The number of natural induction methods and options have grown exponentially over the last several decades. In my practice, as an Acupuncturist, I’ve seen a huge influx in women seeking Acupuncture and alternative medicine to speed up the labor process in the avoidance of a medically induced childbirth. While most of the natural induction methods are fairly harmless and offer some benefit in triggering the natural hormonal reactions of labor, there are some that would be better left on the shelf
First off, we should probably address the WHY behind the number of women seeking natural options to encourage the onset of childbirth.
The current medical model of birth is intimidating for the modern mother. The US birthing statistics are pretty dismal. Currently the US is ranked 47th in maternal care in the world, just under Iran. A 2016 report by the Center for Disease Control stated that 23.3% of births are medically induced. In fact, a survey done by Childbirth Connection found that 41% of women who delivered in US hospitals in 2011-2012 had their primary care provider attempt induction. Of those 3 out of 4 did have their labors induced. That is a frighteningly high number, and enough of a scare to cause the most medically trusting of women to consider home options for labor induction.
What is Evening Primrose
Evening Primrose, Oenothera biennis, is a plant native to North America, Europe and Asia. It produces beautiful yellow flowers that bloom in the evening, hence the name Evening Primrose. It has a long and rich history of use among Native Americans as a topical anti-inflammatory for conditions such as minor wound healing and eczema, and as an internal cure for sore throat and gastrointestinal conditions. Ayerveda prescribes the herb for the treatment of women’s conditions. Pliny the Elder, the ancient Greek philosopher, spoke highly of the herb and its use in the treatment of several ailments. In modern Herbology it has found a popularity in the treatment of women’s health disorders such as PMS, breast lumps and tenderness, menopausal conditions, and among midwives and lay women as an aid to induce childbirth labor.
So, How Does it Work?
The active ingredients of Evening Primrose oil are Gamma Linolenic Acid (GLA), Linoleic Acid (LA), Oleic Acid, Palmitic Acid, and Stearic Acid, with the two most prominent compounds being GLA and LA. Both GLA and LA are polyunsaturated Omega 6 fatty acids. Linoleic Acid is considered an essential fatty acid, as it cannot be made in the body and must be consumed in the diet. Gamma Linolenic Acid is naturally produced in the body by the conversion of the LA found in the diet. Both of these Omega 6 fatty acids serve a purpose in the body, and both are part of the production of prostaglandins. As the cascade of LA conversion unfolds, LA is converted to GLA which is converted to Dihomo-Gamma Linolenic Acid (DGLA) and lastly converted into Arachidonic Acid (AA)...AA is then converted into a variety of prostaglandins and blood coagulators.
Prostaglandins and Labor
There are multiple forms of prostaglandins in the body, each with its own unique functions. When we are talking about the activation of the labor processes we are talking about the 2 series prostaglandins, or PGE2/PGF2. PGE2 prostaglandins are triggered by the naturally occurring increase in estrogens at the end of the maternal gestation period. As the estrogens increase, so does the production of PGE2 and PGF2-alpha, as well as PG receptors on the cervix. PGE2 has been shown to stimulate interleukin-8, an inflammatory cytokine that promotes the influx of neutrophils and induces remodeling of the cervical extracellular matrix, and to induce functional progesterone withdrawal. PGF2-alpha has been shown to increase the levels of oxytocin in the uterus, decrease progesterone levels and increase the production of Hyaluronic Acid in the cervix in conjunction with interleukin-8 produced by PGE2. These are all great things for the natural labor process. The importance of the cervical softening aspect of labor is, arguably, the most important part of natural labor. If the cervix is not soft, it cannot dilate. All of this cannot happen without adequate AA.
Not all Prostaglandins help with Labor
DGLA can take another prostaglandin pathway to form the 1 series prostaglandins. While PGE2 is an inflammatory prostaglandin, PGE1 is an anti-inflammatory prostaglandin. PGE1 is widely used for its ability to dilate blood vessels and increase blood flow, reduce platelet aggregation and lower blood pressure. In the normal consumption of Linoleic Acid the body naturally converts the Omega 6 oil into the necessary prostaglandin forms, either 2 series for increasing inflammatory responses, or 1 series for increased vasodilation and anti-inflammatory responses.
Evening Primrose Theory Vs. Reality
When you read this, it is hard to see the faults. In theory Evening Primrose oil would seem a miracle for the induction of labor. I contains not only the LA which comes down the cascade to produce both PGE1 and PGE2/PGF2 prostaglandins, which is a balance of anti-inflammatory and inflammatory responses. As well as the GLA, which in theory would also induce the same response, increasing the prostaglandins as needed for either inflammatory or anti-inflammatory responses. Theories are always well placed, and in theory, if evening primrose is beneficial for other women’s health conditions, such as menopause and PMS, would it not also be beneficial for the pregnancy mother. Although Evening Primrose Oil contains both dietary Linoleic Acid and Gamma Linolenic Acid, and the body can convert both into the correct inflammatory prostaglandins, there is concern over the wide use of Evening Primrose for the induction of labor, because dietary GLA works differently than converted GLA.
