By the time a pregnant woman draws near her due date or breezes by it, with no sign of baby, she may get a little desperate. What to do? Many women turn to folklore.
Myriad are the well-intentioned people who promise surefire, old-wives' ways to jumpstart labor. Apparently, moms-to-be are listening: new research shows that half of women who reached 37 weeks of pregnancy tried methods like walking, having sex, eating spicy food or stimulating their nipples to induce labor.
They also tried exercise, laxative use, acupuncture, masturbation and herbal supplementation, according to the new study by researchers at Ohio State University. The findings indicate that in a survey of 201 women who had just given birth to healthy, full-term babies at the school's medical center, just over half — 102 — reported trying to bring on labor through the methods above.
"There are all kinds of obstetrical folklore and old-wives tales out there," says Jonathan Schaffir, associate professor of obstetrics and gynecology at Ohio State University and lead author of the study, published in the June issue of the journal Birth. "If it's not something perceived as being harmful, patients think there's no downside. Even if it doesn't work, it's something to pass the time."
The women who reported trying to induce labor constituted a particular demographic: younger, about age 27 — as opposed to 30, the average age at which women waited for labor to start on its own — and pregnant beyond 39 weeks with their first baby.
I distinctly remember how impatient I was feeling when I was four days late with my first child. I'd read that the eggplant parmigiana at a restaurant called Scalini's, outside Atlanta, had yielded hundreds of births. So that Saturday night in December 2002, I ordered the classic Italian dish at a restaurant near our home in Raleigh, N.C. My parents' friend — a mother of four and a physician — also suggested eating pineapple to kickstart labor, so we tracked one down in the dead of winter. And, for good measure, my husband drove alarmingly fast over several sets of speed bumps. Later that night, I went into labor. (When I was similarly late with my other two children, I laid off the pineapple and speed bumps but ordered the eggplant. Like magic, I went into labor the same day.)
I can't remember if I told my doctor after the fact, but the study found that more than half of the women who tried such interventions on their own did not consult their providers, which could be concerning should they try to initiate labor too early. In the June issue of Obstetrics & Gynecology, a new study shows that infant mortality rates are halved by waiting until at least 39 weeks rather than 37 weeks to give birth. Forty weeks is an actual full-term pregnancy, but many have long considered gestation to weeks 37 to 38 as more or less equivalent; increasingly research shows those last couple of weeks matter.
Moreover, Schaffir points out that although most methods are pretty innocuous and risk-free, a few — namely castor oil and nipple stimulation — can be unsafe. Some studies have found that castor oil is effective at inducing labor, perhaps in the same way it stimulates intestinal contractions. But it can also cause severe diarrhea and maternal dehydration, and there have been reports of babies passing meconium (their first bowel movement after birth) while still in utero. And nipple stimulation — the one method that can consistently work, by spurring the production of the hormone oxytocin — can result in strong uterine contractions that are difficult to manage.
Of the women who tried to hurry along their labor, most relied on walking or sex; 22 ate spicy food, 15 performed nipple stimulation, five used a laxative, two did acupuncture and one each relied on masturbation or an herbal supplement. Some women tried multiple methods.
As for having sex, it makes physiological sense that intercourse could hasten labor because semen contains prostaglandins, which are used to induce labor. But studies haven't borne that out. "I tell my patients, If you want to have sex because you like to have sex, knock yourself out," says Schaffir.
Ultimately, the biological mechanisms underpinning the start of labor remain pretty much a mystery. "By and large, labor is an issue that women have little or no control over," says Schaffir. "The best, safest thing is to let Mother Nature take its course."