9 Natural Induction Methods Examined: What Does the Evidence Say?
Neve Spicer • November 11, 2024 • 5 min read
Towards the end of pregnancies, many women try methods of natural induction. The evidence supporting various traditional methods is variable, and benefits, side effects, and notable potential health risks are present. Understanding what science says can help individuals make informed choices in consultation with a provider.
Induction of Natural Labour induction Myths, Realities and Precautions
The following section will review nine standard natural induction methods, discussing the proposed mechanism, evidence, and safety considerations. Avoid potential hazards by avoiding risky labor triggers and get advice from your obstetrician before choosing any method mentioned below.
Castor Oil
Castor oil has been used throughout the centuries to induce labor, and studies suggest that it does so on some 58% of occasions. This oil stimulates prostaglandin release, which in turn may have the result of inducing cervical changes. Adverse effects, such as nausea and diarrhea, are common, however. Castor oil should be used near the due date and with extreme caution, given its contraindication earlier in pregnancy.
Breast Stimulation
The historical and scientific backing of breast stimulation is based on the release of oxytocin to soften the cervix. A study has shown that, with this method, cervical ripening may be achieved in about 37% of cases. However, excessive stimulation may cause uterine hyperstimulation, and guidance from professionals may be essential.
Red Raspberry Leaf
Red raspberry leaf is generally taken as a tea and is thought to enhance blood flow to the uterus and stimulate contractions. Traditional use, however, is tempered by a relative lack of scientific research regarding its effectiveness. Animal studies have suggested possible adverse side effects, and no human data are available that supports a correlation with successful induction of labor.
Sex
Sex is most commonly advised as a natural induction method based on the principle that sex introduces prostaglandins and oxytocin, and orgasm induces uterine contractions. The few studies in the literature report no significant effect on labor timing. Generally safe for women when pregnancy is otherwise low-risk but may not speed labor.
Acupuncture
Acupuncture is a traditional Chinese practice that has been done to stimulate labor through the induction of hormonal responses. However, some studies show its effectiveness in improving cervical ripening but not necessarily inducing active labor. An experienced practitioner would appropriately consult its safe application during pregnancy.
Blue and Black Cohosh
Native American groups traditionally utilize blue and black cohosh plants for gynecological use. These plants are highly discouraged nowadays from inducing labor because of the risk of toxicity they may bring. Although they establish substantial contractions, they have been observed to sometimes cause extreme complications-possibly congenital disabilities and heart problems in newborns
Dates
Some cultural beliefs view dates as helping induce labor by stimulating the release of oxytocin. They do not help stimulate uterine contractions to start labor, but clinical research does support that dates support cervical dilation and reduce the need for medical inductions during labor. They also support less hemorrhaging post-delivery when consumed later in pregnancy.
Pineapple
Something in pineapple called bromelain is an enzyme that is supposed to stimulate contractions of the uterus. Animal tissue studies have determined it would only work if applied directly to the tissue, so it’s doubtful this is a natural method for inducing labor.
Evening Primrose Oil
Evening Primrose Oil, taken almost exclusively in capsule form, is another common naturopathic remedy to ripen the cervix. Still, studies are very few and indicate a greater risk of labor complications, such as intervention during delivery, and it is not recommended very often.
Safety and Consultation
Many of these methods are extremely popular; however, most are unsupported by scientific data. Any method should be discussed with a healthcare provider because all may be contraindicated depending on gestational age, maternal health, and pregnancy risk levels.
Try going for a walk, have a warm bath and relax while you’re waiting for your baby. “Optimal fetal positioning,” can help baby to come into a better position to support labor. You can try sitting upright and leaning forward by sitting on a chair backward.
Conclusion
Natural methods of inducing labor vary widely in efficacy and safety. Practices like breast stimulation and dates confer some benefits, while others, such as those involving castor oil and blue cohosh, carry risks. Based on the available evidence, decisions about labor induction through healthcare providers are usually the safest.
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Sources :
1.S. M. Okun, R. A. Lydon-Rochelle, and L. L. Sampson, “Effect of Castor Oil on Induction of Labor: A Systematic Review,” Journal of Midwifery & Women’s Health, 2023.
2.T. K. Ford, H. H. Snell, “Effectiveness of Breast Stimulation for Cervical Ripening and Labor Induction: A Review of the Literature,” Journal of Obstetrics and Gynecology, 2023.
3.R. E. Smith, D. M. Wilson, “Red Raspberry Leaf and Its Role in Pregnancy and Labor: A Critical Review,” Alternative Medicine Journal, 2024.
4.A. L. Jameson, “Sexual Activity and Its Effect on Labor Induction: A Review,” International Journal of Obstetrics, 2023.
