Sex, Pineapples, Evening Primrose Oil, Oh My!.....

It sounds like a recipe for a wild night on the beach, but no, it is just the beginning of a list of all the things people try to get labor going.

Pregnant women spend the first 36 weeks of their pregnancy worrying about whether labor might come too early and spend the last four weeks (or six weeks for the unlucky) worrying that it will never come. However, it is not so easy to understand what might actually bring about labor too soon or help it along when a pregnancy extends past its expiration date or a mother’s (or her doctor’s) tolerance.


There is a nice little analogy I came up with a few years ago to help my patients understand this complicated process. It starts with a horse in a barn, because, well, I am from the southwest and we talk about things like horses and barns.

The baby is the horse:

The horse lives in a barn:

Around that barn, is a fence:

And all the other little horses, or babies, are out in the pasture:

The horse lives happily inside your uterus until, eventually, usually between 37 and 41 weeks after conception, it decides it wants to get out, but it doesn’t just want out of the barn, it wants past the fence and out to pasture with all the other baby horses. 

The horse, your baby, is the one that decides to get out of the barn, and sends that signal for labor to start.

So why do people even bother with things like sex, pineapple, acupuncture, evening primrose and all the other things people try to get into labor, or why do they tell women to avoid sex if there is a concern about premature labor? If the horse is the one that decides to get out of the barn, how do any of these things work?

Well, sex, evening primrose, pineapple, spicy foods, and acupuncture are the equivalent of leaving the pasture fence with the gate open. Once your little horse decides to get out of the barn, these things help your body be ready to receive the signal and make it easier for your horse to join the other little horses in the pasture.

There are also middle of the road tools to aid in the labor process, things that open the fence gate, but also lift the latch on the barn door, things that achieve both cervical ripening and promote uterine contractions, things like membrane sweeps and nipple stimulation or castor oil...they are a little more aggressive, but will often get the job done without a medical induction.

​A true induction, utilizing medicines like pitocin, cytotec, or cervidil, is different. The medicines in an induction are the equivalent of opening not just the fence gate, but also the barn door. Even if the horse was locked up tight a few hours before, induction will get the labor process started. Even if the horse wasn't quite ready to do so, when the barn door is open, the horse will usually wander out, though it still might take many hours and the horse might get a little stressed out in the process, especially if the fence gate wasn’t open. And sometimes, no matter how long you leave the door open or how hard you pull and tug, that horse will simply stay put in the barn.

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So what about premature labor? What if I don’t want to inadvertently put myself into labor. Will sex or a pineapple smoothie make my baby come too soon? Premature labor is poorly understood, but it seems that it really is an inherent problem with the barn door. The barn door is dysfunctional and broken and it doesn’t matter how we lock it or try to secure it, it won’t stay closed. We can stitch the cervix closed, put a mom on bedrest, or give her medicines to make contractions stop, but if that barn door isn’t working, all we are really doing is slowing down a horse who is already on its way. Eventually, the horse will get out of the barn and even if the fence gate is closed, it will simply jump the fence.

However, if our barn door is functional and locked up tight, we can leave our fence gate as open as we like, and that little horse is not going anywhere. ​