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Sophie Messager

Tag: choice

  • How listening to drumming can unlock your brain

    How listening to drumming can unlock your brain

    As an ex-scientist turned doula and healer, and as someone whose signature approach is to blend scientific and spiritual knowledge, I love above all else to help others embrace their woo. I also like give people a embodied experiences, because I believe that we learn best by experiencing things (especially things we might be skeptical about!).
    Using drum healing, and in particular, using drum journey (listening to drumming as a tool to unlock your brain, set intentions, and find answers) is such an experience.
    If you are a skeptic, I get you. I used to think drum healing was bullshit, and I explain my journey, which started with experiencing it for the first time in an unplanned manner, in this blog.
    You might be surprised to hear that repetitive, heartbeat-style drumming has been shown in published research to slow down brain waves, as well as to synchronise different parts of the brain and even to stimulate your immune system! For me it’s simply a faster way to enter a meditative state, and make my thoughts more fluid and creative. I find it particularly helpful to find the answer to a question I may have. A bit like having a massage can loosen your muscles or any tightness you may have, listening to repetitive drum beats can loosen your brain, making it easier to access knowledge.
    I’ve recorded a 20 min drum journey called “birthing something new”. I used a very powerful carved birth drum created by drum artist Juha Jarvinen to record this journey. I included a short guided introduction and conclusion.
    To best enjoy this process, set an intention (for example, an answer to a question you may have, or a solution to a problem), and then set aside 20 min (or even only 5 to 10 min-you do not have to do the entire journey to get the benefits) during which you will not be disturbed, and either sit or lie down comfortably. You may find that the sound works best using headphones. Relax and enjoy the journey. I’d love to hear what you think of it!

  • Do you struggle to describe everything that you do professionally under one title?

    Do you struggle to describe everything that you do professionally under one title?

    I used to struggle to define myself professionally because I thought that I needed a title that covered ALL of my hats.

    It was easy when I started after my professional reconversion from scientist to birthworker, I just called myself a doula. Then I grew, I learnt a lot of new things, and started teaching them. After a few years, I gave up some activities to make room for new things I had learnt and felt more drawn to. Soon I found myself struggling to describe what I do. It bothered me because I thought I had to find a title that covered it all.

    I discovered a new word in a French book. The word is slasheuse. A slasheuse is a multitalented professional who has carries out several activities/wear several hats in their work. The term makes reference to the slash sign being used between the different areas of their work. I like this expression because it describes me to a tee. I wear many professional hats:

    I am a scientist/doula/healer/teacher/author/facilitator.  Under each of these categories are many sub categories. Too many to put in a title.

    I’m grateful for having discovered authentic marketing coach George Kao who taught me that I don’t need to describe all of myself under one title (here is one of his articles about it ) and it is incredibly liberating.

    It’s OK to talk about each of your many work and personal life interests in turn and without a particular logic or order.

    It’s OK for people to know you only for the aspects of your work that resonate with them.

    It’s OK not to have a title that covers them all.

    If my work as a doula has taught me one thing, it is that everyone of us is unique. That we are beautiful and messy and full of paradoxes. And we are more than the sum of our work, the sum of our interests and hobbies. We are also always evolving, growing and learning new things and dropping some off. We aren’t static.

    If, you, like me, are a “slasheuse” (or a slasheur), I invite you to discover the ease and joy that comes when you stop trying to fit your beautiful unique self into tight neat little boxes.

  • The buffet curator: an analogy for doula work

    The buffet curator: an analogy for doula work

    Imagine you were going to a buffet restaurant in a foreign country, and that you had no idea what the foods on offer tasted like, or what the dishes contained.

    Imagine that you didn’t speak or read the language

    Imagine that you had your own dietary restrictions, such as being vegetarian, or being gluten free, or allergic to nuts.

    Imagine that the buffet restaurant was this enormous place, with more than a hundred dishes on offer.

    Imagine that, as you started queuing in front of the dishes, that people kept moving in front of the dishes, and that you knew people behind you would become impatient if you didn’t move.

    Wouldn’t you feel stressed? Wouldn’t you worry that you are going to pick the wrong dishes, some that you will not like, or that could cause you a major allergic reaction?

    Now imagine if you had a guide, someone who knew the restaurant and all the dishes in it.

