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If you're freaking out a little (or a lot) at the thought of pushing a small cantaloupe sized head out of your vagina and also want to do everything you can to avoid unnecessary medical interventions at your birth, including cesarean, you’re probably here because you’re doing your homework ahead of time to learn what to do to make this upcoming passage into motherhood as short, easy, empowering, and as safe as possible for yourself – and your baby. I'm here to help!
Thirty-five years of practice initially as a home birth midwife, and then as an MD specializing in women’s health, including obstetrics, as well as being a momma of four, has shown me that labor and birth can be – yes – hard work – but beautiful, powerful events in our lives. While there should be absolutely no judgment over what type of birth experience you prefer or ultimately require, it’s worthwhile considering what natural tools we have that can help us avoid the speed bumps that often lead to preventable birth interventions – the most common being not going into labor within a reasonable amount of time after your due date (this is hotly debated – most obstetricians think within a week after, however normal human gestation actually goes up to two weeks after, which most midwives support), having a long labor, or need for pain medication, which often becomes the case when labor is going long.
While there should be absolutely no judgment over what type of birth you prefer or require, it’s worth considering the natural tools that can help you avoid preventable birth interventions.
Support Your Body's Innate Wisdom
Fortunately, our bodies know exactly what to do to bring our babies into the world – but we have to support this with:
- A healthy diet
- Daily walking or other movement
- Regular yoga for flexibility, strength, and supplements
- Getting educated about birth
- Being around birth-positive women and care providers during pregnancy
- Doing the deep inner work of unlearning patriarchal beliefs about birth – particularly that it’s inevitably a catastrophe waiting to happen
- Having a plan for working with and through labor’s intense sensations
A few of my favorite books on preparing for birth include Spiritual Midwifery, Birthing from Within, Ina May's Guide to Childbirth, and for a deeper understanding of which medical inventions are necessary and which are overused, Henci Goer’s The Thinking Woman’s Guide to a Better Birth.
The support of another woman in labor, whether a doula who is supportive of you, knows the ‘tricks of the trade’ like nipple stimulation (I know, doesn’t sound sexy but it really works), and also knows how to kickass to protect your space if you’re birthing in hospital – or a midwife in a hospital or at home – has been shown to dramatically reduce the need for medications, forceps, and cesareans, with happier, healthier moms and babies, too, at the end of the day.
There’s also some good science – and safety – behind two of my go-to natural remedies that can give you that little bit of extra assurance you’d like to know you’re doing everything possible to help your body get ready for birth: tried, true, and tested red raspberry leaf, and the red date.
Eat Dates and Drink Raspberry Tea
Red Raspberry Leaf (RRL)
Literally the leaves of the plant that provides us with delicious raspberry fruits has been used for at least centuries in Europe and amongst North American native tribes as a mineral rich tonic tea, to support a healthy pregnancy and “tone” the uterus to help women prepare for birth. It remains popular, with about 63% of US midwives recommending it.
How RRL Probably Works
Red raspberry leaf is high in vitamins C, E, A, B and has significant amounts of major minerals like magnesium, potassium, calcium, and phosphorus that not only nourish the uterus, but provides minerals it needs to contract and relax – which is exactly the combination you need for labor to work effectively for the powerful muscles of your uterus to push your baby out. It’s also rich in a naturally plant constituent called fragarine which is thought to also tonify and stimulate uterine muscle.
How It Can Help
While RRL doesn’t actually appear to be very effective at stimulating or shortening labor, research has found that drinking RRL tea or taking capsules can have a number of benefits.
The results of a double-blind, randomized, placebo-controlled trial consisting of 192 low-risk, first-time moms found that RRL tablets, taken daily starting at 32 weeks' pregnancy until labor, reduced the rate of forceps deliveries while another study found that raspberry leaf was associated with:
- Decreased likelihood of preterm labor
- Decreased likelihood of going too far past your due date
- Decreased need for having your bag of waters artificially ruptured to stimulate labor
- Lower overall rates of caesarean section, forceps delivery, and vacuum extraction.
While RRL has been used practically since time immemorial with no evidence of harm, two rat studies did find some curious results that I want you to at least be aware of. In one study, RRL tea and capsules at typical doses were found to have the effect of stimulating uterine contractions – as we’d expect them to do to support healthy labor. However, in very high concentrations, contractions were inhibited – quite the opposite effect we’d be looking for. In another study, this one also conducted on rats, the authors observed that pregnancy seemed to last longer, and there were was some changes in the rat offspring – they appeared to go into puberty early. Now these are not problems that have been observed in humans, in spite of literally centuries of use, and the rat mommas in both studies consumed RRL products in doses far higher than humans would normally ingest. And the bottom line is there are a lot of differences between rats and humans (most of the time!).
When To Start Taking It
As a pregnant midwife-herbal-momma I drank it daily starting about halfway into my pregnancy – always carrying my mason jar of tea with me. This was in the 1980s, long before the days of green juice – so I got some strange looks when I was out and about, having a swig! While some recommend starting it in the first trimester, I generally recommend avoiding it then because, while there are no studies associating it with miscarriage, there is some evidence that it increases uterine contractility. Herbalists and midwives consider raspberry leaf to be a gentle, effective, nutritious herb to use in the second and third trimesters – and I concur.
How Much to Take
If you start in the mid-second trimester, stick to a cup a day. By mid-late third trimester, you can bump that up (get it, bump!) to two cups of tea daily. Several studies have now shown that taking 1-2 cups, regularly in the last trimester, can make labor easier. In some European countries where use is popular, midwives recommend starting around 36 weeks, with 1 to 2 cups daily.
