Studies, Risks, and Dosage for Inducing Labor With Castor Oil
Is It Safe to Use Castor Oil to Begin Labor?
Castor oil is a pale or yellow vegetable oil that's pressed from castor beans, and it can be found in most drug and health food stores. Although it has been used for centuries to treat a variety of health conditions and is most often taken orally as a liquid laxative, it is also a widely-used and effective way to start contractions after 40 weeks of pregnancy. According to Karly Nuttall, licensed midwife and hormone specialist who has helped deliver over 700 babies during her two decades of clinical experience,
Using castor oil to induce labor is simultaneously a good and bad idea. It's strong and often effective when no other non-chemical methods of induction work, but you pay the price in intestinal woes! My clients who have been brave enough [...] say they're glad they did it but would never do it again. [...] Because of that I only recommend it as a last resort [...] and I only recommend trying it after 41 weeks.
I am a certified birth doula and owner of Trimester Talk, a leading pregnancy website. During the 41st week of my own pregnancy, I decided to drink a little castor oil as a last-ditch effort to get things moving, and it worked. Below, you'll find all the research I conducted and the questions I found answers for in order to make my decision.
How Does Castor Oil Help Start Contractions?
When taken orally, there are three main ways castor oil works to induce labor:
- It induces contractions in the bowels, which in turn can cause the uterus to to begin contracting as well.
- It dehydrates the body, which can also cause contractions.
- Scientists have discovered that ricinoleic acid, a key component of castor oil, targets prostaglandin receptors on smooth muscle cells in the intestines and uterus to stimulate contractions.
The Meconium Debate: What Is the Biggest Risk of Taking Castor Oil to Induce Labor?
If you research castor oil induction thoroughly, you'll find that there are two camps:
- Those who claim that taking castor oil may have the same laxative effect on the baby as it does on the mother. As such, using the oil to induce may increase the chance of meconium—the baby’s first stool—being passed during labor. This can potentially be harmful to the baby if it’s aspirated, or inhaled, into the lungs, potentially causing pneumonia or developmental delays.
- The second camp claims that castor oil labor induction has no relation to passing meconium.
This is still an area of controversy, so you’ll want to talk to your doctor and look at the research yourself before you decide. But here are some facts that might help you make a decision:
- Babies born postdate (40 weeks and over) have a higher chance of passing meconium in the womb because their bowels are more mature.
- Babies born without using castor oil to induce labor can still pass meconium in the womb (at any gestation date).
- Babies born with castor oil labor induction often do not pass meconium in the womb.
- No well-documented study has linked meconium and castor oil labor induction or proven that (these types of) laxatives can pass through the placenta.
- Approximately 57% of women who take castor oil after 40 weeks go into labor. However, this is a vague statistic and doesn't account how far along they were (how many weeks over 40 they were pregnant) or other conditions such as pre-labor or other forms of natural induction.
Other Possible Risks, Dangers, and Side-Effects of Using Castor Oil to Begin Contractions
Along with the possible risk of meconium, there are some other things to consider:
- nausea: although you have a 57% of inducing labor, the chance that you will feel nauseous is almost 100%. A small number of women also vomit due to the strong effect of the oil.
- intestinal discomfort: intestinal cramping and gas are the most common side-effects.
- diarrhea: since it is a laxative, this is a very common side effect.
- dehydration: diarrhea usually causes dehydration, so you'll need to make sure to drink lots of water.
- pooping during labor: nobody wants to talk about this, but it's true. Pushing the baby out uses the same muscles as pushing out a bowel movement, so you can imagine what's likely to happen during labor if you have diarrhea. But the truth is that it is extremely common to have a bowel movement while pushing, it can't be avoided, and it happens to most women, whether or not they used castor oil to aid labor.
- nothing: some women will not experience any effects or side-effects at all.
Approximately 57% of women who take castor oil after their due date go into labor within 24 hours.
What Do Doctors and Experts Say About Using Castor Oil to Start Labor?
Medical opinion on the subject varies widely. Some obstetricians and midwives regularly recommend the use of castor oil to induce labor once a woman passes 40 weeks, while others discourage or strongly warn against it.
