The Case for Castor Oil

It was forty-two weeks and two days into my pregnancy, and I was completely out of patience. Between the heartburn, the back pain, and the anxiety, I hadn’t slept more than a few hours a night in a month. I was DONE.

So on Sunday morning, I said damn the torpedoes, and ate two servings of Ina May’s castor oil eggs. I was in hard labor less than three hours later.

There were great things and crappy things about my labor. But one thing that took me by surprise was the pain. From the very beginning, my contractions came hard and fast, so intense that they felt like physical blows that knocked me down and then kicked me again before I could get back up. The pain was beyond description, so overwhelming that I asked for an epidural, even though I knew full well all of the great reasons not to get one.

Shortly after that, my waters broke, and they were stained with meconium–-a possible sign that my baby was not doing great. I was threatened with a c-section, but asked for more time, and ended up birthing vaginally. An hour after my baby was born, she was taken away from me for three hours to receive IV antibiotics to treat the fever that she had been born with.

We know that pitocin given in labor can cause this experience of intensely painful, hard-and-fast contractions that come too close together for the body to recover in between. We also know that because of this, pitocin given in labor can cause fetal distress, the signs of which are meconium-stained waters, fetal heart decelerations, and sometimes, maternal fever. 

I experienced all of these things after taking castor oil, and before being given pitocin. So I got curious: were my hard, fast, painful contractions caused by the castor oil? Was the castor oil a contributing factor to the meconium-stained fluid, the fever that I and my baby both developed, and the heart decelerations she’d had while I pushed? Was it possible that this absolutely classic, “safe,” non-pharmaceutical induction method could actually be a bad idea? 

Given my own experience, I fully expected to find some surprising positive correlation between castor oil use in late pregnancy, the kinds of complications I had, and c-section, which is often spurred by those complications. 

But I didn’t find that. Instead, I found overwhelming evidence that not only does castor oil seem to be super effective at starting labor in post-dates pregnancy, but that it also seems to be super safe at starting labor, carrying none of the same side effects as pitocin. It even seems to greatly increase the likelihood of vaginal delivery as opposed to c-section. 

In a study conducted in Brooklyn, NY, fifty-two pregnant women who were past their due date were given around 4 tablespoons of castor oil (about the same amount I consumed in my two servings of Ina May’s castor oil eggs). Thirty of those fifty-two started labor within 24 hours of their dose (that’s 58%, as opposed to 4% of the control group). Of those thirty women, 83% delivered vaginally. 

Another study conducted in Israel found similar results, with the important note that castor oil consumption only increased the likelihood of labor starting that day and ending in vaginal delivery for women who had already given birth vaginally at least once. And another out of Purdue found that 91% of women who had consumed castor oil to induce labor were able to give birth vaginally at a freestanding birth center, with little to no complications. 

A meta-study out of Iran that looked at over 1200 women total found that 81% of those women in the study induced with castor oil gave birth vaginally, as opposed to 69% of women in the control groups. That’s a reduction in c-section rates from 31% (about the U.S. national average) to 19%, just from using castor oil to start labor–a pretty great benefit. This meta-study also looked specifically at complications, and found that the incidence of meconium-stained amniotic fluid was actually three times higher in control groups than in groups that started labor with castor oil. 

Pretty much the only consistent bummer associated with using castor oil to start labor after 40 weeks was…drumroll please!…diarrhea. Almost everyone who took castor oil got diarrhea. For the record…I did not (hey, a win is a win).

Most of these studies went so far as to recommend that castor oil be used instead of pitocin to start labor in people past their due date, given that it seems to confer all of the benefits, none of the side effects, and contribute significantly to better outcomes with fewer interventions in general. 

I still have questions that these studies didn’t answer: Could consuming castor oil have any effect on rates of epidural use? On perineal tearing? On homebirth outcomes? Did people who took castor oil report hard and fast contractions, such as those I experienced? How about the rate of incidence of maternal and neonatal fever? I would love to see a meta-study that directly compares pitocin use and castor oil use in terms of complications and outcomes. In addition, I did find spotty evidence that using castor oil to start labor might be less effective for people who haven’t birthed before, and even a tad bit risky for people who have had previous c-sections. I’ll dive deeper into those questions in a future post.

I have to admit, I would have loved to have found that the castor oil I took was one of the reasons for the troubles I experienced during my labor. It would have been such a simple explanation, with conclusions that I could act on immediately in recommendations to my clients.

But according to these studies, it’s next to impossible that the castor oil caused my baby to poop in utero, and it’s likely that it contributed significantly to my accomplishment of a vaginal delivery, rather than a c-section delivery.

Did you take castor oil to start your labor? What was your experience like? I’d love to keep hearing stories about this.