How to induce labor at 30 weeks

ROCHESTER, Minn. -- A new Mayo Clinic study of pregnant women who experience early membrane rupture has found induction of labor at 32 weeks gestation to be a viable option.

"Our findings show us that mothers and babies do just as well when the mothers are induced at 32 weeks rather than later at 34 to 36 weeks, the current standard of care," says Brian Brost, M.D., Mayo Clinic high-risk pregnancy specialist and study co-author. "So, why take the risk of infection in keeping the baby in mom longer if there's no difference in how the babies do?"

In cases of prolonged early membrane rupture, obstetricians must do a careful dance to get the unborn baby as close as possible to term, while avoiding the increased risk of infection. Mothers in this situation are at risk for infection of the membranes surrounding the baby, and such infection can prompt premature delivery or infection of the uterus after delivery. Unborn babies are at risk for a host of infections, including one that can lead to cerebral palsy, from bacteria entering the baby's bloodstream via the membrane rupture.

"The idea is to deliver the mother before the baby gets an infection," says Dr. Brost. "The dilemma is trying to deliver later so baby can get older but before an infection can set in."

The study found that infections in both mom and baby were significantly lower in mothers experiencing membrane rupture when they opted for induction at 32 weeks pregnancy rather than waiting for spontaneous labor. In addition, hospital stay for the newborn was considerably shorter in cases where the mother was induced.

"After 32 weeks, it's unusual for a baby to have lifelong problems," says Dr. Brost. "If the baby is infected due to the membrane rupture between 32 and 34 weeks, however, the long-term outcome can be worse."

The Mayo Clinic researchers indicate their findings show induction at 32 weeks gestation is an option for women with prolonged premature membrane rupture and their obstetricians to consider to decrease potential infection risk. However, Dr. Brost adds that it is important that such induction occur at medical center equipped to care for the premature infant. In order to confirm the study's findings and prompt a change in nationwide standard of care for mothers with premature membrane rupture, the Mayo researchers say their results would need to be replicated in a large study with multiple medical centers. Currently the practice at Mayo Clinic, says Dr. Brost, is to talk to women in this situation about the option of induction at 32 versus 34 weeks.

The Mayo Clinic researchers conducted their study by analyzing a prospectively maintained obstetric database for spontaneous membrane rupture between 24 and 31 weeks gestation between January 1992 and December 2003. They found 408 cases. The investigators examined the experiences of women with premature membrane rupture who were induced at 32 weeks. The experiences of these women were compared against women with early membrane rupture who waited for spontaneous labor and those whose induction became mandatory due to other medical factors.

Other Mayo Clinic study collaborators include: William Watson, M.D.; Stephen Contag, M.D.; and Melanie Dixon, M.D.

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Materials provided by Mayo Clinic. Note: Content may be edited for style and length.

For the past 40 weeks you’ve been waiting to meet your baby, but then… nothing happens. There are many theories about how to kickstart labour naturally, and you may be keen to try them. But be aware that there is not enough scientific evidence to prove that any of them work.

It’s very important to get advice from your midwife before trying anything to get your labour going.

“I wish I'd chilled out and enjoyed those last few weeks a bit more. I was so keen to get my babies here, but it's important to use that time to take time for yourself, and any hobbies you have, or things you want to do, because you don't have as much chance once the baby arrives!”

Nicole

Walking more

Being upright helps your baby move down on to your cervix. Exercise can also help you sleep, reduce your anxiety and improve your mood, which may help at this point in your pregnancy. Just make sure you listen to your body, find a balance and only do what you can. You’ll need to save some energy for labour.

Find out more about walking in pregnancy.

Eating dates

There are some small studies that suggest that eating dates for a few weeks before your due date may encourage your cervix to open (dilate). However, there isn’t enough research to confirm this is true.

“I started eating 6 dates a day 4 weeks before my due date. At 39 weeks, after a membrane sweep, my contractions started in the afternoon and when I arrived at hospital the following morning, I was already 7cm dilated. Who knows whether the dates helped or not.”

Karen

Drinking raspberry leaf tea

Raspberry leaf tea is a type of herbal tea that is high in vitamins, minerals and tannins. It is thought to help tone the muscles of your womb so they work more efficiently when you're in labour.

Some women start drinking raspberry leaf tea in their third trimester, but you should not use raspberry leaf to try to get your labour going. If you suddenly start taking it when you’re due or overdue, it may cause excessively strong contractions, which can cause your baby distress.

If you want to try raspberry leaf tea, it’s recommended you start taking it around 32 weeks pregnant. Start with 1 cup of tea a day, gradually increasing to 3 cups spread throughout the day.

