Natural Induction

I wanted to be able to say that the truth of what I have written today is a happy medium. But I'm unable to because I admit I have a strong bias.

At the same time what I am giving you is my opinion and some resources, and it’s up to you.

I believe women are smart and can make their own decisions about their birth and their baby. You don’t need someone flat out telling you “Do not do this" or shaming you for your choice.

I expect you to use your BRAINS (Benefits, Risks, Alternatives, Intuition, Nothing, Smile) - explained here) to thoughtfully consider any decision you would make, whether inducing or not.

 I won't be discussing medical induction because I am going to assume if you are someone who wants to freebirth, that you understand medical induction can ONLY be done in a hospital. And likely, you really want to avoid that. 

The exceptions are membrane stripping and breaking waters which can sometimes be done in office, or at home by a midwife.

I do not consider a “stretch and sweep” to be a natural method.
If you aren't planning to freebirth, or want to know more about why these methods are unsafe and mostly unnecessary, please look up

Sara Wickham - Inducing Labour (book), In Your Own Time (book), and many free blog posts  https://www.sarawickham.com/articles-2/ten-things-i-wish-every-woman-knew-about-induction-of-labour-the-article/ 

Rachel Reed - Why Induction Matters (book) and blog post https://midwifethinking.com/2016/07/13/induction-of-labour-balancing-risks/ 

Billie Harrigan blog post https://billieharrigan.com/blog/2019/5/6/birth-hijacked-the-ritual-membrane-sweep 

In Australia in 2018, 45% of selected women were induced! That is a horrifying statistic. (That number may likely be higher because "selected" usually means "low risk" and "high risk" women have very medicalised births)

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Why would we need to induce using "natural" or medical methods?

There are a lot of common reasons that are explained as being medical necessity such as:

• Postdates

• Small baby

• Big baby

• Placenta deterioration

• Preeclampsia

• Excess fluid

• Waters being broken for many hours prior to labour starting

And a few “non” medical reasons:

• Uncomfortable

• In pain eg SPD

• Mental health of the mother

• Previous precipitous labour

• Scheduling conflicts (with carers for the mother or her other children, or for the Dr)

• Risking out of a homebirth/birth centre by a certain gestation

If a woman is fully informed on the risks and benefits of any induction procedure, then she is absolutely welcome to make use of any method, for any reason. 

However, many women are basically coerced into natural/medical induction because they are told it is medically necessary when it isn't.

I wish for all women to be informed to avoid unnecessary procedures and the ensuing risks to her and her baby.

Being told that you need to try natural induction to avoid a "big" or "Post-dates" baby does not take into account your personal scenarios. The majority of women grow a baby that is the right size for their body, and postdates often simply means that the gestation calculation was incorrect, or that your baby, being the unique variable normal human that it is, doesn't read a calendar, and instead comes when its lungs and body are developed and ready for the outside world.
Someone else wanting you to have your baby ASAP is not reason enough for you to endure increased risk in birth. I don’t care if your midwife has other clients, your doctor has a Saturday Golf Tournament, or your mother already booked flights. Not their baby, not their decision.

If it’s important to YOU to have your mother present, then YOU get to weigh that up for yourself.
Practice standing up for yourself and protecting your baby now. Practice standing by your decisions when you believe in them. You are a strong mother!

A quote on avoiding induction:

“membrane sweeping is a procedure meant to induce labour so that the client won’t be induced later. 

It assumes that the later induction is non-negotiable and the client’s best hope is that this early induction “saves” her from the risks of the later induction.

This is no different than all those “natural” inductions that are employed when trying to induce labour so the mother doesn’t have experience an induction – or the challenge of just declining the planned induction. It takes the approach that planned inductions are non-negotiable. Of course, mothers may chose a natural induction as a means of expediting the births of their babies for a number of reasons and I fully support their autonomy and choice to do so.

