One of the most common questions pregnant people have in their 3rd trimester is how to get labor started. As understandable as this question is, one of the reasons I find it frustrating is that lots of people have an opinion about ways to do this, yet none of it is scientific in the least. You’ll often get suggestions for everything from having sex to a bumpy car ride to eating spicy food and pineapple (fresh, not canned). While I’m a big believer in the importance of storytelling and community-based knowledge, the problem when we go to modern-day sources for this (Facebook, the internet, *this blog post), is that we lose the guidance and support that should come along with it. Guidance and support from a person who knows you well is important because it means the advice-giver is more intimately familiar with you as an individual and your unique situation. When we give and receive advice over the internet, it can be problematic because we often don’t understand the reasons behind why the question is being asked and we have no idea how the advice is going to manifest itself in the person if it is followed. And remember that everything we choose to introduce into our body is an intervention, whether it’s a naturally occurring substance or not. (Take evening primrose oil, for example.)
With these points in mind, here is my answer to this question: consider not doing anything! That’s right. Stop trying to get labor started. (Here is my caveat to this: if there is something [anything] that sounds appealing to you that could potentially be effective in kick-starting your labor, I’m all for it. It’s your body after all.) But what if you hate pineapple? Please don’t eat it. If you don’t feel like having sex? Don’t have it. Seriously. Why force yourself? It’s counter-productive. The only reason to have sex is because you want to! (And a bonus is that semen contains prostaglandins which the pregnant body produces on its own, and are known to help ripen and soften the cervix, preparing it to open.)
If you’re currently trying things to get labor started, consider that a feeling of desperation is often the motivator, am I right? Let’s examine where that feeling is coming from because I think it’s an important discussion. Why should pregnant people be feeling desperate in their last weeks and days of being pregnant? Is that really fair to them? Why shouldn’t we be encouraged to pamper ourselves and enjoy this unique time in our pregnancies? Don’t we deserve that? After all, we’ve made it this far. Why should we have to rush through this last part, right before our lives are about to shift in a very big way?
I realize that “do nothing” is infuriating advice in and of itself. Actually doing nothing is much easier said than done when you feel 10 million months pregnant. But guess what? This feeling of being “way too pregnant” is actually a very early sign of labor beginning. Yes, it’s true. There is light at the end of this tunnel! You will be holding your baby in your arms soon. How soon? No clue. And that uncertainty is the real challenge here. We are all so intensely uncomfortable in our society with the idea that we don’t know when this baby is going to come.
How could you possibly still be pregnant?! When is your due date?
You are so LATE!
Your baby is being stubborn!
Your baby is too comfortable!
What are you still doing here?! [at work]
You’re about to POP, aren’t you!?
And then from our medical care providers:*
I’m not comfortable with you waiting any longer.
Your baby is getting too big.
Your fluid is getting too low.
*Always consult your care providers in regard to any health concerns you may have. This website provides general education only, not medical advice.
In regard to statements made by care providers, I would like to take a moment to reference an FAQ page, When Pregnancy Goes Past Your Due Date, from the American Congress of Obstetricians and Gynecologists (ACOG):
“The health risks for you and your fetus may increase if a pregnancy is late term [A pregnancy that lasts 41 weeks up to 42 weeks is called “late term.”] or postterm [A pregnancy that lasts longer than 42 weeks is called “postterm.”], but problems occur in only a small number of postterm pregnancies. Most women who give birth after their due dates have uncomplicated labor and give birth to healthy babies.” Read the full fact sheet here.
So, while there could definitely be valid reasons to induce prior to 41 weeks, even ACOG is saying here that we’re working within a range up to 42 weeks. Healthy pregnancies lasting between 37 and 42 weeks are considered normal. Yet so many people who get induced are pressured to induce before that time.
In regard to “baby getting too big” or “fluid getting too low,” remember that there is some grey area here. In the absence of gestational diabetes, a baby is considered clinically large at 11 lbs. (5,000 g) or 9 lbs. (4,500 g) if gestational diabetes is present. (ACOG, 2002 in Gobbo et al., 2012). Also remember that estimated due dates are in fact an estimate and not always accurate. And while low fluid can pose risks, there is also no evidence that low fluid at term, in the absence of other problems, is a sufficient reason to induce. Read more here.
So if you want to know how to get labor started, I would like you to be able to first consider whether you actually want to be induced or whether you are trying to avoid it. Then you can evaluate for yourself whether there are any significant risks to you or your baby if you choose to wait for spontaneous labor. Then, maybe, just maybe, you can rest a little easier knowing that almost everyone who’s left alone will give birth spontaneously within the 42-week time frame: without trying anything! Is it challenging to wait? Absolutely. And if you want to try some things, here’s a nice overview from our friends at MomLovesBest.com of the benefits and risks of some of the options. But if you fill the time doing things you enjoy that help you to feel supported, relaxed, special, amazing… maybe, just maybe, you could even enjoy the wait!