my mentoring sessions - online or local in the Mid-Ohio Valley.  Just send me a message at mdbergum - at - esalibirth - dot - com.

Stripping the Membranes

Sweeping the Membranes

Stretch and Sweep

Most of us have heard the terms at one point or another because many moms are induced and this procedure often precedes an induction.  It is designed to stimulate prostaglandins prior to an induction and hopefuly start the dilation process to avoid pitocin or at least make a mom more "ripe" for induction success the following day.  A provider inserts their digits for a vaginal exam and separates the membranes/bag of waters/amniotic sac from the lower portion of the uterus which is known to stimulate prostaglandins.  During a vaginal exam you say?  Yes, they can do this without your consent - without you knowing.  In fact, I know moms that have been told "Oh, by the way, you might experience some bleeding tonight because I stripped your membranes."  Legal?  No...  but who's stopping them?

Prostaglandins, with high levels naturally in semen (in fact, some cervical ripening medications have been derived from the high levels in pig semen), make the cervix more pliable which aids during the dilation process. Moms body will typically make all that is needed - provided she lives a healthy and well balanced lifestyle that allows proper hormone production and body function.  Time, however, is needed during the gestational period as most first time moms birth closer to 42 weeks and most multips also birth after 40 weeks - with wide fluctuations on either side of these numbers.  It is indicated that a longer menstrual cycle is more indicative of a longer gestational length than conception date.

So, is stripping the membranes really necessary?

When moms are recommended for induction, they are often given what is called a Bishop score which looks at various factors such as gestational age, cervical dilation and effacement, number of vaginal births...etc.  A higher Bishop score is connected with higher success for induction... and it is also connected with spontaneous labor happening sooner anyway.  Makes sense, right?  A mom with signs of progression is likely closer to spontaneous birth.  Let's keep in mind a question as well... if mom is in *need* of an induction, is scheduling it for next week the best way to go?  Is the induction actually needed?  Do we know that in many cases the risks of induction are the same as the risks for the situation warranting the induction?  Weigh the pros and cons of waiting vs. the risks of all induction methods (herbal, "natural"...  are any inductions actually natural?, sweeping the membranes, oral/vaginal prostaglandins, breaking the water...etc.).

Also, take a look at Primal Health Research and the studies that indicate because of the risks immediately and long term from pitocin induced births, cesarean often carriers less risk for breastfeeding, bonding, depression, fetal/maternal distress...etc.

In addition to sweeping the membranes, moms are often given some sort of cervical ripening agent either orally or vaginally... or both.  In many cases, this is Cytotec - an ulcer medication which has off-label use for induction... it can also cause uterine rupture and death of the mom and/or baby.  Pitocin also carries these risks in similar rates - but pitocin can be turned down for strength if the uterus seems to be hyper-stimulating (which isn't always measured accurately).  Once Cytotec has been taken orally or given vaginally, that's it - there's no going back - and without proper studies of the medication for this use, we get a wide range of dosages and a wide range of efficacy and experience.  Cytotec is approved for post-birth hemorrhage, however.

While also sweeping the membranes, moms may experience AROM or PROM - Artificial/Premature Rupture of the Membranes.  While ROM may happen spontaneously at home in a low percentage of moms giving them time to monitor their health while waiting - when you're in the hospital and with most medical care providers, that's it - your labor clock has started.  There's no going home now or waiting things out.  You often receive an IV and antibiotics because of the now increased risks for infection.  And while home birthing women have experienced their water breaking and then sealing, this doesn't happen in a hospital birth.  You're either waiting a few hours for labor to begin on its own, or provided with augmentation to get labor contractions started.

Some moms say, "I don't have another option."

There are ALWAYS options.  Not feeling comfortable with one of your options is a different story altogether.  Explore that.  Why are you afraid of the alternative?  What can you do (especially if you're TTC or early in pregnancy) to prevent those fears from limiting the choices you're comfortable with?  What is available to provide you with the knowledge and skill needed to overcome those fears?