Since it doesn’t have the most pleasant taste when taken as a tea by itself, I generally recommend mixing it with some spearmint and rose hips for a delicious tea that can be taken daily, 1-2 cups throughout the second and third trimesters. You can use capsules or tablets instead, 1.5-5 grams daily, if you just don't groove on the tea.
Aviva's Pregnancy Nourishment Tea
Many of the popular pregnancy teas you see on the market came from one of my original blends published in my now classic book The Natural Pregnancy Book. This is a simple, delicious version you can drink hot or iced. For use as a “Labor Day” tea, I actually use 4 Tbsp. of RRL and make the whole thing in a quart of water for sipping throughout labor and after the baby is born. You can even make popsicles to enjoy during labor.
For one quart of tea, mix together
- 2 TBSP. red raspberry leaf
- 2 TBSP dried stinging nettles
- 1 tsp. peppermint leaf
- 1 tsp. rose hips
Place into a teapot, 1 quart mason jar, or or French press.
Steep in 16 oz. of boiling water for 20 minutes. Strain and drink 1-2 cups daily.
Will keep in the fridge for 2 days.
Make sure any herbal tea products you purchase contain actual RRL because raspberry flavored teas don’t have any of the RRL benefits.
[Mountain Rose Herbs is a great online source for purchasing bulk organic herbs – I have no financial relationship to the company.]
Date fruits are perhaps one of our most ancient ‘sweets.’ Delicious, they are also nutrient-rich, loaded with fats, proteins, carbohydrates, a variety of vitamins, and minerals, and fiber. They also turn out to be a common remedy for preparing for labor in certain parts of the world. In a study of 919 Iranian women, asked what natural remedies they used in pregnancy for labor preparation, 26% said they ate red dates as part of their preparation at the end of pregnancy. Talk about food as medicine!
How They Probably Work
While we still don’t fully know how dates work to, it appears they might have an impact on the oxytocin we need for labor to start and progress on time and effectively.
How They Can Help
Three scientific studies have shown that red dates are associated with
- Increased cervical “ripening”
- Less need for labor induction
- Greater likelihood of being more dilated when arriving at the hospital
- Less need for pitocin to stimulate labor and greater likelihood of induction working if it’s needed
A 2011 study found that women who ate 6 dates a day for the four weeks leading up to their due date were
- Significantly more dilated when they got to the hospital
- Had a significantly higher rate of intact membranes
- Were significantly more likely to go into labor spontaneously (i.e. without induction)
- And had nearly half the length of first stage of labor
A 2014 study found that women who ate dates from 37 weeks on had
- Greater cervical dilatation at admission
- Higher success rates of labor induction when needed
Studies that have looked at blood sugar levels in women eating dates this way have found no changes, however, this has not been studied in women with diabetes, so if you do have gestational, Type 2, or Type 1 diabetes, do discuss their use with your midwife or doctor.
How Much Do I Take
Based on the studies that have shown some effectiveness, it’s recommended to eat about 70-80 grams (about 2.5 ounces) of red dates daily starting at about 36 or 37 weeks of pregnancy, and continuing until labor begins. The 2007 study I mentioned specifies deglet noor dates, and suggests that about 6-8 per day is the magic number. Medjool dates are likely fine as well, but typically are twice as large, so maybe keep it to 3-4 of those.
FYI: An Herbal Don't
There's an herb called Blue cohosh that's been used historically in late pregnancy and in labor to get – and keep – labor going. While it's very effective, it's not without its risks. These are rare – but do include an increased risk of baby going into distress in utero, and even more serious consequences for baby than that. As a midwife-MD I do use it, but only when there's a medical need to induce, and a natural approach is within reason, and with personal guidance and with proper monitoring of baby's well-being. I have particular expertise in this herb as I wrote my medical school senior thesis on it over the course of two years and conducted extensive surveys of contemporary midwives and an exhaustive search of the pharmacologic and historical literature. As so many herbs, it does work – but it's more like an herbal medication – and like any medications, can have unintended consequences. If you're a midwife or other birth care provider, my senior thesis is published in the form of an official botanical monograph, can be purchased here from the American Herbal Pharmacopoeia (I did not get paid to write this beyond a small institution research stipend in 2006 by Yale, nor do I get paid for the sale of this book, not even a royalty, nor was I salaried as AHP Medical Director) or can be read as the thesis itself here for free.
Intention and Surrender
Each baby and momma have their own story that they create together – and we don’t have total control over how it all happens in the end. Our bodies are beautifully wise and know how to birth our babies. However, complex cultural factors and changes in how we live in modern times, along with over-medicalization, mean that we do need to put some intention and conscious effort into creating the birthing experience we hope for – and natural remedies, along with a healthy pregnancy and doula or midwife support (or both) can make this all the more likely.
- Listen to Natural MD Radio: Meet The OB Speaking Out on the US Cesarean Section Rate
- Read Aviva's blog on Labor Induction: The Low Down on Natural Approaches from a Midwife-MD
- Read more on Labor Induction, Choosing What’s Best for You and Your Baby, and The Low Down on Natural Approaches: Part 1
- Get your copy of Pocket Guide to Midwifery Care by Aviva Romm
- Get your copy of Botanical Medicine for Women’s Health by Aviva Romm
- Enroll in the Herbal Medicine for Women online course
- Get your copy of Botanical Safety Handbook, Second Edition