Midwives Brew

Labor, and the long agonising wait for it to start.

It feels like you’ve been pregnant forever, in fact you have been pregnant forever…you seriously cannot remember a time when you could walk more than 20 paces without getting out of breath, bend over with ease, or see your toes…with their unpainted tips. Oh how you will never again have bare, unkempt toenails…

Yes, I have been there. Twice. And both times I longed for pregnancy to be over.

I wasn’t one of those women who blossomed during pregnancy; I did not revel in growing to the size of a house, mirroring a ripe tomato, and looking like I was about to give birth to triplets…or a whole new planet!

I ached, I was constantly hot and uncomfortable and I could write a book about heartburn!

So even though the thought of labor brought uncertainty and anxiety, I could not wait for it to start.

Induce Labor Meaning

With that said, I never actually tried many tactics to induce labor – well apart from a strong curry and a birthing ball, but all the curry did was add to the heartburn I already had, and the ball ended up…well just being a ball!

Induce = to lead or move by persuasion or influence;
to bring about…to cause. – Dictionary.com

But there are a whole range of methods to help induce labor; some with varying success, and others…not so much. Some are down to medical induction while others are more natural like pineapple juice…sex…hot baths…caramel sundaes…eh?? Oh yeah…keep forgetting, that wasn’t on the list 😉

And then there is midwives brew.

Sounds like some witch’s concoction doesn’t it?!

What is Midwives Brew?

Midwives brew is a labor inducing method using natural ingredients. It actually dates back to the 1800s and is reported to have originated in Europe; a midwife would make this brew and give it to a pregnant woman who was overdue. It is also called The German Labor Cocktail because of its popularity with midwives in Europe.

Its original ingredients were gin, water and gooseberry leaves, with the common ingredient – and the labor inducing part – being gin.

Midwives Brew has reportedly had a lot of success with mothers, but like with many of the natural labor inducers, there is very little scientific evidence to prove that it works.

So what are the contents of midwives brew and how on earth does it induce labor?

Before we delve into this subject, let me just state I am not a health practitioner and am certainly not an expert in midwifery. Always consult with your doctor or midwife before attempting any intervention with your pregnancy – and it goes without saying that any labor inducing home method is for normal pregnancies that are full term of 40 weeks or more and the body is ready for labor...and your doc approves!

Midwives Brew Recipe

Midwives brew is a drink with a mixture of ingredients.

These ingredients have been known to include peppermint/spearmint leaves, lemon juice, cloves, cinnamon, salt and ginger.

But the most popular ingredients are:

• castor oil
• lemon verbena tea
• almond butter
• apricot juice

The common ingredient and the labor inducing part of the brew is castor oil. The other ingredients are mainly to disguise the taste of the castor oil and to help it go down a little better – although it does have a tendency of coming straight back up again!

There are some variations of midwives brew, including a ‘cocktail’ that includes alcohol:

• castor oil
• vodka/champagne/gin
• orange juice

I’m still not convinced this would taste any better though, and alcohol mixed with castor oil sounds to me like a disaster waiting to happen…

How to Make Midwives Brew

• 2tbsp castor oil
• 250ml lemon verbena tea
• 2tbsp almond butter
• 300ml apricot juice (pineapple, mango or peach juice can be used instead)

Instructions

1. Let the teabag of lemon verbena steep for 10 minutes.
2. Add together the lemon verbena tea, castor oil, almond butter and apricot juice.
3. Blend until the consistency is a smooth paste.
4. Best served warm as this helps to move it through your body.
5. If you want to try it cold, add some crushed ice or cubes (pretend you’re on the beach with your favorite cocktail…ok that might be stretching the imagination a little too far!)

How Long Does Midwives Brew Take To Work?

Because every pregnant woman is different and hasn’t experienced the same nine months, so too will the time it takes to take effect; varying anywhere from 30 mins to 48 hours.

