The first thing you should do if you are overdue is to wait. Have patience and let your baby decide what his or her birthday will be. You’ll be making most of his/her decisions after that.
When you should
You should only consider inducing labor when it is riskier for your baby to remain inside you than to be born. Conditions under which you might want to consider getting things started include:
- You haven’t delivered one-week after your pregnancy due date
- Your membranes have ruptured and it is getting on towards 24 hours later (to reduce your risk of infection)
- Medical complications (your health care provider will help you in those cases)
- To time delivery before another herpes outbreak
- You have a history of rapid labor (to control the onset of labor so you can get where you need to deliver)
When you shouldn’t
Two things you must know first: your doctor or midwife should have told you that your cervix is “ripe” (it has begun to soften and dilate) and you must be confident that your due date is accurate so that you don’t inadvertently deliver your baby too early. Always talk about it with your doctor or midwife first – not being comfortable doing this is a sign you might want to choose a different one next time.
How to do it!
- Walking during pregnancy, walking to bring on labor and walking during labor are all good ideas. Being upright and moving helps to bring the baby’s head down into a good position for delivery and applies pressure against the cervix. Just don’t overdo it and tire yourself out.
- Nipple stimulation sometimes causes uterine contractions. We know the two are connected, right ladies? This technique has been shown to increase the likelihood of labor within 72 hours, but only in women whose cervixes had already begun to dilate. Hands off it causes powerful contractions until someone can monitor the baby’s heart rate. (1)
- Sexual intercourse – my personal favorite. Supposedly sperm contains prostaglandins that can help soften up the cervix, but the more effective action is the orgasm. As if it isn’t good enough all by itself! Orgasms are like mini contractions anyway and the oxytocin released may get the real contractions going. No side effects, good for the relationship, what have you got to lose?
- Castor oil worked for me. It does not directly influence your uterus. It stimulates your bowels, which contract next to the uterus and can get things going – but only in women whose bodies are very ready for labor. The downside is diarrhea!
- Acupuncture – Most studies on its effectiveness have been small or inconclusive, but some women have success with this method after 1 to 3 episodes. Other findings suggest a reduction in the duration of labor. With few, if any side effects, it is certainly a good option. (2, 3)
- Herbal therapies – evening primrose oil has been shown to increase prostaglandins, which is what your body produces to initiate labor. The usual dose is 2 or 3 500 mg capsules a day after your due date either into your mouth or into your vagina – you decide! This herb seems to be gentle and safe. Black cohosh and raspberry leaf, however, are more aggressive and unpredictable. No good data exist about these herbs’ reliability or safety and it is hard to know how potent the preparations are, so you might want to try other methods.
- Eat dates. This is a new one for me. A recent study from Jordan found that women who ate 6 dates per day for 4 weeks before their pregnancy due date had riper cervixes at admission, were more likely to go into spontaneous labor, and had shorter labors than women who had not eaten the fruit. Who knew? (4)
Studies have shown that between 30% to 50% of women try to induce their labor with one of these techniques! (5) But if you don’t have a good reason to induce, just remember your desire to have “natural childbirth” and let nature take its course.
- Kavanagh J, Kelly AJ, Thomas J. Breast stimulation for cervical ripening and induction of labour. Cochrane Database Syst Rev. 2005.
- Stein E. A randomized controlled trial of acupuncture for initiation of labor in nulliparous women. The Journal of Maternal-Fetal and Neonatal Medicine, August 2006.
- Lim CE, Wilkinson JM, Wong WS, Cheng NC. Effect of acupuncture on induction of labor. Journal of Alternative and Complementary Medicine. 2009;15(11):1209-14.
- Al-Kuran O, Al-Mehaisen L, Bawadi H, Beirawi S, Amarin Z. The effect of late pregnancy consumption of date fruit on labour and delivery. J Obstet Gynecol. 2011; 31(1):29-31.
- Chaudhry Z, Fischer J, Schaffir J. Women's use of nonprescribed methods to induce labor: a brief report. Birth. 2011;38(2):168-71.