    Imagine if, because you even entered the restaurant, your guide had taken the time to find out about your needs, made sure they understood what you wanted (and didn’t want), and then explained to you which dishes you would be able to choose from. Imagine that they had even gone and asked the chef which dishes were safe for you to eat. What if the guide could even ask the chef to prepare a different dish especially for you? How much safer and enjoyable would the experience be?

    This is what a doula can and will do for you, as you enter the maze of choices that pregnancy, birth and the postpartum bring. The many options, including ones you didn’t even know existed. The conflicting advice you find on every single topic.

    A doula is like your own buffet curator. As your doula gets to know you, your unique needs and preferences, she can sift through the many options available to you and present you with a curated list of options which you can pick from.

    You doula cannot pick the dishes for you, only you can do that, but having the list tailored to your needs might save you a lot of time and stress.

    A doula then walks the path with you, supporting you along the way and always being available to any questions as you choose, and get to decide what’s right for you. You even can change your mind at any point! Imagine how empowering this feels?

    If this resonates with you and you would like to work with me, you can find out more about the education and support I provide for families and birthworkers in the form of one to one support, and online courses.

  • Ten reasons to hire a doula even if she cannot be physically present during your birth

    Ten reasons to hire a doula even if she cannot be physically present during your birth

    What’s the point of having a doula if she cannot be present physically during the birth? Aren’t doulas just mostly hired for their supporting presence during that special time?

    Honestly when lockdown started in 2020 and hospitals in the UK introduced restrictions to one birth partner only, I asked myself the same question. I asked myself this question because despite having worked as a doula for over 8 years I had almost no experience of supporting labour remotely. I was utterly dismayed when I found out that I was no longer welcome in the hospital along the families I was already committed to supporting. Yet over the last 10 months, whilst I didn’t attend many births in person, I acquired a wealth of knowledge and experience in providing incredibly different forms of support in the forever changing rules in and out of lockdown. One thing that never changed for me locally is that my local hospital never relaxed the one partner only rule (I know that other hospitals in the country did things differently).

    Interestingly, many couples still choose to hire me for support despite knowing that I may not be able to be present at their birth. I am already booked for several different families in 2021, and including some repeat clients. I’m totally honest with people and explain from the onset that it is unlikely that I’ll be able to be physically present during their birth, unless they birth at home. But in these challenging and unpredictable times, having the support of a doula can still make a world of positive difference to your experience of pregnancy, birth and the postpartum. I’ll make a separate blog post for postnatal doulaing after this one.

    So what difference can a doula make even if she cannot be there with you at the birth?

    • 1) Antenatal education and birth choices

    In the extra challenging situation that lockdown and changing hospital policies bring, having someone to help you navigate your options is more important than ever. As your doula, I have an in depth knowledge of my local hospital policies, often being aware of policy change before members of the public. A doula can help you prepare for the unexpected and help you create birth plan that cover every possible eventuality that may present itself. It’s something doulas have always done, and I wrote a blog post called Why you may want to have a plan C (for cesarean) in your birth preferences.

    • 2) Emotional support

    Having someone you have gotten to know and trust, and who is always available at the end of the phone or email when you feel the need for support is even more important than before. In most trust there is no named midwife or a person you can contact directly within the health system at the best of times, but since March 2020, with the stretched NHS, this has become worse. Several of my clients said they left messages with weren’t returned. Just having someone you know you can call and talk to when you’ve worried about anything during your pregnancy, birth and the postnatal period, can make a world of difference to your wellbeing.

    • 3) Knowledge and information

    As before the pandemic, access to knowledge and information is a big part of doula support. There is a whole maze of information to navigate! Where will you have your baby, what kind of birth do you want, what if you cannot get your preferred choice, what are your rights, what’s the scientific evidence behind what you are being offered, what is right for you, yours and your family’s unique circumstances? I can help you access a whole network of people, from other health professional to complementary practitioners outside of the NHS, from osteopaths to complementary therapists to breastfeeding professionals.

    I supported a family who wanted to have a VBAC (Vaginal birth after cesarean). They wanted to be in the local birth centre but had been told this wasn’t possible. They weren’t based in Cambridge, but through my network of birth workers, I obtained the details of the consultant midwife at their local hospital. They had a meeting with her and got granted access to the birth centre. They had a beautiful empowering waterbirth there.