There are many cases of labor starting shortly after ingesting midwives brew, or its main ingredient; castor oil – mostly within 12 hours:

A study published in the 2011 American Journal of Obstetrics and Gynecology was undertaken on 80 pregnant women of 40+ weeks gestation. 37 women were given 60ml of castor oil, while the remaining 43 in the control group received a placebo. They found:

‘the odds of entering active phase of labor within 12 hours of administration of intervention was 3 times higher among women receiving castor oil compared to women receiving placebo’

Gilad R et al

The take-home here is if you’re going to try midwives brew, have your bag packed, nappies on the ready, keys handy, and other-half prepped…just in case you’re one of those in the 30-min range…

Can You Eat After Taking Midwives Brew?

I don’t think the question is can you eat but rather – would you want to eat?

The best time to take midwives brew is apparently on an empty stomach, preferably early morning.

And after taking the brew, your stomach can feel a little…dodgy, and this, more often than not, leads to bouts of sickness….or projectile vomiting as I read on one forum!!

Of course, if you’re feeling fine and want to eat then there is nothing that suggests you can’t have any food afterwards, but I guess it might be best to wait an hour or so to make sure your stomach is going to keep hold of the brew!

Is Midwives Brew Safe?

A midwives brew recipe contains all natural ingredients but that doesn’t mean they are 100% safe; they can have some pretty nasty side effects including nausea, dizziness, fatigue, diarrhea and dehydration, which in turn can lead to other, more serious conditions.

Midwives Brew Side Effects

Let’s take a closer look at the main ingredients of midwives brew and its possible side effects.

Some of the side effects that have been reported include (and are not limited to) the following:

• Nausea
• Diarrhea
• Dizziness
• Fatigue – this is down to the lemon verbena tea which acts as a mild sedative.
• Irregular and painful contractions
• Allergic reaction – from the almond butter or apricot juice
• Dehydration

The Main Ingredients

Castor Oil

Castor oil is a vegetable oil which is derived from the castor plant, its given name is Ricinus Communis.

Ingesting castor oil as a labor inducer dates back to ancient Egypt and has been a recommendation by some health professionals throughout the ages, as well as mothers themselves.

In fact a midwife would give a pregnant woman castor oil to help bring on labor, although ‘most midwives avoid recommending castor oil unless the cervix is ripe’.

Lisa Summers CNM

What is Cervical Ripening?

Cervical ripening (also called cervical dilatation) is when collagen fibers of the cervix break down as the water content of the cervix increases.

A Knoche et al

In simple terms: during pregnancy, the cervix is closed and firm, and keeps your baby safe inside. When labor starts and when he/she is nearly ready to arrive, the cervix ripens; it begins to soften, become thinner and open (dilates) until it is wide enough for your baby to pass through.

The cervix is given a Bishop’s Score between 0-10 which is based on five factors (one factor being how many centimeters the cervix is dilated) and determines the readiness of labor…Bishop’s Score of 10 being ‘I’M COMING OUT MOMMA!!’

Does Castor Oil Work?

The most popular use for castor oil is to help ease constipation; it is a natural laxative which causes spasms in the intestines and bowels.

This spasming can also occur in the uterus to the uterine muscles which can lead to contractions – and these uterine contractions can start labor off.

But in some instances the use of castor oil can cause lingering spasms which could be harmful to both mom and baby. For this reason alone, it should be administered under the guidance of a medical professional.

• Oxytocin – Contractions are caused by the hormone oxytocin. This hormone is produced during pregnancy and helps to contract the uterus during labor. Scientists have developed Pitocin which is a synthetic oxytocin that is given to women to help bring on contractions.
  
  Castor oil can stimulate the release of the body’s own hormone oxytocin.

Although castor oil is a natural ingredient, it can cause dehydration if a woman suffers from severe nausea and diarrhea – unfortunately these side effects are way more common than successfully inducing labor!

