Intresting read: especially the last part
The active ingredient of castor oil is ricinic acid. The pharmocological name is oleo ricini. It is a powerful laxative and acts by stimulating the gut. If labour is not far off castor oil will stimulate the uterus to contract - Castor oil contractions - this will give the uterus enough of a "kick Start" to start off labour. As it is often used when a pregnancy is post term there is often meconium in the liquor This is not sinister. It is a feature of the postmature fetus Its gut has matured amd it has passed meconium. This is not in itself a sign of fetal distress.
Before the days of of synthetis oxytocic drugs we used "ol ric" frequently to start, and augment labours. I still suggest it to women occasionally.
The dose is 25-30 mls It is disgusting to take. I mix it with a similar amount of a sour fruit juice, lemon or grapefruit, shake it up, give it to the victim to swig, then pass her a tissue to wipe her mouth, then give her a dry biscuit to eat. I took it myself on two occasions - YUK YUK YUK
Mary Cronk, independent midwife
www.marycronkmidwiferyservices.co.uk
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I think that I would have been prepared to try castor oil to induce labour, despite the side effects, if it meant that I could stay in control and not get transferred up the system. (i.e. from GP unit to consultant unit) When I went overdue with my third the GP unit wrote me off and referred me back to my GP who was unable to get consultant unit cover immediately.
I'd rather stay in control and drink a glass of disgusting liquid at home than have ARM done by a consultant with no consent in hospital! Point taken about the lack of research, but seriously, can you think of any centre that would bother to do and RCT (randomised, controlled trials) when there are so many other methods of IOL (induction of labour)?
Margaret
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We gave 4 fl oz caster oil + orange juice + 1/2 tsp. bicarbonate of soda, which caused it to fizz and made it a little more pleasant to take!
The assumption was that it is a rectal stimulant and because the nerve supply to the rectum passed through the same plexuses as the uterus, it would stimulate labour. Having given it to women for a few years in the late 60s and early 70s, I believe it was effective for those at term. Many went into labour within 12 hours of taking it.
I agree that it is not particularly pleasant, but is better for many women than invasive procedures to induce labour. However, I also agree that research should be undertaken before recommending it.
Ruth
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My mum has horrific memories of Castor oil to try and induce labour when she was pregnant with me. At 41 weeks her blood pressure went up and she was admitted to hospital for induction. She has no doubt that it may have helped to stimulate her labour but would not wish the other unpleasant side effects on anyone. She also says it took at least two doses so maybe labour started spontaneously anyway and everyone just put it down to the castor oil. (This was in 1966)
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4 oz castor oil in orange juice mixed well and swallowed fast (it tastes foul) causes a bad case of the runs but I have found it helps to start labour. another dose can be given 12 hrs later. if it does not work, perhaps this baby is simply not ready.
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Castor oil was used by generations of women earlier this century before the advent of evidence based practise. It was foul, it did indeed give a dose of the runs and women found this totally unpleasant. And I seriously question that it did ever induce labour. It has never been the subject of a research study as far as I know and in my opinion should not be recommended to anyone unless it is.
Linda
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"I came across a worrying article stating that any type of 'natural' induction is very dangerous and that use of castor oil could lead to cord prolapse."
I have been using castor oil to encourage labour in women who wish for various reasons to do this for over thirty years with discrimination and I would be interested to know why the wide statement is made that it is not advisable.
Of course, like anything else there are contraindications and I carefully question the woman as to:
Why she wants to encourage her baby to be born before the spontaneous onset of labour.
Has she any history of irritable bowel syndrome or any other gut problems
Has she any piles or any history of piles.
I then offer to examine her vaginally to assess the cervix as in my experience if the Cx. is not ripe the castor oil is unlikely to start labour. I also check the presentation and station of the head and would advise not to proceed if the presentation was other than cephalic and well in the pelvis. There is a danger of cord prolapse if any labour starts with a malpresentation and a high presenting part and therefore if castor oil is taken and there is a prolapse of cord, the castor oil is blamed .
If all is well, I suggest she take 25-30 mls of castor oil mixed with the same amount of a sour sharp fruit juice like lemon or lime or grapefriut, have an assistant beat the nauseous mixture, hand it to the woman, who drinks it as quickly as she can, the assistant then removes the glass and washes it carefully so that no smell or taste lingers, the woman wipes her mouth with a tissue she has ready, eats a crisp dry biscuit or dry toast and awaits events.
Mary Cronk, independent midwife
www.marycronkmidwiferyservices.co.uk
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USE OF CASTOR OIL IN PREGNANCIES AT TERM
David Garry, DO, Reinaldo Figueroa, MD, Jacques Guillaume, MD, and Valerie Cucco, DO
Context . Despite wide use of castor oil to initiate labor, the obstetric literature contains few references to this botanical laxative. Derived from the castor plant Ricinus communis, castor oil may possess properties that are useful in post-term pregnancies.
Objective . To evaluate the relationship between the use of castor oil and the onset of labor.
Design . Prospective evaluation.
Setting . A community hospital in Brooklyn, NY.
Patients . A total of 103 singleton pregnancies with intact membranes at 40 to 42 weeks referred for antepartum testing. Inclusion criteria included cervical examination, Bishop score of 4 or less, and no evidence of regular uterine contractions.
Intervention . Patients were alternately assigned to 1 of 2 study groups: a single oral dose of castor oil (60 mL) or no treatment.
Main Outcome Measures . Castor oil was considered successful if labor began within 24 hours after dosing. Groups were compared for onset of labor in 24 hours, method of delivery, presence of meconium-stained amniotic fluid, Apgar score, and birth weight.
Results . Fifty-two women received castor oil and 48 were assigned no treatment. Following administration of castor oil, 30 of 52 women (57.7%) began active labor compared to 2 of 48 (4.2%) receiving no treatment. When castor oil was successful, 83.3% (25/30) of the women delivered vaginally.
Conclusions . Women who receive castor oil have an increased likelihood of initiation of labor within 24 hours compared to women who receive no treatment. Castor oil use in pregnancy is underreported worldwide. This small series represents the first attempt to evaluate the medication.
(Altern Ther Health Med. 2000;6(1):77-79)