    I also supported a woman who was facing an induction of labour that she didn’t want or felt was justified. We had a chat over the phone and I reminded her of her rights to choose, ahead of a meeting with her consultant. I received a very grateful email afterwards explaining that she had felt much calmer and confident going into the meeting thanks to our chat, and that the meeting had gone very well. She went into labour naturally.

    • 4) Practical support

    I am skilled in many support techniques that can help make your pregnancy, labour and birth, and postpartum period more comfortable. I can teach them to you, or signpost you to someone who can support you if you aren’t local to me.

    In 2020 several of my clients had breech babies, I was able to teach positional and rebozo breech turning techniques via video calls (I became very good at using a tripod to hold my device, and at contorsioning myself to demonstrate positions!) or in person. I was also able to signpost them to osteopaths who helped balance the pelvis so the baby had more chances to turn, or to acupuncturists who taught them how to do moxibustion. I also helped to access the information to help them decide whether having the baby turned manually (known as an external cephalic version) with an obstetrician was the right choice for them, as well as what would happen during the procedure/

    • 5) Labour preparation

    I can help you be prepared for what do expect during labour and birth, and decide what kind of comfort measures you’d like to use, and explore their pros and cons. I can teach you such comfort measures so you are feeling prepared and confident, even when I’m not physically present.

    In 2020 I started writing custom relaxation scripts to help with things from promoting relaxation and confidence, to help turn a breech baby, to help labour start when due date had passed and an induction date was looming. I recorded myself as I lead expectant parents through those scripts and sent them the recording to listen to. One couple reported that they went into labour after listening to the “overdue” relaxation script I had sent them over and over again, and that the mother went into labour despite the pressures of the looming induction and had a very straightforward birth.

    As well as teaching you some of the many comfort and relaxation measures for labour I know, I can teach the ones that suit you to your partner. This means that your partner will feel more confident in supporting you, that the two of you can work better together, and that you are both likely to have.

    • 6) In person Labour support

    As a doula, I’m still able to provide in person support in early labour at the couple’s home. This means that I can come and support you when labour starts, and help you feel comfortable, confident and safe. This means that you do not have to worry about when it is the right time to go to the hospital (or call the midwife if you’re having a homebirth). This means that there is a reassuring presence in the background. It can help both you and your partner feel much calmer and safe. It means that you are more likely to have a straightforward experience, especially if this is your first baby and you do not know what to expect or what is normal.

    All hospitals still allow one partner, and I have supported families who chose to have me being present at the birth in the hospital, for example if the partner had to stay at home to care for older children.

    • 7) Remote labour support

    Because we will have gotten to know each other well, you’ll have come to trust me and feel safe with me. By the time you are in labour, knowing that there is something you can call at any hour of the day or night, and that I will be there

    As I mentioned at the beginning of this blog, I was myself unsure of what difference I could make remotely. I was pleasantly surprised to find that I could still make a world of difference during labour.

    I could join couples at home in early labour, I could be there on the phone or video calls in early or later labour. Because I had prepared the partner with extra techniques, when they called me describing a stall in labour, I was able to guide them through specific rebozo techniques designed to help resolve such issues with great success. I was still able to provide advocacy and help people navigate their options.

    During a birth in 2020, a partner called me as labour had stalled and there were talks of moving to theatre. As I had taught him some of the most useful labour dystocia resolving techniques I know. After asking him a few specific questions I suggested a couple of positional and rebozo techniques. The baby was born vaginally 40 min later. Another partner called me telling me that his wife had been pushing for 2h, and that due to arbitrary limits on pushing duration from the hospital, transfer to the delivery unit was being strongly suggested. He asked if they could refuse. After asking if both mother and baby were well, I reminded him that it was their decision to make. The baby was born in the birth centre pool 20 min later.

    A challenging time last year was when I had to watch a woman that I had previously supported as a doula 3 times before, walk into the hospital alone for her planned cesarean birth (my local trust currently only allows partners in the ward as they go into theatre, so the mother is alone in the antenatal ward until she gets called to go to theatre). I went to meet her in front of the hospital. I thought I hadn’t made a difference but later one she said “It definitely helped to still have you as my doula in lockdown as it was really lovely and comforting to know you were just at the end of the phone for a chat or advice. It was also lovely to see you outside the hospital before I went in, and to talk to you in the evening about the birth”.