It can also be used as a relaxing tea supplement…although nausea, diarrhea, laxative, spasms and dehydration, to me, do not really go hand-in-hand with relaxation!

Oh and you can also take castor oil as an enema…yeah not gonna happen!!

Interestingly, castor seeds contain ricin which is a very potent toxin.

The castor plant is also manufactured as a furniture polish.

Hmmm not winning any points there either…

Lemon Verbena Tea

Lemon verbena is a flowering plant and comes from South America, it has an authentic lemon twang, flavor, and fragrance.

It is used to disguise the taste of, as well as to help settle the stomach from the projectile-vomiting castor oil!

It can also act as a calming effect, and can help with digestive ailments as well as being used as a fever reducer, and sedative.

• Mango nectar can be used as an alternative to lemon verbena tea.

How to make lemon verbena tea:

1. Add a handful of lemon verbena leaves to a mug of near boiling water and let steep for around 10 minutes (or longer depending on how strong you want the tea).
2. Drain the tea leaves.
3. Add sweetener or honey if required.

NB: Lemon verbena also comes as an essential oil but oils should not be ingested during pregnancy as there isn’t sufficient evidence to say if they are safe for baby – Mayo Clinic Health System.

Almond Butter

A nice nutty flavor to try and combat the taste of the castor oil, almond butter is used to add more fat and oil to the brew to help with the spasms – Parenting.FirstCry.com

As this contains nuts, people with a nut allergy can swap this nut butter out for a nut-free alternative like coconut butter.

It can also help with diarrhea as the butter can help ‘stick’ things together…lovely.

Apricot Juice

So here are some alternatives to the witches…I mean midwives brew.

And as above, always check with your doc or other health professional before trying any labor inducing method.

A Hot Bath

As well as being extremely soothing and relaxing, a hot bath could also encourage contractions to start. This is one of the better options to try and if nothing else, it can help calm the mind and prepare you mentally for the days ahead.

When a bath doesn’t do it for you, a hot water bottle placed on your tummy could be all that your labor needs to get started – and it’ll be fun watching the bottle bop up and down with your baby’s movements!

And still on the subject of heat, another way that could help things along is to rub warm olive oil over your tummy (ignoring how icky this feels) and cover with a heated, damp towel. Then sit back, watch your favorite chick flick and wait for those first twinges.

Exercise

So, you’re either gonna do it or you’ve already skipped to the next one!

This is not the energetic, run-a-marathon type of exercise though – but if you’re even half way capable of that…hats off to ya!

But a gentle walk can help loosen the muscles and prepare your body for labor. It is also a great stress reliever, although be warned, there’s a very good chance you’ll see every other new mom out, already with their brand new babies in their brand new prams!

Ok, maybe not such a great stress reliever…

Hypnosis

Although hypnosis is recommended more for active labor, it may also provide a safe alternative for inducing labor – Nishi et al.

As yet though, there is no evidence that hypnosis can be used to start labor. But the mind is a very powerful thing and can convince the body to do many things…maybe one day this method will be a well-documented and successful inducer.

If nothing else, hypnosis is a great relaxant, both in mind and body.

Birthing/Yoga Ball

Birthing balls, also known as yoga balls, are popular for use during active labor – I have no idea why anybody would want to bounce on these when you’re trying to deal with contractions – but they have also been known to bring on labor itself.

I did actually try a birthing ball, hoping to be on my way to the maternity ward very shortly afterwards.

I sat on it, I bounced on it, performed the ‘figure-eight’ on it, I even did somersaults on it…ok that not so much.

But I did spend quite some time gently bouncing away, but nothing, not even a Braxton!

Maybe I just didn’t bounce long enough, but with a stomach the size of an elephant, this activity just wasn’t the most enjoyable way to spend my final days of pregnancy!

Sex

Not something most pregnant women are in a rush to do when they feel like the Titanic but it’s an age-old belief that having sexual intercourse when you’re full-term can help induce labor.

