Behavior or nutritional strategies for hastening labor
February 11, 2016 2:51 AM   Subscribe

Here's the billion dollar question for someone 37 weeks pregnant: what, if anything, can I do to (safely and gently) encourage the onset of labor?

The internet is full of ideas. (Walk. Eat mango and pineapple. Avoid some omega 3s. Sex. Squats. Cow-cat stretches.) What does the empirical literature say?* Is there anything that differentiates those who deliver at 39 weeks from those who deliver at 41 weeks, anything I can influence at this point?

* My Google Scholar searches for "human parturition eggplant parmesan" are getting me nowhere. :)

I'm not really interested in physical interventions like stripping membranes. But I'd be interested in helping the baby understand where the exit is and feel ready to come out, and in making sure my body is nutritionally primed to hear the signal if he sends it.

I'd also love any more info on the labor initiation process. I don't entirely understand the various hormones involved in triggering birth. It'd be nice to know more, especially if I could then match various symptoms I might have to the process.

I've read many basic websites, the Mayo Guide to a Healthy Pregnancy, and similar resources. Links to journal articles, textbook chapters, or anything with more detail would be great. I did take organic chemistry and biochem, and though I forgot most of it, I'm willing to wade through dense material if it's worthwhile. Thanks!
posted by slidell to Health & Fitness (36 answers total) 4 users marked this as a favorite
Our midwives told us orally ingested semen. Not vaginally.

I had Caesarians.
posted by taff at 2:55 AM on February 11, 2016 [3 favorites]

Unfortunately the answer is, as our OB keeps telling us: no. The baby comes when the baby is ready. There are home remedies which if they do work nobody knows why, and there are induction methods that are pretty jarring and that's basically it! We tried Rasberry Leaf tea and it induced Pro-dromal later for a week so caveat emptor there.
posted by Potomac Avenue at 3:03 AM on February 11, 2016 [5 favorites]

Best answer: Well, as a scientist very familiar with searching the literature, I read every single paper I could get my hands on about what, if anything, would bring on labor. As far as I recall there is only one method that holds up under rigorous statistical analysis: nipple stimulation, like with a hospital grade pump for 2 hours.

I tried every single trick out there. Some of them (most notably raspberry leaf tea) caused a whole lot of contractions that failed to go anywhere.

I was induced at 42 weeks with 2 doses of misoprostol (no pitocin). Still took 40 hours. And that was with a baby tbat dropped at 36 weeks that my midwife thought would come early! I sure wish I had better news for you.
posted by Cygnet at 3:07 AM on February 11, 2016 [9 favorites]

At 37 weeks, there's not much you can do but wait. Having a baby that early can have negative effects anyway.

Home remedies that my doc told me had some effectiveness: walking and sex. My baby did come early, but I was obviously close at 37 weeks and horribly uncomfotable. My OB knew I wasn't going to make it to term at 36 weeks. I did walk a lot in the end of my pregnancy, but mostly because baby was so low, sitting down was terrible.

One of my coworkers told me baby in the inside is so much easier than baby on the outside at around 37 weeks. I wanted to punch him in the face, but he was correct. Babies need to nurse every 2-3 hours on the outside along with diaper change. There is no nighttime break. This no night period is longer for early babies than 41 week babies typically.
posted by Kalmya at 3:25 AM on February 11, 2016 [10 favorites]

I got a back massage when I was about 30 weeks pregnant and the Chinese lady giving it told me to come in for a foot massage when I was ready to have the baby as it induced labour. Because of this very reason she refused to give me one at that point in the pregnancy as they didn't want the baby to come too early. I never went back but obstetricians tell you not to get foot massages for this reason so there must be something to it.
posted by Jubey at 3:40 AM on February 11, 2016 [2 favorites]

Some slight evidence that semen might ripen the cervix, so sex. Walking will help the baby get into position and will certainly get things going once contractions start.