    Zelle the doula shared this account of supporting a birth over the phone (you can read the whole story here)

    “It feels like she’s wrenched the phone out of her husband’s hand, as her eyes lock on to mine “Zelle!” she breathes as a surge crashes like wave over her “Zelle-I-really-need-an-epidural” she scrunches her face up “I can’t CAN’T do thissss”. I am calm. An even tone. The bit I wish I was there for, because I would stroke her hair out of her face and be gentle with her poor tired body and be slow and gentle and grounding. I have to do it all with my voice instead. “A,” I say. “You are so strong. You are magnificent. This is transition, that hard bit we talked about. This feeling will leave.” I’m conscious of the fact the adrenaline will kick in momentarily. ” You know what to do. Your body knows this. You’ve been in labour a *long* time. It’s a lot of hard work. There’s no shame in an epidural if you want one. But you’re wrong on one point, A, you CAN do this. I completely believe with every fibre of my being that you can do this. I believe in you.” She shoves the phone back in to her husband’s hand. “I CAN do this!” she breathes. I am so proud I wipe tears away.”

    • 8) Navigating the unexpected

    If anything happens during pregnancy, birth or the postpartum you can rest assured that I will be there to help you navigate the situation. From labour starting early or labour, or a sudden diagnostic of a medical situation which changes your birth choices, I have supported these kinds of scenarios for the last 8 years and I know how much of a difference it makes to have someone by your side to help you find out how to make the best of it.

    • 9) Postnatal preparation

    Postnatal preparation and support is one of my favourite topics. I feel it is so important that I wrote a book about it, called Why postnatal recovery matters. As your doula, I can help you prepare for the postpartum, be it the immediate few hours post birth in the hospital or at home (including how to prepare for the fact that most partners may not allowed to visit postnatally in the hospital), or the later parts from coming home with your baby, from feeding choices to parenting choices. As part of my contract you get 6 weeks of unlimited phone and email support after the birth of your baby.

    • 10) Postnatal support

    After your baby is born, especially if you are alone in a postnatal ward without your partner, or if you have your partner but medical staff is too busy to help support you, I can do call or video calls as soon as you need me to help answer any needs you may have. I have become skilled at provided feeding help over video calls, either myself or putting you in touch with breastfeeding counselors, who have also become very skilled at providing feeding support over video calls. More in my next blog on postnatal support during lockdown.

    Finally, here is a story from a mother I supported in 2020:

     “It would be easy to feel like pandemic restrictions preventing extra birth partners would make hiring a doula pointless. After all, if they can’t be at the birth, why bother, right? I might have felt the same, if it weren’t for our experience of growing and birthing our daughter in 2020 with Sophie’s help.

    When the pandemic hit, and suddenly even my husband wasn’t allowed in to scans or appointments. Secondary birth partners were banned from births completely. These restrictions still hadn’t been eased by July, when I unexpectedly entered prodromal labour at 36 weeks gestation. After a week of contractions at home that weren’t getting any more frequent, I entered the hospital to have my labour artificially progressed. I laboured, for large parts alone, for five further days, before finally delivering my daughter by c-section (or belly birth, as I like calling it!). Again, even getting my husband into hospital to support me was a fight. The presence of a doula was a complete non-starter.

    So do I regret hiring Sophie? ABSOLUTELY NOT.

    If anything, I am MORE grateful we did because of COVID. More than ever, being asked to navigate the labyrinth of the maternity care system is a nearly impossible challenge women are being asked to undertake. Especially in a pandemic, alone. I have no idea how I would have begun to survive it without the preparation Sophie did with us, and the support she still managed to provide both during and after our birth.

     I had the space I needed to process rather than internalise my grief. I had the planning and preparation I needed to take care of myself both during and after the birth. I had the support I needed to bring my baby home to an overjoyed family that was ready to receive her. I had the confidence to know I can be and am exactly the mother she needs. I was left so in awe of the work of doulas that I’m becoming one. ” Elle.

    If you’d like to read more about this topic, I wrote a blog called The Value of a doula, one called What do you get when you hire a doula, or why she’s totally worth the money, one about how a doula can support you if you are having a planned cesarean birth, and one called The incredible things doulas do to support their clients. Whilst these were written before 2020, much of what I explain in them still applies.

