When I found out I had this bizarro liver-pregnancy condition Intrahepatic Choleostasis of Pregnancy (ICP), the scariest news was that I could potentially have a stillbirth, a possibility that increases as the pregnancy progresses and is most likely between 37-39 weeks. (You can read all about ICP in my post here). The unique thing about my situation was that I received a diagnosis at 36 weeks. The management protocol for ICP pregnancies is to induce labor at 36-37 weeks, no matter what, to lower the risk of a stillbirth.
This is my second child. My first was born naturally in a birth center with midwives. My daughter who is 2 1/2 now very much liked residing in the womb. I was 41 weeks 4 days pregnant when I finally went into labor. I had employed all of the “tricks” and old wives tales one reads about when one is very pregnant and very tired of being so. However, I attribute my water breaking entirely to acupuncture. I had seen an acupuncturist for the time preceding my pregnancy and during since I had a history of losing my early pregnancies. When I learned that acupuncture would not only help me to retain my pregnancy when I wanted to but also trigger labor, naturally I made an appointment pronto.
The acupuncturist told me that I was close when she checked my “points”. She set me up in a private room (it was a community acupuncture facility, so I was accustomed to getting stuck with needles in a room with three other people), laid me on my side and inserted the needles in the appropriate places. Within 30 minutes I was HOT, sweating and getting anxious. I needed to get the HEY out of there! I was a minute away from removing the needles myself when my practitioner walked in. She freed me and sent me on my way. That was at 11AM.
My water broke at 5:45 after a lovely dinner out with friends in which I was breathing through labor pains that I would not acknowledge as such. My friend, a mother of two, wisely informed me on our walk home, “Michele, you’re in labor”. Right, she was!
Anyhow, let’s fast forward 2 1/2 years. I am faced with being induced with Pitocin, the artificial form of Oxytocin, which as I’m told, results in a very hard VERY fast labor with no reprieve. That sounded like a nightmare to me. Not to mention, I had a home birth planned with a midwife. I so was looking forward to a nice relaxing labor in my own home. With a low risk labor, this is likely to go just fine.
Alas, this was not my fate. However, I’m not the type to just lie down and do what the medical community tells me to do. Since I arrived late in the game as it was, I was confident (perhaps unwisely so) that my baby was going to be just fine. I’ll save you the suspense—he was! Perfect!
So I decided I was going to try to get things going MY way and not with that scary Pitocin. My midwife, who is legendary in the Richmond area, was up for the challenge. When we learned that at my 39 weeks I was at least 2 cm dilated, she swept my membranes. What this means is, if you don’t know, is that the practitioner will insert a finger into the cervix and run the finger around the inside surface to separate the placenta from the uterus. OUCH! Actually, it wasn’t as bad as I thought it would be. And this practice is thought to help spur on labor.
After that, I made my acupuncture appointment. This Doctor of Traditional Chinese Medicine was new to me but she knew her stuff. I liked her no-nonsense approach. I filled out the brief questionnaire, I don’t think she read it at all, and then answered her 10 questions. She immediately laid me down and inserted the needles in all the points known to help induce labor. I also asked her for herbs. She sent me home with two vials, both of which were marked in Chinese characters. One is meant to help stimulate qi (or chi, our life energy) which I was apparently deficient in, evidenced by my fatigue and weak pulse. The second vial is intended to help induce labor. I followed the directions and swallowed 8 pellets three times a day.
The next layer? Evening Primrose Oil. Taken orally and inserted vaginally can help to release prostaglandins, the hormones that get labor going. Check.
Old wives tails and even some limited research suggest that pineapple juice and figs help to stimulate labor. Long shots, but hey–why not? They’re both delicious.
Finally, my midwife was engaged in a ten-year long study focused on the efficacy of the “birth drink”. This German concoction is a medley of castor oil, apricot juice, almond cream, lemon verbena and champagne. The castor oil is really the “active ingredient” here and an age-old remedy to induce labor, but always advised to be the LAST resort because the ramifications are unpleasant. It works by stimulating the intestines, which results in the runs! But the idea is that the contractions in the intestines release prostaglandins that help to start labor. The addition of the almond cream helps to slow down the oil and help it stick to the intestinal walls rather than result in violent cramping. The picture above is of me drinking THE drink. Actually, it was quite delicious!
