# Questions about induction (castor oil and pitocin)



## Kundalini-Mama (Jul 15, 2002)

My sister is 39w pregnant and for medical reasons she is going to be induced on Monday. She is currently 2cm and 50% effaced, baby is at -1 station.

Now, I'm looking for the _best_ way to take castor oil, as she is really thinking about taking it on Easter before the (pit) induction. I know it has to be taken on a full stomach, but that is the extent of my knowledge.

ETA: Where do you buy castor oil anyway?

Also, her OB said they shouldn't have to do cervadil, and my sister has downright refused cytotec. So it looks like she is going to have pit. She was wondering what that will be like. She knows it will probably hurt like hell, but will she need to be on her back for monitoring? Is there any wiggle room?

Thanks in advance,
Amy


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## aprildawn (Apr 1, 2004)

i just want to subscribe because i'm facing an induction next weekend for medical reasons.


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## momto l&a (Jul 31, 2002)

I did castor oil. The best way to take it IMO is with some very cold root beer. Take a swig of oil then wash it down with the root beer. The root beer seems to cut down the oil. I tried OJ and the didnt work.

I had one bout of you know what and that was it.

It gave me loads of small contractions they lasted4 hours then stopped. An hour later the real ones started and 2 hours later the baby was born.

I was 43 weeks and I would do it again.

Wishing a speedy birth for the sister and you aprildawn


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## Artisan (Aug 24, 2002)

She will most likely have to be on her back for at least a good while. With an induction they require constant fetal monitoring. So unless the hospital has a telemetry unit (she could call now and check), she will be stuck in the bed.

In terms of the castor oil, hmm... the best way to take it is slowly. Start with slow doses and ramp up. Start by mixing a Tbsp or two in some scrambled eggs for breakfast and see if anything happens. If not, a few hours later, have some more (4-5 Tbsp) in an ice cold drink, like OJ or root beer, see if anything happens. She can up the dose every few hours. If she's taken 4-5 doses and nothing has happened, I would stop.


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## Artisan (Aug 24, 2002)

Just wanted to add that if the castor oil does bring on some contractions, she might consider using a breast pump to help keep the contractions coming.


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## KayleeZoo (Apr 8, 2003)

I've heard that castor oil can cause really bad cramping as well as contractions and that it can stress the baby out and cause meconium- is this true?


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## hubris (Mar 8, 2003)

My mom used castor oil - I believe she mixed it with orange juice. Look into the concerns listed above, though. I would probably try something that stimulates the bowels that causes less cramping, first - like prune juice, or spicy food (or both).

Has she tried any other natural labor induction methods? Ideas:
- red raspberry leaf tea
- sex (semen contains prostaglandins, which ripen the cervix, and orgasm can stimulate uterine contractions)
- nipple stimulation (stimulates oxytocin production)
- walking or other exercise
- applying evening primrose oil to the cervix to help ripen it
- applying pressure to the point inside of the ankle


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## Full Heart (Apr 27, 2004)

Quote:


Originally Posted by *KayleeZoo*
I've heard that castor oil can cause really bad cramping as well as contractions and that it can stress the baby out and cause meconium- is this true?

Well if this were true than most pit induced labors would also have meconium since those contraction are much harder than something brought on by castor oil! If you take too much it can cause dehyrdation by causing severe runs. Learned that the hard way







: .

Also, I tried the root beer route and it stayed suspended in the foam...it was nasty. Go with the OJ or the eggs. drink plenty of water. Clitoral and Nipple stimulation are a good idea as well. Sex would be ideal. Also a really good cry does wonders, if nothing to start labor







.

Michelle


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## doctorjen (May 29, 2003)

Don't know much about castor oil, but wanted to weigh in about the monitoring. They will want continuous monitoring most likely, and actually this isn't terribly unreasonable given that pitocin can cause hyperstimulation and distress. However, there is no reason to have to stay on your back to be monitored. She should insist on being able to move around. It helps if her support person can learn to adjust the monitor to keep the heartrate tracing. Telemetry monitoring may also be an option, allowing a much wider range of activity. Even without telemetry, the monitor cords are long enough to allow standing/squatting at the bedside, sitting in a chair or on a birth ball, and all manner of positions in the bed itself. No one should be stuck on their back in bed!


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## momto l&a (Jul 31, 2002)

Quote:


Originally Posted by *KayleeZoo*
I've heard that castor oil can cause really bad cramping as well as contractions and that it can stress the baby out and cause meconium- is this true?

Well my dd was 3 weeks 'late' and had no meconium.
I didnt have any bad cramping and I think the only stress to the baby was due to being shot out of me :LOL

dd#2 was 2 weeks late and had meconium. I used corn silk tincure to induce her.


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## MsMoMpls (Oct 22, 2002)

I made a castor oil smoothy- raw egg, orange juice and ice. You get castor oil at the drug store. I only took one shot and the cramps are stomach-achy. You shouldn't do castor oil unless you are already progressing some.