Until the last few decades, castor oil and soap enemas were commonly used in hospitals to induce labor. However, doctors discovered other methods of induction that had higher success rates because they were more forceful on the body.
If you do have a high-risk pregnancy or are ill, it's a good idea to either seek medical advice or avoid castor oil as an induction method.
Below, you'll find links to several studies and publications.
Medical Studies, Publications, and Links About Castor Oil Induction
If you want to do more research on your own—which I recommend—you may want to start with some of the studies and publications listed here.
- Castor Oil Increases Labor Onset. This study found that women were more likely to go into labor within 24 hours of taking castor oil.
- Castor Oil Study On 600 Women. This study found that there was no big difference in the likelihood of going into labor between those who did or did not take the oil. However, the study also found no harm to the mother or infants, either.
- Castor Oil Literature Review. This meta-analysis reviewed the biggest studies on castor oil inductions, offering an overview of the current research on the subject.
- According to a 2012 research paper in Proceedings of the National Academy of Sciences, scientists have discovered that ricinoleic acid, a key component of castor oil, targets prostaglandin receptors on smooth muscle cells in the intestines and uterus to stimulate contractions.
- On this subject, the well-known guide What to Expect When You're Expecting says this:
Hoping to sip your way into labor with a castor oil cocktail? Women have been passing down this yucky tasting tradition for generations on the theory that this powerful laxative will stimulate your bowels, which in turn will stimulate your uterus into contracting. The caveat for this one: Castor oil (even mixed with a more appetizing drink) can cause diarrhea, severe cramping and even vomiting. Before you chug-a-lug, be sure you're game to begin labor that way.
But Isn't Castor Oil Used for Abortion?
Some people argue against using castor oil because they've heard it’s an abortifacient, a substance that causes abortion. While this is true, it’s somewhat beside the point: abortion, induction, and the contractions experienced during labor all share the same basic goal: moving the baby out of the womb. Many medical induction aids, including Pitocin, are also commonly used both in abortion and in birth.
Before Inducing Labor With Castor Oil
- Try other natural ways to induce labor first. Other forms of natural induction (including nipple stimulation, evening primrose oil, exercise, and sex) can be a lot more pleasant and won't have as many potential side effects.
- Don’t try to induce contractions early, before 40 weeks. If your body is not ready to go into labor, it will not work and can cause complications. Unless you have a good reason (discomfort is not a good reason!), don't attempt this before 40 weeks. If you're facing medical induction, make sure you're aware that it's within your rights to refuse or ask for a later date.
- Only take it to induce. Do not take it as a way to speed up labor. Doing so can make birth even more painful.
- Do it at your own risk. Talk to your medical professional if in doubt.
- Don’t take too much castor oil. Never take more than 1-2 tablespoons (1 oz maximum, or approximately 30 ml) in a 24-hour period.
- Drink lots of water, as castor oil is a laxative and will dehdyrate you.
How Should I Take Castor Oil?
The short answer: You drink it. Some people drink it straight, while others prefer to mix it with something. Here are some suggestions:
- Mix with juice or a strong-flavored drink to cover the taste or dilute the texture.
- Take as a shot, and then chase it with something to remove the taste.
- Drink slowly over ten minutes, either mixed or in small straight amounts.
How Much Castor Oil Do I Need to Induce Labor?
Many people recommend taking half a cup or more of castor oil. Personally, I'd only recommend taking 1-2 tablespoons at most. Take enough to let the oil do its job, but don't overdo it—in fact, taking too much can lead to severe dehydration.
What Does It Taste Like?
Castor oil is a thick liquid which some people do not like the taste of at all. Others say it is nearly tasteless. It is a thick, clear, oily liquid similar in taste and consistency to cooking oil. Some report a soapy taste as well.
What can I drink with castor oil?
If you need to, you can either mix or "chase" it with any kind of juice, tea, or liquid you'd normally drink. Have a tall glass of water on hand to wash it down.
How Fast Does It Work?