But really? Nothing short of medical induction is going to get that baby to go anywhere before that baby is ready. My daughter was born at 41+3 (labor started, finally, after I walked briskly for four miles but that might be a coincidence. I'd had prodromal labor since 35w) and I'm currently 36w with my second. Cervixes gonna cervix.
posted by lydhre at 4:01 AM on February 11, 2016 [2 favorites]

This is a mental game. As everyone says, there's no home remedy to start labor.
Tell yourself that the baby will arrive at the far end of the spectrum - 42 weeks - and forget about trying to make the baby arrive.
Of course you are uncomfortable, and maybe even in significant pain. No pregnant lady feels good at that time. If it becomes dangerous hopefully your medical team will induce.
37 weeks is way too early. Plan to be pregnant for at least another month.
posted by littlewater at 4:30 AM on February 11, 2016 [2 favorites]

I went to 42 weeks in the middle of a brutal heat wave, so I feel you, but alas no. Baby comes when baby comes, and if baby doesn't come by a certain point, that's an obstetric issue best dealt with in a hospital.
posted by soren_lorensen at 4:32 AM on February 11, 2016 [1 favorite]

Best answer: This really is the billion dollar question! If we knew what/how to bring about labor, there'd be a lot less mystery surrounding birth. Lots of research has been done in rats and sheep, and it seems like we know that the initiation of spontaneous labor comes from some intricate dance between fetus, mom, and the placenta/membranes. The best predictors of who will deliver at 39 vs 41 weeks (assuming a healthy mom and babe) are often prior pregnancies (though it sounds like this is your first) and family history (any moms/aunts/sisters you can ask?) But beyond that...

Echoing the above: semen does contain prostaglandins that may help ripen the cervix. Nipple stim is evidence-based, but a rigorous regimen is required for actually bringing on labor...this is also not recommended to do until unless you've checked with your midwife/OB and have clear guildelines. There is some research on traditional chinese medicine/acupuncture/acupressure (see foot massage note above) but generally in very small studies without a lot of statistical umph to back them up. There's some research that eating dates can shorten your labor. But even the methods that science supports (cervical ripening, inducing contractions, etc.) sometimes fail.

In short: if you know your baby is head down, I'd focus on regular, gentle exercise and good, healthy eating, and trying to enjoy the last weeks of your pregnancy. You can look up information on doing lunges and stretches to encourage an OA position and avoid asynclitism, which may in turn shorten your labor and make it "easier." But, birthing a baby is hard work, so you want to be well-rested and well-fed for the labor (and newborn-caring) that lie ahead. Good luck and safe birthing!
posted by stillmoving at 4:37 AM on February 11, 2016 [3 favorites]

I carried two babies post date (41w3d and 42w) ad unfortunately no, baby will get here when they get here. I tried everything (including a pump!) and nothing. You just have to wait which is exactly what you don't want to hear I know, sorry.
posted by julie_of_the_jungle at 4:55 AM on February 11, 2016

This made me smile! You are a first time mom for sure. Walk as much as you can, drink plenty of water, eat everything in site, in small amounts to prevent heartburn, and have as much sex with your husband as he can manage (keep him hydrated as well). Your baby will come when it is time for your baby to come. Try to relax as much as possible as stress can make everything seize up. I think that is why so many people find that sex works- it's difficult to achieve orgasm if you are stressed. Ask for a full body massage and get it done.

This is your time to be pampered. Have your husband read this: This is your time to be pampered. He should be waiting on you as much as possible. It should be all about you right now. Once you give birth, it's all about the baby. Take this time for you right now.
posted by myselfasme at 5:08 AM on February 11, 2016 [11 favorites]

>making sure my body is nutritionally primed to hear the signal if he sends it.

Especially in terms of having an as-pleasant-as-possible labor once those signals start, I would recommend staying as well-hydrated as is practical. I had some labor slowdowns that might have been at least partly due to getting dehydrated (my mind was elsewhere, and other folks in the room apparently thought the process would be faster than it was.) It's not going to kickstart anything but it is good prep for the upcoming marathon.
posted by tchemgrrl at 5:09 AM on February 11, 2016 [1 favorite]

Buzzfeed just did an article going through some methods you may want to check out.
posted by Mouse Army at 5:34 AM on February 11, 2016

As someone who had her babies at 38, 35, and 34 weeks (after drugs & bedrest for weeks, that last) respectively, I can tell you that the reverse -- trying desperately to keep them in, particularly the last two -- probably does not work. But being well-rested, well-hydrated and well-fed is going to help you no matter what nature decides.

All that said, walking for me definitely impacted on my child for whom I was on bedrest. While we were trying to keep him in but I was trying to stay employed, there was a period before I just went on bedrest where if I walked too much (= one flight of stairs) contractions would start. So you could try a walk every wouldn't hurt, provided it's not icy where you are or something.
posted by warriorqueen at 5:42 AM on February 11, 2016 [1 favorite]

I'd be interested in helping the baby understand where the exit is and feel ready to come out, and in making sure my body is nutritionally primed to hear the signal if he sends it.