It’s actually the orgasm that is the most effective part of intercourse.

Remember that oxytocin? For a woman, that’s what an orgasm releases, and as mentioned above oxytocin can help the uterine muscles to wake up and start those contractions!

And when he climaxes, the semen contains prostaglandin hormones which can help ripen the woman’s cervix.

Dare I say, a win-win all round…

Again, not that you would want to but sex is a no-go after a woman’s waters have broken due to a high risk of infection.

Other Alternatives…Not So Much!

Nipple Stimulation

Although this sounds harmless…and maybe a little uncomfortable if you’re over-sensitive, but nipple stimulation should only be performed under a doctor’s supervision as it can cause prolonged contractions!

It’s all to do with that oxytocin again.

Nipple stimulation, which includes using a breast pump, can stimulate oxytocin production, which we know causes the uterus to contract (it is also the reason why breastfeeding can help the uterus to shrink back to its pre-pregnancy size).

And indeed in a 2015 study, it showed that (compared to other groups) the women in the nipple stimulation group had shorter phases of labor and delivery – Demirel et al.

But nipple stimulation has been known to work a bit too well, and ‘may also cause sever, prolonged contractions that cause fetal distress and harm’ – Dr Elaine Duryea, UT Southwestern Medical Center.

I didn’t know about this technique when I was pregnant, but if I did, I think I like things shrinking back in size after pregnancy better than any risk to my baby.

If only I could now find something to shrink my ass back into pre-pregnancy shape!

Acupuncture

So if you’re not uncomfortable enough, you can always have a bunch of needles stuck precariously in your skin!

Acupuncture is a Chinese practice that is said to target certain organs or body parts that have an ailment, by sticking needles into parts of the body that are connected to them via meridian pathways.

When used to promote labor contractions, the needles are supposed to stimulate hormones (oxytocin) that start those contractions.

Acupressure

Acupressure is very similar to acupuncture but instead of needles, the acupuncturist uses physical pressure to various parts of the body that are ‘connected’ to the areas that are causing problems for the patient.

As with its needle-sticking side-kick, this method may increase blood flow to the uterus, which in turn affects the hormones (oxytocin) that stimulate uterine contractions.

But, there is insufficient evidence to prove either acupuncture or acupressure works to bring on labor, they may help with the pain of contractions but as a labor inducer…not so much.

A 2017 study published in the Midwifery Womens Health concluded the following:

‘Acupressure may reduce labor pain and labor duration, but acupressure has not been found to increase cervical ripening or induce labor’.

J Schlaeger et al

Spicy Food

There are some foods that may help to induce labor – namely spicy food, even though there is no actual evidence that eating anything with a bit of a kick will start things off!

Spicy food has the same effect as castor oil and can lead to uterine contractions.

Unfortunately, it can also cause acid reflux, so not recommended if you’re already suffering from heartburn – that would be me then!

Red Raspberry Leaf Tea

Not to be confused with raspberry fruit tea – no, I didn’t know there was a difference either. But then I’m not a herbal tea drinker…just good ol’ English…and my twice daily coffee injections of course 😉

Back to the herbals…

Raspberry leaf tea is one of such herbal teas that is said to increase blood flow to the uterus and help strengthen the muscles.

Unfortunately, it does not induce labor.

It’s really meant for when you’re in labor, but it can be consumed beforehand to help the muscles become more efficient when labor finally arrives. A bit like muscle building for your uterus!

Apparently, raspberry leaf tea is of the nicer herbals, but if you’re still not convinced, it can also be taken in capsule form.

Essential Oils For Labor

Essential oils are not to be ingested during pregnancy but using an essential oil like lavender, jasmine or peppermint as a fragrance can have a calming effect while in labor, although, unfortunately, they cannot induce it.

