So, what starts labour then? Any knowledgeable types out there?

[hobnob57]

The reason for my asking is that I was induced at 40+14 last time and ended up with an emcs and I really want a VBAC. Consultant midwife is saying that I'm likely to be post dates again so I need to consider my strategy for that. I KNOW I can wait it out with monitoring, but I also know how fed up I was last time and how I could potentially make a snap decision to have a CS that I would probably later regret.

So, are there physiological triggers for labour, and can they be accelerated by other things? I want to know the facts as opposed to the old wives tales so that I can either totally relax and wait for things to happen themselves without fear of missing out on a chance, or get active with some of the 'speeder uppers' (none of which worked for me last time, but hey, was I doing them enough?).

I think I know the answer to this because of preterm births, but is it normal for labour to be able to start without baby's head being engaged/pressure on cervix? This baby (and the last one) seems to do a lot of popping in and out of the pelvis but never staying there for too long or until I change position. Will sitting on a ball/dining room chair backwards etc. all the time really help with engagement and will this actually make any difference to labour starting? Or could I just slob out on the sofa and be comfy for the next 3-5 weeks?

And, if by some miracle it does start itself, I see that a lot of women go to bed for a bit to sleep when they can. But this is usually when baby's head goes AWOL for me. So do I sit up and wait it out? I seem to remember exhausting myself doing this with DD when I had very regular and strong BH for over 10 days, but it would be worth it if it really helps my chanced of spontaneous labour. I just found the recovery from the emcs so debilitating for so long (combined with SPD that didn't go away), I'd really rather do anything to avoid it again. So encouraging labour by 40 weeks is on the cards, but I know I could just wind myself up with it and make myself more tense than need be so I'd just like to know what evidence-based ideas seem to work (if any).

Do we actually have a clue what the physiological labour triggers are? It's always struck me that if men got pregnant, a whole lot more research would be done into things like morning sickness, labour, etc., but that's a whole other thread

hoovering, worked both times for me!

If only I knew I would be doing it myself!

The things I have been trying are...

• evening primrose oil (taken internally)
• nipple stim
• acupressure (I looked on youtube for a demo of some points).

Don't know if they work but it is easier than eating a million pineapples!

The time needs to be right
Physical activity
Optimal fetal positioning
Membrane sweep when cervix is favourable
Sex - prostaglandin in ejaculate
Some evidence for acupuncture/relexology

Pineapple - you need to eat your weight in pineapple for it to make any difference
Raspberry Leaf Tea/Capsules - can make 2nd stage a bit quicker/easier but does not induce labour

I did most of the above as I too was desperate to avoid repeat CS. I had the benefit of vaginal delivery with DS1, so knew it could be done, but had been 15 days over dates with him.
DS3 arrived 40+12 .
To this day I'd swear that vigorous membrane sweep followed by pushing DS2 on his bike all afternoon set me off overnight. Dr who did the sweep said to me: "Do not go home and put your feet up: scrub floors on you knees!" but: physical activity + hips higher than knees = I kinda see her point...

Good luck to you . Hope you get the delivery you want.

Hmmm pacific you've got a point about time being right. I tried the following for DD:
sex (can't remember how either)
2 sweeps
long walks
hot baths
nipple stim
RLT capsules (set of mega BH which got me all excited but got me nowhere - now wondering if it's worth it?)
sitting on ball
curries
mild laxatives (was desperate!)
Scrubbing floor (but was SPD agony)

Didn't know about Bishop's scores - I'm now wondering what mine was with DD?

So, do we reckon it's all worth another go then?

what's the bit about hips higher than knees?

I'm tired of pineapple too mrsH and I've only had 1/4 of one for 2 nights in a row so far. Might knock that one on the head.

Fact is, science does not really know what sets off labour, that's why babies delivered between 38 and 42 weeks are considered "term".

Hips above knees is to allow for better fetal positioning which in turn can put pressure on cervix which in turn can lead to hormone cascade etc etc... you see where this is going ! So, sitting like I am sitting just now (big comfy low sofa, feet on higher hard chair) is baaaaaad - apparently - but oh so comfy and good for swollen ankles .

Grrr. Half of me wants to say 'sod it' and forget all of this and just be as comfy and happy as possible, distracting myself with other things and seeing what happens.

But I don't think the practical side of me will let me do that....

BTW my consultant MW said that optimal foetal positioning shouldn't be something to stress about since that's what labour is designed for - to get foetus into the best position for labour (although it obviously doesn't work in every case). Difficult not to pay attention to it at times though, especially when it is so espoused by yoga teachers, etc. Anyway, not sure it helps to START things? But then, as tesco says, every little (might) help?

I was talking about this with MW today, she was advising me to do anything it takes to go into labour before 40 weeks, though I have doubts about being able to influence much especially as DS was 10 days overdue! But anyway she said something about reflexology...

