In Part One of this (admittedly rather short) saga, I found myself in a position that I hadn't expected as a doula, and it was leading to quite a few conflicting emotions. Most who know me in real life probably know how I strongly dislike hypocrisy...yet here I was, attempting to self-induce labor for a reason which many may not even feel is particularly valid (short answer...mainly financial).
Many midwives and doulas feel that negative emotions or doubts surrounding birth can hinder the birth process, and since I had experienced two pretty fast and uncomplicated births, I was also concerned that I was setting myself up for a more difficult labor by inducing labor, not to mention during the day. Both of my other labors had started at night, and I just felt that was when I was "supposed" to be in labor.
Back to the induction...
Still, when my mom arrived with the castor oil and root beer, I promised her that I would take it at 11:00 am, 41 weeks and 4 days pregnant. Before then, I called my midwife to get some final directions on preparation. She was so sure that this would work, she said that she was going to take a nap to make sure that she would be well-rested for that night! I still had my doubts.
At 11:00, I took 1 tablespoon of castor oil, mixed it with some vanilla ice cream, poured in some root beer, mixed it again, and then added more root beer. (If you're looking for more exact measurements, you won't find them here. This is just the way I prepare everything. It drives my husband crazy). At this point, I didn't even bother with all natural, organic root beer. I'm already compromising my ideals, so why bother? *insert sad ironic laughter*
It actually wasn't that bad. And so we waited. At 2:00 pm I took another dose, which is pretty common from what I've read, especially with the low-dose castor oil induction. I tried to go about my day as normally as possible, but the frustration was slightly setting in.
NOTHING WAS HAPPENING. And I do mean nothing. No extra bathroom trips, no nausea, contractions....nada.
At 4:45 I sent my midwife a text message lamenting the fact that nothing was happening and I really had hoped that I wouldn't have to make dinner. Selfish, I know. But then....
I felt the familiar, although mild, sensation of a contraction. In my three births they have always started out the same way and just gotten progressively stronger. Really low, tightening sensation, pretty much like a menstrual cramp. 6 minutes later, I had another one. BINGO! Since my previous births were fast, I went ahead and told my midwife, and she said that she would meet us at the birth center at 6:15.
I was pretty happy that SOMETHING was changing, but I still felt really strange. This wasn't supposed to be how my labor started. I had imagined waking up in the middle of the night or early morning with contractions. The daylight was throwing me off, the crazy children were jumping on the couch, the sun was still streaming through the windows. Not surprisingly, my contractions nearly stopped in the hour before we got to the birth center.
As we arrived, I honestly felt silly that we were even there. I wasn't feeling much of anything other than some really spaced-out, weak contractions. But, my midwife didn't seem concerned. My husband encouraged me to think of the whole experience as a night at the spa..which was actually a really great idea. He prayed with me, the kids went to play with Thomas the Train (and Friends, of course), and I was left in the "birth cave" room with the diffuser, a birth ball, my chosen music, and, OBVIOUSLY, twinkle lights.
10 MINUTES LATER (around 6:30) I walk into the kitchen at the birth center. "Okay, I want to get in the tub now". The tub has a curtain; how amazing is that?! Contractions were 2-3 minutes apart, at least a minute long. Not too bad, though. (I took a LOT of RRL tea and ate pounds of dates throughout my pregnancy.)
Time gets really fuzzy after this, but about 15 minutes in my husband left to get food. Maybe 30 minutes later I mentioned to my midwife that she might want to send him a message and tell him to come back. I wasn't feeling pushy yet, but I could tell that each contraction was getting me closer to that point. The midwife was sitting quietly in the corner, and we were both pretending like she wasn't there. I started to get that desperate, "I need to get this over with" feeling, AKA, transition.
My husband walked in, and I started pushing. Pushing is just a crazy, disconcerting feeling to me. I would love to be like those women that I've seen with the calm, controlled demeanor while squeezing a (not so) tiny human out of their bodies, but that isn't me. I guess it never will be. Like my two others labors, my water broke right as I started pushing. A few minutes later, at 7:34 PM, Corbin was born, all 8.5 pounds of him. He was almost 1.5 pounds bigger than his younger brother, and I believed it.
So much for my spa experience; we were at the birth center a total of 3 hours! (Even with delayed clamping, skin-to-skin, immediate breastfeeding and being pooped on three times...)
The only way that the castor oil changed my experience of labor was by making it happen a bit earlier than it would have. I didn't have any negative side effects, and my labor, which was about 1 hour from regular contractions, felt basically the same as my others, just faster. As much as I would have liked to go into labor on my own with this baby, I would likely make the same decision again if in similar circumstances.
