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Discussion Starter · #1 ·
Can anyone give me some good info, or link me to a thread, with good info on the negatives and pluses of using cohoshes to stimulate labor? I have a vague idea that it's controversial to use these, but this is a technique my midwife sometimes uses, so I need to organize my thoughts about this.
I'm about 41 weeks, had 4 kids at 39-40 weeks and one at about 41 weeks (or at about 42 weeks by u/s dating but I think it was wrong.) I'd rather not have the baby past 42 weeks. My last (post dates) one had mec staining and lots of drama.
The two year old is nursing, which stimulates a few contractions but I seem to be immune to prolonged nipple stimulation this time. I'm walking, staying active, using evening primrose oil and drinking rrlt. I won't do castor oil because of the meconium thing. I'm not feeling super impatient but I know if I want to get the baby out by 42 weeks, now's the time to start encouraging labor and planning ahead. I'm considering a membrane sweep but not for several more days yet. The cohoshes would be recommended to me (by my midwife) in conjunction with that, I believe. My extreme PREFERENCE is to go into labor spontaneously, without any shenanigans but again, I'm not comfortable going more than another week or so.
 

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I'll share my thoughts on induction at home both as a midwife and a mama who gave birth at 43+ weeks.

t is normal for a baby to be born anytime from 37 to 42 weeks. That means 12 days post dates is NOT a late baby and still within the realm of normal. I strongly believe that babies come when they are ready. We also need to carefully check due dates. Forget ultrasound dates if mom knows her LMP or conception date this is better. Did the OB add days for the length of her cycle? Did he add 5-7 days if it's a first baby? Tthe due date could easily be 10-12 days different depending on how it's calculated.

You also need to realize that "post dates" is a term relative to the EDD relating to the mom. "post term" is a clinical finding in a baby that can not be determined until after the baby is born. Most "late" babies are not "post term". All mamas at the end of pregnancy start to feel "done" with pregnancy and ready to have baby in their arms. This is normal. I urge you to not sign up for an induction and other interventions because you are impatient. Is there any other reason to induce? Are the vitals for you and baby normal. Baby a normal size (between 5lbs and 11lbs)? Baby reactive and responsive? Mama healthy with good nutrition? Amniotic fluid normal for 40+ weeks? My experience is that in most home inductions there isn't a medical reason for the induction. It is either due to impatience or pressure from back-up docs.

In my practice I do not routinely induce or encourage induction for a postdates baby. After 41.5 weeks babies need more monitoring (FHT, BP and Palpation, reactivity tests... not ultrasounds) and mamas need more support emotionally and physically. In all my years of practice, I have observed that most (not all) home inductions make for long labors that are hard on mom and baby. Most inductions are done to avoid a hospital induction being pressured by back-up doctors. The places for a "home" induction without this pressure, in my opinion, are rare and few.

Induction, even at home, of a low risk healthy pregnancy, is an unnecesary intervention. And all interventions can lead to other interventions that grow in proportion.

That being said... I'd like to share a few thoughts and some research about home induction techniques.

The "old faithful" home induction technique has long been Blue and Black cohosh tincture. This needs to change. Blue cohosh is not as safe as we used to think. There is evidence to show that if can negatively affect the baby and cause problems PP. In addition to this is often causes irregular contractions and a labor that will later stall out. Aviva Jill Romm has been doing a study on Blue Cohosh and it's safety/dangers. There are better herbal options. Your midwife may not be familiar with the current research about Blue cohosh and/or may not know of other herbal techniques that can work for this. Change is hard and often comes slowly. You can read some of the new articles from the New York paper with Tierana Low Dog at http://www.gentlebirth.org/archives/blueCohosh.html She conducted a recent blue cohosh study along with Aviva Jill Romm.

The other long used method is castor oil. I'm not a fan of castor oil. While it can work it usually comes with a lot of vomiting, nausea and massive diarhea. While this stimulates labor it also depletes moms reserves and if labor turns out to be long may lead to maternal exhaustion or fetal compromise just because we wore mom out before she really got started. There are just better ways. Even if mom doesn't wear out at labor her PP is more difficult because she lost her reserves.

The first step in any induction should be carbohydrate loading and good hydration. If mom has the reserves she needs for labor (i.e. run a marathon) she is more likely to go into labor on her own. Also she needs to be well rested. Sex, food and laughter (and less pressure) are a good place to start. I agree with Ina May that what gets the baby in, gets the baby out (energetically as well as physically) Before any induction you've also got to know baby position and what mom's cervix is like.

Mexican midwives use Cumin tea with a 1/2inch slice of potato at the bottom of the cup. 1tsp to 6oz hot water and drink for several hours. Some swear by it and the midwife who told me this has a lifetime of experience so I tend to believe her. Russian midwives sometimes use cold water inductions, yes a freezing cold shower for just a few seconds.

As for herbal ways to induce there are better choices than B&B. You can email me privately if you'd like herbal suggestions to discuss with your midwife.

Homeopathics can be used for an induction. Homeopathics don't work one remedy for one symptom so you really need to look at the whole picture of what is happening with the woman. Again, avoid Caullophyllum (blue cohosh) for inductions. Some choices might be Arnica, Cimicifuga, Pulsatilla, Gelsemium, Argentum nitricum 30C, and Lycopodium 30C. I'd start with obvious symptoms and then explore such as: no dilation, mom a bit dazed, apathetic perhaps pulsitilla, with emotional distress gelsemium and so forth. I recommend Miranda Castro's book of homeopathy for pregnancy if your interested in learning more.

You can help a labor start by ripening the cervix with Borage and Flax Seed Oil , Black Current Oil. or Evening Primrose Oil placed next to the cervix. Some midwives also do cervical massage (which can be uncomfortable and is definitely invasive) or use cervical presssure points.

