Get Yer Freak On. Doula's Orders.

Today is my May Mama's estimated due date.  Well okay, her original EDD is the 28th, but they pushed it back to today because of imaging.  Which means I'm still considering her to be due on the 28th.

When I talked to her today, she was anxious.  Her last two babies had been born at 39.5 weeks exactly, and going "past" her due date was worrying her.  I reassured her that all babies are born eventually, and besides, as her midwife already said, third babies tend to be the odd ones out.  Old wives' tale, sure, but backed up with years of observation by pretty much every midwife I've ever talked to.

Then, showing my nerd-colors a bit, I reminded her that babies, like wizards, are never late.  They arrive precisely when they mean to. 


We went on to have a good conversation about inducing labor naturally.  And no, I'm not talking about smearing your vag with evening primrose oil or doing shots of castor oil.  I tend to be cautious about those methods when a mama isn't being threatened with medical induction, since they tend to have negative side-effects that are, let's say, unpleasant.

But to simply get things going, I always say, a mama needs to simply have a really good night: get a nice long foot/calf massage, have a half glass of red wine, and have some good sex.  Or as I call it, the Sex, Booze, and Foot Rubs Method.

While the above methods tend to be looked at as mere old wives' tales, there is in fact scientific basis for their use.  And besides, unlike castor oil and assuming we're only recommending a half glass of wine, there is little to no risk of negative side-effects.

Here's why they work!

The Sex

Oxytocin, the so-called "love hormone," is at least partly responsible for three distinct physiological events in a woman's reproductive cycle: orgasm, labor, and breastfeeding.  As a sex-positive doula and lactation educator, you might say that oxytocin is my homegirl.

The female orgasm was once thought of as relatively inconsequential to the reproductive process.  In fact, some fertility specialists have even suggested that orgasm "dilutes" a woman's chance of becoming pregnant.  (I call bullshit.  Also sexism.  But that's another post.)  Au contraire, says a bulk of new-ish research that essentially reaffirms what lay-health workers have been saying for years: orgasm increases your chances of conception.  See, when a woman orgasms, her body releases even more vaginal secretion than she does when simply "aroused," helping to lubricate the sperm's path to the egg.  Additionally, the oxytocin released via orgasm contracts the uterus, lowering the cervix (the "neck" of the uterus) and making the uterus more accepting of a fertilized egg (ever wonder what that tight feeling in your lower abdomen was?).

Sidebar: Oxytocin is also associated
with trust, which helps explain why
women who have good relationships
with their care providers tend to have
smoother labors.

So oxytocin contracts the uterus.  Hence labor.  But the wonder-hormone's job isn't over when the placenta is delivered.  Oxytocin is also responsible for the milk "letting down" during breastfeeding.  See, when a woman first lays eyes on her baby, she's essentially OD'ing on oxytocin, as is baby.  That's the love hormone doing its job.  Baby will hopefully find her/his way to a nipple and begin suckling.  When the nipples are stimulated, oxytocin is released from the posterior pituitary gland, contracting the tiny myoepithelial cells inside the milk ducts, forcing milk out of the breast and into baby's mouth.  That oxytocin release is still doing it's job "down there," helping mama's uterus to clamp down post-delivery, thus reducing risk of excessive postpartum bleeding. 

I mention the connection to breastfeeding because oxytocin is also released with nipple stimulation.  Women who are into nipple stimulation during sex may enjoy it for a number of reasons, but physiologically it's because that burst of oxytocin contracts the uterus (which essentially puts interior pressure on the clitoris and, well, you get it).  In other words, if you're into nip-stim, include that in your labor-inducing sex practice.  Otherwise you can just turn on your breast pump when you're finished doin' the deed, and you will probably get a lot of the same benefits.

If a woman is having sex with a man, his stuff may play a labor-inducing role as well.  Semen contains prostaglandins, autocrine hormones that help to soften ("ripen") the cervix.  A softer cervix makes the fertilization/implantation process more likely, but these hormones work the same when a woman is already pregnant.  The low dose of prostaglandins in semen alone aren't likely to induce labor in a woman who's not yet term (which is why care providers don't warn against sex during pregnancy unless a woman is at risk for preterm labor), but the mild softening in a term mama might just be enough to tip her into labor mode.  As an added bonus, if he's, let's say, "gifted," his penis hitting against the cervix may indeed induce some mild (but not earth-shattering) uterine contractions.

Captain Obvious moment: I generally don't recommend the prostaglandin method if a mama is in a relationship where she's at risk for a sexually transmitted infection.  The last thing she needs is to be infected with an STI right before a baby comes squeezing through her vagina!  If infection is an issue, sex with a condom still contains the benefits of oxytocin and cervical pressure.  Masturbation is a safe and effective alternative for women who don't have a partner (or just simply don't want to engage in partner sex).  Again, oxytocin is stronger than prostaglandins... go team vag!

The Booze

While its use remains controversial amongst even the most alternative midwives, wine in small quantities (a glass or less) is thought to help the mother's body relax through the anxiety that often hinders the body's ability to start labor on its own.  Anxiety leads to the release of catecholamines, the "stress hormone" which interferes with the release of oxytocin.  So while the alcohol itself does not induce labor (it can, in fact, cause vasodilation, which actually hinders labor progress), a bit of wine to "take the edge off" of what ever stress a mama may be experiencing can help things along. 

The Foot Rubs

There are several pressure points in the feet and ankles that, when massaged, may induce uterine contractions.  The first is in the soft area between the achilles tendon and the medial malleolus (the "knotty" bone on the inside of the ankle).  The second is about four finger-widths above the malleolus.  Even if the massage does not actually induce contractions, a nice ankle rub may help with the ankle swelling many women experience as they get further along in pregnancy.

A midwife also once told me that the heel is a reflexology point to the cervix.  In fact, she says, you can often read how effaced (soft) a woman's cervix is by compressing her heel, and can often soften a "tough lip" by rubbing out hard points.  I have no research to back that up, just one midwife's anecdote.

And by now my May Mama has called and said that since I gave her the above information, she's been contracting steadily (but lightly) for the past little while.  So there.  Get yer freak on, doula's orders.