The “drink” protocol is that you rest immediately after and then walk briskly for a half an hour hoping for contractions to start. I talked to my midwife and explained I felt more Braxton Hicks contractions than anything. But this was the night we had planned as our very last night to induce. So if it wasn’t happening by that night on its own, then we would have to go with the Pitocin. I met my midwife at the hospital and she performed a check. I was 4 cm dilated. Woo hoo! I agreed to have my water broken, which would have scared me at 2 cm dilated, but at 4, I was fine with it. I didn’t feel a thing. And in case you’re wondering, having your water broken is considered labor augmentation, not induction. That was at 11:45 PM.
Within 15 minutes I started having real labor contractions! We totally did it, and I felt triumphant. I thought I was in for an easy labor. I was hooked up to the heart rate monitor and a nifty contraction monitor that tells you how strong the contractions are. I felt like this labor was super easy and manageable. (That’s me taking a selfie of my “easy” labor while my husband sleeps in the background).
Unfortunately, at this moment I forgot the agreement I made with my midwife. I told her to just tell me what to do to get the baby out quickly and easily. I had not considered how much more painful that would be. I’ll spare you the description, but suffice it to say I was at one point squeezing a comb to offset the pain, which worked not at all. My husband told me later he was legitimately concerned about me.
But, the end goal of delivering a healthy, ALIVE baby without Pitocin and without pain meds was achieved! If you have a similar goal in mind, this is how I used a combo of old wives tales, proven approaches, and a lot of intention! PLEASE discuss this with your care provider first (Really, I mean it!) and also do not attempt to do this unless medically necessary or if you are past your “due date”.
How to Induce Labor
- Pineapples and Dates–Eat a half a pineapple a day including the core where bromelain is richest. Feel free to blend into a smoothie! I ate five dates a day but the data on this is limited. Apparently, they have to come from a very specific region but they are delicious so I didn’t mind! (Read the research here)
- Evening Primrose Oil–Orally twice a day, and inserted vaginally at night. Helps ripen the cervix.
- Homeopathic Remedies–Homeopathy is NOT a catch-all for “alternative” or “holistic” medicine. It is a specific approach. (Google it!) These are the remedies my midwife had on hand to give me: Caulophyllum (blue cohosh) and Cimicifuga (black cohosh), both of which are thought to instigate uterine contractions
- Acupuncture/Acupressure–There are specific spots that can be stimulated to spur on labor. Namely, the webbing of the thumb, the small of the back, behind the shin bone 4 finger lengths higher than your inner ankle bone, and the outside of the pinky toe. I received two acupuncture treatments and also worked all of these areas with pressure myself three days leading up to my labor.
- Chinese Herbs–My acupuncturist sent me home with two bottles of herbs, $8 each. I have NO idea what they are as the bottle is written with Chinese characters. I did look them up online and found the ingredient lists, but this info didn’t mean much more to me! I place a lot of trust in Traditional Chinese Medicine, so you would have to as well! Just ask for herbs. A skilled practitioner will assign what’s right for you.
- Good Ol’ S-E-X— Yes, this can work. For a few reasons: 1) Semen contains prostaglandins, and by now, you know what they do. 2) An orgasm can trigger uterine contractions along with it. 3) Oxytocin is released by nipple stimulation and orgasm. Do it!
- The “birth drink”–My midwife is actually conducting her own private research on the efficacy of this German concoction. She has observed that it works well for women “who are ready”. She didn’t want me to drink it prematurely because it may have been pointless (not harmful). The active ingredient here is castor oil. And the other ingredients help mitigate the nightmarish impact of castor oil on the intestinal tract. The idea here is, intestinal contractions can also release prostaglandins. But no one wants violent ones! The cream base helps the oil to cling to the intestinal wall instead of racing right on through. The bubbly helps you to relax and the lemon verbena, is both an anti-spasmodic for the intestines and helps promote uterine contractions.
Here’s the recipe:
2 oz castor oil
4 tbsp almond butter, almond cream (if you can find it) or another creamy base, such as coconut milk (from the can, not the carton)
3/4 cup apricot nectar
3/4 cup champagne/sparkling wine
Lemon Verbena, 3 drops Essential Oil OR Tea (brewed strong, half cup)
Shake it all up with some ice and drink quickly within 15 minutes. This is no easy task! Rest for an hour afterward and if nothing major occurs, walk briskly for a half an hour or so. Get those contractions going! I drank mine at 2 pm I started to have minor contractions about 6 hours after this. By 11 pm I was 4cm dilated and had my water broken. The rest is history! Good luck, ladies, and let me know how this works out for you!