5.B. C. Zhang, Z. W. Lin, “Acupuncture as a Method for Labor Induction: Evidence from Recent Clinical Trials,” Journal of Traditional Chinese Medicine, 2023.
6.D. K. Patel, J. M. Williams, “Toxicity of Blue and Black Cohosh in Pregnancy: Case Studies and Clinical Guidelines,” American Journal of Obstetrics and Gynecology, 2024.
7.M. J. Abdullah, F. E. Azzam, “The Role of Dates in Pregnancy: A Review of Effects on Labor and Birth Outcomes,” Nutrition in Pregnancy, 2024.
8.S. L. Chung, L. M. Harrison, “Pineapple and Its Potential Role in Labor Induction: A Review,” Journal of Obstetric and Perinatal Research, 2023.
9.L. M. Weston, A. R. Franklin, “Evening Primrose Oil for Labor Induction: A Comprehensive Review,” Journal of Alternative Therapies in Pregnancy, 2024.
Patient Information Induction of labour Women’s Services. (n.d.). Retrieved November 9, 2024, from https://www.enherts-tr.nhs.uk/wp-content/uploads/2019/10/Induction-of-Labour-v5-09.2020-web.pdf
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Individuals with progressive, aggressive or metastatic disease requiring treatment should take extra caution to protect themselves and self-isolate. See [immunosuppressive treatment](#immunosuppressive) section for further information. #### **Liver Disease** Having chronic liver disease may put you at risk of experiencing severe symptoms once infected with SARS CoV-2. Compromised blood liver functions are a common feature in individuals who are critically hospitalised with COVID-19. The liver is an essential [detoxifying](https://nabtahealth.com/glossary/detoxifying/) organ. Its primary function is to filter blood from the digestive tract and the rest of the body. The liver also stores and releases glucose as needed, makes [cholesterol](https://nabtahealth.com/glossary/cholesterol/), and stores [iron](https://nabtahealth.com/glossary/iron/). The liver holds certain types of white blood cells, and supports immune function by clearing infections. Liver disease involves a process of progressive destruction and regeneration of the liver, often leading to scarring and permanent damage. This progressive liver damage often causes a dysfunction in [metabolism](https://nabtahealth.com/glossary/metabolism/), leading to [insulin resistance](https://nabtahealth.com/glossary/insulin-resistance/) or impaired insulin production (see [diabetes](#diabetes) section). This in turn affects the immune system and the ability of the body to clear infection, thus hindering the way the body responds to infectious pathogens such as SARS CoV-2. #### **Kidney Disease** As more data emerges on the clinical characteristics of individuals who have been hospitalised or who have died from COVID-19, it is becoming apparent that the most affected organs, after the lungs, are the kidneys. Kidney disease occurs when the kidneys are unable to filter out water and waste from the blood effectively. The filtration of waste products is a natural part of the metabolic process; therefore, factors such as medication, environmental pollution and infection that add to waste generation, also add to the pressure on the kidneys to work efficiently and effectively. Kidneys have historically been thought of as organs that are unable to regenerate, but new research shows that they do have regenerative capabilities, but this process is likely to be slow. As cellular turnover slows down naturally with age, and because age is directly associated with acquisition of kidney disease (see [age](#age) section), recent reports from the USA show that most of the COVID-19-related deaths to date in individuals over 65 have concurrent kidney failure as the main cause of mortality. If compromised kidney function means that the body is not able to effectively filter invading pathogens and toxins, infection with SARS CoV-2 will put additional pressure on the kidneys, potentially leading to kidney damage and toxic shock which will require immediate hospitalisation. Individuals with NCDs such as kidney disease should take their conditions very seriously and talk to a designated healthcare provider about putting appropriate measures in place to protect themselves. Maintaining good hydration and a healthy lifestyle is key. ### **Other factors** #### **[HIV](https://nabtahealth.com/glossary/hiv/)/ AIDS** Testing positive for Human Immunodeficiency Virus ([HIV](https://nabtahealth.com/glossary/hiv/)) does not make you more susceptible to developing severe COVID-19 symptoms, provided you are on effective [antiretroviral](https://nabtahealth.com/glossary/antiretroviral/) treatment. However, if you are not on appropriate treatment, the [HIV](https://nabtahealth.com/glossary/hiv/) virus is free to attack your immune system, putting you at a higher risk of developing AIDS. AIDS stands for Acquired Immuno-Deficiency Syndrome. As the name indicates, this is a progressive condition that results in destruction of the immune system. Without a functioning immune system, you will become immunocompromised, meaning that it will be more difficult for your body to fight an infection. This increases the likelihood of you experiencing more severe symptoms, should you become infected with SARS CoV-19, of. If you have [HIV](https://nabtahealth.com/glossary/hiv/) you should already be under care of an appropriate healthcare provider who can properly monitor your condition. #### Smoking Tobacco smoke exposure increases