Before we get going, the #1 thing you need to be monitoring is baby’s movements.

The bad news: SO many providers educate about kick counts wrong.

The good news: I can give you the RIGHT way to do them here based on you, and your baby — which is what is most important.

Remember baby’s movement is always a comparison against themselves — how are they moving compared to how they usually move? If your provider has said 10 movements in 2 hours, that is WRONG — download the cheat sheet above!

Caution: Advice Ahead

This (or any article on The Pregnancy Nurse) should be taken as medical advice, this purely educational. Please talk with your provider about your specific needs and circumstances.

So, I’m just here to show you what the studies show. I will not be linking to Primrose oil or talking about how to get any because it is SO important to talk with your provider about what your plans are.

If you read this, and decide that primrose is right for you, you should be discussing it at your next checkup. You should NOT be “hiding” this from your provider. They need the full picture of:

• How you’re feeling
• How baby is doing
• What you’re doing

From what I’m reading this isn’t something that should be used prior to 37 weeks at all in pregnancy. If you’re earlier than that just click the back button, or find another article that interests you — this article isn’t for you!

Ok, with that — let’s get into it!

What is Evening Primrose Oil (EPO)?

It is made from the seeds of the evening primrose flowers, found in North America. People traditionally used it to treat conditions including bruises, hemorrhoids, and sore throats.  It contains linolenic acid, gamma-linolenic acid, and vitamin E.

Honestly, in looking at it this is 100% not something that you should be playing around with, without talking to your provider. It looks like it can have other effects that could be really problematic if you had specific conditions including mental or clotting disorders — so PLEASE, AGAIN — talk with your provider.

You can find it with supplements, it’s usually offered as a gel cap. Some people take it for other things like acne, cramps or hot flashes.

What does EPO do?

The thought is that the linoleic acid produces a prostaglandin response in the body. That would be similar to when we use Cytotec (although the results don’t seem to be as immediate).

So, similarly to Cytotec we’re hoping that it will soften the cervix.

The studies measured this cervical softening using the bishop’s score. That’s just a numbers-based rubric that we use to easily say how “favorable” the cervix is to going into labor.

Example: If your cervix is closed, thick and high up in your pelvis it is unlikely to go into labor quickly (doesn’t mean it WON’T — we’re just talking about likelihood) — as compared to a cervix that is a bit open (1-4 cm), soft and baby has moved into your birth canal a bit. That cervix is more likely to go into labor easier. I talk about it in this post on cervical ripening.

Although, they don’t seem to have a total grasp on exactly what the primrose oil is doing.

I will say that a lot of pregnancy is being given options and deciding what works best for you — in consultation with your doctor.

I know that I always felt sort of weird talking to my doctor about things that seemed a bit more “out there” — or frankly, even things that seemed mildly embarrassing, like bloating, or pain in my legs when I worked.

When I learned to communicate better with the principles in here I realized that my provider really does want to help me, but really can’t if I don’t get him/her a full picture of what’s going on.

If you’d like to be able to communicate better with your provider, feel more free to talk to them about what’s really going on, and then get more information to more easily make choices on your own I think this class will be so helpful.

How is it taken?

In the studies they had people taking it oral (by mouth) and also vaginally. In general vaginal showed increase bishop’s score vs oral — although not across the board.

There is a study that showed that oral use wasn’t effective in decreasing pregnancy time.

Don’t worry — I’m going to have a summary of all the studies I read, so keep reading.

Dosing?

Dosing seemed to be somewhat all over the place, but I mostly saw 1,000 mg dosing.

Let me quickly remind you that all supplements can put basically whatever they want on the labeling of their supplement. Meaning, you could get way more than 1,000 mg or way less (or frankly, something entirely different). I always recommend using a vitamin that has 3rd party testing. I tend to get mine at Costco because they have stronger requirements and I’m there all the time. Just a note on that. This is ALSO true of prenatal vitamins.

The start date among the trials varied quite a bit too. Some started daily at 38 weeks, some had a one-time dose, and some for 10 days. There wasn’t really a consensus on when/how long was best.

What do the studies show?

The meta analysis (meaning it looked at several studies and pulled out some main themes between them) showed a decreased the time interval between primrose administration and childbirth.

This means that people who took the primrose oil had their babies sooner than those who didn’t take it (based on the same due dates). I couldn’t find exactly how much sooner they had them…. the charts were confusing and I didn’t see any minutes listed…. and that was the only study I could find that really concluded this.

Across the board it didn’t seem to decrease active labor time (meaning you weren’t laboring for a shorter period of time)

Some did show a decrease in cesareans.

Some also showed an increase in 5-minute APGARS (although no change with 1-minute APGARS). For me, this maybe means baby like struggled less during labor — although I ultimately have no idea. It is good news though, if babies are doing better at 5 minutes, that’s a good thing (babies that have a lower 5-minute APGAR are more likely to need to go to the NICU to transition to an air-breathing world).

The APGAR is another rubric we use to easily communicate to each other how baby transitioned into life after birth — it takes into account how vigorous they are, their color, and more.

On my first baby when I heard rumors of things like this, I mostly just wondered if the item would help me contract. It took some time, and some education, to realize that it was more about the safety of both myself and my baby with the item rather than it just sparking contractions. This is honestly why most don’t recommend midwives brew — because it can have bad effects for both and baby (and likely won’t kick you into labor).

I love that this helps you know what types of questions you should be asking about interventions like cesareans, inductions, or even medications to know if they’re what you (or for your baby) really want.

We aren’t taught important stuff like this in high school, which is why I recommend taking class during your pregnancy. Luckily, that one takes a lot longer than 4 years (more like under 3 hours) and doesn’t include any algebra. Thank goodness!

Risks of Primrose Oil in Pregnancy

Some of the studies did show some risks or drawbacks. These weren’t large numbers of people who had these problems, but enough that they felt it was worth noting.

• Increased chance of meconium staining (where baby poops inside the womb – often shows baby is in distress)
• Some showed nausea, vomiting, diarrhea, prolonged rupture of membranes and arrest of descent.
• It may increase your risk of bleeding if you’re taking clotting/platelet medications.
• I’ve also read you shouldn’t use it if you have any schizophrenia issues.

Ultimately, the risks seem less than that of castor oil — as far as I can tell.

And, of course — as supplements aren’t FDA tested in the US we’re never sure how much is actually in the capsule.

Ultimately, these risks made many studies and professional organizations not recommend primrose oil because they don’t see adequate benefits, but do see a lot of risks (especially if you were doing it at home without baby being monitored).

Want to know more ways to put yourself into labor — check out these posts:

• When Should I Start Drinking Raspberry Leaf Tea?
• Can Curb Walking Induce Labor?
• What is Stripping Membranes? (Membrane Sweep)
• When to start Eating Dates During Pregnancy?
• Can a Hot Bath Induce Labor at 39 Weeks?

Studies Summarized

I pulled out four studies I found and summarized their findings here:

1⃣This meta analysis showed using EPO in term and post-term pregnant women was clinically effective in improving their Bishop score. This showed both oral and vaginal had this effect. It also increased 5-minute apgar scores.

