Whether you’re patiently waiting for your baby to arrive or facing a medical labor induction, chances are you’re curious about how to get labor started naturally.
There are many theories on ways to induce labor, some of which are: eating spicy food; going for a walk; having sex; or engaging in other things that stimulate oxytocin release, such as massage.
Another way to stimulate oxytocin release is through manual nipple stimulation.
Have you heard of nipple stimulation to induce labor contractions?
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 that the innate wisdom of natural processes to assist labor and birth were handed down through generations of women who observed and supported normal births.
Nipple stimulation is used to encourage uterus contractions and help the uterus contract after birth. It can even strengthen slow or stalled contractions during labor. This might help you avoid the risks of medically speeding up your labor.
You can read about the risks of labor induction in BellyBelly’s article Induction of Labour | What Are The Risks Of Being Induced?
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.
You can read more about this in BellyBelly’s articles 5 Things Oxytocin Does That Pitocin/Syntocinon Doesn’t and The Early Days Of Breastfeeding |What’s Normal And What’s Not?
Oxytocin, sometimes referred to as the love hormone, plays a very important role in labor and birth. Oxytocin release causes the contractions that open or dilate the cervix and then push the baby down through the vagina.
The idea behind nipple stimulation to induce labor is that it mimics the action of breastfeeding and causes your brain to release the hormone oxytocin.
Medical inductions are usually started with a synthetic form of the oxytocin, known as Pitocin or Syntocinon.
According to the American Journal of Obstetrics and Gynecology, intrapartum nipple stimulation therapy, used in full term pregnancies, is a feasible and acceptable method of labor augmentation.
How long after nipple stimulation does labor start?
If you’re impatient for labor to begin, you’ve probably skipped ahead to find out how long after nipple stimulation labor might start?
A meta-analysis of randomized control trials in 2005 found nipple stimulation increased the chances of labor beginning. Almost 720 full-term pregnant women were assigned to nipple stimulation to induce labor or not.
Of those women, almost 38% went into labor within 3 days of beginning the nipple stimulation, compared with 6.4% of the women who didn’t stimulate nipples.
Another study in 2014 looked at nipple stimulation to induce labor 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 a rise in oxytocin levels 3 days after beginning nipple stimulation, with a marked increase 30 minutes after beginning.
Other research has shown nipple stimulation to have an effect on the length of labor. A 2015 study 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 intravenous oxytocin or other methods of labor induction and more than 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 the safety of the baby. Nipple stimulation can cause what is known as uterine hyperstimulation. This is when contractions happen too frequently and last too long. It can lead to the baby becoming distressed and requiring medical interventions to be born safely.
That’s 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, where women were low-risk and their pregnancies were full-term, researchers found no evidence of harm when women did nipple or breast stimulation.
One study concluded breast stimulation for low-risk pregnant women might be a safe, efficient and cost-effective intervention, to avoid adverse perinatal effects associated with women 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 group). The women in this study were from India and were considered high-risk, due to having high blood pressure, being post-term, or because 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; in 1% there were reversible fetal heart rate patterns.
Because of the conflicting reports in the scientific literature, breast stimulation is not recommended for high-risk pregnancies.
Are you hoping for a SAFE, NATURAL BIRTH? Learn from some of Australia’s
best educators – you’ll feel more CONFIDENT and skilled heading into birth.
Click to find out more!
7 steps for nipple stimulation to induce labor
Before beginning nipple or breast stimulation, talk to your doctor or midwife about whether it’s the right option for you. Your care provider might not recommend nipple stimulation until you are dilated, as this indicates your baby is ready to be born. Early or preterm birth poses risk factors for poorer health outcomes for you or 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
- You can breastfeed or use an electric breast pump.
Here are the 7 steps to help induce labor:
#1. Stimulate only one nipple at a time, to avoid any chances of hyperstimulation
Hyperstimulation is when your uterus is contracting too often and for 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, towards 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
The recommended amount of time to stimulate varies but the general consensus is a maximum of 15 minutes, to avoid injuring the nipple and hyperstimulating the uterus.
#5. Take a break for 2-4 minutes.
After the break, repeat steps 1 to 4 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 nipple
Repeat this process for up to an hour. If contractions don’t start, stop the process 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 fewer) minutes apart.
If your nipples feel sore and tender, you might 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 labor
There are many benefits of nipple stimulation for inducing labor.
Nipple stimulation might:
- Reduce the frequency of elective labor induction
- Reduce the rate of related complications, as a result of inducing labor
- Support normal vaginal birth
- Provide better outcomes for women and babies
- Reduce the rate of emergency c-section
- Significantly reduce the rate of postpartum haemorrhage, as shown in comparison studies in the breast stimulation group (0% versus 6%).
Women who are considered high-risk should seek the advice of their healthcare provider before trying nipple stimulation to induce labor.