Black & Blue Cohosh

[3xx1xyFamily]

As a birth professional how do you feel about it's use?

In my scenario (below) what would you suggest?

I am 40 weeks 2 days (EDD was Jan 6... based on LMP/Ovulation/conception, so it is fairly accurate) I am an HBAC, 14 months from birth to birth. On Jan 4th, I was only a finger tip dilated and 50% effaced. I've had no complications in either PG (c-sec was coerced by OB to accommodate his needs), blood pressures great, no swelling, etc...

My MW suggested Blue & Black Cohosh, by inserting it into the cervix at our next appointment this friday (Jan 11th... 40w 5d)... I can't decide!!!! All the info online is inconclusive about it's safety. I'd prefer to go naturally, but, I can't help to say the idea of induction is appealing at this point.

I want more opinions on these herbs!

[nashvillemidwife]

Herbs are a last resort for me, and I'm somewhat of an herbalist. I am concerned about the safety and not just the information out there on the internet, but because it can be very slow to work you up to active labor. It's a pharmaceutical, even though it was created in dirt and not in a laboratory. Personally, I'm concerned about the safety of using it in labor and I feel like the baby needs careful monitoring. I certainly wouldn't insert it in the cervix. Has anyone else heard of this? If you really feel you need to do something I'd recommend evening primrose oil.

Personally, castor oil is my first line. I do feel a little weird about it because this isn't based on any scientific research. Yes, it's very unpleasant (going in and going out), but in my experience either it's going to do the job or it's going to tell you your body's not ready. It's rather fast acting too, there's no piddling around if you take it at the right dose. Too many people don't consult their midwives, and they either take "just a little bit" thinking it might possibly maybe gently encourage labor to start, or they take too much and poop their bowels out while trying to cope with out-of-control contractions.

Of course castor oil is a naturally occurring pharmaceutical too and I really have no evidence that it's preferable to herbs, but that's what I think. YMMV

[WildNettle]

Hmmm, I am a doula and herbalist, and I've never heard of using the cohoshes internally like that. I would not do that. I am not even sure that using them ON the cervix like that would do the same thing as taking them internally. And actually, someone using them like that makes me wonder if she really knows her herbs that well. The cohoshes are traditional partus preparators, but just b/c they are traditional doesn't mean they are recommended or necessarily a good idea with all births. I have used blue and black cohosh with a couple of clients, after very careful deliberation. Both were 41 weeks (or thereabout), with stop and go type labors. One really wanted labor to start asap, as she was scheduled for an induction after the weekend if she didn't go into labor. I prefer not to use them, period, but in some situations I think it's acceptable. Yes, they are herbs, and yes they are natural, but using something, anything, to push your body into labor, well, isn't natural. You aren't that far past your due date, and baby simply may not be ready. Let your baby and your body determine when the time is right, don't force it!

[MsBlack]

I have not heard of this internal/cervical use of the cohoshes either. I also do not favor, in general, the needless use of medicinal herbs. As I see it, there are (loosely put), 'nutritional herbs' and 'medicinal herbs'. Sure, use those nutritional herbs to nourish yourself, use them fairly freely. But when it comes to medicinal herbs (like the cohoshes), I tell my clients--why take medicine if nothing is wrong? Instead, nourish yourself well in all needed ways with food, beverages, rest and love--and trust that your body will do what it knows quite well how to do.

To me, there is the safety factor--and medicinal herbs CAN have negative side effects, just like synthetic pharmaceuticals. Risks and benefits must be weighed--there are times when the potential benefit is worth the risk (as with any med. or procedure). I don't see that you have reached that point yet! You are still very much 'normal for you'.

But there is also the Inherent Trust factor, something I think is every bit as important--maybe even more important--than the safety factor: by using medicine without any indications that it's necessary, the message your mw is giving you is that she doesn't trust that you are able to do this yourself; she is indicating that she doesn't much trust birth (at least, birth without HER interference/guidance/direction); she is undercutting your trust of yourself and birth. To me, this has the most risk for you--you want to be feeling trusting and inspired, able and strong right now, not doubtful and 'probably needing some sort of help'.