Some moms say, "My provider is forcing me."  In some shape or form, they're being coerced and often in a negative/controlling/fear-tactic sort of way.

Woah!  This is a CLEAR indication that your provider doesn't understand birth at all.  We'll get to this more in a minute... but how on earth can you TRUST a provider that has to use fear tactics to make you submit to their will?  If the provider is recommending the best for you and wants you to have the best experience, why are they incapable of providing the evidence and the love that makes you comfortable with their choice?

One thing to remember is that you have rights and can refuse any recommendation. In most cases (not saying it hasn't happened before) - they're not going to hold your arm down, stick an IV in it, and give her pit without her consent... whether forced or coerced - she still gives consent.  Why, yes, they can strip your membranes without your knowledge - if you're not accepting vaginal exams, this is not possible. This leads us to another question.  Are vaginal exams necessary?  Well, for thousands of years babies came without vaginal exams.  Babies, with some providers, are still coming out without vaginal exams.  Ask "why do you need to do that?"  Ask "what information might you learn that would change how we approach labor and birth?"

If you're not comfortable with your alternatives for care and location, you could take a lawyer to an appointment with you and a copy of A Guide to Effective Care in Pregnancy and Childbirth (not saying that's 100% accurate as studies have flaws... but you can at least look up the studies that your provider is *supposed* to be following as you're in your appointment). Unfortunately the fear that surrounds women is often the "I can't switch" reason vs. the actual inability to switch providers. They fear home birth more than they fear pitocin. They fear unassisted birth more than they fear the years of unknown ahead from what an induced birth can cause. They are not educated on unassisted birth from their provider or birth class, so they're still assuming the worst and thinking their situation - regardless of induction method - is still the saf"ER" route.

Let's look at this for just a moment.

Home Birth

Stripping the Membranes

Natural level of prostaglandins

Little to no vaginal exams

Bacterial presence from the home

ROM typically occurs during birthing stage or shortly after

Patience

Higher - in comparison to hospital birth - level of spontaneous and non-augmented birth

Higher - in comparison to hospital birth - level of vaginal birth

Increased Prostaglandins

Increased Vaginal Exams

Increased risk for infection (albeit, studies show negligible)

Increased risk for Premature Rupture of the Membranes (now studies show the risk of infection is no longer negligible)

Decreased "labor clock"

Increased risk for Pitocin & decreased level of spontaneous birth

Increased risk for cesarean

Now, let's think about home birth vs. induction.  Induction doubles the risks of cesarean, increases pain significantly, increases epidurals (and those risks), increases uterine rupture and mother/baby death, increases PPH.... and home birth increases spontaneous vaginal birth, breastfeeding rates, decreases postpartum mood disorders, and reduces all interventions.  This doesn't even cover the comparison to unassisted birth.

There are a variety of risks with stripping and all that goes with it (like moms getting cytotec slipped in without consent - not to mention the risks of infection... which I would think a provider would be more cautious about if a mom were GBS+... but that's another reason antibiotics are given to all GBS+ moms because they can practice invasive without a second thought... or so they think and now new generations believe).

So what is a mother to do?  What about those moms that really have been encouraged so much by our culture to believe intervention is safer than the alternatives?

I focus on WHY moms might not be moving into spontaneous labor ON TOP OF the fact that most 1st time moms birth closer to 42 weeks. Additionally, moms with longer menstrual cycles tend to gestate longer as well.  These are averages that we know IN ADDITION TO every mom and baby needing different things... like time...

What I also remind moms is they need to get their head out of the game.  Relax, de-stress, unwind, and stop thinking about a birth date.  Stop thinking about what someone is going to recommend to you.  Stop thinking about the birth.  Stop thinking about work.  Stop thinking about that misinformed person that keeps asking you "if they're going to let you go past ____ weeks."  Stop thinking and just ENJOY.

Stripping the membranes might increase prostaglandins and a Bishop score, but this is letting the tail wag the dog!  Dilation... rather, labor progression is much more about an efficient uterus than it is about a ripe cervix - and we all know what causes an efficient uterus, don't we?