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## pamamidwife (May 7, 2003)

I've had quite a few clients choose to do castor oil and I've never seen an increased risk of meconium. In fact, six times out of seven, it started labor within an hour or two.

I think the whole meconium issue comes from the fact that we're dealing, typically, with babies past the due date. That in and of itself can cause meconium release without fetal distress. Meconium with reassuring heart tones is not a bad thing - it just is normal for some babies.

It sounds like she has a favorable uterus, though her baby seems a bit high, so I wouldn't recommend breaking water at all. Castor oil might do the trick.

I usually recommend women doing it after a good night's sleep (taking Unisom helps to get some good sleep) and a good breakfast. We usually do 2Tbs in some cold, cold root beer. The mom drinks through a straw while another person continually stirs the liquid so the oil doesn't separate. Sometimes we'll do another 2Tbs another hour later, but usually it's not necessary.


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## dynamicdoula (Jun 11, 2004)

Quote:

Now, I'm looking for the best way to take castor oil, as she is really thinking about taking it on Easter before the (pit) induction. I know it has to be taken on a full stomach, but that is the extent of my knowledge.
Actually I don't think a full stomach matters much, but I don't have firsthand knowledg either. I tell my clients that they have to consider where they are already (sounds like she's already making some progress), and how they'll feel if it doesn't work, before I offer ANY suggestions like this. But here are a few things she can do to help:

The thing I would definitely encourage her to do most (if she were my sister, and not my client) is Evening Primrose Oil. Three capsules vaginally @ night, 3 capsules orally in the morning. This will help her cervix to soften even more than it is.

The castor oil sounds like a reasonable option at this point but definitely address with her the risk of having loads of diarrhea and vomiting and nothing else happening. *It's a real possibility.* She does not want to go into labor dehydrated, it would make it that much tougher for her. So start slowly, and hydrate, hydrate, hydrate. She can mix 2oz with some scrambled eggs, or with a shot of orange juice, wait a few hours and do another shot. But it is a laxative! So expect some.. well.. side effects.









I would be glad to email you the document I give my clients- send me an email: doula at dynamicdoula dot com.

Can I ask on the medical reason for the induction? Maybe we can offer some other types of suggestions?

Quote:

Also, her OB said they shouldn't have to do cervadil, and my sister has downright refused cytotec. So it looks like she is going to have pit. She was wondering what that will be like. She knows it will probably hurt like hell, but will she need to be on her back for monitoring? Is there any wiggle room?
Okay here are some things to know and consider:

With any type of medical induction she will be on the monitors continuously. *This does not mean she has to be in the bed, nor should she be.* She may have to advocate strongly for herself here, but it is important that she not start her labor in the bed. Try a birth ball (bring one if you have to), or the rocking chair- or even sitting fully upright in the bed if there is no other choice- anything but *laying down*. It will be a little less convenient for the nurses and they might get pushy about it but encourage her to stand her ground. Laying down in labor leads to slower, more painful, more complicated labor!
Change positions every 30-45 minutes as you can. Go from side lying to sitting up, from the ball to the rocking chair, from dangling between dad's legs to the ball, etc. Just keep that body moving.
The toilet is a wonderful place to labor and no one will mess with her in there. She will relax her pelvic floor automatically, she can pee or dribble fluid or poo or whatever she needs to do without worry, and it's private, dark, just like most laboring women want it. Encourage her to "pee" (as in, whether she actually needs to or not) as often as possible.
She is in charge. She has the right to move, get out of bed, even eat, etc. if she chooses to. Keep in mind that the medical staff has your safety in mind but they also have their other patients, their schedules, their routines, etc. in mind too. Don't be afraid to ask for what you want, and to push sometimes. As long as there isn't an emergency, make that space her own and take advantage of everything she can.
Bring food, bring your favorite drinks- throwing up in labor isn't fun but it's a lot better to have some calories on board than to starve, and it's a lot better to barf up chicken noodle soup than dry heave. Don't be afraid of puking in labor- it's your friend!








Do the best you can. Encourage her to do the next best thing she can do- we aren't robots who can plug into an outlet when our batteries get low and function at full capacity. She's going to get tired and she will be in pain- these things can change your judgment about things that you feel strongly about when you're not hungry, tired, in pain. Be forgiving of yourself and do the best you can.
Consider asking the doctor to turn the pitocin down, or off all together once a labor pattern is established. *This is not usually done.* She will have to probably really advocate for this but there's no reason to run Pitocin, be stuck on monitors, etc., if her labor is doing fine on its own!
She will know what to do- encourage her to trust herself to make the right decision at the time, and tell her that you trust her to, as well. There isn't any wrong choices, only the best one you have available to you!

Good luck, please feel free to email me if I can be of any other assistance!


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## dynamicdoula (Jun 11, 2004)

Quote:

Has she tried any other natural labor induction methods? Ideas:
- red raspberry leaf tea
Red Raspberry isn't a labor inducer, it's a uterine tonic.


