Ways to Induce Labor Part 3: Castor Oil

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Will using Castor Oil get you a baby? Or just an upset stomach? What does the research say on using castor oil for labor induction?

Disclaimer: None of these methods should be used unless recommended by your provider, not even the “natural” methods. “Natural” does not automatically mean risk free. Some common recommendations are evidence based; others are passed on as old wive’s tales and are ineffective or possibly harmful. Normal, low risk pregnancies should not be induced prior to 39 weeks, and ideally not before 41 weeks, without a medical indication. Healthy babies will come when they are ready; taking the baby too soon can result in breathing and feeding difficulties, as well as increase the risk of c-section. Mom being uncomfortable, having difficulty sleeping, multiple rounds of false labor, or excitement for the baby to come are NOT reasons to induce. That being said, there are times when induction is appropriate, and this decision should be made with your provider.

Castor oil is an oil traditionally used as a laxative. It is also commonly touted as a way to start labor. Most of the research studies about its use in this manner are older, or are poorly designed studies that show conflicting information. There is a study that was published recently, in 2012, that was a randomized, double blind, controlled trial- the “gold standard” for research.

This study’s aim was to examine the effectiveness and safety of castor oil for induction of labor in post-dates pregnancies. Women included in the trial were between 40-42 weeks gestation with singleton pregnancies, had a bishop score of 7 or less (a score used to measure how ripe the cervix is, and how likely an induction would be to work), no uterine activity, and no previous c-sections. Eighty women were included in the study, 37 in the treatment and 43 in the control group. The treatment group received 60mL of castor oil, while the control group received a placebo of 60mL of sunflower oil.

The results showed that women who took the castor oil were 3 times more likely than the control group to go into active labor within 12 hours of taking the oil. Of those that had not gone into labor at 12 hours, participants were still more likely to go into active labor faster than the control group at 48 hours. Outcomes were similar between the treatment and the control groups. There were no statistically significant differences in c-sections, meconium fluid (when baby has a bowel movement before birth), chorioamnionitis (uterine infection), instrumental delivery (vacuum or forceps), or APGAR scores of <7 at 5 minutes. The authors conclude that castor oil is a safe and effective induction method, even in the outpatient setting.

Discussion: This was a small study, and it is possible that it was too small to detect slight safety differences between the castor oil and placebo. That being said, it was well designed and as the results stand, the castor oil appears to work, and be safe. Castor oil is typically thought to increase the risk of meconium in the fluid, but this was not shown to be true. More likely, castor oil is being used to induce postdates pregnancies, when there is statistically more likely to be meconium fluid anyway, and it is being attributed to the castor oil when it would have been present either way. Common side effects of castor oil are diarrhea, nausea, and vomiting. In my experience, it can also cause “weak”, annoying contractions that aren’t strong enough to dilate the cervix, but are enough to make the mother uncomfortable and tired. While castor oil may be more effective than waiting for labor to occur spontaneously, it is certainly not a “fun” method, especially if you are one of the unfortunate people who get the side effects, but not the labor!

Gilad, R. et al. (2012). The CIC trial- castor oil for induction of contractions in post-term pregnancies. American Journal of Obstetrics and Gynecology. 206 (1).

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