Moving helps with induction. Walking, alternating walking with one foot on the curb and the other off, with moderate walks can be a good start. OR stairs alternating with long walks. Lifting the belly can help put the babies head on the cervix. Nipple stimulation (but it takes a lot to start labor so use this with other techniques). Massage in general as well as Reiki, pressure points or hydrotherapy can help other techniques.

Acupuncture can be a good choice. Start with LI-4 and SP-6. Acupressure on these points can help too. Cranial massage especially around the hypothalmic point or cranio sacral work can enhance other techniques. Using castor oil EXTERNALLY to massage the belly (and feet) and use castor oil packs or castor oil rubs on the belly with some heat.

More invasive techniques include sweeping the membranes which is painful and can take 3-5 days to be effective. (At which point labr probably would have started anyway) It also can't be done if mom is Group B positive or has ROM. Cervical dilators such as laminaria or catheters or AROM. AROM come with the risk that if labor doesn't start now your fully committed and can't just wait a few more days. It's all in at that point. AROM should be an option only after everything else has been tried. AROM can also cause the cervix to regress backwards or stop a labor all together for several hours which can really defeat a mom emotionally.

In the hospital they can start with prostogladin gel or laminaria to ripen the cervix and walking, moving maybe sweeping membranes. They don't have to start with pit. A doctor could also do any of these in the office and send her home to "see what happens". If you have a doula or midwife, it's a good idea to not be alone (the mom) in the hospital during any part of an induction. This is when doctors talk women into thing or do things without proper consent.

My experience is that the most common reason an induction is done at home is to avoid a hospital induction. Home induction is better than hospital, if it works which is usually does. I FIRMLY believe that if you are not knowledgeable about the herbs and homeopathics you shouldn't use them. You don't need to be an herbalist or homeopath but you do need to build a relationship and knowledge base with the plants you choose to work with.

It has been my experience that most inductions lead to long, irregular and harder labors. Mamas and babies are best left alone if at all possible. Home inductions that are done "At moms request" for no health/medical reason are an intervention that is not in her best interest and not necessary.

I have also had moms that induce on their own without informing me, as their midwife. This is not ok and it really pisses me off. There is a reason they hired a midwife, both the midwife AND the client need to be honest and provide disclosure if our relationship is to work and for the health of mama and baby. It is equally frustrating when the doula gives mom things without anyone checking in with the midwife. So by the time they call me to their house for a long dragging exhausting labor that is stalling out it is already past the point where I could have done something different to help them or perhaps advise against this course by providing information/education. There's a reason you are the doula and I'm the midwife. We need to work together.

And even though it's controversial I have to say this. It is my strong opinion, based on research and evidence, that it is NEVER ok to use cytotec for induction in or out of the hospital. - especially out of the hospital. Marsden Wagner, Ina May, Michel Odent, Henci Goer and many many other wise and experience midwives and birth researchers agree with me. I know cytotec is use at home by many midwives.. more than you'd imagine. It is also not always done with proper information or consent which is wrong ethically and morally. There is the idea that it is safe because they have had "good results" when they have used it or because they "use tiny amounts". The evidence disagrees and this is like convincing yourself it's safe to be hit by lightening because you were hit once and it turned out ok. Most of us spend our lives involved in the birth movement fighting for a woman's right to do what her body was designed to do, birth naturally. We struggle against the interventions and managed style of doctors... when we start to do these interventions at home we have become the very thing we were fighting against.

I encourage you to read some of these links about cytotec if your interested
http://www.midwiferytoday.com/articl...vescytotec.asp
http://parenting.ivillage.com/pregna...6xr4-p,00.html
http://dir.salon.com/story/health/fe...ndex.html?pn=3

Hope some of this is helpful to you. Meanwhile have a cup of raspberry tea and tune in to your baby. Many blessings.....
 

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Discussion Starter · #3 ·
Wow thanks for a great post Beth!
I agree with what you're saying, especially about post dates... my last daughter was a spontaneous labor at (officially) 41 weeks 6 days, although I'd say it was 40 weeks 6 days... nonetheless, my opinion did not count against the extreme pressure I was under from my OBs!
My other babies were born before or on their due dates, and ALL were bigger than she was, and I don't consider her "late" at all, I've always made a point of saying she was post-dates not post term; she needed all that time to be ready and certainly didn't seem "late." She had meconium, at the very end of labor I think (possibly due to nuchal cord) and again; hospital birth OMG everyone have a fit over mec, cut the cord instant she's born deep suction her out mess around and torment her, after all we have a NICU team lets do the full rigamarole on this poor baby seconds after birth. She didn't nurse well for months.
In case you are wondering? I was having her in the hospital because I had a massive stroke less than two years before, and I was a little worried about the birth!
This one's going to be born at home, and, I'm in early labor right now; contrax and bloody show last night and this morning; so I expect a baby tonight or tomorrow hopefully.
So looks like I didn't need to worry about this after all. : wink I was officially due the 23rd of September but since that due date depended on a conception date 8 or 9 days after the last time I had unpregnant sex, I've been working under the assumption that the 20th was a more likely, latest possible due "date" ... And wanting to have this baby before Oct 4! Preferably in September!
 

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I induced my first with black and blue cohosh.

I regret it because
1) natural induction is still induction. it was an awful labor and nearly killed me, my uterus just pooped out at the end and couldn't push effectively or clamp down after to stop the hemoraging

2) that child has had a wide range of mental and physical problems since the very beginning and i wonder, with how poorly regulated and tested supplements are, if somehow there were impurities in them (or the vaginal EPO i used). I don't know why that is, but i'm suspicious enough of these tinctures to be mentioning it here! that and how they overstressed my uterus! wish i'd just gone late!
 
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