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## morninglark (Mar 21, 2003)

Making a smoothie worked best for me. I tried it once with OJ and it separated before I could get it all down and I lost it. Then we tried mixing it up in the blender with some yogurt and OJ, that helped keep it from separating and made it go down easier.

I also had to transfer to the hospital where I had pitocin (but no pain meds, no fetal distress, etc.). They kept wireless monitors on me and I was able to walk around, get in the tub, birth on a birthing stool, etc. Of course my mw and dh were there to advocate for me and control how much pit I was getting. I wish I could say that I had a speedy labor, but it lasted about 16h after the caster oil kicked me into Active Labor.

Best wishes to your sister!


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## wasabi (Oct 12, 2004)

Having had pit with two labors and castor oil to kick off my third and only successful natural labor I'd pick castor oil any day! I took 4tbls mixed with OJ and just downed it. It really was not bad at all imho. I only had one incident of gastro distress which took place quite a bit later. I was really surprised because I think it was about 6 hours later. When that happened I did start contracting with some regularity. I decided to try to get some sleep and woke up about 3-4 hours later in active labor. Now I will add that was almost exactly 12 hours after I took the castor oil. Maybe it was a coincidence maybe not I can't say but I was facing a transfer to OBs/induction/etc in a few days and I thought it was worth a shot. I had been taking EPO, RRL tea, doing nipple stim, sex etc. I'd had tons of BH but they were doing nothing. So maybe my body was just ready to go and all those things combined syngeristically to make labor get started.







:

DD did not have meconium. However my second who was only about 2 days later/a week early depending on my dates did have it. While I did have pit with her to augment labor the meconium was there beforehand (AROM prior to pit). I am very much with Pamela on this one. There are no studies documenting increased meconium with use of castor oil. I have heard people being told this anecdotally quite a lot but I really think it has to do with the sample group who is willing to use castor oil for labor induction. They are overdue and more likely to have meconium. I have a friend who recently had a very successful homebirth. She did use castor oil and the baby did have meconium however so did her first birth when she didn't use it. I don't think it was every entered into my records that I used castor oil with DD's birth so I would not be included in a meconium-free group if someone was collecting data. Really in the grand scheme of things I think it's a lot better than medical/chemical induction. Yes she might just end up dehydrated but if castor oil doesn't work it's also quite possible the pit isn't going to either unfortunately.







Did want to ditto though that pit does not have to equal in bed and certainly not on your back. I probably was in bed quite a bit after I was on the iv but I was not on my back at all and that was 13 years ago. I know they have better advances in monitoring now. With DD I was monitored for the brief time I was at the hospital though I did not have an iv and I was in and out of the bed and all around. It's really up to her though she may really have to push the issue. Good luck to her.


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## Kundalini-Mama (Jul 15, 2002)

Thank you *SO* much everyone!!

She went out and got her castor oil today, and is planning the scrambled egg, root beer regime









And thank you so much for the pitocin info--she has heard me







and I'm sure it is nice for her to hear it from someone else.

She has a doula for the birth, and I'll be coming up ASASW (as soon as she wants) to assist w/breastfeeding (or not, if she chooses







)

Oh, and she is being induced for a variety of reasons, she has heavy calcification on her placenta (stage 3) along w/some HTN, lupus and hypothyrodism, so it seems like the baby will be safer out than in.

Oh, and the bestest, nonrelated news, they have decided *not* to circ!! So maybe now their son will just pop out









I'll keep you updated!
Amy


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## dynamicdoula (Jun 11, 2004)

Is there an update to this?







I'm eager to hear how things went!







:







:


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## Kundalini-Mama (Jul 15, 2002)

Thank you for the reminder.

My sister birthed her son on Sunday, 3 April, via a cesearean birth. She was in active labor for 30 hrs, and pushed for 3. The hospital thought the baby was "too big" (







), but it turned out that he was a brow presentation--hence the long, painful labor, and the lack of success while pushing. She is being d/c-ed tomorrow from the hospital, and despite the outcome, feels very empowered from her choices.

The induction, both castor oil and pit, failed. She got to 4-5cm & 80%, and they told her they could send her home, or break her water and set her up for a whole host of interventions that she didn't want. So she chose to go home. My nephew did phenomonal on the pit, and they said, that despite the placenta, the baby seemed to be thriving and there was absolutely no rush to get him out. They wanted nature to do its thing









Her doula called me before she went into the OR and told me to come down as soon as I could, when I got to the front desk and told them I was J's sister, they all started whispering..."Oh, that's J's sister" :LOL I have no idea what transpired exactly, but evidently she was very vocal about her needs....."I don't want that", "I will not consent to that", and possibly, "my sister told me...." I'm so proud of her.

I made her some soup, and am driving up w/my infant on Thursday w/a week's supply of food







I will let her know that she has been asked about









Amy


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