Natural methods of labour induction (1) Sex/ coitus

Last post I was querying the efficacy of ‘natural’ forms of labour induction…

** DISCLAIMER: this is an examination of the current literature only. Please do not try any of these methods (or anything else that would be considered stupid!) without first discussing with your own healthcare provider **

First on the list – sex (or – to be said with stiff upper lip – coitus).

This is one thing my obstetrician said could definitely bring on labour. Let’s look at the evidence…

The action of sexual intercourse in stimulating labour is unclear, it may in part be due to the physical stimulation of the lower uterine segment, or endogenous release of oxytocin as a result of orgasm or from the direct action of prostaglandins in semen. Furthermore nipple stimulation may be part of the process of initiation.

A Cochrane review looking at the effects of sexual intercourse for 3rd trimester cervical ripening or induction of labour found that the role of sexual intercourse as a method of induction of labour is uncertain (mainly due to the lack of well-designed studies).

A study carried out at the University of Malaya found that women who had more coitus at term had the same spontaneous labour rate, Caesarean delivery rate, and similar neonatal and other secondary outcomes as the control group (those who did not have more coitus). They concluded that among women scheduled for labor induction who were advised to have sex, an increase in sexual activity did not increase the rate of spontaneous labor.

Another study also carried at the University of Malaya (something about the tropical weather…?) found that having coitus at term did not result in any difference in labour onset and labour induction (compared to a control group).

Another study carried out in Asian populations found that women who reported coitus were less likely to go into spontaneous labour prior to their scheduled labour induction. Reported coitus and orgasm were not associated with adverse pregnancy outcome.

This was in contrast to another study which found that reported sexual intercourse at term was associated with earlier onset of labor and reduced requirement for labor induction at 41 weeks. The authors found that at 39 weeks of gestation, 5 couples needed to have intercourse to avoid one woman having to undergo labor induction at 41 weeks of gestation.

Bottom line: there doesn’t seem to be much evidence supporting sex as method of labour induction but there’s certainly no harm associated with it, and if you can still manoeuvre your body into positions appropriate for sex, then go for it! Congratulate yourself with the fact that by late pregnancy, most women have trouble manoeuvring themselves from the chair to a standing position…

NB: please remember that intercourse is contraindicated if your waters have already broken, due to the risk of infection.

We’ll continue looking at other methods of ‘natural’ labour induction in the next post/s…

REFERENCES
Tan PC , Yow CM , Omar SZ . Effect of coital activity on onset of labor in women scheduled for labor induction: a randomized controlled trial. Obstet Gynecol. 2007 Oct;110(4):820-6.
Omar NS , Tan PC , , Yusop ES , Omar SZ . Coitus to expedite the onset of labour: a randomised trial. BJOG. 2013 Feb;120(3):338-45. doi: 10.1111/1471-0528.12054. Epub 2012 Nov 12.
Tan PC , Yow CM , Omar SZ . Coitus and orgasm at term: effect on spontaneous labour and pregnancy outcome. Singapore Med J. 2009 Nov;50(11):1062-7.
Tan PC , Andi A , Azmi N , Noraihan MN . Effect of coitus at term on length of gestation, induction of labor, and mode of delivery. Obstet Gynecol. 2006 Jul;108(1):134-40.
Kavanagh J , Kelly AJ , Thomas J . Sexual intercourse for cervical ripening and induction of labour. Cochrane Database Syst Rev. 2001;(2):CD003093.

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