2⃣ This one showed there isn’t enough evidence that it does cause cervical ripening.

3⃣ This study studied it in comparison to Cytotec and It showed that it DID cause cervical ripening and there were less cesareans compared to the Cytotec group (frankly super promising — I hope to see more studies about it).

4⃣ This one from AJOG showed acupressure, primrose oil and castor oil to be the least effective in cervical ripening.

On a NON-pregnancy front — one other thing I saw studied was how primrose oil might be used to help open the cervix in the days before a gynecological procedure like an IUD insertion or maybe a uterine biopsy. I know those can be really painful, so if we could prep our bodies in advance, that would be amazing. I really think we should be looking into this more, not stifling it!

Now, if you read all these studies and decide that primrose is right for you, you discuss it with your provider and they’re against the idea you can always say “I am planning to take primrose oil — is there anything I should be watching for?” Their job is NOT whether you can take it or not, their job is to explain the risks and what to watch for. I will say most providers (including myself) are going to be against this because there are risks to starting labor on your own at home. Just FYI.

When I was pregnant with my first I really thought my doctor told me what I would/would not do — but as I learned more I realized that I was always in the driver’s seat of my delivery and I got to make the choices.

In Summary

Honestly, none of the evidence was compelling enough to make me think this was a viable way to do something at home. It seems fairly similar to Cytotec in how it can soften the cervix. It also seemed to have very few drawbacks.

I was impressed by the meta analysis that showed a decrease in the amount of time people were pregnant (although, still not sure how much time it shaved off of being pregnant) — and if I was desperate to start my labor at home I might consider it as one of the better options.

Reminder: If you really want to go into labor, talk with your provider about a hospital induction — see which ultimately really seems best for you.

I think if I were to do it, I’d plan to take it vaginally (overall it seems the most effective) which — frankly — doesn’t sound fun as a 9 month pregnant woman. Also, because that area has so much more blood flow during pregnancy I’m always mildly concerned I’ll have a bad reaction to something down there. No thanks.

However, if you’re really wanting to be done being pregnant, it isn’t a crazy think to discuss with your provider. There are clearly a lot of studies on it, and people are looking into it. But, AJOG doesn’t seem to recommend it — so you at least know that going in.

It may have some promise, but again — you want to be SURE that you’re doing it with your provider’s knowledge — and knowing what to watch for as it progresses (or goes nowhere).

And, like I said above — you shouldn’t feel like ANY question is off-limits with your provider. Learning to communicate with them early and often throughout your pregnancy is one of the most important things you can do.

And, remember that YOU are always in the driver’s seat of your birth. You make the choices, you make the calls and they’re just there to consult and assist you as you progress on this journey.

If you wish you…

• felt more comfortable talking with your provider
• wish you knew better questions to ask
• or just wish you understood pregnancy/labor better

I’d recommend jumping into this. In just a few hours we can have you asking questions & laboring like a pro!

Want to do a vibe check before diving into the whole thing with me? — check out my free labor pro tips. It’s your first step toward getting in the driver’s seat of your birth.

I also have a YouTube video based on this same topic:

Sources:

Shahinfar S, Abedi P, Jahanfar S, Khajehpoor M, Chashmyazdan M. The effect of evening primrose oil on cervical ripening and birth outcomes: A systematic review and meta-analysis. Heliyon. 2023 Feb 8;9(2):e13414. doi: 10.1016/j.heliyon.2023.e13414. PMID: 36846678; PMCID: PMC9947258.

Kalati M, Kashanian M, Jahdi F, Naseri M, Haghani H, Sheikhansari N. Evening primrose oil and labour, is it effective? A randomised clinical trial. J Obstet Gynaecol. 2018 May;38(4):488-492. doi: 10.1080/01443615.2017.1386165. Epub 2018 Feb 9. PMID: 29426270.

Shahraki AD, Mirhoseini S, Movahedi M, Hajihashemy M, Haghollahi F. Comparative Study of the Effect of Vaginal use of Primrose Oil with Misoprostol on Cervical Preparation of Prim Gravid Women: A Double-blind Clinical Trial. Adv Biomed Res. 2023 Mar 28;12:78. doi: 10.4103/abr.abr_30_22. PMID: 37200751; PMCID: PMC10186053.

Outpatient cervical ripening and labor induction with low-dose vaginal misoprostol reduces the interval to delivery: a systematic review and network meta-analysis
Vilchez, Gustavo et al.
American Journal of Obstetrics & Gynecology, Volume 230, Issue 3, S716 – S728.e

The post Does Evening Primrose Oil Induce Labor? appeared first on The Pregnancy Nurse®.

Before we get going, getting the RIGHT questions answered is SO important — grab my induction question checklist right here:

How long does it take to give birth after being induced?

Average time for an induction using cervical ripening agents is about 19 hours plus or minus 12 hours — as tallied in this study.

It depends on:

• Cervical readiness & Baby’s Position
• Prior vaginal deliveries
• How your body responds to the induction method(s)

So, it really depends — but I’m going to give you some ideas based on why/how you are being induced… so let me give you some more information (feel free to click to the area you’re interested in):

Things That Affect How Long Your Induction Will Take:

If you’re really interested I totally recommend checking out this study — you’ll see how specific variables effect how long the induction is.

Note: That study is done with those who had a Dinoprostone induction which means they were less than 3 cm when they started and used cervical ripening agents to get labor going.

Cervical Readiness: Your Bishop Score

Your cervical readiness is one of the most important parts of how well your body takes to an induction usually, although not always).

We qualify your cervical readiness as something called the “bishop score”. It measures how prepared your cervix is to open. It’s on a scale of 0 to 13. You don’t need to know your bishop score, but some hospitals won’t do an elective induction if your cervix isn’t open/soft enough.

What/Where is your Cervix?

Your Cervix is at the end of your vagina, it’s at the opening of your uterus.

Cervical Dilation

This means how OPEN your cervix is. I have a whole post that explains vaginal dilation on my sister site, but what you need to know is that as the baby progresses into your pelvis, the cervix opens. Kind of like when you push your head through a tight sweater neck.

The numbers go from 0 (or closed) to 10 (ten is actually when your cervix disappears behind the baby’s head).

The more open your cervix is, it normally means your induction will be shorter. Which make sense, as you don’t start to push the baby out til’ 10 centimeters (cm).

Cervical Thinning

If you keep the “head through a sweater” analogy, you’ll know that the sweater thins at the neck as you pull your head through. The same thing happens with your cervix.

Medical providers measure this as a percentage. Anything more than 50% normally just called “thick” (frankly, it’s impossible for us to know how thick your cervix is in the beginning).

We CAN measure the length of your cervix but that is done by ulrasound, rather than our hand.

That all being said, if your cervix is thick, it normally takes longer until the baby comes out.

Baby’s Station

This measures how above or below your ischial spines (your butt bones) the baby is.

I think it’s easier to envision how high or low in your pelvis the baby is.

If the baby is high it will take longer for it to descend.