I, too, have to wonder how much she actually knows about what she is doing in this--and would be interested to see any research about it. I hope that you do not allow it before YOU get to see her evidence. NOT just 'what she's heard some other mws do', but an article, a book ref, something. You can tell her that you want to think carefully about it before consenting, and ask her to please share her references with you to help with your considerations.

all the best!

[BirthIsAwesome]

Although I have read extensively about herbs, this is my opinion as a doula, not a trained herbalist!

I personally feel that induction (except stuff like s*x, nipple stimulation, kissing, squatting, walking, pelvic rocking, eating spicy food, evening primrose oil on cervix + orally; all 100% harmless) should not be attempted on anyone pregnant until 42 weeks. However that is just me. I'm very low tech/non interfering.

At 42 weeks I might suggest castor oil packs on the belly (castor oil orally is thought to induce meconium release; it is a laxative and the baby gets some too). If that didn't work, and the mom is soft, stretchy, and effaced (in other words very "ripe"), she could try using herbs. However, a mom with a former c-section is not a good candidate for black/blue cohosh. Every mom reacts differently with herbs and black/blue cohosh (an oxytocic herb) sometimes produces stronger-than-normal contractions, which is not good for a scarred uterus, especially one that only had 5 months of break between birth #1 and conception #2. Think of it as a natural and weaker form of Pitocin.

Other herbs such as pure Red Rasberry Leaf tea and pure Peppermint tea are non-oxytocic. You take 4 teabags or 2/3 oz. of dried herb in 8 oz. of boiling hot water; cover and steep for 30 minutes. Take Peppermint tea first thing in the morning, then three hours later take Red Rasberry Leaf tea prepared the same way. Alternate all day, eat a spicy supper, and end with Red Rasberry before bed...and then s*x! Should bump you right into labor! RRL tea works by toning and preparing the uterus for labor and P tea works by stimulating the uterus; spicy food with pepper, ginger, garlic, and chili powder work like this too.

But there is also the Inherent Trust factor, something I think is every bit as important--maybe even more important--than the safety factor: by using medicine without any indications that it's necessary, the message your mw is giving you is that she doesn't trust that you are able to do this yourself; she is indicating that she doesn't much trust birth (at least, birth without HER interference/guidance/direction); she is undercutting your trust of yourself and birth. To me, this has the most risk for you--you want to be feeling trusting and inspired, able and strong right now, not doubtful and 'probably needing some sort of help'.

I also second the above paragragh by MsBlack. Please don't feel that you can't birth on your own. Your body is an awesome creation and it is perfectly capable of giving birth. Some of the above techniques are simply gentle "encouragement" to get the process moving faster---not better.

Just my two cents--I hope it was helpful!

[nashvillemidwife]

Originally Posted by BirthIsAwesome

At 42 weeks I might suggest castor oil packs on the belly (castor oil orally is thought to induce meconium release; it is a laxative and the baby gets some too).

Taken orally castor oil mostly directly on the bowels, otherwise it would have the same effect on the body since it is readily absorbed into the blood steam through the skin. It does not have a significant systemic effect to cross the placenta barrier in enough concentration to affect the baby.

Most times castor oil is used to induce postdates. Postdates babies are prone to have some meconium because they've been cooking so long their bowels are matured. It's no coincidence that castor oil babies are more likely to have meconium, but it's not a cause-and-effect.

[Doula Dani]

Originally Posted by BirthIsAwesome

Although I have read extensively about herbs, this is my opinion as a doula, not a trained herbalist!

I personally feel that induction (except stuff like s*x, nipple stimulation, kissing, squatting, walking, pelvic rocking, eating spicy food, evening primrose oil on cervix + orally; all 100% harmless) should not be attempted on anyone pregnant until 42 weeks. However that is just me. I'm very low tech/non interfering.

I will agree with this.

[BirthIsAwesome]

Thanks for that information, nashvillemidwife!

[nashvillemidwife]

You're welcome. As usual, I could be wrong. It doesn't all make since. For example, why is putting castor oil on the belly effective at all, since it's not being applied directly to the bowels? (Maybe because it's being applied in such close proximity to the bowels and/or uterus? Maybe.)

