Is there really any such thing as a “natural” induction

At some point in the future, I may cull the internet and get all the so-called “natural” induction methods out there and organize them all into one post. Things that spring to mind include walking, sex (as long as your water hasn’t broken), nipple stimulation (including breast pumps), “labor inducing” Eggplant Parmigiana, and good ol’ castor oil. Anecdotal accounts would suggest some efficacy of all of these things, but I don’t know if there have been any good studies of any of them.

There are some people who think there should be no inductions, even among these “natural” methods — that baby and baby alone should determine when labor starts, and any move to hurry up the natural process is flirting with danger.

There are others who think that no artificial induction method should be used, but that these “natural” methods are fine because they’re, well, “natural.”

Then there are people who don’t mind any induction method at all, even for non-medical reasons.

I think that most inductions are unnecessary, and therefore introduce unnecessary risk; however, there are sometimes very good reasons for either the mother or the baby for an induction to take place, so I would not put myself in any of these camps.

I had not thought much of any of these methods until recently. When I was at term with each of my pregnancies, I was ready to have the baby, and did some of these without thinking much about it. But I’ve never taken castor oil. When I was in labor with my first baby, my water broke before contractions started. Due to the legal and medical constraints put on my midwife in attending a birth at home, it was necessary for the baby to be born within 24 hours, or else she would automatically have to transfer care to her back-up OB and to the hospital, so she wanted me to get some castor oil and take it. Not having any in the house, I sent my husband out to get some, and by the time he got back, contractions had started on their own. So of course, I didn’t take that nasty stuff. (If you haven’t read the rest of Keith’s birth story and want to, click here.)

And I never thought much about castor oil, except in passing — usually when somebody on some email list would bring it up, either a midwife, childbirth educator, doula, or just a pregnant mom tired of being pregnant. I assumed it worked (the mechanism that it’s thought to work by is to stimulate uterine contractions by stimulating bowel movements and contractions; often when a woman goes into labor, her bowels begin to move right before labor commences, or in the early stages of labor); and at the least, it wouldn’t cause any harm, other than the nasty flavor of it going down.

Then I read this article by Gloria Lemay in which she questions castor oil inductions, and said,

I worry about women taking castor oil because you also give your baby castor oil when you take it through the gut. This means the baby will get diarrhea and pass meconium, too. Then you’re into all the transports for meconium.

Maybe I should have done more research into the possible negatives of castor oil (besides maternal diarrhea and gagging the stuff down); but this was one of the few things, if not the only thing, I ever read saying that castor oil was bad for the baby. I’ve heard numerous things from medical-types questioning the effectiveness of it, but never anyone saying it could harm the baby.

So, I read that post on Dec. 17; fastforward to New Year’s Eve when a friend from church tells me that she’s going to start taking castor oil that night to hopefully start labor. Just some background: although midwives are not illegal in our state, we don’t have very many in our area, and this woman chose as her midwife a friend from Georgia who is a homebirth CNM and has attended many women in our state. Her due date was New Year’s Day. The mother thought she would have a fast or a very fast labor because all of her mother’s labors were four hours or less; the midwife planned to come to this area on New Year’s Eve and wait until the baby was born, so that she could attend the labor and birth. She suggested castor oil and a few different herbs to encourage labor to begin, which the mom was only too happy to take, because she was so tired of being big and pregnant. I’m sure she also didn’t want to make the midwife leave her family for up to two weeks, waiting for labor to begin naturally, either!

Although the mom knew I had two home births, and was a “birth junkie” she rarely if ever sought me out for my opinions or advice or help on pregnancy or labor. Many times I gave my opinion unasked, and I got the feeling that it was, perhaps, unwanted advice. That I was perhaps over-eager, overstepping my bounds, or whatever. So when the mom told me that she was going to take castor oil, I kept my mouth shut. Frankly, I was a little more concerned about a potentially bad reaction from the herbs than the castor oil, but I didn’t say anything about anything. After all, I’m just a birth junkie who has had two home births; the midwife is a certified nurse-midwife with training that not even Dr. Amy could question, and more experience than I could hope for (she’s given birth 9 times, in addition to attending I don’t know how many births). More than that, she’s a friend and I respect her — who am I to question her? So I kept my mouth shut.

This morning, I talked to my mom, and she said that the woman from church had her baby on Sunday, not long before church services started, and that they had to take it to the hospital immediately. She said double pneumonia from meconium aspiration. That was all she knew. The midwife and the husband had taken the baby; some friends had stayed with the mom and helped get her cleaned up, and then took her to the hospital as well, to be with the baby. That was all she knew, which was information from right after the birth, right before church.

So, I called the husband’s mother to see what the lastest news was. She didn’t really know much more, not having heard lately from her son and daughter-in-law, except that the baby was in the NICU on a respirator. She was getting ready to go to the hospital to find out more — not wanting to call her son, in case they were sleeping.

And I’m beating myself up for not telling the mom about the possibility of castor oil causing not just her bowels, but the baby’s bowels, to move.

I want to say it was just coincidence — after all, I’ve heard numerous stories of castor oil inductions (or failed “inductions”), and hadn’t heard an equal number of such stories in which the baby had passed meconium, much less had to be taken to the hospital for it. But I wish I’d told the mom, because I feel like now the baby is suffering (and of course, the mom and dad are suffering, too), and I might have been able to prevent it. At the time, I felt like had I said anything, it would have been dismissed. And, of course, if she had ignored what I said and still taken the castor oil, then when all this happened, she would have guilt upon guilt added to her conscience, for having caused it. Maybe it is just a coincidence. But maybe there’s a little baby in critical care on a respirator right now because I didn’t want to appear like a know-it-all nay-sayer.


3 Responses

  1. Castor oil can cause tetanic contractions and a fairly tumultous labor. Some CNMs and HB midwives recommend it and others don’t. Plus a disgusting chorro.

    As with any induction method, the best thing to ask is “why?” That goes for both the care provider and the mom, of course. Is there a really good reason why this baby needs to be OUT within the next 24 hours?

  2. I know how you feel with the “should I or shouldn’t I” inner voice. It’s not easy having knowledge and not having it appreciated.

    When babies aspirate meconium, I wonder if the cord was cut. An unmedicated baby can deal with mec the same way that an adult can deal with falling in a mud puddle face first—hold breath, cough, snort, sneeze, wretch, cough, snort, sneeze, wretch, vomit, spew. The problem usually results from someone panicking when the baby doesn’t breathe right away (he’s still getting oxygen through the cord) and they cut and clamp the cord in order to take the baby to suction and resuscitate. This cord cutting cuts off the oxygen and the baby inhales the particulate matter into his lungs.

  3. […] on January 22, 2009 by Kathy I had previously mentioned a friend from church who chose to have a “natural” induction instead of letting labor take its course. I’ve gotten some more information about the birth, […]

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