NORMALLY, the lower your baby is, the more it will start to open your cervix (again, as you push your head further into the sweater it opens more).

Consistancy of your Cervix

This means how firm or soft it is.

Early in pregnancy your cervix is hard and firm like rubber, then it softens up as you progress. If your cervix is hard we know that it will take a bit of labor in order for it to soften.

If it’s your first baby, you will normally have a firmer cervix than subsequent babies.

Baby’s Position

This means the baby’s position in the womb. Is it looking at your belly button, or your spine.

If the baby is positioned looking up — it sometimes takes longer. However, babies can spin at any time.

Honestly, that’s the good news on all of these things. Babies drop or move or change and can advance your labor quickly at any time (or they can stay the same… such is mother nature, right)?

NOTE: If Baby isn’t head down that is called breech positioning and normally requires a cesarean section.

Now, most often (but not always) — as you get closer to your due date, you are more likely to be “favorable‘ in these areas. So, a woman who is at 41 weeks of pregnancy most often has a more favorable cervix (and will have a quicker induction) than someone who is 37 weeks (where labor may take a long time). However, if you’re being induced early (especially for medical reasons) it may not be favorable — and that is OK too, we work with that frequently in the hospital.

As a note, most often first-time mothers take less time also, so all of those things will be considered before an induction of labor by your health care provider.

And finally, remember that ALL these things are just guesses based on statistics — who knows what will happen for you and your birth!

This is a lot to understand, and frankly — it’s even the half of it. I can get your prepared for ALL of it in just a few easy hours in here.

Problems With an Unfavorable Cervix

When doctors schedule an induction, they consider how “favorable” your cervix is.

That is an over-generalization of the items I mentioned (that are also in your bishop’s score).

If your cervix isn’t favorable (or if your bishop’s score is low) it means that it will likely take longer for your induction.

And, the longer an induction takes, the more medication we have to use, the higher risk you become as you labor longer and longer.

So, obviously we would prefer that you have a favorable cervix coming in.

However, if your induction is medically necessary (see below) it doesn’t matter how favorable it is, as we NEED to have the baby out!

Want to know more about inductions? — check out these posts:

• 5 Things NOT to do Before Your Induction
• Pitocin to Induce Labor
• Inducing Labor at 39 Weeks: Pros and Cons
• 5 Reasons to NOT Get Induced
• What Happens if Your Induction Doesn’t Work?

Prior Obstetrical History

If you’ve previously had a vaginal delivery, it normally takes less time for subsequent babies. Not always though, especially with an early induction — but, usually.

The part that is sped-up the most is the pushing part since your birth canal has already been stretched by a previous head.

How you Respond to the Method of Induction

Just like any medication, some people respond better to them, than others. Some people take a lot, and it’s hard to say if that’s how their body responds to the medicine, or if their body just isn’t ready to have a baby.

BTW, if you’re facing an induction, check out my easy tips to help you prepare for your induction!

Issues With the Baby

If we need to stop/start the induction frequently because of problems with the fetal heart rate that can obviously make your induction take longer. Some babies don’t love contractions or don’t respond well to them, so that is just something we have to take as it comes.

In general, this isn’t super frequent, but it does happen. Also, sometimes mid-induction your baby will show signs of distress, we will stop for a bit and it will resolve.

However, if the stress is too much, they will encourage you to consider a cesarean section. Studies do show that if you are being induced prior to 39 weeks you do increase the risk of a c-section if you are being induced (although if you are being induced prior to 39 weeks there should be a reason for your induction prior to being full-term).

If you’re getting induced early, I have a whole post on what to expect at a 37 week induction!

What did the Arrive Trial Show for Induction Length?

The Arrive trial tested to see if an elective induction at 39 weeks was more risky (for you or baby) than waiting to see if you went into labor on your own. It showed a few things (this is a very surface level review of the study, I go more into in a bonus video in here)

• You were less-likely to have a c-section if you had a 39 week induction rather than waiting to see if you go into labor on your own
• Length of time in labor and delivery was greater if you were induced at 39 weeks, but time in postpartum was less (because less people had a c-section)
• No adverse outcomes were noted for babies being induced earlier.

This study is controversial because it contradicts most of what the labor community has thought prior to it. More studies are coming (although preliminary data backs up this study) — but I think it is an important one to consider. I have a whole bonus video about it in here.

Things Your Providers Can Do to Speed-Up Labor

There are things we can do to speed up your labor. They are done to hopefully create a vaginal delivery.

Make sure you get informed consent before any of these procedures, as each do have potential risks (and benefits).

Membrane Sweep

Your provider will do this in the office after a cervical exam.

It is basically them just using their finger to go between your cervix and your bag of waters.

It is non-invasive and personally I find that it might bump you if you were already close to being in labor. If you weren’t going into labor, it doesn’t do much.

It is mildly painful, but worth a try if you’re 39 weeks and would love to go into labor.

If a membrane sweet is going to work — labor usually starts within 24 hours.

Your doctor may ask you if you want this after about 39 weeks of labor (or, you can ask for it as well).

Foley bulb Insertion

This is where our doctor inserts a tube (called a balloon catheter) up the birth canal into your cervix.

We then fill a balloon at the end of the tube with saline, which slowly stretches open your cervix.

This can be done in your doctor’s office or at the hospital. Fairly non-invasive, and if it doesn’t work it’s not something you can’t walk back from.

It is annoying to have put in, but after that you will likely feel some cramping or contractions with your cervix (hopefully) starting to open.

Your cervix must be somewhat open in order for this to work (otherwise they can’t get the tube into your cervix. In general they use this for 12-24 hours, and then remove it (or sometimes it falls out on its own).

Amniotomy

This is when your healthcare provider breaks your amniotic sac (the nurse can’t do it at the hospital, a obstetrician or a midwife has to do it).

This should be done at the hospital and is an official beginning to labor because once your water breaks we should get the baby out soon (the next day or so) There is always a risk of infection once your water is broken and the baby isn’t protected by that anymore.

Your water can also break at home (although that only happens about 15% of the time).

Breaking your water is often something that doctors do once ou are are already in labor to speed things along.

Induction Agents

These are medications we give that should start uterine contractions (or induce labor). When your provider schedules you as an induction, he/she will likely use one of these methods. They are used very carefully, because at too high of doses they can cause a uterine rupture. They start labor contractions similar to natural labor (vs spontaneous labor).

Cervidil / Cytotec / Prepidil

These are called cervical ripening agents (meaning they ripen your cervix just like you’d ripen an avocado for it to be softer to eat). Some can be given orally, but some are placed using a gloved finger near your cervix. They are prostaglandins (hormones).

These are usually given to soften your cervix, and then you move to…

Pitocin

Is given via IV. It is the same compound your body makes that puts you into labor on its own — the hormone oxytocin (it is just the synthetic version). You can learn more about pitocin.

What if These Induction Agents Don’t Work?

In that event (and it does happen) — we have to ask ourselves:

• Does the baby medically need to come out (in which case you’d need a cesarean delivery)
• Could we wait a bit longer and try again (in which case you might go home).

