With this series, Gina and I both believe that a “natural” induction, is still an induction in a way. You are still using interventions to start labor before you may be ready.
There are risks and benefits to everything we do in life, and for one person it may be worth taking the risk for the benefit while another person it’s not worth it.
We always recommend discussing options with your provider and doing your own research before using any of the induction methods we discuss in this series.
Castor Oil: What is it?
Castor Oil is a vegetable oil that is derived from castor beans. It is clear to pale yellow in color and has a very distinct taste and odor. It is used in many items such as food preservation, soap, paints, moisturizers, lubricants, and dyes.
It has medicinal uses to include being a laxative and believed to induce labor.
Will it induce labor?
The research does seem to support that compared to doing nothing, Castor Oil had a higher likelihood of having labor start within 24 hours of taking the dose.
There are some factors that can increase the possibility of castor oil being effective at inducing labor:
- Past 40 weeks
- Prior Vaginal Birth
- Cervix dilated
- PROM (water breaking before contractions begin)
Many midwives have some sort of cocktail recipe that they recommend called a “Midwife brew”. It includes some sort of a fat and mixed up with something tasty to make it easier to drink. Some included it with almond butter or in a milkshake! Most recommend 60mL of castor oil at a minimum. If this does not work within 4 hours, some recommend taking a second dose.
Most of the recipes I have seen also seem to involve champagne, but that may just be my experience.
A lot of people stated they didn’t want to take it because there is a risk baby will poop in the womb because of the laxative effect. That was not supported by research, there was not an increased number of babies with meconium at birth in the Castor Oil group versus the control groups.
The castor oil does not cause GI distress in babies in the womb which leads to the meconium. Meconium is usually passed because baby is in distress, so it would be due to something causing stress on baby, such as long labor or contractions too strong and too close together. But castor oil could cause a long and stressful labor, which may affect baby inadvertently.
How does it work?
It is not know how it necessarily works in regard to induction but there are a few theories of why it causes the uterus to contract.
- It is believed that because it irritates the bowel, which are located next to the uterus, this cause the uterus to be irritated as well and start to contract.
- It may also cause labor contractions due to dehydration from the diarrhea or nausea that can occur after taking it.
- Lastly, there is one study that showed that putting castor oil directly onto the uterus muscle, this can cause the uterus tissue to contract compared to a control solution. This showed that the castor oil can possibility that contractions happen.
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Risks & Benefits
Even though research does support that castor oil is more likely to put someone into labor than expectant management. There are ALWAYS risks and benefits to anything we do in life. Castor Oil is no exception!
Benefits
- Labor can be stimulated without the need for a medical induction within 24 hours, this is a HUGE benefit for those who are wanting an out of hospital birth and possibly risking out of having one because of your Gestational Age
- Increase Bishop Score, if labor is not stimulated
- If water has broken before contractions (PROM) it can be a natural way to bring upon contractions, especially if planning an out of hospital birth
- Research does not support there is an increased risk of meconium, lower 1 min APGAR score, or C-section from Castor Oil
Risks
- GI Distress:
- Nausea – a LARGE number of participants in the castor oil studies stated they were nauseous from taking Castor Oil
- Diarrhea!
- Dehydration!
- No research on taking it if you have a higher risk pregnancy, or a prior c-section (VBAC) There was one study, but it didn’t definitively state if it was a safe or effective option
- Only research on taking one dose, not multiple doses
- Theoretical risk for Hemorrhage because Castor Oil is a blood thinner – although I could not find any research to support this!
Our Professional Opinion
Roxanne: Labor & Delivery Nurse
From my experience as a nurse, those that have come in after taking castor oil were usually having some sort of diarrhea and nausea/vomiting. They were usually harder to get an IV in because they were somewhat dehydrated after taking the castor oil.
I personally never saw any negative birth outcomes related to castor oil use, but I have heard stories of people having intense diarrhea and nausea their entire labors to include during pushing and delivery.
I personally would not have taken it to induce my labor because of that GI issues, and I hate throwing up!
Gina: Birth Doula
From my experience as a doula, those that have taken castor oil either do not go into labor, or if they do, it is a long and hard labor. They have a hard time relaxing because they are just pooping non-stop.
Would I take it personally? In most situations, no. I would prefer to allow my baby to come when they are ready, and I find that trying to force labor, even with natural induction methods, tends to make labor harder.
But, if I was going to risk out of my birth location (you cannot give birth at home with a legal midwife past 42 weeks in our state), then I would consider taking castor oil after all other “induction” methods have failed to put me into labor. I would need to be pretty close to 42 weeks, though.
In general, though, I don’t recommend castor oil since it has not been a positive experience for me as a doula so far. But, I am always supportive of whatever decision my clients want to make with their births.
Mamastefit Survey Results
We surveryed our followers on Instagram to do a mini study of Castor Oil and the results are below:
Did you use Castor Oil? Yes or No?
We had 747 answered:
- 84% say NO WAY!
- 10% say YES!
- 6% said they would have, but they went into labor so they didn’t need to
When we asked why 84% said no, the most common answers were:
- Horror stories of GI Distress (nausea and diarrhea)
- Heard that it could stimulate the baby to pass meconium in the womb
- Heard it was dangerous/unsafe or advised against it by someone (family, friend, provider)
- Could cause Hemorrhage
- Taste Bad
- Wanted to wait for labor to happen on its own – didn’t want to induce to include natural induction methods
- Didn’t know it was an option
For those that did take castor oil their reasons were:
- Wanting to avoid induction
- Past their due date and feeling desperate
- Were near 42 weeks and would risk out of their out of hospital birth
- PROM (water breaks before contractions)
- Prodromal Labor
- Friends had good experience
Of those that took Castor Oil, we had a few specific questions:
How many weeks were you when you took it (102 answered)
- 15% were 37-38 weeks
- 12$ were 39 weeks
- 36% were 40 weeks
- 37% were 41+ weeks
Did they go into labor within 24 hours?
- 34% said yes!
- 12% said yes but they had to take more than the 1 dose
- 13% said they went into labor but it took longer than 24 hours
- 41% said no!!
For those that went into labor, how many weeks were they? We had 37 answer
- 37/38 weeks: 8%
- 39 weeks: 11%
- 40 weeks: 30%
- 41+ weeks: 51%
When asked how they drank it? Majority of answers were:
- Midwives Brew
- Almond Butter cocktail
- Orange Juice
- Milkshake/Smoothie
- Straight Shot with and without juice to follow
When asked how their labors went? We had 40 people answer. Most common answers included:
- Most reported once contractions kicked it, it went FAST!
- The next highest answer was “normal and uneventful”
- Long with and without complications was the third highest answer
- 3 mentioned needing to have a c-section after long labors
- 1 had meconium
- 2 reported having heavy bleeding
When asked if they have GI distress after taking? We had 100 people answer:
- 15% said both nausea and diarrhea
- 11% had only nausea
- 50% had only diarrhea
- 25% had none because of their stomachs of steel