Is Black Cohosh safe to induce labor?

In the art of full disclosure, I have never been pregnant, and have no children, so I don’t personally know the feelings of pregnancy.  That being said, I did work in women’s health for a short period, and I have a ton of friends and family who have been there, done that, are doing it multiple more times, and love to talk about it! I love to chat with my friends about the trials and tribulations of their pregnancies, and I think it is such an exciting time. The only time that I think “yikes” is when they are at the end of their pregnancy, digging deep to work basically until they go into labor, they look miserable, and they tell me how exhausted and miserable they truly are. So, I know that people are always looking for ways to induce labor, towards the end of the pregnancy (i.e. after 39-40 weeks) and I always hear the suggestion of Black Cohosh to take as an herbal supplement that will induce labor, but I wanted to look into the safety, the dose, and if it actually works? Labor induction is really just a fancy term for starting the birthing process before your body spontaneously goes into labor, and many people get antsy towards the end of pregnancy, especially if they don’t go into labor after their due date!  Some people say yes, some say no, and I started to wonder if it is how you take it, the dosages, or if your body needs to be ready!

What is Black Cohosh?

Black cohosh is also known as snake root or rattle root, and it is from the buttercup family, which is a perennial plant that is native to North America. It has been used for thousands of years by women to treat all sorts of womanly ailments, including induction of labor…and the juice was used as bug repellant because bugs tend to hate black cohosh and never go near it.

How does it theoretically work?

Apparently there are two different types of cohosh: black and blue.  Black cohosh is thought to have a uterine tonic effect, in that it supposedly strengthens the uterus and causes contractions to occur, and nourishes the uterine tissues to ready them for labor.  Blue cohosh is thought to be similar but causes stronger contraction effects.  But women also take this supplement to ease the symptoms of menopause, PMS symptoms, decrease cramping related to periods, and all of these women claim it works wonders. There is some research to support the use to ease menopausal symptoms, despite the mechanism not truly being understood.  Sounds like a miracle drug to me; it fixes all female issues, right?  In theory, it works similar to estrogen on the body, but it has not been able to be proven. The problem is that while the drug, anecdotally, helps to induce contractions and start labor, it does not “ripen the cervix” in that it can cause the start of contractions but the opening to your uterus, the cervix, is closed tight, which can lead to the need for a cesarean section (AKA a c-section);  a surgical incision through the mother’s skin, into the uterus, to deliver the baby through the stomach when they are unable to deliver vaginally.  The goal is to not require a c-section, but to lead to a successful vaginal birth, so the need to ready the cervix is crucial, or you could just cause yourself one long, uncomfortable labor, and possibly the need for a surgical intervention.

How much do I take?

Before taking any herbal supplement, I strongly encourage you to talk to your Healthcare Practitioner (HCP) so you know how much you should take or what interactions you should look for.  The only suggestions for doses to take for induction of labor is 5 drops of black cohosh tincture to a cup of water or tea, starting with one cup a day and moving up to two for a week, and then increasing to 10 drops of tincture per cup for two cups a day until you go into labor. As I said before, this is intended for people who have fetuses of appropriate gestational age (i.e. read to be born so 39 weeks and above!) any younger fetuses, and you run the risk of per-term labor and a premature birth. It is noted that when black cohosh is used for menopausal symptoms, the supplements should not be taken for longer than 6 months at a time, and the “tinctures” don’t allow you to know how much you are ingesting, and you should only take no more than 900mg/day.

Are there any side effects?

– Headache

– Stomach irritation/upset

– Liver failure in high doses

– Seizures

– Low blood pressure

– Irregular heartbeat

– Visual disturbances

– Postpartum hemorrhages (bleeding post birth is difficult to stop)

– Neurological impairments in the babies (when both black and blue cohosh are used)

Who should avoid it?

– Women in pregnancy not intending to induce labor

– Women who have (or have had) breast or uterine cancer

– Anyone with liver disease

– Anyone with clotting or bleeding disorders (clotting factors are made in the liver- the supplement may make the problem worse)

– People with allergies to aspirin

– Anyone with any chronic conditions on medications, until you clear it with your HCP

*I urge anyone thinking about taking an herbal supplement, for any reason, at any point during their pregnancy to discuss with their HCP because of the possible side effects on you and your baby.

All this being said, I really cannot find any true science behind this working, it is all word of mouth, with some women claiming it works, and others say it doesn’t do anything.  I was really hoping there would be some sort of consensus on how to take it, how much, how it actually works….but there is nothing for the induction of labor, only suggested uses for menopause.  My best advice is to talk to your HCP, and go with what they suggest, as there are many other non-herbal ways to induce labor! Plus, nature has a way of working things out, and so does your body; you may want this baby out, but maybe there is a reason your body wants to hold on and protect your wee one for a little bit longer, so try to work with your bodies timing, and if you do need to be induced, go with a safer route….or at least under the guidance of your HCP.

Yours in Good Health