Your induction may need to be postponed until your body is more ready.

DIY Induction Methods

Many women take castor oil, or try other things to start their labor. Studies & experience show that things like this (particularly castor oil) can be very problematic, and don’t often work — so be mindful before you try an induction of your own.

Things you can do to speed up labor:

There are things you can do to help speed up labor….

Delay Epidural

It seems smart to just come in and get your epidural the minute you get your induction so that you won’t have to feel any pain.

I feel like there is a benefit to your body feeling some pain before you get the epidural.

This allows you to move more and possibly walk or sit on a labor ball to help baby find the best position.

Movement & Position Changes

As I said above, movement and position changes can help the baby find its best spot for delivery.

Some patients are unwilling to change positions. Sometimes some nurses don’t change your position once you have an epidural. I like to move my patients every hour (once they have an epidural).

So, just try to change your position and use movement to your benefit when you have it (even if you’re on pitocin you can often stand by the monitor and move in sexy hip circles or use a stool or a yoga ball).

Changing positions is so important I have cards that help you find your best spots in here.

Elective vs Medically Necessary Inductions

An elective induction is something you are choosing to do. Reasons can be:

• You have childcare for a specific day
• Your husband can come on a specific day
• Your doctor is available on a specific day
• Your doctor just thinks you should have the baby
• You are tired or miserable being pregnant with no specific medical issues.

Medically Necessary Inductions

Often medically necessary inductions happen before you are due. I have a whole post on 37 week inductions.

These are done because providers feel baby’s health will be better outside your womb, than inside.

A medically necessary induction can happen for a variety of reasons — I go into the vast majority of reasons in My Online Course, but the top few are:

Diabetes

Both gestational diabetes and type 1 or 2 diabetes can be a reason to be induced early as baby might be bigger, and you have an increased risk with pregnancy.

Baby Size

The baby’s size can always be a indicator to be induced.

Large Baby

If the baby is getting too large, it might not come out of your pelvis.

Small Baby

If the baby isn’t growing as it should, it is likely that we can help it grow better outside.

Too Much / Too Little Fluid

Oligohydramnios

This means that you have too little amniotic fluid. This can be problematic because baby needs to be surrounded by fluid to both protect it and the cord (and cushion it so it doesn’t get squished).

Polyhydramnios

This means you have too much amniotic fluid. This can be a problem to over-stretch your uterus, or too much room for baby.

Preeclampisa

This is a disorder of your smooth muscle caused by something in the baby/placental development. It is often characterized by high blood pressure or lab work changes with our urine and blood.

That means the only way to stop it is to get the baby out.

Which, is why you might need to be induced.

Other Reasons

Like I said, there are a lot of reasons why a doctor will induce you — these are just the most common.

Alright, so hopefully you understand that all of these come together to show how long your induction will likely be.

Is your hospital bag packed? — I have a handy packing list right here:

Textbook Labor Plan

If your baby read the textbook — it would know that average labor progresses about 1 cm per hour and then pushing begins.

However, most babies don’t read that book and labor can be tricky.

I find that the first 5 centimeters go longer than the last 5.

I also find that none of this starts until you’re actually IN LABOR (called active labor), and sometimes it takes a while to get there (often based on how thick or firm your cervix is).

Active labor is defined as the point when your cervix is dilating at least 1 cm’ish/hour.

With all that being said, if you’re induced early, an induction can sometimes even take 2-3 days, but if you’re induced after 40 weeks and have a very favorable cervix your baby could be out in just a few hours.

Which, I realize isn’t helpful at all. There is no shame in asking your doctor how long they think it will take (believe me, they have an educated guess), or asking your nurse once you’re in labor (it’s hard to tell until you’re in active labor and actually changing your cervix).

Length of Induction FAQ’s

AND, finally — I am a big fan of letting mother nature take the lead and going into labor on your own. If you can avoid an induction I would recommend that if at all possible, mostly because of the length of time that an induction on a an un-ready cervix can take. But, sometimes you can’t avoid it, so hopefully this article gave you some good info as well!

I know this all seems very complicated, but it really isn’t. Let me help simplify it for you in The Online Prenatal Class for Couples. In just a few hours I can have you totally prepared for birth.

OR, if you can’t even fit that in, check out Inductions Made Easy where I can get you ready for the induction side of things in under 30-minutes.

Source:

• Zhao L, Lin Y, Jiang T, Wang L, Li M, Wang Y, Sun G, Xiao M. Prediction of the induction to delivery time interval in vaginal dinoprostone-induced labor: a retrospective study in a Chinese tertiary maternity hospital. J Int Med Res. 2019 Jun;47(6):2647-2654. doi: 10.1177/0300060519845780. Epub 2019 May 17. PMID: 31096809; PMCID: PMC6567707.

The post How Long Does an Induction of Labor Take? appeared first on The Pregnancy Nurse®.

But first, how do I know all of this?

Hi, I’m Hilary — The Pregnancy Nurse . I have been a nurse since 1997 and I have 20 years of OB nursing experience, I am also the curly head behind Pulling Curls and The Online Prenatal Class for Couples. ​ I have helped thousands of expecting families have their baby, as well as what they can do to be more comfortable at home before being in active labor. Plus, I’ve had three of my own. SO, let’s talk baths.

And, if you’re looking to understand more about labor (and possibly let it come on faster by you not being anxious about it) — your first step is right here.

Can a hot bath bring on labor at 39 weeks?

No, not really. First off, a hot bath isn’t ever a great thing when you’re pregnant. Both you and baby could overheat (and feel miserable) but it’s likely not going to get your uterus contracting.

It’s a good question, but I bet you don’t love the answer. After a hot bath and it helping your muscles relax sounds pretty great right now.

BUT, as far as inducing labor (meaning, going from no labor, to starting labor and progressing to active labor) the answer is no. All of that is done with hormones and your body.

But the answer also has some nuance.

Before we get started, please only consider a WARM bath. Pregnant women (or birthers) should not have HOT baths. It really just warms your baby (and you) up too much. This is from the minute of conception through delivery — so just something to remember and tell your friends.

If you want to use a hot tub talk with your healthcare provider about what water temp is safe you for you and your baby. I’ve seen some say they’re fine, and other say no way. So I’m not sure what’s best.

What Does a Warm Bath Do?

It helps you relax. That’s really what baths do. If you hate baths, I probably wouldn’t take one — because it may not help you relax.

I do think it’s a great thing to do the day before your induction though.

When you relax, muscles may loosen up and baby may find their position better, or they can drop further into the birth canal. That’s the good news.

If you’re in early labor, a bath may help baby find their right position and help labor happen at a quicker pace, possibly. It may also do nothing, but if you enjoy it that’s a big win either way.

But, a bath alone will not start contractions.

Honestly, one other thing that really helps people relax is taking a prenatal class. Getting confident about the labor room can help your brain relax into labor as well!

What Else Can a Bath Do?

One thing I want to mention is that baths can be tricky when you’re 9 months pregnant.

Beyond the temperature possibly being an issue baths are hard. They’re slippery, and it can be REALLY hard to get out. I would definitely not take a bath unless your partner is there to help you get out (or at least stand by).