We don't really know how castor oil works which is why I'm leery of using it, but I still think it's a better choice than herbs and certainly a better alternative than having to go to the hospital to be induced.

My main point is that I do not believe it causes the baby to pass meconium, unless the castor oil induction causes such strong uterine contractions that the baby gets stressed, in which case babies wouldn't have meconium more often any other induction. I do think it's faulty logic to assume the baby poops just because mom is pooping too. I can see how that might make sense but that's just now how the placenta works. For some women it causes vomiting, but I've never heard of a correlation to vomiting babies.

[mwherbs]

I think that castor oil must have some prostaglandin action- the older herbal remedy--
I know that some mws do some prep stuff like recommending evening primrose oil - and may place it on, at or in the cervix
blue and black cohosh - I am wondering what the mw is really planning on doing I too have not heard of using it by placing in the cervix- I have heard of using it as a douche, an enema, teas and tincture drop dosing- also homeopathic doses
patience, is probably the best remedy to use at this point, but with that said I am not there and have not been caring for you and don't know the whole story and what she may be thinking, discuss it with her before hand and figure out what might be best-- ask her just like you are asking us ,

[3xx1xyFamily]

Originally Posted by BirthIsAwesome

I personally feel that induction (except stuff like s*x, nipple stimulation, kissing, squatting, walking, pelvic rocking, eating spicy food, evening primrose oil on cervix + orally; all 100% harmless) should not be attempted on anyone pregnant until 42 weeks. However that is just me. I'm very low tech/non interfering.

This is how I feel too. BTW, all of the above mentioned have been done or are currently in daily practice.

Like I said, I'd prefer to go naturally, but I can't help to say the idea is appealing, so I have to ask the questions and get the info to make that decision... which, ladies, you've given me everything I was hoping to gain. Thank you.

I still stand by my original decision (pre-1st pg decision) I'm here for the long haul. As long as she's healthy inside me, I'm going to leave well enough alone. I've told the MW, that come Monday morning if I am still PG I'd like to get an NST & U/S to look at the placenta and make sure everything is healthy for me to remain PG, we can make further decisions from that point.

Thanks again. The feedback and opinions are greatly appreciated.

[BirthIsAwesome]

I'm so glad we all were able to help you with making your decision. Good labor/birth prayers going your way! I forgot to say that eating a whole, raw pineapple is said to speed up softening and effacing of the cervix. I don't know why :

[dinahx]

On the subject of the Cohoshes in general . . . I was so scared of them and I didn't use them in my first labor when it was a little slow to get going and my midwife recommended them . . . but after reading a lot more, I now think that if I ever needed them, I would use Black Cohosh first (in a situation where a medical induction was warranted) and then Blue as a last last resort. I feel pretty strongly about choosing the Cohosh's over Pitocin in a situation where Pitocin was warranted . . . Can anyone confirm my intution that Black Cohosh alone would be a little safer than the two together?

[jul511riv]

subbing to read later.

[ryansma]

Originally Posted by jul511riv

subbing to read later.

me too

[jul511riv]

Originally Posted by dinahx

On the subject of the Cohoshes in general . . . I was so scared of them and I didn't use them in my first labor when it was a little slow to get going and my midwife recommended them . . . but after reading a lot more, I now think that if I ever needed them, I would use Black Cohosh first (in a situation where a medical induction was warranted) and then Blue as a last last resort. I feel pretty strongly about choosing the Cohosh's over Pitocin in a situation where Pitocin was warranted . . . Can anyone confirm my intution that Black Cohosh alone would be a little safer than the two together?

As a beginning herbalist, I wonder what it is, exactly that your intuition is telling you about black vs blue and so forth...

Herbs and their dosages are indicated based on:
1. what they do
2. any contra indications
3. the energy of the specific herb
4. intuition

Now this intuition would vary on the circumstances, which one couldn't forsee, but COULD take a stab at...but there are some herbs, like oils, that simply dont sit well with a specific person, regardless of their academic applications.

So, I guess what I'm asking is, might it be some of this as well for you?