A study was done on 126 pregnant women who were about to go into labor; 63 of these women were given citrus aurantium oil (citrus blossom oil) on their collars compared to the other 63 women (control group) who were not. The group who could smell the citrus blossom oil reported significantly lower anxiety levels compared to the control group – Namazi M et al.

Other essential oils that could help during labor include:

• Citrus blossom – stress reliever
• Lavender – calming and relaxing
• Jasmine – pain relief, may intensify contractions
• Peppermint – pain relief, help nausea when in labor, postpartum assistance
• Rose – pain relief, may help to speed up labor
• Evening primrose – may soften cervix, help to speed up labor, stress reliever postpartum
• Lemon or mandarin – pain relief, stress reliever, energy booster
• Frankincense – pain relief, chronic stress reliever
• Clary sage – relief from pain and uneasiness
• Geranium – relaxing and comforting
• Roman chamomile – calming, also helps with stress and insomnia
• Bergamot – stress reliever

More information on oils and how they can help when in labor can be found over at FirstCry and Happy Parents, Happy Baby.

NB: Always use a carrier oil like almond or olive oil and take the necessary precautions when applying directly to the skin or adding to bathing water. Do not ingest any oils while pregnant.

Fresh Pineapple

Ok, so it’s an enzyme called bromelain that is found within the pineapple that could stimulate contractions by softening the cervix.

Again, there is not enough evidence to support ingesting a pineapple will have any effect on the arrival of labor.

Oddly enough, there was a 2016 study published in The Journal of Ethnopharmacology that showed, when applied directly to uterine tissue (isolated from the body), pineapple extract caused uterine contraction!

Not exactly possible on a live subject – but would you want to anyway?!!

Oh, and pineapple can cause heartburn…although only when eaten I assume 😉

Can a cervical exam start labor?

Yes…and no.

If your body is ready to go into labor at any time, then yes a cervical exam could start it off by…

‘stimulating the release of prostaglandins which are used to induce labor’

Cat Bowen, Romper.com

But, if your body is some time off from releasing your babs, and is not ready to begin labor, then no; a cervical exam will not start labor…

Unless of course you had a pineapple…sorry couldn’t resist!

Midwives Brew Stories

The big question – does midwives brew work? Does it actually bring on labor? And are there any success stories?

Although there are many stories of women claiming they went into labor because of drinking this famous brew, it is not proof enough that it was the reason labor started. No matter how soon the midwives brew appears to take effect, it is not to say labor wouldn’t have happened at that time anyway.

Midwives Brew Success Rate

There are numerous reports on the interweb that anecdotally, the midwives brew success rate is around 85% but I could not find any sources that back up this figure.

What I did find was a 2000 study published in the Alternative Therapies in Health and Medicine. A total of 103 pregnant women of at least 40 weeks into their pregnancy were split into two groups of 52 and 48. The group of 52 women received one 60 mL dose of castor oil, compared to the other group who received nothing.

The results were interesting – 30 of the 52 women (57.7%) began active labor compared to only 2 of the 48 women (4.2%) in the control group.

25 of those 30 women (83.3%), who went into active labor after taking castor oil, delivered vaginally. Maybe this is what the 85% success rate is referring to? Although it is how the women delivered their babies and not the success of the castor oil.

Nevertheless the results of Garry et al’s study is compelling, and although their subject group was very small, they concluded:

‘women who receive castor oil have an increased likelihood of initiation of labor within 24 hours compared to women who receive no treatment’

Garry et al

It is just a shame that the study was done on a very small group of women – and those 30 women could have been ready to go into labor without any inducer anyway. But I’m sure most of those women would attest to the effectiveness of the castor oil being the cause.

Likewise, if you do a search, you will find plenty of women who strongly believe their contractions started after taking midwives brew – and until extensive research is done and proves otherwise, it will remain as a possible labor inducer.

Conclusion

Like many other ‘natural’ methods, there are side effects of ingesting castor oil that don’t seem to be all that worth it, given that it is not a ‘sure-thing’, and especially when those side effects can lead to problems much more harmful.