I know it sounds crazy, but it’s just super easy to slip and hurt yourself — so be careful. Even as you get closer to your due date.

They do NOT recommend getting into the tub after your water breaks for the most part — but ask your provider about that too. It could increase chances of infection.

Can a warm bath help you dilate?

Now, this one does seem possible — but why?

1. Relaxing helps your entire body relax, including your cervix.
2. Getting in/out of the bath and just normal floaty-movements might help baby engage next to the cervix heading into the birth canal.

Honestly, if a bath helps you relax and you feel safe doing it with your set-up do it! You deserve it during those last weeks!

What if I Don’t Like Baths?

I like baths, but I don’t love them that far into pregnancy. It’s just HARD To hoist myself out of the bathtub.

I mostly actually recommend warm showers. Just letting the water hit your back in early labor can be a NICE distraction and can also help all those muscles relax. Bonus if you have a massaging shower head.

I recommend letting the warm water hit your back and shift your hips side to side (hopefully letting those hips relax at the same time).

In fact, that’s one of the things I go over in my natural pain management bonus video in The Online Prenatal Class for Couples. We go through lots of household things you can use (like racquetballs) to help your body relax during early labor and labor longer at home.

What are some natural ways to induce labor?

Once again — that is tricky. The main things that we know to induce labor safely, are the things done at the hospital. If you’re super miserable you could always ask your provider about an induction of labor.

BUT I have written about quite a few things and if they will put you into labor:

• Will Eggplant Parm put you into labor— In that post it turns out that if enough people do ANYTHINg around 39 weeks pregnancy, some will just go into labor naturally).
• Will a prenatal massage put you into labor? As one who loves a good massage, I sure hoped so!
• How do you increase oxytocin to put you into labor?
• Can coughing induce labor — I’d guess the people googling this aren’t feeling all that great.
• Can jumping jacks induce labor — this article reminds us that pain is different than labor
• I really need an article on spicy food and if it will induce labor — but no, not normally.
• And finally, midwives brew (contains castor oil) — is it safe (spoiler alert: not really)

The main thing that most people think will work is nipple stimulation, but it only works while you’re doing it and it will likely not put you into active labor (unless you were going that way to start with). Bummer, right?

If you’re desperate to get that baby out I do have a whole guide on how to go into labor that might interest you. It’s also part of The Online Prenatal Class for Couples — and frankly, being less afraid of labor is a BIG step into going into labor.

If you’re not sure you’re quite ready, check out my free beginning prenatal class.

I hope this post helped answer any questions you had about taking a warm bath during pregnancy and if it can help induce labor. For more natural pain management options check out The Online Prenatal Class for Couples at the link above.

If you have any questions don’t hesitate to ask them in the comments!

The post Can a Hot Bath Induce Labor at 39 Weeks? appeared first on The Pregnancy Nurse®.

First, let me explain why I know so much about the induction of labor:

Hi, I’m Hilary — The Pregnancy Nurse . I have been a nurse since 1997 and I have 20 years of OB nursing experience, I am also the curly head behind Pulling Curls and The Online Prenatal Class for Couples. ​ I have helped thousands of families start and finish an induction of labor. I have talked to many about the risks and the benefits and I have seen the outcomes of thousands of inductions.

Most providers believe that going into spontaneous labor is the gold standard of labor.  Especially on your first baby. It can be hard to wait until 40+ weeks when your body decides to labor on its own, or maybe your water breaks.  Obviously the baby’s health is our #1 concern in this situation and the delivery unit will be sure to watch over the health of both of you carefully.

What is natural labor?

“Natural labor” (the term) has gotten confusing in the last few years — but I want to define it for the case of this article.  Natural labor would be one in which no medication was used to start labor.  We won’t be focusing on pain management options too much in this article, so natural labor would just be referring to spontaneous labor which didn’t have medical intervention.

FYI, new research shows that possibly inducing at 39 weeks, even without a medical cause, could help mom feel less uncomfortable towards the end of pregnancy and possibly also have better outcomes for babies overall.

This research is the ARRIVE TRIAL and I have a whole bonus video about it in here so you can really understand what it means for you.

That being said, it is important that parents understand the risk of complications that can come with starting labor contractions with medication — so let’s get into it.

What does ACOG say about when doctors can induce?

ACOG stands for American College of Obstetricians & Gynecologists.  It is the professional organization for OB/GYN’s in the US.  Their standards of care (and making sure they keep their license) is taken from them.

They state that it is reasonable for obstetricians and health-care facilities to offer elective induction of labor to low-risk nulliparous women at 39 weeks gestation.  However, that also depends on the hospital having enough staff and the patient requesting it.  SO, that mostly says if you WANT an induction of labor after 39 weeks, they should be willing to offer it.  Keeping in mind that has to flex with what the hospital is able to offer (and at the time of the writing of this article, hospitals do not have a lot of staff).

That means that the hospital needs to take people in spontaneous labor, or those who medically need to be induced, before those who are choosing to have an induction.  Similar to how the ER takes patients who are having a heart attack before those who have a small cut or a cold.

If you’re looking to learn more about inductions & the labor process, your first step is really to take a class. I love The Online Prenatal Class for Couples where in just a few hours you can get prepared for your entire hospital delivery. It has a chapter on inductions, and one on healthcare communication to help you get the best care.

Pro Tip: Your Bishop Score

Knowing your bishop score can help you know if an elective induction of labor is really a good idea.  The bishop score takes into account:

• Cervical Dilation (how open it is).
• Cervical effacement (how thick it is).
• Certical consistency (is it soft or hard).
• Baby’s station (how high or low the baby is in the pelvis).

BTW I have a whole post on vaginal exams and what this all means.

For most doctors they really only think an elective induction is a viable option as you progress into a large bishop’s score.  If your cervix is rock hard and closed, an elective induction of labor may not be the smartest thing.  When you start with a lower bishop’s score, it usually takes a larger amount of time for baby to be born.

What this means for you: If your cervix is only 1 cm, and pretty thick — your induction will take longer (and frankly, be more miserable) than someone who is already 3-4 cm and their cervix is thinned. If you’d prefer not to have a really long induction, this is something to consider.

Hate vaginal exams? I also have a post on what to do if vaginal exams are uncomfortable.

When Will Your Healthcare Provider Schedule an Induction

If you have a medical reason for an induction, they will weigh the risks of the baby staying inside vs the baby coming out.  We will talk about the medical reasons a doctor might induce you a bit later in this article.

If you are wishing for an elective induction (meaning you are requesting the induction and there is no medical reason) – your doctor will consider your due date.

Most often they will not offer an elective induction until 39 weeks of pregnancy.  That is just one week shy of full term (or the end of pregnancy – your due date).  Babies at this gestational age are likely to do fine outside the womb.  

And yes, this is where the ARRIVE trial (which you can find here) comes in. 

In the study they found that offering a 39 week elective induction of labor vs expectant management (that’s where doctors would just watch you and only act if they saw something was wrong) did not have any increased risks for the baby, had a lower chance of a cesarean – participants were more likely to have a vaginal delivery.

