Whether you’re waiting (impatiently) for your baby to arrive or facing a medical induction, chances are you’re curious about how to naturally kick labour off.
In a study published in Birth, almost 50% of women say they’ve tried at least one method to try and start labor at home.
There are many methods on offer: spicy food, sex, walking and even massage. One method that is quite successful is nipple stimulation.
Nipple stimulation is used to encourage uterus contractions, help the uterus contract after birth, and even strengthen slow or stalled contractions during labor. This may help you avoid the risks of medically speeding up your labour.
Nipple stimulation and induction of labor
Using nipple stimulation to bring on labor isn’t a new invention. Over 200 years ago, midwives would use the practice to speed up labor that had slowed or stalled.
In those days, if labor was long or not progressing, injury or death to mother or baby was more likely to happen.
It’s likely the innate wisdom of natural processes to assist labor and birth were handed down through generations of women observing and supporting normal birth.
Nipple stimulation for induction of labor
After you give birth, breastfeeding your baby will stimulate your nipples to trigger the brain to release oxytocin. This is a hormone that stimulates contractions of your uterus, helping to return it to pre-pregnancy size.
Oxytocin plays a very important role in labor and birth. Contractions open or dilate the cervix then push the baby down through the vagina.
The idea behind nipple stimulation is it mimics the action of breastfeeding and causes your brain to release oxytocin.
Many women use nipple stimulation for induction of labour to encourage contractions to begin or strengthen. A study showed 50% of women in Japan use nipple stimulation to help induce labor.
Medical inductions are usually started with a synthetic form of oxytocin, known as Pitocin or Syntocinon.
How long after nipple stimulation does labor start?
If you’re impatient for labor to begin, likely you’ve skipped ahead to get the answer to how long after nipple stimulation does labor start?
A meta-analysis of randomized control trials in 2005 found nipple stimulation increases the chances of labor beginning. Almost 720 full-term women were assigned to either stimulate their nipples or not.
Of those women, almost 38% went into labor within 3 days of beginning the nipple stimulation, compared to 6.4% of the women who didn’t do any nipple stimulation.
Another study in 2014 looked at nipple stimulation in low-risk first-time mothers. From 38 weeks, half of the pregnant women massaged their breasts for 15-20 minutes, three times a day. These women gave birth on average at 39.2 weeks.
The women who didn’t do any nipple stimulation gave birth on average at 39.5 weeks. The study also showed lower rates of c-section in the group of women who used nipple stimulation.
In 2018 researchers published a study showing levels of oxytocin rose 3 days after beginning nipple stimulation, with a marked increase 30 minutes after beginning.
Other research has shown nipple stimulation has an effect on the length of labor. This study from 2015 showed stimulating the nipples during labor shortened the first stage of labor to an average of 3.8 hours.
The average time for the second pushing stage was 16 minutes, and five minutes for the third stage (placenta).
Again, none of the women had a c-section birth. Many of the women who didn’t do nipple stimulation needed medical induction methods for labor to begin, and over 8% had a c-section.
Can nipple stimulation cause fetal distress?
If nipple stimulation is so effective, why isn’t it a more widely known and used practice to induce labor?
The main issue is around safety for the baby. Nipple stimulation can cause what is known as uterine hyperstimulation. This is when contractions happen too frequently and last too long. This can lead to the baby becoming distressed and requiring medical interventions to be born safely.
This is why women who are using nipple stimulation are told to alternate breasts rather than stimulate both at the same time, and to pause during contractions.
In several studies, such as this one, where women were low risk and their pregnancies were full-term, researchers found no evidence of harm when doing nipple or breast stimulation.
One study concluded breast stimulation for low-risk pregnant women may be a safe, efficient and cost-effective intervention to avoid adverse perinatal effects associated with going past their estimated due dates.
A study included in the 2005 meta-analysis was stopped early due to 4 fetal deaths (3 in the nipple stimulation group and 1 in the synthetic oxytocin induction group). The women in this study from India were considered high risk due to having high blood pressure, post-term, or their babies had intrauterine growth restriction.
None of the other studies in the meta-analysis reported any deaths. German researchers found uterine hyperstimulation occurred in 10% of women during nipple stimulation and in 1% there were reversible fetal heart rate patterns.
Because of the conflicting reports in the scientific literature, nipple stimulation is not recommended for high-risk pregnancies.
7 steps for nipple stimulation to induce labor
Before beginning nipple stimulation, talk to your doctor or midwife about whether it’s the right option for you. Your care provider may recommend waiting until you are already dilated as this indicates your baby is ready to be born. Early or preterm birth can have challenging outcomes for your baby.
If you are given the go-ahead, there are a few options:
- You or your partner can manually stimulate your nipples by hand
- Your partner can orally stimulate your nipples
- Breastfeed or use a breast pump.
#1: Only stimulate one nipple at a time to avoid any chances of hyperstimulation.
Hyperstimulation is when your uterus is contracting too often and too long. This can be very painful for you and potentially cause your baby to become distressed.
#2: Using your thumb and forefinger, gently massage the areola, the darker skin around your nipple.
This stimulates nerves that trigger the release of breast milk when a baby feeds. It can be easier to massage inward toward the nipple.
#3: Start with your thumb and forefinger at the areola, and gently roll or pull down the nipple.
This should cause the nipple to become erect. This encourages the trigger of oxytocin as it mimics the sensation of a newborn suckling at the breast.
#4: Continue to stimulate the nipple for no more than 15 minutes.
Recommended amount of time to stimulate varies but the general consensus is 15 minutes maximum to avoid injuring the nipple and hyper-stimulating the uterus.
#5: Take a break for 2-4 minutes.
Then repeat the above steps on your other nipple. Remember swapping breasts avoids hyperstimulation of the uterus.
#6: After you’ve waited another 2-4 minutes, repeat on the original nipples.
Repeat this process for up to an hour. If contractions don’t start, stop and try again later, up to three times per day.
#7. Once you feel contractions begin, stop the stimulation and let your body take over.
If the contractions stop or stall, you can use nipple stimulation for 5 minutes per breast to increase them. You should stop stimulating if your contractions are 3 or less minutes apart.
If your nipples feel sore and tender, you may find that lubrication helps to ease the discomfort of nipple stimulation.
A natural nipple butter, coconut oil or a few drops of breast milk will work well as lubrication.
Benefits of nipple stimulation for induction of labour
There are many benefits of nipple stimulation for induction of labour.
Nipple stimulation may:
* Reduce the frequency of elective labour induction
* Reduce the rate of relevant complications as a result of labour inductions
* Support normal vaginal birth
* Provide better outcomes for women and babies
* One study showed a reduced c-section rate in breast stimulation group (8% versus 20.4%)
* Significant reduction in the rate of postpartum haemorrhage in the breast stimulation group (0% versus 6%).
Women who are high-risk should seek the advice of their healthcare provider before trying nipple stimulation to induce their labour.
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