With about 4 million births per year in the United States, at any given moment there are thousands of pregnant women who have just gone past their estimated due date. As a professional labor coach (doula) and the mother of a nine-month-old, I interact with these women regularly. I like to think of them as belonging to a certain sisterhood, in limbo together between 40 and 41 weeks pregnant.
The experience can be lonely though, in spite of, or perhaps because of the bevy of family and friends calling to ask “have you had your baby yet?” as well as the seeming casualness with which many obstetricians propose setting a date to start labor with drugs – in the past two decades, the rate of medical inductions increased by 140 percent.
According to a study published this month in the medical journal Birth, fifty percent of mothers surveyed tried to start their own labors when they believed pregnancy was taking too long.
I did. And this was after saying for years that self-inducing was something I saw no need to do.
For the 201 women in the Birth study, the most popular attempted methods were walking, sexual intercourse, eating spicy food, and nipple stimulation.
Some of these techniques have scientific evidence to support them. For example, an earlier study found that “only 6.9% of sexually active study women remained undelivered at 41 weeks of gestation, compared with 29.8% of abstinent women.” Since the hormones of birth and arousal are the same, a range of sexual activities could hasten labor when pregnancy is full-term.
Lead author of the Birth study Dr. Jonathan Schaffir says spicy food creates intestinal activity that might encourage labor, and nipple stimulation has been proven to bring on contractions although standard protocols do not exist for its use.
Googling “natural ways to induce labor” brings up almost half a million results, from sites as mainstream as What To Expect When You’re Expecting, to a YouTube video with a husband demonstrating acupressure on his wife. In contrast, on another Web page a commenter named Sheryl offers this critique:
“Where’s the fire? What’s the rush? Yes, I know you are uncomfortable, but that is pregnancy. Your baby is not done yet. Period. Labor will start spontaneously when fetal development is complete. Have you ever heard of a fifty-week gestation? Have you ever seen your neighbor’s dog explode because labor never started? Just wait! Please! …You won’t have this chance to be lazy and pampered for a long time. Your baby will thank you.”
The question that remains unexplored in the Birth study is, “Why?” What are the reasons women feel the need to do something as dramatic as make their bodies go into labor? During my fifteen years as a doula, when a pregnant woman would ask me what I thought the best natural induction method was, I would answer kindly and firmly, “patience.”
In my own pregnancy I warded off the potential for feeling pressured, by choosing not to tell anyone my so-called due date. I only said my baby was expected in mid-September, which was actually two weeks late. Even the American College of Obstetricians and Gynecologists says that unless mother or baby is unhealthy, pregnancy does not carry increased risks before 42 weeks.
The night before Labor Day, my boyfriend was off doing his own thing, so I found myself on the sofa watching Billy Crystal in Mr. Saturday Night and tried out some nipple stimulation. I was 40 weeks and 3 days pregnant, perfectly average for a first baby, and therefore my body was probably ready on its own. Nipple stimulation can be done just as it sounds, by rolling the tip of the nipple between one’s fingers—studies show this releases the most hormones—or it can include a larger area of breast tissue. (Mothers whose pregnancies are considered high-risk should not use this method, and women who do use it should stop if contractions last longer than 90 seconds each.)
My approach was to massage the palm of my hand in a circle without paying too much attention to technique, on and off for thirty or forty minutes. Contractions came on immediately and regularly, and once I was satisfied that my personal science experiment had been successful, I stopped it and finished the movie. I woke up in labor the next day.
I remember performing my experiment more out of curiosity than under duress. It was kind of cool that it seemingly worked. Researchers on the Birth study noted that mothers who attempted to self-induce were more likely to be having a first baby (first babies tend to come later than subsequent babies, so it makes sense that these moms might feel more interested in, or pressured to get things going). They also found that the self-inducers were more likely to have had a vaginal birth. Depending on the lens with which you interpret this study, a vaginal birth could be seen as an important benefit, considering that drug-based inductions are associated with higher cesarean rates.
The study ends with the following observation by its authors: “A substantial portion of women used nonprescribed methods to induce labor, often without discussing them with a physician. Maternity caregivers may want to inquire about such issues, especially where interventions may do more harm than good.”
The researchers’ conclusions might miss the point somewhat. Although due dates are notoriously inaccurate, our culture and our healthcare system place great significance on them, and we increasingly expect pregnant women to have their babies “on time.” Yes, the day a baby is born is one of the most important events of a lifetime. It’s normal for women to feel restless at the end of pregnancy, and literally bursting with expectation. But we’ve encouraged a bit of an obsession with self-inducing, and there’s probably a kinder way to honor that special moment right before the transformation into motherhood.
So the next time you talk to a woman between 40 and 41 weeks pregnant, let her know that at least from your perspective, she’s perfect right where she is.
Ananda Lowe is a certified lactation consultant, long-time doula and co-author (with me, Rachel Zimmerman) of “The Doula Guide to Birth,” published by Bantam Books.