We need to critically evaluate the mentality that says, “let’s try to induce so we don’t have to induce”. - Billie Harrigan

Natural induction:

"...the routine use of natural interventions transmits and reflects the same messages to women as medical intervention - that their bodies are not enough, and they need something additional for birth to work effectively" Rachel Reed, Reclaiming Childbirth 

But what if you really do have a medical need for baby to be born quickly?

What if you’re faced with a C section because it’s time sensitive for baby? What if you have preeclampsia? What if you've hit your personal limit for opened waters?

If you're in such a situation, quickly research what you can do. Visit a trusted website, or talk to a midwife or someone else you trust. 

We could argue all day about what is needed or not. Only you can take your personal situation into account and decide.  (this is where the BRAINS comes in handy)

Some you might look into though - preeclampsia has been reversed with the Brewer emergency Protocol. 

In a situation where you are concerned for baby, depending how baby is, you may have to go straight for a C section rather than the stress of an induction, so if someone tells you that you have a few days then it may not be that urgent to induce.
Knowing what time you have will help you decide.
For example, you may commit a certain amount of time to “natural” methods before trying for medical induction or C section.

Medical reasons may need medical induction. And remember that you have options, such as trying the bulb first instead of Pitocin/Syntocin/Cytotec.
Depending on why you want/need to be induced, consider what you would try first.
In my opinion, you should try the most natural and low risk methods first and work your way up.

You also can take into account what your Bishop's Score is, whether you are already dilated, (check your own dilation) or whether you are having mild contractions/prodromal labour that you would like to strengthen, or a labour you believe is taking a long time.

Castor oil is believed to have risks, so many would advise don’t start with that, and others would advise don't use it at all.

You might not think of this as an induction method, but rest and relaxation would be my first choice. Resting tells baby that it is safe to come, and also promotes oxytocin, a natural contraction maker.

Here’s that “natural “ list of methods I promised:

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Rest

• Nap

• Warm Epsom salt bath

• Massage

• Meditation

• Melatonin 

Oxytocin/Hormone Shift

• Sex (nothing in the vagina if waters are broken)

• Masturbation (internal or external - external only if your waters are broken)

• Massage

• Nipple stimulation 

• Look at pictures of babies

• Have a good cry

• Have a good laugh (comedy movie)

• Mind clearing and fear release

• Talk to baby and ask them to come.

• Something that gets your adrenaline going

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Movement/Positioning

• Walking (for more oomph, specifically with one foot in the gutter or up/down stairs) 

• Miles Circuit 

• Dancing/Belly Dancing

• Effective birth ball “bouncing” and "figure eights"

• Spinning Babies Inversions and other techniques https://www.spinningbabies.com/help-i-want-to-avoid-induction/  

• Deep Squats

• Bumpy car ride

• Acupressure

• Rebozo 
  
  

Stimulate Contractions

• Midwives Brew (contains castor oil) and creates diarrhea and cramps

• Orgasm

• Herbs

• Spicy Food 

• Enema 

• Self cervical agitation 

• Clary Sage (particularly effective rubbed on belly or on acupressure points on feet)

Ripen the Cervix (mostly through natural prostaglandins)

• Homeopathics

• Cohosh - as a herb or homeopathic

• Semen 

• Dates

• Pineapple 

• Spicy food

• Evening Primrose Oil (EPO) orally or vaginally (has been indicted in cases of postpartum haemorrhage) 

• Eggplant Lasagne or eggplant parmesan

• Acupuncture
  
  

Slower methods

• Herbs and tinctures like Nature's Sunshine 5-W and cohosh (some herbs can cause placenta issues or are for after birth - please be careful and take due diligence before ingesting anything!)