    If this resonates with you and you would like to work with me, I offer education and support for families and birthworkers in the form of one to one support, and online courses.

     

  • Inducing labour with Castor oil : is it safe?

    Inducing labour with Castor oil : is it safe?

    Castor oil induction has bad press in the UK. Negative stories abound, claiming severe negative effects on mother and baby. For years, I too believed this to be true. I took it for granted that it was dangerous.

    A couple of years ago a doula told me that several of her clients had successfully induced their labour with it, and that the stories didn’t match their experience. She also said that, faced with the prospect of a long induction in an antenatal ward, some women felt that it was a lesser evil. This conversation spurred me to look for the research. I was very surprised to find that it was actually quite safe, and that the stories didn’t match what the published research said.

    Birthworkers often talk about strongly held beliefs within maternity care, that turn out to be myths. You know, the kind of belief that everybody seems to have, without question, that gets perpetuated through stories, yet when you analyse the research you find that there is very little evidence to back it up (the placenta “failing” at the end of pregnancy being one of the most common ones). After reading the research on induction with Castor oil, I was embarrassed to admit that I’d fallen prey to this myth believing myself.

    I cannot help but wonder how Castor oil came to have such bad press in the UK. For some reason it has fallen out of fashion here (Midwife Becky Reed told me that it used to be used in the UK in the past), and yet it is still more commonly used in the USA. A survey of 500 US midwifes in 1999 showed that it was the most commonly used natural substance used to induce labour.  American Midwife Ina May Gaskin mentions it in her Guide to Childbirth. When Ina May came to a the Doula UK conference in 2017, doula Sue Boughton asked her what she thought of it and she said that it was perfectly safe and that they used it all the time.

    This is what Ina May says in her book, Ina May’s guide to Childbirth:

    “Indigenous peoples all over the globe have used castor oil to induce labor for centuries. Taken orally, castor oil acts as a laxative, and the stimulation of the digestive tract often starts labor at term. No one knows why castor oil works to start labor. When there is little or no money to be made as a result of research, generally little or no research is done. Nobody has figured out how to make an appreciable amount of money from castor oil, so this subject has received virtually no research attention. Nevertheless, castor oil seems to be quite safe. Nearly nine percent of nearly eleven thousand pregnant women in a large birth center study used it to start labor, with no adverse outcomes. At The Farm Midwifery Center, we recommend beginning a castor-oil induction at breakfast after a full night of sleep. One tablespoon of castor oil is added to scrambled eggs or is mixed with fruit juice to make it more palatable for the women. If necessary, she takes one more tablespoon one hour after ingesting the first.”

    I want to share what the research says, to help you decide whether you think that castor oil induction is a good idea or not, and also so that there is an up to date review of the evidence to signpost women to, if they feel that it is an option that they would like to explore.

    Before I do this I need to give an important disclaimer: I believe that our culture’s obsession with inducing labour as soon as a certain date has reached  is not only unhealthy, it is also not based on solid scientific evidence. I wrote about this before in this blog. Therefore I want to be clear that I haven’t written this blog to encourage women to induce labour with castor oil. It is designed to provide a review of the evidence so that people can make truly informed decisions.

    what is Castor oil?

    Castor oil is an oil extracted from castor beans, which are produced by the castor plant, Ricinus communis. It has laxative properties. (It is often used to empty the bowel in a medical setting prior to examinations )

    How does Castor oil work?

    The way Castor oil stimulates labour was only elucidated in 2012. Contrary to popular belief, castor oil doesn’t only work by only stimulating the gut (though this might play a role in the process as well). After being ingested, castor oil is broken down in the intestine, releasing ricinoleic acid, the main fatty acid in castor oil. Ricinoleic acid attaches directly onto receptors which are present in both the bowel and the uterus. As well as stimulating contractions of the smooth muscles in the bowel, research has shown that it causes uterus tissue to contract, and that in mice that lack its target receptor (prostaglandin receptor EP3) it does not produces uterine contractions.

    How is it taken?

    Castor oil is taken orally. Although Ina May Gaskin suggest a tablespoon or two (A tablespoon is about 15ml), most of the research studies used a dose of about 60 millilitres (so 4 tablespoons). It is usually suggested to mix it with fruit juice to make it more palatable. Interestingly, in one paper the authors used sunflower oil as a placebo and said that women couldn’t taste the difference between Castor oil and sunflower oil once it had been mixed in orange juice. One publication refers to a cocktail or smoothie as follow:

    • 2 ounces castor oil
    • 1 cup champagne
    • 1 cup apricot nectar
    • 4 tablespoons of almond butter.