It can take anywhere from two to six hours for castor oil's effects to begin, and the effects can last from one to six hours. It can take from 5-24 hours for labor to begin, if it's going to, although labor does not start for approximately 43% of women who use it.
- Make sure you have plenty of water available to keep you from being dehydrated.
- Be close to a toilet.
- Have your bags packed and ready to go to the hospital.
Benefits of Castor Oil Induction
- You don't need to be dilated or effaced for it to work.
- Although stronger than other natural induction methods, castor oil still will not put you into labor unless your body is ready—unlike a medical induction.
- It's all-natural and plant-based. You can even buy it organic, if that's important to you.
- You decide if you want to try it or not. Being in control of the if, when, how, and how much you use is a great comfort to many women.
- It can clean out your system so that it's less likely you'll have "accidents" while pushing during labor, except if labor begins very quickly or was about to begin when you took the castor oil anyway.
I decided to try castor oil as a last-ditch effort when I was at 41 weeks. I was scheduled for a medical induction at 41+3. According to the doctor just three days before, I was undilated, and the baby wasn't completely down in the birth canal.
I drank one tablespoon of castor oil at 3 p.m. in the afternoon. I was running to the toilet from approximately 5:30 p.m. to 7 p.m. and then had no more side effects. I cleaned my house so I was ready, just in case, and at about 11:30 p.m., I decided that it was time for bed.
I lay down on the bed and immediately had my first contraction. This was followed by a second contraction two minutes later. We arrived at the hospital, and my baby girl was born four hours later, a healthy 8 pounds, 4 oz, with no complications. She had an almost perfect Apgar score of 9 followed by a 10.
In hindsight, I would not induce labor with castor oil again, because now I'm aware that I can refuse medical induction. However, I would still choose it instead of Pitocin in the event I needed it.
Frequently Asked Questions
How much castor oil should I use?
You might have a powerful reaction, so it's smart to start small. Take a tablespoon or two and wait to see how your body responds. If nothing happens within 6 hours, you might consider taking a little more.
How fast does it work?
It usually takes at least two hours, but 7 at most, for the oil to work, if it's going to. It works for 57% of the women who use it after 40 weeks of gestation.
Is it safe to make yourself go into labor?
Women have been using various methods to prompt contractions since the beginning of time. Pitocin, a synthetic form of your body's oxytocin, is used in hospitals throughout the world to induce labor. It is always recommended that you wait until your baby is due before you try to give birth. Get an ultrasound to verify your due date.
Can I use castor oil if I'm 38 weeks pregnant?
It's important to let your baby grow at its own pace and let your body's natural cycles work. It is not recommended that you try to induce labor before 40 weeks. If you're hoping to use it as a laxative, not as a means of inducing labor, you should consider a different method. Talk to your doctor.
Can I use castor oil if I'm 39 weeks pregnant?
The last days of pregnancy can be very difficult and uncomfortable, and it's very hard to wait, but still, inducing labor before 40 weeks is not recommended.
What does castor oil do to the baby?
Although no reliable studies have been done, some believe that the oil might have the same laxative effect on the baby as it does on mom. If the baby passes meconium (their first stool) during labor, and if it’s inhaled into the baby's lungs, there can be complications. See "The Meconium Debate" above.
Does castor oil help dilation or effacement?
Although castor oil might promote the release of prostaglandin receptors and help trigger the cervix to dilate, there is no reliable evidence to support this fact. However, it often sets off contractions which, in turn, lead to dilation and effacement of the cervix.
Will using castor oil affect the mode of delivery? Does it influence whether the birth will be vaginal or via C-section?
There is a big and ongoing debate about whether inducing labor increases the risk of having a C-section. However, according to a recent metaanalysis conducted at Thomas Jefferson University and published in American Journal of Obstetrics & Gynecology, induction at full term does not increase the risk of cesarean section. In studies of castor oil cited above, the rates of cesarean section vs. vaginal birth was not considered statistically different between the groups of women who induced with castor oil and those who did not. In addition, "The incidence of meconium-stained amniotic fluid, Apgar scores, and birth weights was similar in both groups."
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What Was Your Experience Like?
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