38 weeks have passed and you’re looking to induce labor.
Your back hurts. Your feet are tired. Your innards haven’t functioned “normally” for months. You are done with pregnancy.
You hop on Pinterest and before you know it your fingers have tapped out “natural labor induction” and you ended up here.
I get it. I see so many mamas at 38 and 39 weeks who are exactly where you are and frankly, I’ve been there myself.
So I wanted to get some labor induction ideas down on paper (well, pixels anyway) for mamas to be able to peruse and then discuss with their midwives or ob-gyns. But first, some important information about the differences between labor preparation and labor induction.
Sometimes all you need to do is get ready
You don’t need to induce before your due date, you need to prepare your body for birth. Induction is a very specific term. It means “to bring about” labor. When you’re at 36 weeks you’re tired and you want to be done, but when you get right down to it you don’t actually want to bring about labor. Babies are naturally born between 38 and 42 weeks for a reason.
The big “but” here is that when you prepare the body and the baby for labor with any of the techniques below your labor will come sooner naturally. Instead of forcing a specific outcome, you’re allowing it to happen in its best possible course. So it is possible for a labor to happen sooner than 40 weeks without an induction, but it happens when the body is prepared for it.
When to induce labor naturally
Sometimes we pass the 40 week mark, the baby is done cooking and we start the waiting game. This is when as a TCM or Traditional Chinese Medicine practitioner I start looking at the reasons why labor hasn’t started and it’s usually for two reasons: liver qi stagnation or kidney heart disharmony.
Both of these are signs that a mother is stressed or anxious about the upcoming labor and that sympathetic dominance cycle is interfering with the proper hormone cascades that need to happen to trigger labor, meaning:
The goal for inducing labor is going to be moving a mama from fight or flight into rest and digest OR to directly trigger the appropriate hormonal cascade.
So without further ado:
1) Evening Primrose Oil
The first way we can naturally impact this hormonal cascade is Evening Primrose Oil. For anyone who has spent any amount of time in a trying to conceive forum you are familiar with the acronym EPO which I will be using here.
EPO naturally contains a substance known as a prostaglandin. Prostaglandins have a major role in inflammation, a process which we want to encourage in the birth process. Inflammation gets a bad rap when in reality it’s a naturally occurring process that prepares a healing environment OR prepares a body for change. Chronic inflammation is a sign that something is chronically wrong. Acute inflammation is the sign of a change – like a dilating cervix.
Some midwives will use EPO to encourage cervical dilation. If this is something you would like to pursue, contact your midwife or obgyn for dosage and application.
2) Sexual Stimulation
Commonly considered one of the more “fun” version of labor induction, sexual stimulation can be used for labor induction for two reasons: 1) semen naturally contains prostaglandins and 2) orgasm causes the release of oxytocin.
Orgasm can also lower stress and anxiety, meaning that from a TCM perspective sexual stimulation can address the two patterns thought to contribute to running past the 40 week mark.
However, the “therapeutic dose” of sexual stimulation is three times a day. The amount of prostaglandins that semen contains is relatively small.
I think that this technique could work for some women, but given that one of the patterns for delayed labor is caused by deficient kidney qi , excessive sex could cause problems some women and delay labor further.
3) Nipple Stimulation and Breast Massage
Ina May Gaskin is one of my favorite women on this planet. For those of you unfamiliar with her work, she is one of the women who brought the idea of natural childbirth back into the public eye. Her book Guide to Childbirth (affiliate link) was one that I kept handy my entire pregnancy and frequently recommend to my patients.
One of the techniques that is frequently shared in the birth stories and discussed in the “Going into Labor” chapter is nipple stimulation and breast massage.
The reason these techniques work is in part the same reason sexual stimulation works: nipple stimulation triggers the release of oxytocin which in turn triggers uterine contractions.
According to Debra Betts, a leading midwife and acupuncturist from New Zealand, the best method for nipple stimulation is to rub or brush the nipple for 10-15 minutes every two hours. A difference should be noticed after 2-3 applications. Another technique is to massage the breasts for 1 hour 3 times a day.
You can either perform these techniques yourself or have your partner do them. There is a possibility of greater oxytocin release when performed with your partner as it is the “cuddle hormone”.
