So you’ve read my thoughts on letting your baby choose its birthday instead of manipulating labor. You’ve relaxed and enjoyed life but now you’re a few days past week 41 and you know the rules don’t allow Texas midwives to attend a birth of a woman past 42 weeks and zero days. So what can you do to avoid transferring to the hospital for your birth?


Relax as much as you can. Stress hormones are the kryptonite to labor hormones. If possible, allow yourself only a few minutes a day to freak out. Then come back to trusting your body and the process. There are some tricks that work and many that don’t. The fastest way to find out what doesn’t work is to ask on Facebook for tips. When I see these posts I just want to pull my hair out. Please don’t ask Facebook for midwifery advice-ask your midwife!


Here’s what you’ll see and why it doesn’t work:

Walking

If walking worked, we’d have women on bedrest their whole pregnancies. Think of the science: if babies start labor with their signals, pray tell how does you moving your legs to walk briskly do anything at all? It doesn’t if you’re not experiencing contractions. What it will do is wear you out before labor has even started.

Countless times, I’ve seen a mom walk and walk all day in order to bring on labor. She goes into labor that night (which she would have anyway), got one hour of sleep, sore legs, she’s zapped of energy, and can’t endure labor without pain medication. This is an unwise choice if you have no contractions. If you have sporadic contractions, it might intensify them. However, most of the time if you have sporadic contractions, rest is your priority because if labor is starting in earnest, you’ll need endurance.

Bouncing on a birth/yoga ball.

This doesn’t work any more than walking does to initiate contractions. It is excellent for your body, your posture, and in helping baby get/stay in a good position but does nothing to start labor.

Red Raspberry Leaf Tea

This is a great uterine tonic and highly recommended but just for general uterine tone. It does nothing to bring on labor.

Eating Spicy Foods

We think it’s a hormonal signal baby’s body throws out. Spice doesn’t affect the baby’s hormones.

Riding down a bumpy road

Nope not this either.

Sex

Maybe! The prostaglandins in semen and the contractions from mom’s orgasm may help.

Nipple stimulation

Maybe! The oxytocin released by using your breast pump or having your partner/you stimulate your nipples may push you over the labor brink. The risk here is that some moms might overdo it and no one is monitoring how baby is tolerating the contractions. For this reason, I recommend only 15 mins of stimulation in any one hour- period.

Castor oil

Maybe, but beware! When castor oil works, its often because it has stimulated the bowels, which are close enough to the uterus- that the uterus decides to contract. If your bowels are that stimulated, you likely have a lot of diarrhea which means in labor you may be dehydrated. You could also have very loose stools and that’s not fun during labor. Worst case scenario: you have a newborn, a sore bottom from birth, and a sore bottom from wiping – while feeling extra weak from dehydration. It doesn’t affect everyone this way, but there’s no way of knowing how your body will react.

So I’m 41 Weeks, What Do We Do Now?


Hopefully, you made the choice to just wait on your body and your baby. You’re living life and resting well for the big day (ahem, night. It’s almost always night).
In the middle of your 41st week, we’ll send you for a Biophysical Profile ultrasound to check on baby. We can do a non-stress test – which is putting the fetal monitors on you to see how baby reacts to your random contractions. Both of these check on baby and reassure us that all is well.


As we get closer to the 42nd week, it’s time to consider our options:

  • Wait for labor to start on its own. Some moms really don’t want to manipulate the process. Usually, labor will start by 42 weeks. If not, we will discuss transfer of care options (yes, that means we can’t be your care provider after 42.0 weeks).
  • Start to gently coax baby out with some of our favorite herbal tinctures, most suited to your situation. These aren’t ideal for everyone so please don’t just buy anything suggested on facebook or online without talking to us first.
  • Try the breast pump/nipple stimulation
  • Chiropractic adjustment (these work best when chiropractic care has been done throughout the pregnancy).
  • Acupuncture
  • A unique combination of the above options, plus sex
  • “Midwife’s brew”
  • Placement of a foley catheter into the cervix to manually stretch it open and possibly start labor
  • Breaking the water (this can only be done in certain situations and carries risks)

The options presented to you by us will be unique to your situation. As your midwife, I want you to lead your care but I ask you to lead it in partnership with me. Together as a team, we can brainstorm the best approach(es) to try and discuss timing. Starting these tricks first thing in the morning is much smarter than trying them at night. Keep in mind the stamina you will need in labor, that you may not have if you were kept awake all night with contractions.

Please consult with us before trying to get labor started on your own! We do everything we can to make sure your preferred birthing suite is available (timing is key) and it’s possible your birth would coincide with another.

As a mixed practice (a Certified Nurse Midwife and a Certified Professional Midwife) we tackle this issue slightly differently. I’m more of a purist and may encourage a more relaxed approach to “induction” but you have access to both of our styles. Just tell us what you’d like to do and we’ll follow your lead.