This is a pretty controversial study in obstetrics, however other studies are starting to confirm these results.

This is why it’s really important that you talk with your provider about your unique circumstances, especially about your bishop’s score to see if you’re truly a good candidate for an elective induction – if that is what you want.

As a note, some providers are really encouraging women to have an elective induction at 39 weeks due to that study, but remember you can always make up your own mind.

I have a whole podcast on reasons you might want to be induced:

How do doctors schedule inductions?

Most often they call the hospital and speak with someone who schedules the inductions and figures out a time that will work. The hospital only has specific # of times/day that they allow inductions, so the first one to call in would get that spot (although if there is a medical reason that would “bump” someone who has an “elective” induction).

A patient can NOT call in and schedule their own induction.

Can a doctor schedule the induction for the next day?

Very often they will, but sometimes the day is full or there isn’t enough staffing to take more patients.

Medical Reasons for An Induction of Labor

Today I’m going to share some of the common reasons why your doctor might induce you.  There are a LOT of reasons, but I want to touch on common ones.  That’s why it is important to have this discussion with your own provider.

High Blood Pressure or Preeclampsia

High blood pressure is often a reason for an induction.  Be it just maternal hypertension (high blood pressure with no signs of preeclampisa) or preeclampsia, both are indicators for an induction.

Gestational Diabetes

This is a reason that many women are induced.  It can be Type 1, Type 2 or gestational diabetes.  It depends on how well your blood sugar is controled, and what management you are doing (insulin, medication or diet-controlled).

Ruptured Amniotic Sac

Once your amniotic sac is ruptured, there is a risk of infection.  The amniotic membrane helps protect baby from outside bacteria – but once that’s broken things can affect the baby.  While this isn’t exactly induced labor – I normally call it a labor augmentation.  

But, regardless of the terminology, if your water is broken and within a few hours your uterus is not contracting, they will likely want to induce those contractions with Pitocin.

There are other reasons, like baby being too big or too small, or too much or too little amniotic fluid.  All of these show an increased risk to baby staying in the womb rather than coming out.  In other words, their health problems could be worse staying inside your uterus.  In making the decision for an induction they will take into consideration any healthy problems, any medical conditions that the baby might have and any risk factors for either of you.

BTW, if you want to know more about how they test for any issues in the third trimester you’ll love chapter two in this.

Risks of Induction

As with any medical procedure (including natural labor) there are potential risks of an induction.

There is an increased likelihood of cesarean section.  As we are creating the contractions vs your body creating them – there is a chance of uterine rupture (meaning your uterus contracts so hard it pulls apart).

Baby’s heart rate can have an issue with the strong contractions.  The placenta can come off of the uterus (called a placental abruption) because the contractions are so hard.

This is why pregnant women who are having an induction of labor are monitored more closely and we are very careful with the medications we use.  We will watch both baby’s heart rate and uterine contractions carefully to make sure that both are safe.

Before an induction of labor, your provider should go over the risks and the benefits of an induction.

Induction methods

There are many induction methods that providers can use to start labor:

Membrane Stripping

Stripping membranes or sometimes called a membrane sweep is when your provider takes a gloved finger and “rings” it between your cervix and your bag of waters to separate the two and possibly stir up hormones in that area to get things started.  

This is most often done in the doctor’s office (and may or may not work).

Foley Catheter Balloon

This is where a small balloon is placed in your cervix to help manually open it.  It is basically just pushing against the sides of your cervix.  This can be done in the doctor’s office (it stays in for usually 12 hours, or until it falls out on its own) or in the hospital (it can also be given with cervical ripening agents as talked about below).

Artificial Rupture of the Membranes

This is where your doctor takes something similar to a long crochet hook and tears a hole in your bag of water allowing it to escape. 

This often makes uterine contractions strong and more effective.  This is done in the hospital setting with monitors on.  Once your water is broken you do need to have the baby in the next day or two due to an increased chance of infection if baby stays in loger.

Cervical Ripening Agents

These are medications that put hormones in your body that stimulate the softening of your cervix and the beginning of labor.  The three most often used ones are:

• Cervidil
• Cytotec
• Prostin Gel

The medication used is most often due to provider and hospital preference.

Pitocin

Pitocin is the synthetic form of the hormone oxytocin that your body naturally creates.  It is given via IV and used to create contractions.

Often pregnant people are given cervical ripening agents and then given pitocin after their cervix is 3 centimeters.

What is the Best Option For My Induction?

It really depends on you and your baby’s health history. Your needs, wants, and wishes.  That is why you have a provider you can discuss these options with!

Can I induce myself?

Many women who are not offered an induction by their healthcare provider may try home methods of induction, like castor oil, nipple simulation, or spicy foods.

Remember, your provider is not starting an induction because they think that it is safer for the baby to wait until mother nature is ready for it.  These “natural” methods are no safer (and in some case less safe – looking at you castor oil) than the methods the hospital uses.

The idea is that these will also release oxytocin into your bloodstream to make labor start.

Interested in getting labor going? I actually created a whole guide book on starting your own labor that you might be interested in.

Healthy women have the option of sometimes choosing when labor starts, but the best thing is to consult with your healthcare provider about what to do for baby’s birth, and how it would be most responsible to proceed.

Ok, now that you’ve learned a bit about inductions — let’s dive a bit deeper into how they happen and what to expect from start to finish at the hospital. You can do all of that in this prenatal class, and I guarantee you’ll feel more prepared to have your baby!

I love what Samantha had to say:

“Presented real information with a blend of humor that encourages memory and a feeling of realness many online classes fail to achieve.”

Read more reviews of The Online Prenatal Class for Couples here

Or if you JUST want some induction information I have a class called Inductions Made Easy that explains all of in detail, including if it’s the right choice for you.

The post When Will My Doctor Induce Labor? appeared first on The Pregnancy Nurse®.

Hi, I’m Hilary — The Pregnancy Nurse . I have been a nurse since 1997 and I have 20 years of OB nursing experience, I am also the curly head behind Pulling Curls and The Online Prenatal Class for Couples. ​ I have also had 3 children of my own, and know how desperate you are to feel great during pregnancy. Let’s talk all about prenatal massage!

Benefits of prenatal massage

There are a lot of benefits to pregnancy massage.  If you are paying for a massage — make sure you are going to a trained massage therapist.  

First off, massage can increase blood flow to certain areas, which is great during pregnancy.  Because the mechanics of your body have changed, it will feel SO good for things to get the rich blood flow they deserve.

While having a regular massage is likely fine, there are specific benefits to massage depending on your weeks of gestation.  I would also recommend telling your licensed massage therapist if you are pregnant so they can be aware of any health concerns in relation to your massage.

I don’t think it’s a bad idea to look for a therapist who has additional training in the massage of pregnant women.  That way they will know how to best help you and stay on the safe side as well.

Pro Tip: Communication is ALWAYS key when you’re pregnant. It just helps practitioners of any sort better know how to care for you.

