Food is powerful. Throughout history healthy cultures have used special foods or diets during pre-conception and pregnancy to promote fertility, healthy pregnancies, and easier childbirth. Some of these have been studied by modern science, and some really haven't, but in general they have a long track record of benefits and almost no associated risks, so why not try a few? You and your baby may benefit greatly.
Keep in mind that none of these foods or supplements are meant to induce labor. Your baby will come when he or she is ready! But a well-nourished uterus is efficient and strong, and this may help to promote a faster, easier birth for both of you.
Fish Oil and Fatty Fish
Many studies have suggested that fish and fish oils have many benefits for pregnant women and their babies. Some of these include the reduction of chance of miscarriage, incidence of preterm labor, and even complications such as pre-eclampsia and gestational diabetes. The most likely reason for this is that fatty fish and fish oil are quite high in omega-3 fatty acids, which balance out the omega-6 fatty acids that are a little too common in many modern diets, which, in turn, reduces inflammation in the body and the placenta.
Eating fish is sometimes discouraged during pregnancy, usually out of concerns of excess consumption of fish that can have high levels of mercury. Generally these are predator fish that grow very large and tend to accumulate more mercury and other toxins from the environment. It's certainly a good idea to limit or even avoid shark, swordfish, king mackerel, and tilefish. It's also wise to avoid farmed fish for the same reason that factory-farmed meat is also on my 'avoid' list- it is not nearly as nutritious and the animals are not raised in an environment that is healthy or normal for them. So what varieties of fish are advantageous for pregnant women, and why should you eat them, if possible?
The Mayo Clinic suggests that wild-caught salmon, anchovies, herring, sardines, and Atlantic and Pacific mackerel are all safe choices for pregnant women. Shellfish such as shrimp, clams, lobster, and scallops have also been prized by cultures that lived near the sea for their role in fertility and healthy pregnancy, and these foods tend to be low in environmental toxins.
Although it was the observation that groups of women who ate more whole fish experienced less preterm birth and other pregnancy complications than those that ate less or no fish, most studies have been done on fish oil supplementation rather than fish consumption itself (likely because it's easier to measure and track fish oil supplements). What evidence can we find there? One large study found that for women who had experienced a previous preterm birth, or other high-risk pregnancy complications, fish oil supplementation was show to reduce the rate of preterm birth by 44%. This study also demonstrated a benefit in reducing preterm birth. These Australian researchers argued just last year that fish oil supplementation should be standard at the population level to help reduce the preterm birth rate, since the positive effect has been fairly well established and there are no established risks to supplementation.
One caveat here is that most studies involving fish oil report a lengthened gestational age, usually between 4 and 7 days. This isn't necessarily a bad thing, because the preterm birth rate is generally reduced, and in fact may be a positive side effect, but this also may increase the pressure for induction of labor if pregnancy continues past 41 weeks. (Find lots more information on the evidence regarding induction of labor past 41 weeks, and the myth of the estimated due date Here.)
I think it's good to remember that women experience the most benefits when consuming the ENTIRE food. The original research into fish oil came about because women who consumed fish were known to have longer pregnancies and babies who weighed more. Although supplementation with fish oil may be helpful, consuming low-mercury, wild-caught fish like salmon on a regular basis is really the wisest course of action.
I'm going to be honest, though. I don't enjoy eating fish. And I really dislike salmon. So I supplement with fermented cod liver oil from Green Pastures. You can look it up here.
Dates are commonly used in the Middle East for labor pain; even the Qu'ran refers to Mary being instructed to eat dates before her labor with Jesus. Interesting stuff! So what evidence is there that dates may actually have an effect on childbirth?
A recent study carried out on a relatively small amount of women (69 women consumed dates and 45 did not) had a pretty amazing result. After only 4 weeks of daily supplementation with dried date fruit, women who ate 6 dates per day, 4 weeks leading up to their estimated due date (hahaha) had significantly shorter labors, less induction or augmentation of labor, and a higher percentage of intact membranes at admission to the hospital than the women who ate none. And when I say that labor was significantly shorter, I mean 7 HOURS SHORTER. You can read the abstract here.
Why might dates have such a helpful effect on labor? Simple! They are very nourishing! Although each variety of date is unique, these sweet fruits contain at least 15 minerals such as potassium, calcium, iron, magnesium and zinc, 23 types of amino acids, vitamins, carbohydrates, protein, 14 types of fatty acids, dietary fiber and a lot more. A nourished body and uterus work more efficiently to give birth than one that is lacking, and dates can help to fortify the whole system.
Another fascinating study also examined if dates can help to reduce postpartum blood loss BETTER than pitocin, and they did! Amazing. You can find it here.
The bottom line? Although there are many factors that go into the length of a woman's labor, there does seem to be something to the idea that dates can help to shorten it. They also may help to lessen the chance of excessive bleeding after birth. Better yet, they are yummy (most people think so, anyway). And they certainly won't hurt you!
Although there is some debate about the effectiveness of ascorbic acid (the synthetic form of Vitamin C that you often see in supplement form), or the natural form found most often in acerola cherries and other fruits and vegetables (and even raw milk, but NOT in pasteurized milk), there is no doubt that Vitamin C is hugely important in human health, and especially for pregnant women.
Vitamin C deficiency is implicated specifically in premature rupture of membranes and preterm birth. One study found that supplementation of just 100 mg of ascorbic acid reduced the incidence of premature rupture of membranes by over 75%! This study was similar and demonstrated that women with a previous history of preterm birth had a much higher chance of carrying to term if they took Vitamin C supplements from 14 weeks gestation. Preventing premature rupture of membranes can be very important for women who have a higher risk of going into labor before 37 weeks, or those desiring a birth that is not induced, since usually after the amniotic sac has ruptured, hospital guidelines require that a baby be born by 72 hours at the latest (and sometimes as little as 24 hours).
I do think that it's important to note that some studies have not shown a link between Vitamin C supplementation and prevention of preterm birth or premature rupture of membranes, but since there is really no known risk to supplementing with Vitamin C, and especially not for the relatively short time period of pregnancy, I don't see a reason NOT to try it. Some Vitamin C supplements are derived from genetically-modified sources, so avoiding those is important to me personally. I tend to prefer whole food supplements, but those may be prohibitively expensive for some, and the reality is that MOST studies have used plain 'ol ascorbic acid, but still demonstrated a benefit to pregnant mothers.
Have you tried any of these strategies for preventing preterm birth, premature rupture of membranes, or prolonged labor? What was your experience?
Next up.....supplements that I cannot recommend as a doula, no matter how popular they are...
I look at birth from the perspective that our bodies are wonderfully made, and if we really believe that and work with the birth process and nourish our bodies properly, they will function optimally, most of the time!