    How effective is it?

    There is a Cochrane review of the literature from 2013, which includes 3 studies: . The three trials included in the review contain small numbers of women. All three studies used single doses of castor oil. The results from these studies should be interpreted with caution due to the risk of bias introduced due to poor methodological quality. Further research is needed to attempt to quantify the efficacy of castor oil as an induction agent.

    • In one study of 47 women, there was a significant increase in labour initiation in the castor oil group compared with the control group (54.2% compared with 4.3%)
    • In one study of 100 women , 52 women received castor oil and 48 no treatment. Following administration of castor oil, 30 of 52 women (57.7%) began active labour compared to 2 of 48 (4.2%) receiving no treatment. When castor oil was successful, 83.3% of the women had a vaginal birth.
    • In one study of 80 women (37 in the treatment group and 43 to the control group) the odds of entering the active phase of labour within 12 hours of administration was 3 times higher among women receiving castor oil compared to women receiving a placebo.

    Two other papers not included in the review, were published in 2018. In one of these papers, 323 women (who birthed in a birth centre) used castor oil to induce labour showed that 81% of the women gave birth vaginally, and the authors stated that this was significantly higher than the national average. They concluded that ” Our results show women who consumed a castor oil cocktail to induce labor experienced adverse fetal and maternal outcomes at very low rates. Further research, including a clinical trial, should be conducted to test the safety and efficacy of castor oil as a natural alternative to labor induction.”

    In the other paper, 82 women were divided in 2 groups of 38 and 44 , and respectively received castor oil and a placebo (sunflower oil). Of the women who received castor oil, 42.1% entered labour within 24 h, 50.0% within 36 h and 52.6% within 48 h compared with 34.9%, 37.2% and 39.5% in the control group. The authors also found that castor oil was effective in stimulating labour in multiparous women (women who had already had at least one baby) but not in first time mothers. No differences in rate of obstetric complications or adverse neonatal outcomes were noted.

    I tried to find some research to compare the effectiveness of Castor oil versus the most common form of drug used to start the induction process in the UK : Prostaglandins, which are usually administered vaginally. This proved complex because the Cochrane review cites many different studies, all with different populations and different outcomes. For example one study with women of mixed parity (first time mothers and multiple pregnancies mothers mixed together), found that, in a study of 343 women with a favourable cervix (this means their cervix was already in a condition close to labour) and a 3mg dose of prostaglandins, found that 12% of women were still pregnant after 24h versus 100% of women who didn’t have the induction. In a smaller study of 39 first time mothers with an unfavourable cervix and a smaller dose of prostaglandins (2mg) compared with a placebo, 79% of the prostaglandin group and 90% of the placebo group were still pregnant after 24 hours. When combining the data the reviewers could not reach statistical significance. The reviewers conclude after looking at all the studies that ” Overall therefore, although not certain, it is likely that vaginal prostaglandin E2 compared with placebo or no treatment reduces the likelihood of vaginal delivery not being achieved within 24 hours.”

    This gave me pause for thought, because on one hand, our culture can be quick to dismiss natural remedies as quackery and non evidence based. Yet I was surprised to discover that the research doesn’t show prostaglandin pessaries as being a very effective drug when it comes to labour induction, but because this is part of the normal maternity care, this doesn’t get questioned. You might be surprised to hear that only 9-12% of the royal college of obstetrician guidelines are based on high quality evidence. I also couldn’t help but wonder how many of the women who get offered an induction of labour get given the statistics about how successful the process is likely to be.

    What are the side effects of Castor oil?

    The most common side effects are diarrhoea (which is to be expected as Castor oil is a laxative) and nausea.