OYTOCIN

Let's think about how to increase oxytocin.  Let's think about how to create uterine efficiency.  You have all the makings, you just need to put it together.

"Oops, I'm so sorry, I can't make it to my appointment today - I'm out of town. I need to reschedule." (Yes, even when you're 41+ weeks).  Call after hours when you can leave a message even, then turn off your phone.  I am not encouraging a relationship with your provider that doesn't involve complete trust, but I do want you to think about what your body actually needs and how you can be a decision making factor in this process.  Then, book a cabin in the woods (semi close to the birth place so driving doesn't hinder you should labor begin) and stay there until your oxytocin levels are now able to rise because adrenaline decreased. Take all the spa treatments, bubble baths, walks on the trails with a camera....etc.  Can't get away?  No problem - do it at home in your back yard, in the park... anywhere that feels relaxing to you.  All these things increase oxytocin and decrease adrenaline. 

While adrenaline is a handy dandy survival hormone that tells us "Nope, not safe to have a baby here/now" - it does so because it is also antagonistic to oxytocin.  So, if you want labor to increase, you need to think happy thoughts and fly away to labor labor land.  Need a little pixie dust to give you a boost during pregnancy/labor?  Ask the oxytocin fairy (i.e. doula).  All these factors work just the same in labor as they do prior to labor.. as the last weeks of pregnancy are really a continuum and not a separation of here is pregnancy, and here is labor.  It's a circle that completes with breastfeeding and starts the process over again.

 

Additionally, work with posture, stretching (the hamstrings and abdomen especially), and abdominal tone all throughout pregnancy.  It is never too late to start.  Tight hamstrings cause a tight back which causes discomfort (decreased oxytocin) and also less ability for the pelvis to flex and allow room for baby. Yoga, Pilates, walking, hiking, swimming, pelvic rocks, tailor sitting, stand up desks, birth balls... all these things that strengthen the body, especially the muscles that support the uterus and pelvis, and support baby's position.  A baby in a funky position with a poorly supported uterus might need some hands on techniques - like spinning babies - to get them into a position where labor will progress further.  Stress and position are a key factor in prodromal labor.  These are all techniques that support the body's natural ability - not "what can I do to self-induce."  Belly dancing is AMAZING for pregnancy/birth. It gets baby into position, it stretches the ligaments, and it just feels amazing. This is what belly dancing's original purpose was - and now there are even birth classes surrounding the idea... but really just some big swirls of the hips and figure 8s with the pelvis are great.

Last, but not least, are you receiving proper nourishment?  Are you getting all your B vitamins, all your minerals like calcium and magnesium, enough sunlight (i.e. natural Vitamin D) for dopamine production which supports oxytocin?  If you're not sleeping well, I'd say you might need to get up and exercise a bit in the sunshine.  All of the necessary nutrients for proper body function can be found in a healthy balanced diet of colorful vegetables (lightly steamed, of course), and healthy food choices.  Dark greens are often a big factor for the modern to THRIVE and work at its optimal level.  A glass of equal parts nettles and Red Raspberry Leaf (a few pinches of each steeped for 3-5 minutes) is a great daily tonic tea that provides nourishment throughout the body.  It is great warm, it is great iced, it is great unsweetened.  If you want it sweetened, though, add a *pinch* of whole leaf stevia - or at most use a smidge of honey.  This is not an encouragement for using these as induction agents!  This isn't even a medicinal dose anyway, just a regular tonic (toning, nourishing) dose in addition to all your tonic foods.  This is encouraging you to make sure you and your baby are receiving adequate nourishment for proper body function.

Your body is amazing.  It was MADE to birth.  When interventions are recommend, only you can decide if this is something you want for your baby and yourself.  Looking at it from a logical perspective, however, often helps us to move the fear tactics aside and get down to the root and not put the cart before the horse.

Blessings on your journey!

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