You can take raspberry leaf in tablet form as well as drinking it as a tea.

Just because raspberry leaf tea is a natural remedy, it doesn’t mean that it’s safe for everyone. You should not take it if you:

• have had a caesarean section within the last 2 years
• are going to have a caesarean for a medical or pregnancy problem in this pregnancy
• have high blood pressure or pre-eclampsia
• had premature labour in this or a previous pregnancy or if you have very strong Braxton Hicks contractions
• have had a very quick labour before (less than 3 hours)
• are expecting more than 1 baby
• are carrying a breech baby
• have any medical conditions, such as epilepsy, heart problems, cancer, blood clotting disorders or endometriosis
• are taking antidepressants.

Talk to your midwife if you’re thinking about taking raspberry leaf tea.

Acupuncture

Acupuncture is a type of complementary therapy that involves a practitioner inserting thin needles at particular points on your body. It can be used to control and relieve pain and help you relax.

There is some scientific evidence that suggests acupuncture can induce labour naturally, but not enough to confirm if it’s true.

Acupuncture is generally safe to have when you’re pregnant but talk to your midwife or GP before you book a session. If you do want to try it, make sure your acupuncturist is fully qualified and that they use disposable needles at every treatment session. Tell your practitioner that you’re pregnant because certain acupuncture points aren’t safe in pregnancy.

Some maternity units are starting to offer complementary therapies like acupuncture. Ask your midwife for more information.

“My hospital is experimenting with acupuncture, so I tried that. I also tried a few other things so I guess we’ll never know if anything particular worked or if our babies just wanted out!”

Maria

Eating spicy curries

The theory is that a spicy curry can stimulate your bowel and also get your womb going. There’s no proof that this can work and it may not be a great idea if you’ve had lots of heartburn or indigestion during pregnancy, which can be common (take a look at our common pregnancy complaints). On the other hand, it may be nice to have a takeaway or relaxed night out at your local curry house while you wait.

“With my son, we went out for a curry the night before my waters broke. It was probably a coincidence but who knows.”

Aisha

Having sex

Having sex when you’re heavily pregnant may be difficult and there’s no evidence that it will help start labour. But there is some science behind the theory. Semen contains a hormone-like substance called prostaglandins, which may help soften the cervix (the lower part of the womb).

If you’re having a low-risk pregnancy, sex won’t cause any harm to you or the baby. Just be careful not to have sex if your waters have broken because this can cause infection.

“Sex didn’t bring on my labour, but it might have helped me get to sleep in those long, dark nights towards the end of pregnancy.”

Sonja

Find out more about sex in pregnancy.

Nipple stimulation

There is also a very small amount of evidence that suggests that nipple stimulation may also help get labour going. If you want to try it, gently rub or roll your nipples. The idea is to trick your body into thinking you are suckling your baby. This releases oxytocin, a hormone that helps contractions to start. If you’re having a healthy pregnancy and you haven’t had any complications, then it’s fine to try nipple stimulation.

Eating pineapple

Pineapple contains an enzyme called bromelain, which is thought to soften the cervix. One pineapple contains a very small amount of bromelain, so you’d have to eat a lot of pineapple for it to have any effect, which probably wouldn’t be great for your stomach. 

“I danced like a loon and ate loads of pineapple. I think you're supposed to eat about 12 whole pineapples to see any effect, which even for me would be a bit much.”

Kate

Things to avoid completely 

Castor oil

Castor oil can make you feel sick, which is the last thing you need during labour. Although this has been a traditional way of bringing on labour in the past, there is still no evidence that it works.

Evening primrose oil

It’s best not to take evening primrose oil in pregnancy, as we can't be sure it’s safe. The British National Formulary, which advises healthcare professionals about medicines, says evening primrose oil should be used with caution in pregnancy. There’s also no evidence to suggest that evening primrose oil is effective in getting labour going.

Clary sage

Some women use clary sage oil to get labour started. However, don't use this oil yourself because there are some risks. For example, undiluted essential oils can cause severe irritation and/or allergies.

As with everything listed on this page, the best thing to do is talk to your midwife before you try anything to bring labour on.

What happens if my baby is late?

If your baby is only a couple of days late, there is no reason for worry. Most babies stay healthy, but if your pregnancy lasts longer than 42 weeks there is a higher risk of stillbirth.Try not to get too anxious about this because your midwife will talk to you about your options for bringing on labour at your 38-week antenatal visit.

The first thing you may be offered is a membrane sweep, which makes it more likely that you will go into labour naturally. If this hasn’t happened by 42 weeks, you will be offered an induction.

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