If you spend enough time in a pregnancy group or on a due date message board, you’ve likely seen the question: “How can I naturally start labor?” It’s an understandable question. People in their third trimesters are often on hyper-alert, looking out for signs of labor, and may grow anxious as a due date draws near or passes.
“People often search for natural or home remedies to initiate labor, especially when they’re past their due date or experiencing prolonged pregnancy,” says Dr. Rakhee Patel, MD, a New Jersey-based board-certified OB-GYN in New Jersey with Pinewood Family Care Co.
Castor oil often pops up as a recommendation from fellow parents. It may be the first time the original poster hears about the purported natural way to jumpstart labor.
“Castor oil is an oil obtained from the seeds of the castor bean plant,” explains Sybilla Howell, CNM, a North Carolina-based certified nurse midwife for Novant Health. “Castor oil is a very powerful laxative. It works to induce bowel movements by causing the intestine muscles to contract, helping with peristalsis.”
While it may get the bowels moving, can castor oil induce labor safely? Experts share their thoughts.
Induction: What It Is & Why It’s Necessary
TV and movies often portray spontaneous labor as starting with a person’s water breaking at an inconvenient time, like at a wedding. For starters, slow, spaced-out contractions typically proceed to the rupturing of a bag of amniotic fluid that’s serving as a protective cushion for a developing baby. Sometimes, labor is not spontaneous; a provider may recommend an induction.
“Labor induction is a way to get the uterus to contract and the cervix to soften, thin, and dilate,” says Howell.
Though one trial from 2019 indicated that an induction at 39 weeks could slightly reduce a person’s chances of having a C-section, providers and parents often choose expectant management (or “wait it out”), explains Daniel Roshan, MD, FACOG, FACS, a maternal-fetal medicine specialist with NYU Langone. Any medical intervention comes with risks, including the need for a C-section.
Still, Dr. Roshan says that induction can be a tool in specific situations. For example, he explains that it can be performed in cases of:
- Medical complications with the pregnant person, such as gestational diabetes or pregnancy hypertension
- Prior stillbirth
- Pregnancy that goes past 40 weeks and six days
- Issues with the developing baby, such as a biophysical profile (BPP) or nonstress test (NST) showing irregular fetal heart rate, movement, or muscle tone
Dr. Patel notes that there are numerous ways to induce labor, including:
- Stripping the membranes, or the separation of the amniotic sack from the uterine wall to ripen the cervix and initiate contractions
- Rupturing the membranes to tear a hole in the amniotic sac, a tactic typically taken if stripping the membranes did not start labor
- Prostaglandin gels to ripen the cervix
- Pitocin drip, which involves using a synthetic form of oxytocin, a hormone that triggers contractions
What About Castor Oil to Induce Labor?
Some research sheds light on the efficacy and safety of inducing labor through castor oil, a vegetable oil made from Ricinus communis.
A retrospective study published in 2018 looked at nearly 300 women who used a castor oil cocktail to stimulate labor. The researchers found that 90.7% delivered vaginally at a birth center or hospital with little to no complications to the parent or baby. Authors called for more research on the safety and efficacy of natural labor induction remedies, including castor oil. More research came out in 2022 as a meta-analysis of eight studies. The analysis indicated that an oral dose of castor oil is an effective way to trigger cervical ripening and labor induction.
“Castor oil can be used at home to get the cervix ready for labor and cause contractions or intensify contractions that are already happening on their own,” says Howell, who advises patients to speak with their providers before taking castor oil to induce labor.
If a provider gives the OK, dosing is important. In the 2022 meta-analysis, most individuals took 60 mL of castor oil to induce labor. Since castor oil isn’t all that palatable, Howell says pregnant people may take it with something else, such as orange juice or a milkshake. Then, a pregnant person will need to wait.
“Evidence supports that castor oil can increase the chances of going into labor within 24 hours of use,” Howell says.
Side Effects of Using Castor Oil to Induce Labor
The idea of jumpstarting labor without medical intervention may sound appealing. However, Dr. Patel advises pregnant people to consult a provider first, especially before using castor oil.
“It’s crucial to note that many health professionals do not recommend the use of castor oil for labor induction due to potential side effects and lack of substantial evidence on its efficacy and safety,” Dr. Patel says.
What might those side effects be? For the laboring person, Dr. Patel says castor oil may not induce labor, but it often induces:
- Nausea
- Vomiting
- Diarrhea
- Dehydration
- Abdominal cramps
“For the fetus, potential risks are largely unknown, but there are concerns about fetal distress, especially if diarrhea leads to dehydration in the mother,” Dr. Patel says.
Moreover, if a pregnant person induces labor before 39 weeks, the baby may need additional help post-delivery. “Electively, we don’t induce people before 39 weeks,” Dr. Roshan says. “Before 39 weeks, a baby’s lungs may not be matured.”
If you’ve taken castor oil to induce labor, Dr. Patel suggests calling your health care provider immediately if:
- There are no contractions several hours after taking castor oil
- You experience severe or persistent nausea, vomiting, or diarrhea
- There are any signs of fetal distress, such as decreased fetal movement
Howell adds it’s important to call your provider if you experience vaginal bleeding or your water breaks.
The Bottom Line
Though there is some evidence pointing to the safety and efficacy of using castor oil to induce labor, there isn’t enough to give some providers confidence in the method. And every provider Parents spoke with urges caution and shared informed decision-making with an OB-GYN or midwife.
“Each pregnancy is unique, and what might be safe for one person could be risky for another,” Dr. Patel says. “Only a health care provider can give informed advice tailored to an individual’s health situation. Moreover, if labor doesn’t begin after taking castor oil, there might be a need for medical intervention.”