Massage in the First Trimester of Pregnancy

Pregnant women may really long for a massage in early pregnancy.  However some professional massage places of business may ask you to not come in during early pregnancy.  While massage seems to be considered fine throughout pregnancy, some practitioners may not want to work on you during those early fragile days due to a risk of miscarriage (as all pregnancies have a risk of miscarriage).  I haven’t seen any specific research on miscarriage and prenatal massage.  Here is The American Pregnancy Association’s thoughts on it.

However, many people WILL take you as a client.  Depending on how you’re feeling (and how big your belly is) you may want to use an abdominal insert that has a cut-out for your pregnant belly — similar to these pillows that let you sleep on your stomach.

You can definitely feel sore muscles during this time of pregnancy.  Your body is already adjusting to moving organs and allowing space for the baby.

Massage in the Second Trimester

Pregnant women in the second trimester are starting to feel more joint pain, possibly water retention and may just want those feel-good hormones a massage will give them.

Prenatal massage can help with that annoying lower back pain, lessen the burden of that extra weight you’re carrying — and all those other physical effects of pregnancy.

However, keep in mind your body will be the happiest during your second trimester, so you may want to consider waiting until….

Massage in the Third trimester 

Pregnant women love massages during those last weeks of pregnancy.  The risk of miscarriage is gone and you may be hoping it will help your body relax into labor (more on that coming).

The later stages of pregnancy often bring more stress hormones (darn those high cortisol levels), high blood pressure, sciatic nerve pain, and craving better sleep — all of which prenatal massage can sometimes help. Of course, breathing through the anxiety can help too (you’ll need lots of techniques at your disposal).

Most women (including myself) find that gentle massage can really help those physical changes and the pains of pregnancy.  Personally, when I had one I left having less pain, less water retention, and I felt like blood supply had returned to my whole pregnant body!  The end of pregnancy is definitely the best time to get a massage (if you can’t afford the time/money to get one several times during your pregnancy).

Personally, I was surprised by how much I appreciated the massage on my lower legs in those last weeks of pregnancy.  Between swelling, pelvic girdle changes and the excess weight my legs took a beating, and they LOVED the massage!

Even if you don’t go to a spa, some gentle massage during pregnancy by your partner can help you have positive feelings for each other.

The positive feelings you get for each other, and the massage can possibly excrete oxytocin which may help you go into labor, but the science doesn’t particularly support it.

Massage in Labor

There is some anecdotal evidence that having massage can help give shorter labors — but it seems like that would mostly be helpful to have massage while you are in labor (as it would help your body relax).  I definitely give partners some massage tips in my prenatal class (it’s in my natural pain management bonus video).

I really think that massage can take away your thoughts from the labor pain you’re experiencing. Which is a win. It can also help take away some anxiety.

If you’re feeling anxiety surrounding your birth, I would recommend taking a prenatal class.

Studies have shown that taking a prenatal class reduces anxiety and can help you feel better about not only your birth experience, but talking to your provider at appointments as well. The Online Prenatal Class for Couples is taught by a labor nurse with 20 years of experience, and is designed to get you and your partner on the same page before birth (partners LOVE that class — it gets right to what they need to know!).

Why Massage Might Be Problematic in Pregnancy?

So, if massage is awesome, why could it be a problem during pregnancy?

Well, first ACOG recommends you get a massage on your side rather than laying like you would normally.  I think they’re OK as long as your provider has an insert that has a cut-out for your belly — but you shouldn’t lay directly on your belly for the massage if your belly is protruding.

Your body has several acupressure points that could start labor (although evidence on that is iffy, and we’ll talk more about it).  Many will avoid foot massage for this reason (which is a shame because my feet were SCREAMING for massage daily during pregnancy).  I found a good article that spoke to foot massage in pregnancy specifically.

Some will just avoid specific acupressure points and still massage other specific areas of the body — so check with your practitioner.

Note: Acupressure and acupuncture are similar, and the same things would be true of both (however, you’ll need to be more thoughtful about your use of acupuncture and your practitioner since it does break the skin).

Keep in mind that many therapists use essential oils in your massage and some are not recommended during pregnancy (and some women are more bothered by specific smells while pregnant).  So, ask them not to use anything beyond carrier oils which have proven fine.

While you might want to be induced later in pregnancy, no one wants to go into premature labor by them touching specific areas of your body or reflex points — which is why they are very cautious.

Also, if you have any symptoms of blood clots, I would probably hold off on a massage (also, be SURE to talk with your provider).  You definitely don’t want them to massage a blood clot loose and pregnant women are at a higher risk for blood clots during their pregnancy.

Types of massage

Prenatal massage therapists may specialize in different types of massage

First off, deep tissue massage’s pressure can be tailored to you and your needs that day.

Strong pressure might be great if you’re sore in deep muscles.  This is great especially on your legs for pregnant women (but obviously not on their abdomen).  It can really help your soft tissues release fluids and feel better.

Light pressure might be great if you’re just looking to feel good and rejuvenated after your massage.

There can be other significant differences in the types of massage offered, so be sure to check what type of massage your practitioner provides.

Some options are (and could be combined with a “prenatal massage”):

• Swedish
• Hot stone
• Aromatherapy
• Deep Tissue
• Shiatsu
• Thai

Please note that some massage therapists are also acupressure practitioners — and you’d want to be sure that they are trained and able to help you safely with your needs based on what they do.

What Should You Do Before a Massage?

Talk with your healthcare provider to see if there is a spot they recommend, or if you have any health conditions that might make a massage problematic.

However, people experiencing a healthy pregnancy should be able to have a massage without issue.  If you’re having the massage laying face down, make sure that they have a cut out for your baby belly.

If you’re experiencing labor pains, it is likely not the best time to have a massage, although talk with your provider (it could also help you relax, as long as your practitioner knows that you are pregnant and likely to have a baby soon).

What about Postpartum Massage?

This can be a good idea for women who have recently had a baby.  Many people prefer to go after their bleeding has tapered off. You may have some excess fluids that would be helped with a massage and I imagine it would feel GREAT for overwhelmed and stressed out tissues to have a massage.

Again, check with your provider to make sure it is OK for you.

Can Prenatal Massage Induce Labor?

There is limited research on prenatal massage and if it allows for shorter labors.  And there isn’t really any scientific research about if prenatal massage can induce labor.

A pregnant woman may have heard that ankle massage (specifically the inner ankle bone by the Achilles tendon) or pressure on specific points may induce (or stimulate) labor.  BTW, check out this post on ankle pain in pregnancy if that’s an issue.

While there isn’t too much research into prenatal massage.  There is a belief that it does help labor outcomes as women are more able to relax during uterine contractions.  I would think that it could help with low back pain for sure (I talk about using massage with your partner in my prenatal class).

There are lots of common myths about how pregnant clients can induce labor, including castor oil (sometimes called Midwives Brew), acupuncture, and use of a breast pump, but until your body is ready it will likely not do much (and castor oil can have some serious consequences).  However, none of those things should be tried at all until you are past 37 weeks gestation to make sure your baby is fully developed before labor.