Unless the baby is breech, he/she knows where the exit is. He/she will signal you when ready and you will hear it loud and clear. Your body and his/hers know what to do without mangoes and squats.

Rest and eat/drink/poop as best you can now so you're ready for the sprint that is labor...and the marathon that is child-rearing.
posted by headnsouth at 6:16 AM on February 11, 2016 [3 favorites]

I ate lots of pineapple and bounced on a yoga ball. (There is little less dignified than being nine months pregnant in August, bouncing on a giant ball in your underwear but you do what you have to.)

This is going to make me sound hippy-dippy and wacky, so take it with a grain of salt, but I had a long talk with my baby. I had to be induced for medical reasons (high blood pressure and low amniotic fluids) and wasn't super-favorable for an induction: not really dilated, only about 50% effaced, no contractions, no real signs that labor was likely or particularly imminent and I was so scared of being in labor for days or having a c-section. So before I left for the hospital, I sat down and talked to my baby about what was going to happen, how it was time for him to come out even if he wasn't quite ready, and we needed to work together as a team for him to come out, that we loved him and were so excited to meet him. Did this work? I dunno but it made me feel better about something I was really scared of, and despite all signs pointing to a LONG AND MISERABLE LABOR, I was "only" in labor for eight hours and things progressed quite speedily and I was holding a baby in my arms about 24 hours after I got to the hospital. I had a great birth that, believe it or not, I look back on fondly, and my baby and I really did work together as a team to get him out. (He was fully posterior, my little stargazer, and it took some trickery and hard work on both of our parts and that of our birth team.)

Good luck!
posted by Aquifer at 6:49 AM on February 11, 2016 [4 favorites]

I know you are miserable, but please use this time to have lots of couple time with your partner. :) Your lives are going to be so very different once baby shows up.

Go see movies, eat at adult restaurants, walk slowly through stores, and just be. :)
posted by heathrowga at 6:54 AM on February 11, 2016 [1 favorite]

I vote for walk, walk, walk, walk, and walk some more - mostly because it helps you feel like you are doing something, and the exercise will only help you in your recovery. (Despite this, both mine had to be induced post term, and that after the indignity of preterm labor, drugs, and bedrest no less.)
posted by telepanda at 7:12 AM on February 11, 2016 [1 favorite]

I was induced at 41w 6d and delivered at 42w 1d, so hey, I hear you. Our midwives said genetics were a big factor but otherwise they have no idea why babies come when they do. My husband was quite late so I blame him. Were either you or the father late? That might give you some pointers. I tried a lot of things and none of them worked, but you're definitely not going to do yourself any harm by drinking lots of water and walking plenty. (Acupuncture, massage, acupressure, evening primrose oil, yoga, talking to the babe....nada for me)

Late is definitely better than early, fwiw. Believe me, I know it's hard on you but it's better long-term.
posted by john_snow at 7:22 AM on February 11, 2016

I was late and wanted to avoid induction so I tried everything, including a hypnobabies track called "Come Out Baby" that I listened to incessantly. Nothing worked, and I cried -- but then had a surprisingly easy/happy induction.
posted by EtTuHealy at 8:31 AM on February 11, 2016 [1 favorite]

On recommendation from my OB (who at the last minute scheduled herself to go on vacation on my due date) we tried castor oil. It worked, but it does what castor oil does to the body, so if you try it make real real sure you keep yourself hydrated and well rested. I was about 1cm dilated and somewhat effaced (I don't remember what percent), and still I was in labor for about 36 hours - that sounds dramatic, so let me break it down; about 24 hours of consistent but not very hard/painful contractions, until my water broke. Once my water broke I got very uncomfortable (baby was sunny-side up) and I was having a difficult time breathing effectively and I realized I wouldn't make it through labor if I allowed myself to become exhausted from pain; I asked for an epidural but because my water had broken they also administered Pitocin. God bless whoever invented the epidural because I slept through the next 10 or so hours. Between 2am and 5am I went from 2cm to fully dilated, while asleep. An hour or so of pushing and baby was delivered.