I wonder if the low dose makes taking castor oil less likely to produce a negative laxative effect, or if perhaps what the castor oil is taken with makes a difference. Most of the recipes that I have seen or heard of used 2-4 ounces of castor oil, often with juice. Not only was I only using one tablespoon at a time, but I took it with ice cream. Downing several ounces of straight fat with orange juice sounds like a recipe for vomiting to me, induction or not.
Conventional wisdom, and even published medical papers like this one, say that castor oil works because it stimulates smooth muscles in the intestines (producing a laxative effect) and the uterus (causing contractions). Or, as the scientists put it: "Thus, the castor oil metabolite ricinoleic acid activates intestinal and uterine smooth-muscle cells via EP3 prostanoid receptors." But, if that is truly what induces labor, how can contractions start but no intestinal effects? I don't know the answer; I'm just thinking out loud. But it seems to me that it should be studied MORE. There are actually not that many human studies on labor induction with castor oil that I could find. WHY NOT? What are the possible side effects of castor oil induction, vs the alternatives?
Castor oil- May cause nausea, vomiting, or diarrhea (Yet, my midwife swears that almost no one gets sick when they stick to the root beer float recipe.) Maybe dehydration.
Pitocin, Cytotec, Cervadil- May cause uterine hyperstimulation, fetal distress, or hemorrhage.
Again, I am not actually a fan of inducing labor. I really do feel that babies generally know when they should be born, and that if they are happy in the uterus, then it's likely a safe place for them to be. But...we don't live in a perfect world, and sometimes we, as mothers, have to make tough choices. At least I wanted to share my choice and experience. Even when we do have to make those choices, it's best to know ALL of your options, and choose the risks that you are most comfortable accepting.
What do you think, would you use castor oil over a medical induction?
I have a confession to make. And an apology. First things first.
I induced labor with my third baby. I am a birth doula who has been pretty (mostly silently) judgemental of women who have done the same thing.
I'm sorry for my negativity, even if I never vocalized my disagreement. I did probably say things like this:
"Your baby will come when it's ready!"
"If you're not in labor, your baby/body isn't supposed to be in labor!"
"Babies don't have calendars!"
"Get a new provider if they won't let you go past 40/41/42 weeks!"
Basically, all of those "don't worry your pretty little head about that" kind of comments. And you know, I still believe all of those statements. I might even use them again, depending on the circumstances. But....I also have a little more empathy for women who feel like it's necessary to get the ball rolling, so to speak. Because I became that woman. It was distressing, to say the least. I felt like I was betraying my conviction that babies KNOW when to be born as long as everyone was healthy (which we were). But.....
I DON'T REGRET MY DECISION. Let me explain. No, let me sum up. (Please someone get that reference)..
I knew going into the home stretch of my third pregnancy that I would likely go past my EDD. My second was born at 41 weeks, and I just felt like this one would be the same or longer. I was right! At my 41 week appointment my care provider commented that it was apparent that I and the baby were doing well and healthy, and she was perfectly happy if I wanted to keep waiting, but that I needed to schedule a biophysical profile for 42 weeks in the event that I got that far. I was content to comply with this request (and find it a very reasonable one), however I realized rather quickly that the out-of-pocket expense is very high for this test. Like, really really high.
She gave me another option, one which she only mentions (unless there is a clear medical indication) to mothers who are past 41 weeks. She said that I could take a root beer float with a small amount of castor oil in it.
Castor oil! No way! I had basically heard two versions of castor oil inductions. These probably sound familiar to you also.
Scenario #1- Nausea, vomiting, diarrhea, but you have a baby.
Scenario #2- Nausea, vomiting, diarrhea, and no baby.
Hmm...I think I'll take NEITHER. Also, it just felt wrong. I needed to give us more time. I couldn't betray my convictions that easily. However, I was assured that this method would NOT make me sick. I would just start having contractions or not. I wasn't sure if that was possible, but I trust my care provider, so I kept it on the back burner as an option. I felt like this baby was bigger than my last two, but that didn't scare me.
Each morning, I woke up still pregnant. No labor. Actually, no signs even of impending labor. I knew I'd have to schedule the test by Friday to get in, so Thursday morning, at 41 weeks and 4 days, still conflicted and feeling like a complete doula hypocrite, I called my mom.
"Pick up the castor oil and some root beer. I've got the ice cream."
....to be continued.
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!