Blue cohosh for VBAC induction?

[smeep]

My friend is a VBAC and is nearing her OB's "must birth by" timeline and someone suggested she take blue cohosh to help induce labour. I know very little about cohosh's for labour induction and have heard both good and bad things.

So, give me the rundown. What do you suggest? What should she look out for? What about black cohosh, should she use both or just one or what?

TIA! :) 

[kltroy]

Honestly, I'd be wary of the cohoshes, just because their effect on UR risk hasn't been well studied, and the dosage is unreliable and difficult to control due to differing concentrations in the commercial supplements. 

What other options does she have?  Has she tried repeated membrane sweeps (like one every 3-4 days for a week or two?)  Has she talked to her OB about having a non-stress test and only inducing if baby looks like it's having problems?  Has she talked to her OB about using a foley bulb to initiate dilation mechanically (works if she's less than 4 cm only)?  How about a gentle pitocin induction if everyone agrees that the baby needs to come out? 

I recall feeling very wary about having my water broken as a method of induction for my VBAC because I didn't want to be "on the clock", but really, if they're to the point where they're inducing, you are *already* on the clock, and this can be a simple and more natural way to get labor going than some other methods, so it's also something to consider. 

IF the doc is completely inflexible about the NST she can always not show up for a scheduled repeat c-section or induction, but I'm betting that she can advocate for a NST if it's before 42 weeks.

...so depending on how far along your friend is, I'd go for (in this order)

1.  Repeat membrane sweeps

2.  Non-stress test

3.  IF baby needs to come out, foley until 4 cm dilated

4.  IF not in labor still at that point, rupture membranes

5.  IF not in labor still after 24 hours of ruptured membrane, gentle pitocin

Just my opinion.  Best of luck to her! 

[Monkey Keeper]

I'd also recommend she try acupuncture.

[tonttu]

Is it one of those routine things  , like "if you´re not in labor by this day , we´ll induce " or is there a real issue , that the baby has to come by a certain time ( and I don´t mean hospital guidelines) ?

Because the problem I see , is , that she greatly increases her risk of ending up with another cs , if the baby is not ready yet , which it obviously isn´t , otherwise she would start having contractions !

So , maybe , she should tell the doctor to just keep monitoring the baby´s well-being and other than that just wait .

If , however , she is at the point , where the baby should really come , she could try nipple stimulation or even taking what´s called a midwife cocktail in Germany .

It is quite effective if your cervix is ready , and it´s a glass of orange juice and a shot glass of castor oil mixed in with it , and then drunk .

It will have two effects , if she´s ready to deliver , she will get nice strong contractions within about 12-15 hours or , if she´s not ready yet , diarrhea , but not really badly harmful .

[Human_Being]

No matter what, skip blue cohosh it is cardiotoxic to the baby. Big doses can basically cause heart attacks, stokes, and seizures in babies. It is big medicine, not to be used unless supervised by someone who knows what they are doing.