With baby #2 I was a week late and baby seemed to be getting big. I tried the castor oil again (shudder, I still can't think of it without wanting to vomit) and it didn't work. I ended up getting induced at 41w3d (baby was born at 9lb1oz, with meconium in the waters). The induction actually went well and very quickly, and again I slept though most of the labor and only woke an hour or so before baby was delivered. Say what you want about going natural, but it worked for me.

So that's one home remedy, with two different outcomes. Baby #2 is 8mos now and if you ask me it's all about the personality of the child. Baby #1 is very compliant and a people-pleaser - he came out because we wanted him out. Baby #2 is stubborn and laughs in my face when I tell him things such as "no, don't eat the electrical cord", so looking back at it I'm not surprised that we had to force him out, the little effer.
posted by vignettist at 9:13 AM on February 11, 2016 [3 favorites]

In Expecting Better, Emily Oster reviews the literature on the various methods. IIRC, the only one with scientific backing is nipple stimulation for an extended period of time (like 45mins+, and preferably with a breast pump).
posted by melissasaurus at 9:14 AM on February 11, 2016

...told me to come in for a foot massage when I was ready to have the baby as it induced labour. Because of this very reason she refused to give me one at that point in the pregnancy as they didn't want the baby to come too early.

We had a very similar experience: In a childbirth ed class the instructor showed us an acupressure point above the ankle that could help induce labor (Spleen 6! I can’t believe I remember it), but she was insistent that we not actually press there until closer to the due date. (As it happened, we didn’t end up needing to use it, so my anecdatum ends there.)

Nthing the suggestion of staying really well hydrated, before and during labor.

Good luck!
posted by miles per flower at 10:24 AM on February 11, 2016

Our first son was 11 days "late". A common home remedy in the part of Japan where we were living at the time was to walk, preferably on sand. So every evening for about a week we would go walk on the beach.
posted by My Dad at 10:43 AM on February 11, 2016

Baby comes when baby comes, and if baby doesn't come by a certain point, that's an obstetric issue best dealt with in a hospital.

Absolutely this, sorry. Feel free to try anything you think might be fun but don't expect any miracles. FYI, I tried the trick where you eat a lot of pineapple but all it gave me was a burning sensation in my mouth.
posted by ThePinkSuperhero at 10:52 AM on February 11, 2016 [3 favorites]

Thirding the comments about foot massage and ankle acupressure points. I don't know that these work, and I don't think you should try them at 37 weeks. But I recall multiple people advising me not to get foot rubs or acupressure on my feet/ankles during pregnancy. I got a pedicure toward the end of one pregnancy and the technician told me he would not rub my feet or ankles because it could induce labor. He told me he had induced his wife's labor that way. In any case, I can recommend getting a pedicure now because it will be relaxing and it's nice to have pretty toes while you're in labor. And you won't have time or energy to get one after baby is born. All the best to you!
posted by areaperson at 11:12 AM on February 11, 2016

I have also heard that something like a tablespoon of castor oil works. I was told it is not gentle.

I am not recommending it as a method at this early point for you. Waiting until 40 weeks is better for the baby. Babies who come early can have lifelong problems because of it.
posted by Michele in California at 12:14 PM on February 11, 2016

Like others have said.... if there really was a surefire method that worked, it would be well-known, because at the end of pregnancy every woman researches this exact thing because OMG GET OUT, right? There are tons of anecdotal things that worked for somebody (for me, acupuncture, hot wings, and bouncing on a yoga ball) but were probably just coincidence (I was late anyway so he was bound to come soon no matter what I did). And after he was born, I don't know why I was in such a hurry to get my son out, because it really is so much easier to be way pregnant than to have a newborn. Just pamper yourself, he'll come when he's ready.
posted by rabbitrabbit at 12:39 PM on February 11, 2016 [1 favorite]

Home remedies that my doc told me had some effectiveness: walking and sex. My baby did come early, but I was obviously close at 37 weeks and horribly uncomfotable. My OB knew I wasn't going to make it to term at 36 weeks. I did walk a lot in the end of my pregnancy, but mostly because baby was so low, sitting down was terrible.

We were told the same, and had awkward unprotected sex at 38 weeks. Within a few hours, I was having prodromal labor that stopped and started for five days. Then I ate a bunch of lasagna, had horrible diarrhea, and went into labor in the tub about ten minutes later. My body had been really ready, though, even going into 38 weeks. She was head down, low enough that I was peeing myself constantly, and I was 2 cm dilated.