Phoenix dactylifera or “medjool dates” are the edible and sweet fruit of the date palm tree. According to a 2011 study published in the Journal of Obstetrics and Gynecology, women who ate 6 dates per day for 4 weeks had a higher mean cervical dilation, a higher rate of spontaneous labor and a shorter first stage of labor.
Dates are amazing qi and blood tonifiers. Eating dates medicinally (6 dates a day is hardly casual consumption) beginning at 36 weeks is doing exactly what I was talking about in the introduction above – preparing the body for labor.
The Chinese idea of the labor process is simple. Three things have to happen:
- Yang activity must replace yin material growth
- Qi and blood should move freely
- The door of the uterus, or cervix, opens (Betts)
Tonifying qi and blood gives the body the tools it needs to make these things happen. Dates are something I definitely discuss with patients around the 36th week of labor. While the dates themselves do not induce labor, they certainly set the stage for an easy (and possibly earlier) one.
5) Acupuncture or Acupressure
Acupressure can be used before and during labor to help things along. You see many posts on Pinterest about acupressure for labor induction because it works.
Acupressure and acupuncture to induce labor done before 40 weeks can trigger labor and it can shorten labor but a shorter labor can sometimes be a more painful labor. This shortening of labor is because the points used for labor induction are very moving – they trigger large and dramatic changes in your system.
Using a natural method to induce labor does not mean that the labor will be natural, and an artificially induced labor by natural methods can have some of the same drawbacks as an artificially induced labor by methods such as pitocin and Cervidil.
The points recommended for acupressure are very strong and I do not recommend them until after 40 weeks have passed.
The most effective use of TCM for labor is prebirth acupuncture. Working with an acupuncturist from 37 to 40 weeks can build up your qi and blood and help it move at the appropriate time.
Prebirth acupuncture, as opposed to acupuncture for labor induction is associated with a reduced rate of medical intervention (where induction acupuncture on its own is associated with an increased rate of medical intervention). It also helps lower the stress and anxiety common in the last few weeks and can ease common physical discomforts like hip and low back pain, constipation, diarrhea and fatigue.
Prebirth acupuncture is also associated with shorter labor. According to a study published by Geburtshilfe Perinatol, mean labor duration for mothers who had received a prebirth protocol had a mean labor duration two hours shorter than the control group.
The difference between this shorter labor and the shortened labor from the labor induction protocol is that this labor is shorter because you have built up the qi and blood to handle it quickly and well. Your uterus is rolling up its sleeves and gettin’ it done.
Prebirth acupuncture can also make other induction methods more effective. TCM is a complementary medicine. It works great on its own. It works fantastically in conjunction with other treatment methods.
Patterns of delayed labor
After 40 weeks, acupuncture can be used to induce labor. After 40 weeks can specifically address the two patterns causing a post-date baby: kidney heart disharmony and liver qi stagnation. A treatment will be customized for you and you’ll be sent home with the homework to use acupressure on a few points.
You will need to apply pressure for 1 minute per point every 2 hours if you’re still in the 40th week. If you cross into the 41st week, talking to a midwife and your acupuncturist about changing your natural induction dosages is ideal.
Natural labor is about preparation and encouragement
Nothing comfortable in nature ever came from forcing the issue. If your body isn’t ready either because your baby is still developing or you’re stressed and your body doesn’t think it’s safe, making things happen faster may work but it’s going to be more painful and stressful for you in the long run.
The best way to have a healthy and “punctual” labor is to give your baby the best opportunity to move into position, to build your qi and blood and to relax.
Disclaimer: I am an acupuncturist in the state of Minnesota, and the information falls within my scope of practice in my state. However, unless I have directed you here as your homework I am probably not your acupuncturist. The information in this post is for general purposes only and does not constitute medical advice. As always, check with your own acupuncturist or primary care provider before making any lifestyle changes. This post does not create a patient-practitioner relationship and I am not liable for any losses or damages resulting or relating to the content in this post.
If you are interested in prebirth acupuncture or acupuncture to induce labor, please visit my services page for more information.
Resources and Links
Ina May Gaskin’s Guide to Childbirth
Jessica Gustafson is a licensed acupuncturist in St Paul, MN specializing in women’s health and fertility. She loves working with patients through the Health Foundations Birth Center on Grand Avenue in St Paul as well as doing home visits in the Twin Cities area. Check out the services page for more information!
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