Use of alternative medicine should be done carefully and with the advice of your doctor or midwife during your entire pregnancy, but especially as you get to the end of your pregnancy.

Some providers do offer induction massages — although I don’t see a lot.  Induction massage focuses likely on your feet and ankle region.  Hopefully expectant moms also get a full body massage that helps them relax and feel great too!

Massage in pregnancy can be a great tool for pregnant moms.  If you plan to go to a spa, make sure that the providers have been to massage school and are licensed.  Or, have your partner just rub what feels good.

If you’re looking to feel more relaxed and calm during your pregnancy, be sure to take a prenatal class.  Studies show it decreases anxiety throughout your pregnancy.  This one can be done in just three hours, and it’s guaranteed to get you more prepared.

Or, if you’re not quite ready for the whole class, check out my free beginning prenatal class.

The post Can Prenatal Massage Induce Labor? appeared first on The Pregnancy Nurse®.

Can Coughing Induce Labor?

The short answer is no, not really.  However, some of the things that happen along with coughing (fever, dehydration etc) can make you contract.

But, coughing can be really complicated during pregnancy…. so let’s keep reading!

But first, how do I know all of this? Hi — I’m Hilary — The Pregnancy Nurse . I have been a nurse since 1997 and I have 20 years of OB nursing experience, I am also the curly head behind Pulling Curls and The Online Prenatal Class for Couples. ​ I have seen THOUSANDS of sick women in labor and delivery triage and I am aware of when it’s OK to treat at home, or when it’s best to see a provider.

I’d love it if you’d join me in my Free Beginning Prenatal Class:

Pregnant & Coughing

Coughing is most often a symptom of an upper respiratory infection.  Most often those are a viral infection, but can definitely cause a bad cough!  Other symptoms can be a runny nose, sore throat or sometimes an increased heart rate due to the fever (however, if your heart feels funny I would definitely consult your provider for medical advice or medical treatment).

Symptoms like a bad cough or a high fever are something you should contact your provider about. We’re going to talk more about why a bit more in this article.

Of course, with a cough comes the importance of disease control and keeping those that you are in close contact with disease-free.  Make sure you are covering your mouth when you cough, using tissue and washing your hands frequently to keep family members safe.

They really recommend all pregnant women get their flu vaccine, so talk with your provider about when that is important for you.

Bad Cough in Pregnancy

Large amounts of coughing can certainly be super annoying during pregnancy, especially with your growing belly.  You need to consult with your health care provider about what/if you can take anything.  As you head into your second trimester, there may be more medications you can take than in your first trimester (see my post on Sudafed in pregnancy). Cold medicines can be really tricky, especially if you have high blood pressure. I also have a post on cough medicines in pregnancy.

Also, if a cough lingers it could be a bacterial infection, and they may want to give you antibiotics for it.

Why Coughs Can be Problematic for Pregnant People

Pregnant women can have more severe upper respiratory issues due to their already decreased lung capacity, plus the blood flow of keeping two people alive vs the general population (meaning you have greater oxygen consumption).  Make sure that you talk with medical professionals if you have a severe illness, shortness of breath or chest pain.  They will want to monitor you in case you have a dangerous complication.

In fancy medical terms, during pregnancy your functional residual capacity (how much air is in the lungs after your exhale) is decreased by 20% — most often due to changes to your thorax during pregnancy (baby pushing up). Your ribs do expand a BIT to help alleviate this, but it doesn’t quite make up for it. it’s why, especially during your later months of pregnancy you’ll feel out of breath frequently.

Please note that it isn’t unusual to have a persistent cough after a viral infection.  Staying hydrated and rest are two of the most important things you can do in that situation.

Coughing can also come with an allergic reaction, so it would be important to know what YOU think is causing it (does it come with itchy, watery eyes as well? — that could be a sign of allergies).

All of this means that if you’re having a bad cough you should definitely contact your provider so they can make sure that you’re doing OK. Your risk of complications can be higher than other’s.

Coughing & Peeing

Sometimes when you cough, you may feel small amounts of urine come out, or you might think it’s amniotic fluid.  It is not unusual to have a bit of urine leakage while pregnant and coughing a lot.  Talk with your provider about it at your next visit.  If you do think your water broke, contact them immediately.

A pregnant woman who has this issue might want to see a physical therapist to strengthen these urine preventing muscles.  The hormonal changes of pregnancy can really be hard on your pelvic floor.

Persistent coughing can make you feel like you pulled a stomach muscle, or even cause pelvic pain from the increased pressure down there.

Preterm Labor

Premature birth is considered anything before 37 weeks of pregnancy and can happen for a variety of reasons, and there are specific risk factors that can cause it, including severe illness (like strong cold or flu).

Preterm birth can often be prevented by staying well hydrated and staying in close contact with your healthcare provider during a hard illness.  Most often premature birth happens due to your body just going into labor, not a cough though.

Coughing can sometimes cause Braxton Hicks contractions, which are just basically “practice” contractions that aren’t actually putting you in labor (it’s just your uterine contractions that aren’t pushing the baby through the cerivx).  Some people also call this false labor.

These types of labor can be disconcerting, especially if it is your first time. Imagine all the pressure that goes on your uterus when you cough — it’s not surprising that it might contract a few times after that.

Even if you are towards the end of pregnancy, if you are ill — they sometimes prefer that you NOT have the baby while you are ill (less chance of the baby catching it).

Coughing After Baby is Born

Many pregnant women end up having their baby while they are sick. I have a few tips for those patients:

If you have had a cesarean section, be sure to “splint” your wound by using a pillow to push over it as you cough. It puts less stress on it (ask your nurse to help you if you have questions).

You might worried about getting baby sick, and while you may want to wear a mask when you’re around baby with a bad cough, your breast milk should also have antibodies that your immune system is helping you to feel better with.

While this study is about Covid 19 it does show that most often babies didn’t get Covid even mom did have it. That’s a some good news in recent studies!

Coughing While Pregnant is Painful

It can be really painful to cough while you are pregnant.  The best way is to make sure that your belly and your round ligament area (that’s the area to the sides of your belly are supported when you’re coughing.  Often people can use a pillow to “splint” this area and support it when you’re coughing frequently. 

So, ultimately no — coughing can’t make the baby descend into the birth canal, but coughing during pregnancy can definitely be annoying and some of the side effects can put you or your baby at risk, so be sure to stay in close contact with your provider.

If you’re not sure if you’re in labor I have a whole post on my sister side about how to know you’re in true labor?  That might help you out in that area.

Ok, now that we’ve talked ALL about coughing during pregnancy, I just want to ask you if you’ve taken a preantal class. Did you know people who have taken a class are 10% less likely to have a cesarean section? It’s crazy results from knowing what’s going to HAPPEN and what to DO from labor.

And, now is a GREAT time to get prepared for your upcoming birth. Save 10% on The Online Prenatal Class for Couples with code PREGNURSE. Can’t wait to see you inside!

Want to do a vibe check before diving into the whole thing with me? — check out my free labor pro tips. It’s your first step toward getting in the driver’s seat of your birth.

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