susceptibility to respiratory tract infections such as COVID-19. Smoking is known to damage the lungs and airways which causes a range of severe respiratory problems (see [chronic lung conditions](#lung)), it also puts you at a high risk of developing lung cancer and [cardiovascular disease](#CVdisease), the latter is the risk factor most frequently seen in those individuals who have died from COVID-19. Smoking does not only directly affect you, it also puts those around you who are exposed to secondhand smoke at risk. In light of the current pandemic, there has never been a more important time to stop smoking, not only for your own health, but also to protect those around you. If you are using e-cigarettes or other ‘vaping’ devices, recent clinical and scientific evidence has suggested that these pose a similar threat to the health of your lungs and heart. E-cigarettes contain chemicals that are not present in traditional cigarettes, but which have additional health implications associated with them. E-cigarettes also carry an additional hygiene risk due to reuse of mouth pieces, which means you are more likely to expose yourself to pathogens, such as SARS-CoV-2, which can survive on a variety of surfaces. #### **Immunosuppressive medication or treatment** There are many medications, treatments and medical procedures that can temporarily reduce the ability of your immune system to fight infection. In this section, we will provide a few examples; however, if you are on any medication or have undergone a medical procedure recently which makes you immune compromised, you should be in regular contact with your healthcare provider. They will be able to determine how vulnerable you are to acquiring severe or critical COVID-19 symptoms and advise you which steps to take to reduce your chances of catching this, or any, infection. * **Immunosuppressants** Drugs that suppress the immune system such as certain biologics (recombinant proteins) and glucocorticoids (steroids), inhibit white blood cells activity or function. These cells are the main fighters of infection in the body and, therefore, taking drugs that stop them from working effectively or reduce their numbers, affects the ability of the immune system to fight infection. This makes you more susceptible to severe symptoms following infection with SARS CoV-2. * **[Chemotherapy](https://nabtahealth.com/glossary/chemotherapy/)** One of the most widely used treatments for cancer is [chemotherapy](https://nabtahealth.com/glossary/chemotherapy/). The mechanism of chemotherapeutic agents is to destroy rapidly growing cells by damaging DNA and other factors involved in cell division. Because of its mechanism of action, [chemotherapy](https://nabtahealth.com/glossary/chemotherapy/) also attacks the highly dividing and healthy cells of the body such as the [stem cells](https://nabtahealth.com/glossary/stem-cells/) of the bone marrow. These [stem cells](https://nabtahealth.com/glossary/stem-cells/) are responsible for providing a continuous supply of the disease fighting, white blood cells. During and immediately after [chemotherapy](https://nabtahealth.com/glossary/chemotherapy/) your body is less able to defend itself against infection. Individuals who have certain types of [cancer](#cancer) may already be at an increased risk of experiencing severe COVID-19 symptoms; and if the same individual is also undergoing [chemotherapy](https://nabtahealth.com/glossary/chemotherapy/), extra protection and caution should be considered. * **Bone marrow transplantation** is a procedure that aims to replace otherwise damaged or destroyed bone marrow with healthy bone marrow. The first step involves [radiotherapy](https://nabtahealth.com/glossary/radiotherapy/) to partially or completely eliminate faulty [stem cells](https://nabtahealth.com/glossary/stem-cells/). The aim is to reintroduce healthier bone marrow via a transplant. As described above, the bone marrow is an essential source of infection-fighting white blood cells. The period between bone marrow elimination and transplant acceptance (i.e. the body adjusting to its new, healthier bone marrow) is around 6 weeks, and this can vary from person to person. During this critical time, a transplant recipient is at extremely high risk of acquiring infections. This includes infection with SARS CoV-2. #### **Living in a care facility or nursing home** Nursing home populations are at the highest risk of being affected by COVID-19 compared to the general population because they have a high proportion of [older](#age) adults who are often living with underlying chronic medical conditions which puts them at risk of experiencing severe or chronic symptoms if infected with SARS-CoV-2. To protect all who live and work in nursing homes and care facilities, regular cleaning and disinfection of common areas, appropriate [social distancing](https://nabtahealth.com/what-is-social-distancing/), and self-isolation measures where required, should be implemented. It is important that carers, who may carry the virus but may not be at risk themselves, also take the necessary steps to protect those residents who are considered high risk. This includes social distancing as much as possible and wearing appropriate Personal Protective Equipment (PPE). #### **Working in a healthcare environment** Being a doctor, nurse or an individual working in a hospital or clinic means that you may