How to Bring on Contractions

Meeting your baby is the reward for successfully starting labor.

As the end of pregnancy approaches, pregnant women watch with great anticipation for signs of labor starting. By this point, your back hurts, you can't sleep well at night and you are ready to finally hold your baby in your arms. Unfortunately, if your body isn't ready to go into labor on its own, attempts to induce labor can be fraught with difficulties -- even for your doctor. While people suggest a variety of methods for bringing on labor contractions, evidence for the effectiveness of only a few actually exists.

Things You'll Need

• Prostaglandins
• Mechanical dilation device
• Misoprostol
• Pitocin

Instructions

1. Stimulate your nipples by sucking, rubbing or rolling them. To ensure you don't overstimulate your uterus, manipulate your breasts for five minutes and then wait 15, to see what effects it has. Only stimulate one breast at a time and avoid nipple stimulation during contractions. Stop when your contractions occur every three minutes or last for a minute or more. The effectiveness of nipple stimulation hasn't been conclusively proven by scientific study, but a 2011 study in "ACTA Obstetrica et Gynecologica Scandinavica" found that breast stimulation was both effective and safe for women who have undergone previous cesarean sections and given birth five or more times.

2. Apply prostaglandins -- substances that can help a cervix dilate, thin and soften -- to your vagina. Prostaglandins such as Cervidil and Prepidil do increase your chances of going into labor within 24 hours, reports a 2003 review of labor induction techniques in "American Family Physician." However, they may also overstimulate the uterus and cause other negative side effects such as nausea, vomiting and diarrhea.

3. Sweep your membranes. In this procedure, your doctor or midwife inserts a finger into your cervix during a cervical check and detaches the amniotic sac from your cervix. A membrane sweep can help bring on contractions, but according to a 2000 study in "Obstetrics and Gynecology", it is only effective in first time mothers who had unfavorable cervices ripened with a prostaglandin.

4. Insert a mechanical device, such as Foley catheter, into your cervix to release prostaglandins and help your cervix dilate. Mechanical dilators do successfully help the cervix open, but they carry risks of bleeding, infection and membrane rupture. Only your health care provider should attempt to dilate your cervix with a mechanical device.

5. Use misoprostol to help ripen your cervix. The review of labor induction methods in "American Family Physician" found that misoprostol increases the rate of vaginal births within 24 hours. It does carry the risk of overstimulating your uterus and may cause uterine rupture in women who had a prior cesarean section.

6. Start an IV pump of pitocin, an artificial form of oxytocin used to start or strengthen contractions. According to the "American Family Physician" review, physicians prefer using pitocin to induce labor when a woman has a favorable cervix, and many studies support its effectiveness in encouraging contractions. However, pitocin does cause longer and more painful contractions, may reduce oxygen to your baby and increases the cesarean rates due to difficult labor oa fetal distress.

Tips & Warnings

• Sexual intercourse is often recommended as a natural method of inducing labor because the prostaglandins in semen may stimulate contractions. As long as your water hasn't broken, this labor induction method is safe -- if a bit uncomfortable -- but scientific evidence doesn't support its effectiveness. Two studies in "Obstetrics and Gynecology," one from 2006 and one from 2007, both found that sexual intercourse at term did not help ready the cervix for labor or increase a woman's chances of going into labor.

• Don't use castor oil or herbal supplements -- such as evening primrose oil, black cohosh or red raspberry leaves -- for inducing labor. They have not received adequate scientific study, and so safe doses and their effectiveness remains unknown.

References

• BabyCenter; Inducing Labor; December 2009
• "ACTA Obstetrica et Gynecologica Scandinavica"; Evaluation of Breast Stimulation for Induction of Labor in Women With a Prior Cesarean Section and in Grandmultiparas; Shmuel Segal, et al.; January 2011
• "American Family Physician"; Methods for Cervical Ripening and Induction of Labor; Josie L. Tenore; May 2003
• "Obstetrics & Gynecology"; Membrane Sweeping in Conjunction With Labor Induction; LC Foong, et al.; October 2000
• "Obstetrics & Gynecology"; Sexual Intercourse at Term and Onset of Labor; Jonathan Schaffir; June 2006
• "Obstetrics & Gynecology"; Effect of Coital Activity on Onset of Labor in Women Scheduled for Labor Induction: A Randomized Controlled Trial; Peng Chiong Tan, et al.; October 2007

Resources

• BirthingNaturally; Nipple Stimulation for Labor; Jennifer Vanderlaan
• BirthingNaturally; Pitocin; Jennifer Vanderlaan