With DS2 my MW told me that the prostglandin in semen was great for starting labour, but it was even more effective if taken orally, IYKWIM...tried it, had a show the next morning, DS2 arrived following morning. Might have been coincidence, or there might be something in it...

Oh god though. I'd rather have pineapple on the menu right now....think will have a piece then go scrub floor again.

I've heard that easy but not sure it's my kind of thing TBH - well done you though!

I've been thinking about things and considering the fact that 2nd babies don't always engage before labour I've decided to be less het up about positioning, but perhaps will look into reflexology or something of that ilk. My yoga teacher was showing us some shiatsu points which will work (only if labour is imminent though - kind of accelerator points if you like).

Saying that, as I went to bed last night I got lots of shoving from the wee one, but it was banging its head off the corner of my pelvis rather than the space in the middle (why do babies do this?!) and I was SOO tempted to sit up and help it along. But as I said, I did that a lot last time to no avail and just got knackered

The fact is nobody really knows why we go into labour when we do, it is a cocktail of hormones produced by mum and baby is the best we know. There is no evidence to support any of the recommened strategies to 'kick start' labour but sex, reflexology, membrane sweep and acupuncture are low risk things to try with anecdotal evidence of success. The truth is that we don't really know whether mowing the lawn etc started labour or whether it would have started anyway. Good luck!

There is nothing you can do. Even a sweep will only work if you're just about to go into labour anyway so is it really helping iyswim?

The baby sends a signal when it's ready and am personally of the belief that I wouldn't want to encourage a baby that wasn't ready anyway.

Of course there will be people who had sex/ate curry/gave dh a blowjob and it all happened but there will be an awful lot of people who did the same things and didn't have a baby.

In terms of them being engaged, dd was fixed and deeply engaged from 31 weeks. She was born at 39 weeks, via em cs after a 28hr labour and 6hrs of pushing. She wasn't so much engaged as utterly wedged in. The labour and a free moving head are what allows the baby to be guided down in the right position.

I understand you're frustrated but you'd be better off putting your feet up.

Yep, it all sounds like sense to me. Yay.

But there's always the niggle that if DD had kickstarted labour earlier, her head would have been smaller and may not have got quite so spectacularly stuck, and would have avoided the emcs. And if I can encourage this one that it's a good idea then it can only be a good thing. But it seems it's baby's perogative after all. Shame they don't share the same reasoning as we do!

Haven't read whole thread.

Apparently fresh pineapple has some useful enzymes in it for starting labour. I ate 2 and went into labour the next day...but it could have been chance! (Or pineapple poisonning)

To ingest enough of the pineapple enzyme to even minutely start affecting you, you would have to eat 8 fresh pineapples. And it wouldn't do anything anyway.

I think once you've had an em cs you always think 'what did I do wrong' or 'could I have done more'? Like I said dd was fixed and engaged and was ridiculously stuck after 6hrs of pushing. 3 surgeons tried to pull her out with a ventouse. One put both hands inside me, tried to twist her head and push it back up inside me. It Did Not Work.

The baby's head is designed to move through the pelvis when the baby is in the right position. It moulds to your body. Its size is mostly irrelevant. Sometimes it doesn't work like that.

I really, really wish you all the best for a successful VBAC. Please come and tell us what happens.

Agree that size of baby's head does not really matter much - certainly not as far as starting labour goes.
V small premature babys with obviously small heads are often difficult deliveries (if it is a vaginal delivery) because they cannot apply the right kind of pressure to the ccervix. Also most of baby's weight gain towards the end of pregnany is fat, so squooshy stuff

I had an emergency cs with my first and am just a few weeks pregnant with second so enjoying the luxury of labour being a long way off yet. I would love to have VBAC but remembering what it was like and bearing in mind what i am like (i seem to hold things in...!) i am not too hopeful. Anyone know the statistics for successful VBAC? I do not want to do 14 hours of being on a drip with double contractions going on only to be told by the midwife every hour that i am no more dilated than i was at the last check...

Redblue - the stats that are often quoted are that you have a 70% chance of success.

Factors that can change your odds include:

• whether you go into labour by yourself
• being mobile during labour
• whether you have ever had a vaginal birth
• the reason for your previous section.

There are others but I have to go pick up DD now!

Good luck - I hope it works out for you My consultant tells me that positive thinking is the way forward!

I found this website very useful and informative.

HTH

Just had my 38 week appointment with MW and baby's head is still 'free'.

BF at the same stage as me has just had her baby boy

I think I'm in for the long haul again. I'll try a long walk daily when it stops raining out there for once. My ball is a little deflated these days.

you know, im not sure that doing all the tricks in the book would bring the baby on and make you avoid a c-section.
i did everything i could to get labour started with DS (acupuncture, pineapple, curry, walks, sex, raspberry leaf tea etc..) what for? I lost my waters prematurely. Had to be induced and then had to have a c-section...
so this time around, be sure i'll steer clar of everything... id rather be pregnant for 10 months than stupidly risk another emcs