have regular exposure to patients who may have tested positive for SARS CoV-2 and, therefore, there is a risk of them passing the infection on to you. Take sensible precautions when handling infected patients; use PPE when at work, such as masks, a clinical coat/suit and gloves, and ensure that it is changed on a regular basis. Outside of work, take steps to protect yourself and those around you who may be vulnerable to infection. Use best practice for maintaining hygiene, including removal of potentially contaminated clothing whilst still at work, washing hands with soap and water, and disinfecting any other materials that may come in contact with others outside the hospital setting. #### **Contact with an infected or exposed individual / environment** Being in close contact with someone who has COVID-19, or someone who has been exposed to the SARS CoV-2 virus, puts you at high risk of infection, which is increased if you have other confounding factors, such as those mentioned in this article. Because the majority of individuals who are exposed to the virus do not display obvious symptoms, extra care to protect yourself should be taken if you are in a high risk category. Based on current data surrounding the length of time the virus remains in our bodies (the incubation period), you should self-isolate for at least 14 days from the time of potential exposure (Day 0) to minimise passing the infection to others. ### **Conclusion** As this article shows, many of the factors that result in an individual becoming ‘high risk’ occur as a result of underlying health conditions. Therefore, it is important to ensure that your current health status is under control and that medication, where required, is taken appropriately. Being aware of the signs of infection such as a fever, cough, shortness of breath, is key. Call ahead before visiting a health care provider or emergency department to alert them to the fact that you have been exposed to the virus. If you are in a country which has implemented tools to alert or monitor infected or potentially infected individuals, you may wish to adopt some of those tools to protect those around you and reduce the chance of cross contamination. The general recommendation is to limit hospital visits and contact with healthcare facilities where ever possible. If you have a chronic condition and require ongoing medical care or monitoring, provided your doctor is okay with it, consider using telehealth, electronic consultations and remote care, as appropriate. If you are considered high risk and require medications or a pharmacy visit, think about asking others who are less vulnerable to pick up what is needed. It is important to keep taking your medications as recommended. Nabta Health is committed to providing you with the most up to date, peer-reviewed, clinically- and scientifically-validated information on COVID-19 and other conditions. If you are not sure what your, or your loved ones’, risk factors are, Nabta Health has built a risk assessment questionnaire, which can be accessed from our Application. The Nabta App can be downloaded from our website ([www.nabtahealth.com](http://www.nabtahealth.com)). **References:** * [https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/groups-at-higher-risk.html](https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/groups-at-higher-risk.html) * Madjid, M., _et al_. Potential Effects of Coronaviruses on the Cardiovascular System: A Review. _JAMA Cardiol._ Published online March 27, 2020. * Ruparelia, N., _et al._ Inflammatory processes in cardiovascular disease: a route to targeted therapies. _Nat Rev Cardiol_ 14**,** 133–144 (2017) * Libert, C.,_et al_. The X chromosome in immune functions: when a chromosome makes the difference. _Nat Rev Immunol_ 10, 594–604 (2010) * ue Tsai, Xavier Clemente-Casares, Angela C. Zhou, Helena Lei, Jennifer J. Ahn, Yi Tao Chan, O.C., et al. Insulin Receptor-Mediated Stimulation Boosts T Cell Immunity during [Inflammation](https://nabtahealth.com/glossary/inflammation/) and Infection. _Cell [Metabolism](https://nabtahealth.com/glossary/metabolism/)_ 28 (6), 922-934 (2018) * Muniyappa, R. and Gubbi, S. COVID-19 pandemic, coronaviruses, and diabetes mellitus. _Am j physiol. Endocrinology and [metabolism](https://nabtahealth.com/glossary/metabolism/)_ 318(5), E736-E741. (2020) * Hanna, T. P. _et al_. “Cancer, COVID-19 and the precautionary principle: prioritizing treatment during a global pandemic. _Nature rev clin oncol_ 17(5) 268-270. (2020) * [https://www.cdc.gov/coronavirus/2019-ncov/downloads/community-mitigation-strategy.pdf](https://www.cdc.gov/coronavirus/2019-ncov/downloads/community-mitigation-strategy.pdf) * Jafar, N., _et al_. The Effect of Short-Term Hyperglycemia on the Innate Immune System. _Am J of Med Sci_, 351 (2), 201-211 (2016) * Cheng, Y., _et al_. Kidney disease is associated with in-hospital death of patients with COVID-19. _Kidney int._ vol. 97 (5), 829-838 (2020) * Parohan, M., et al. Liver injury is associated with severe Coronavirus disease 2019 (COVID‐19) infection: a systematic review and meta‐analysis of retrospective studies. _Hepatol Res_. (2020) * [https://coronavirus.jhu.edu/map.html](https://coronavirus.jhu.edu/map.html) * Ishan, P., _et al_. Association of Treatment Dose Anticoagulation with In-Hospital Survival Among Hospitalized Patients with COVID-19. J Am College Cardiol. (in press) (2020).