It is understandable to want to get to the end of your pregnancy…and fast.

After nine months of growing anticipation and countless weeks of struggling with the multitude of pregnancy ailments – the desire to meet your little one can see you seeking for ways to get things started.

And, like I said, I’ve been there – twice – and was sooooo ready way before it was time!

But our bodies are just incredible: they create and nurture a new life and prepare that life for just the right time to let it out into the big, wide world.

Why try to change this natural way (unless required medically of course), and force your body and baby before they are ready?

There just isn’t enough evidence to prove the effectiveness of midwives brew.

Even though I was so fed-up with pregnancy, knowing what I know now, I would use those final few days to rest, enjoy quiet times, watch lots of meaningless TV, eat caramel sundaes and look forward to the whole new life that awaits.

Believe it or not, pregnancy really does fade into a very distant memory.

References

Citations in Order of Appearance

1. Gilad R, Hochner H, Vinograd O, Saam R, Hochner-Celnikier D and Porat S. 148: The CIC Trial–castor oil for induction of contractions in post-term pregnancies. American Journal of Obstetrics and Gynaecology. Poster Session I Clinical Obstetrics, Medical-Surgical-Disease, Neonatology, Physiology-Endocrinology: Abstracts 87–236. (2011) 206:1, Supplement S77-S78.
2. Summers L. Methods of Cervical Ripening and Labor Induction. Journal of Nurse Midwifery. (1997) 42:2;71-85.
3. Knoche AK, Selzer C, Smolley K. Methods of Stimulating the Onset of Labor: An Exploration of Maternal Satisfaction. Journal of Midwifery & Women’s Health. (2008) 53: 381:387.
4. Verbena Tea Information: Learn About Growing Lemon Verbena for Tea – Gardening Know How.
5. Essential Oils and Pregnancy – Mayo Clinic Health System.
6. Is Midwives Brew a Safe Way to Induce Labor? – Parenting First Cry.
7. Nishi D, Shirakawa MN, Ota E, Hanada N, Mori R. Hypnosis for induction of labour. Cochrane Database of Systematic Reviews (2014), Issue 8. Art. No.: CD010852.
8. Demirel G and Guler H. The Effect of Uterine and Nipple Stimulation on Induction With Oxytocin and the Labor Process. Sigma. (2015) 12:5, 273-280.
9. The Truth about ‘Natural’ Ways to Induce Labor – Dr Elaine Duryea, UT Southwestern Medical Center.
10. Schlaeger JM, Gabzdyl EM, Bussell JL, Takakura N, Yajima H, Takayama M, Wilkie DJ. Acupuncture and Acupressure in Labor. J Midwifery Womens Health. (2017) Jan;62(1):12-28.
11. Does Raspberry Leaf Tea Bring on Labour? – Emily Thorpe, Mother & Baby.
12. Namazi M, Amir Ali Akbari S, Mojab F, Talebi A, Alavi Majd H, Jannesari S. Aromatherapy with citrus aurantium oil and anxiety during the first stage of labor. Iran Red Crescent Med J. (2014) 16(6):e18371.
13. Does Essential Oils Help to Reduce Labour? – Vidisha Chawla, Parenting Firstcry.
14. Essential Oils for Labour & Birth – Happy Parents, Happy Baby.
15. Monji F, Adaikan PG, Lau LC, Said BB, Gong Y, Tan HM and Choolani M. Investigation of uterotonic properties of Ananas comosus extracts. Journal of Ethnopharmacology (2016) 193:21-29. ISSN 0378-8741.
16. Can a Cervical Check Induce Labor? Experts Explain How it Impacts Your Pregnancy – Cat Bowen, Romper.
17. Garry D, Figueroa R, Guillaume J, Cucco V. Use of castor oil in pregnancies at term. Altern Ther Health Med. (2000) Jan;6(1):77-9. PMID: 10631825.