She was born at 38.5. My sister and I were born at 37 weeks and 38 weeks, respectively.
posted by PhoBWanKenobi at 12:41 PM on February 11, 2016

Best answer: From this PubMed article:
It is concluded that the consumption of date fruit in the last 4 weeks before labour significantly reduced the need for induction and augmentation of labour, and produced a more favourable, but non-significant, delivery outcome.
This was a small study (and not a randomized, controlled trial), but I liked the results and I liked dates and I figured eating them couldn't hurt. I went into labor naturally at 39w3d.
posted by meggan at 12:58 PM on February 11, 2016 [2 favorites]

meggan beat me to it - a friend of mine ate dates and thinks it helped too. She still had to go in and have her water broken at 42 weeks, but she was extremely favourable, had no further interventions, and was only in labour for 6 hours or so. Can't beat that, really! Plus, it will help keep you from getting constipated. =P

I tried everything listed above, plus stripped membranes, and still ended up being induced at 42 weeks. Again, though, I was "favourable" and had been in early labour for almost two days. I got the tiniest bit of Pitocin and he just popped right out.

Which is all to say, ultimately, the baby will come when he's good and ready. Take the best care of yourself you can. Waiting is hard.
posted by jrobin276 at 1:23 PM on February 11, 2016 [1 favorite]

Sex with a man who ejaculates - the hormones in semen theoretically help the cervix get ready. This may require every pillow in the house.

Has the baby 'dropped'? It's possible that the pressure of the baby's head may help initiate labor. So anything that helps relax the pelvis and allow the head to get closer to the cervix.

Use this time to run errands, and maybe get some meals in the freezer, if you can. Direct an evil glare at Every. Single. Person. who says Haven't you had that baby yet? Read out loud to the baby, play music, write letters to Baby, anything to make the time feel less frustrating.
posted by theora55 at 4:46 PM on February 11, 2016 [1 favorite]

Response by poster: Belated thanks for these great answers. I'll admit that I lived in denial for half the week trying to at least fully understand the interplay of hormones involved in labor's start to at least know where I was at if not nudge things along, but your chorus of voices is helping me slowly come to accept that there's not much I can do. It was nice to hear all of your stories. Thanks.
posted by slidell at 3:59 AM on February 19, 2016 [2 favorites]

Anecdotally, we had heard the thing about the dates too. We have a couple of different friends who ate them and felt like they had happy results. Hubby insisted I try it but oh my god, they way they spiked my blood sugar was horrible. I'm really sensitive to sugar and I became a raging B for the couple of days I was eating them. Just wasn't worth it in my case. You just have to be sensitive to how food affects your body.
posted by vignettist at 10:28 AM on February 23, 2016 [1 favorite]

Response by poster: My postpartum follow up: I started labor naturally at 40w+2 ... and finally delivered at 40w+5! Labor was triggered by buying a cart full of groceries that would spoil if I didn't manage to cook and freeze them. :)

In retrospect, I'd go back and mark as best answers all the ones that recommended forgetting about hastening anything, going out to adult restaurants, and sending that last thank you note, but I'll leave things as is. I love parenthood; things are just so different now! Your comments did encourage me to better appreciate the time for what it was, so thanks again!
posted by slidell at 4:07 AM on June 8, 2016 [3 favorites]

Response by poster: Oh, I just realized I bookmarked a study that really helped me with this question! At the time, I was looking -- if not for a way to hasten labor -- for a way to know how far off it was. I hoped to find a source that said "Hormone X causes labor. Other signs that Hormone X is increasing are A, B, and C." This article on the hormones that trigger labor got me to finally understand that it was far more complicated than that:
Evidence suggests that there are multiple paracrine/autocrine events, fetal hormonal changes, and overlapping maternal/fetal control mechanisms for the triggering of parturition in women....

Whereas there may be a final common pathway for the initiation of labor, which involves alterations in prostaglandin and calcium metabolism, there are multiple, sometimes complementary, initiating factors involved in the onset of labor (1). These are endocrine, paracrine, and autocrine. The “final common pathway” to delivery is likely to be multiple, parallel, interactive paths that tip the balance in favor of coordinated uterine contractility and cervical dilation.
Maybe a scientist would get more from this article than I did. But I took that to mean "it's really complicated and individual" and finally gave up on knowing how much longer until labor would actually start.
posted by slidell at 12:22 PM on July 6, 2016 [2 favorites]

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