• Dates ( 80g daily eaten during pregnancy from 36w to shorten pregnancy and labour)

• Spinning Babies positioning (keep baby optimally positioned  from 36 weeks onwards) 

• Red Raspberry Leaf Tea (RRLT) drink all through pregnancy. Per day, 1 cup/first trimester, 2 cups/second trimester, 3 cups/third trimester. (Stop if in the rare case it gives you preterm or prodromal labour)

• Wait for a full moon

Exhaustion vs rest
Trying some of these methods, eg walking, or trying lots of methods in a row eg driving around to appointments and forcing yourself to eat lots of different things may have the effect of exhausting you. Occasionally this can be beneficial but more often than not it actually stresses baby and can cause days or weeks of prodromal labour. If you are exhausted when labour starts, it can often make for a longer, harder labour, and lower tolerance for contractions resulting in further interventions.
So in my opinion, I would always opt for restful induction methods first, or alternate days. Walk one day, then rest the next so that you and baby can recover, and birth well together.

Preparation method

Finally, there's a huge difference between preparing your body for impending labour, and inducing labour. One is making sure your body is supported and rested ready to do what it naturally is going to do. The other is forcing your body to start the labour processes before your body and baby are ready.

For example, eating dates, and following the Brewers Diet, and drinking RRLT, and having regular sex in pregnancy will tone your uterus, increase blood volume,  increase your oxytocin, and provide you with energy for labour. It may even shorten your labour.
But taking castor oil may cause your body to have unpleasant and unnatural side effects and force your body into labour. Doing so by stressing your body into thinking baby needs to come asap even if it’s not ready, and compelling it to eject the baby prematurely.

I don't think that a healthy woman with a healthy baby needs to do anything more than prepare her mind and body as best she can and then trust that her body and baby will complete the work it started 10 moons before.
Just as your body conceived the baby, grew the baby’s arms, legs, body, and prepared the baby’s lungs for birth, so too your body knows how to initiate labour and give birth.

 “Women’s bodies really do know how to give birth, and most of the time we don’t need any of these tricks and tools that we carry around, be they rebozos, amnihooks or peppermint oil.” -Sara Wickham

"Herbs stimulate powerful effects in the body, and it pays to be aware of not only what they’re “good for” but how to use them safely. 

I agree women can and should take charge of their pregnancy. That really starts with a mindset shift. I would encourage any woman to move from a medical or pharmaceutical mindset (“what things can I do or take to make my body do X?”) to a wise woman or energetic mindset (“how can I do or take the least amount of ‘stuff’ so my body is free to do what it already knows how to do?”)."

- freebirther 

"Women's bodies can generally be trusted to go into spontaneous labour" - Ina May Gaskin 

"Inducing labour, regardless of the method, involves initiating changes in the body before they would occur naturally" Rachel Reed, Why Induction Matters

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"This is a hard one, because I feel like there is nothing I can really say except there needs to be some trust. You have to believe that your baby will come when it is ready, and when it is ready, the baby will have the easiest time being born. Imagine getting kicked out of the womb, literally, before you were ready! I really urge women like this to be patient and kind with their bodies. It has to start with the message, “I trust you. I know you can do this, because you conceived and grew this baby perfectly. I won’t rush you or doubt you. I trust you, too, baby. That you are conscious and able to be born when it is time”. - Indie Birth Midwifery

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You made it! Thanks for hearing me out on this controversial topic!

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Please know that I believe the important thing is both that baby is safe AND you have had a supported, and empowering birth.
Depending on the situation, induction can help OR compromise your goal.

I wish you all the best when you come to make that decision, and if you’ve made it this far, I do trust it will have been an informed decision and that is all I can hope for.

Remember: no one stays pregnant forever! (If you do, please contact me!)
Happy Birthing!

Further resources

(Told you I can't stop!)

Look at the blogs and books listed at the start under medical induction. 

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Indie birth podcast https://indiebirth.org/past-the-due-date-why-the-system-wants-you-to-freak-out-and-what-to-do-about-it/

Spinning babies https://www.spinningbabies.com/pregnancy-birth/labor/induction/ 

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https://nurturedbirth.com.au/labour-induction-what-are-my-options/

https://magicalbirth.wordpress.com/2015/07/27/when-labour-needs-to-start/

https://avivaromm.com/labor-induction-low-natural-approaches-midwife-md/