    • In the study of 47 women, 45.8% experienced nausea versus 0% in the control group.
    • In the study of 100 women , 100% of women who took the castor oil reported nausea compared to 0% of the women in the control group.
    • Contrary to the high level of nausea and diarrhoea described in the studies above, in the first 2018 study, out of 323 women, only 7 (2.2%) experienced nausea. The authors concluded that ” In the current study, the low incidence of maternal and fetal adverse effects suggest castor oil may be a safe and agreeable way to stimulate labor and avoid unnecessary caesarean birth. Although previous studies cited adverse maternal effects (e.g. nausea, vomiting, diarrhea) as a barrier to castor oil use, participants in this study who received the castor oil cocktail reported a low rate of these effects. In fact, less than 4% of the sample experienced nausea, vomiting, or extreme diarrhea.”
    • In the other 2018 study, 32 out of 81 women (40%) experienced an increase in bowel movement, 4–6 h after ingestion of the oil (42.1% in the intervention group and 37.2% in the control group (who received sunflower oil). The authors did not observe any serious adverse events, and concluded that “Castor oil is an effective substance for induction of labor, in post-date multiparous women in an outpatient setting“.

    Castor oil does not appear to cause severe side effects on the mother or baby. The Cochrane review authors concluded that “There was no evidence of a difference between castor oil and placebo/no treatment for the rate of instrumental delivery, meconium‐stained liquor, or Apgar score less than seven at five minutes.”

    What else matters when it comes to decision making?

    Beside the science showing that Castor oil appears to be pretty safe and effective, there are other aspects to consider. As I explain in this blog , induction of labour is an intervention that has many pros and cons, and you have to weigh the balance of pros and cons for you as a unique individual, with your own unique circumstances. And it is also important to remember that Castor oil IS a form of induction, regardless of the fact that it is a natural substance.

    What are the possible advantages of using castor oil to induce labour?

    • It can allow women to remain in control of the start of the birth process, and to choose where they give birth. When labour is induced in a hospital ward, you are committed to a process, which restricts your birth options. In most hospitals, being induced means the only option is to labour in the antenatal ward (though some hospital offer outpatient induction), then give birth in the labour ward. If you induce labour at home then you remain in control of the choice of place of birth, whether at home, in a birth centre, or in a labour ward.

    The authors of the first 2018 paper stated that ” By stimulating labor and decreasing the necessity for intervention via cesarean section, castor oil as a method of labor induction may enable women to adhere to their birth plans (e.g., at a birth center, vaginally, etc.), benefiting from these positive outcomes”

    • It can allow women to remain in their own environment, with their support partners of choice. Induction of labour can take days, and it is sometimes stopped or delayed half way through if the induction or labour ward becomes full. Because of this, in the recent past I  saw many women undergoing induction lasting up to 5 days. Now in 2020, the new visitor restrictions due to Covid19 mean that partners aren’t allowed in the hospital until women are in established labour. For the mother this may mean days of early labour without any support from anyone she knows and trusts, as well as having no one to help advocate for her.

    I have supported such births recently and they felt very frustrating for the mother, her partner and myself. I provided remote support over the phone, but in my experience the induction felt more upsetting than usual with the lack of face to face support from the partner and myself. I know this frustration is shared by others, and a recent publication has highlighted how women’s rights in childbirths are not being respected since the beginning of pandemic:

    “The position of the rights of women in childbirth is in this context a precarious one. Stories have emerged in mainstream media – supported by personal accounts received by global and European birthrights organizations – of women having their labor induced, being forced to have cesarean sections, giving birth alone, and being separated from their babies immediately after birth.”

    • Impact on support after the birth

    Women whose labour is induced are more likely to end up with medical interventions such as caesarean or an instrumental birth, which may mean a longer stay in the hospital post birth. With Covid restrictions in place, partners are only allowed in postnatal wards for a 1 to 2h visit daily. If a new mother is recovering from a caesarean, or if she is very tired after a long labour and birth, this simply isn’t enough support for a her to get some rest and recover after the birth. Nobody is there to comfort her, or to hold the baby whilst she sleeps. I have listened to many harrowing such stories from new mothers to know that this is a very difficult situation to be in.

    What are the possible disadvantages of using castor oil ?

    • The side effects mentioned above might not be acceptable to some women or their partner.
    • Some women may feel safer being induced in a medical setting.

    In conclusion:

    Using Castor oil to induce labour can cause side effects such as diarrhoea and nausea but it appears to safe for mother and baby. It is also a fairly effective, especially when women have already had one or more babies. Some families may perceive that it is important for them to retain control over the induction process, and may decide that having the diarrhoea and nausea might be an acceptable side effect, compared to the reality of being being induced in a hospital setting.