One of Evening Primrose Oil’s claims to fame is its ability to raise PGE1 levels WITHOUT raising PEG2 levels. (And there is the snap) Several research studies have given this claim backing. Dietary GLA seems to skip the AA conversion steps, not sure why or how. When GLA is consumed orally, it is converted to DGLA while the AA levels remain the same, thus increasing the production of PGE1. While this is great for those with cardiovascular disease, this can be dangerous for those at the end of pregnancy.
Could Evening Primrose increase the Risk of Postpartum HEMORRHAGE
Increased levels of PGE1 are associated with thinner blood, and bleeding issues. The rate of postpartum hemorrhaging has risen exponentially since 1993. So much so that the standard care policy with hospital birth is to administer pitocin postpartum for prevention for all women birthing in US hospitals. Evening Primrose Oil usage can increase this risk, especially when used in conjunction with high dosed fish oils. The combination could lead to blood that is unable to clot properly.
As much as we love our anti-inflammatories, and we should, labor and birth is an inflammatory process. Each of the hormonal cascades necessary to induce labor require inflammatory reactions to work properly. If we are decreasing inflammation by increasing the consumption of anti-inflammatories, this could lead to a delay in the initiation and onset of active labor, leading to an increased need for gestational inductions. Which is what women seeking these alternative methods are trying to avoid.
Is the Risk Worth it?
As much as we love our anti-inflammatories, and we should, labor and birth is an inflammatory process. Each of the hormonal cascades necessary to induce labor require inflammatory reactions to work properly. If we are decreasing inflammation by increasing the consumption of supplemental anti-inflammatories, this could lead to a delay in the initiation and onset of active labor, leading to an increased need for gestational inductions, or birth complications. Which is what women seeking these alternative methods are trying to avoid.
There isn’t much scientific evidence for the safe use of Evening Primrose oil orally, with more research linking its usage to an increase in birthing complications. One study found the use of Evening Primrose Oil starting at the 37th week of gestation did not shorten gestation or overall length of labor and was associated with an increased incidence of prolonged rupture of membranes, increased need for medication oxytocin use, and an increase in the need for vacuum extraction.
Although the use of Evening Primrose Oil for the initiation of natural labor is an often recommended herbal remedy to women looking to avoid the medical interventions that are ever growing in the United States, it may offer more risk than benefit.
Safe options are available, such as Acupuncture, Chiropractic, and the overall benefits of proper nutrition prior to delivery. If you truly want to decrease your overall risk for medical induction and complications, understand HOW nutrition affects your natural labor and delivery processes is essential and should be part of the modern maternity nutritional care.
Echinacea - Purple Coneflower
Echinacea, or Purple Coneflower, is a member of the daisy family. It is native to North American prairies and open woodlands. There are nine species within the genus Echinacea. The most commonly used for medicinal preparations are E. purpurea, E. augustifolia, and E. pallida. All varieties are perennial and easy to grow, making them a good beginning for someone starting a medicinal garden. In my opinion, no medicinal garden is complete without some of these beauties.
E. purpurea or Eastern Purple Coneflower, is the most popular as a cultivar. It is shrubbier in appearance and will grow up to 4 feet tall and 2 feet wide. This variety does not have taproots, like most other species.
E. augustifolia or Narrow Leaved Purple Coneflower or Blacksamson Echinacea is a bit more spindly than the E. purpurea, and will only grow 1-2 feet tall.
E. pallida or Pale Purple Coneflower, is similar in structure and appearance to E. augustifolia, but it grows slightly taller, 2-3 feet tall. Like the E. augustifolia, they grow in long stemmed clumps, making them good for cutting.
It is better to grow seedling indoor and transplant once they are about a foot tall. Seedlings make a good meal for grasshoppers and slugs, their only real predators. They also have a hard time competing with weeds, and do not do well with mulch, as it holds too much water. Echinacea attracts pollinators such as bees, butterflies and if the cones are left during the winter, they will attract birds.
Well known for its anti-microbial properties, it has become the most recognized medicinal herb. Which, unfortunately, because of its demand on the herbal market, it has been over harvested in many areas of the country. It is so easy to grow, that every medicinal garden should have Echinacea. (Did I already say that?)
All parts of the plant are used, although each has a slightly different chemical composition. The flowers and stems are the most commonly used medicinally, which are higher in polysaccharides that stimulate the immune system.
There is debate over which compounds within Echinacea are the most beneficial, but it is most likely a synergistic relationship between them all that gives Echinacea its medicinal qualities. (which is the case with most herbal medicines)
It is also good to note that wild collected herbal supplements may have been mis-identified. There is another plant, Parthenium integerfoium, which looks the same, but has no medicinal value. Another good reason to grow your own.
Native Americans throughout North America have a long history with Echinacea. Although we think of it as preventing the common cold, the Native Americans used it primarily to treat the symptoms, like sore throat, headache, cough, and fever, and to shorten the duration of the cold.
Treatment of the common cold is definitely the most common use for Echinacea. The key is to begin taking the herb as soon as you feel your symptoms (cough, runny nose, sore throat) coming on. Like many other herbal cold treatment, the herbs active ingredients need a strong functioning immune system to work. Once you are days into a cold, it may be too late to stimulate and strengthen the weakened immune system. It is best taken as a tea, several times a day, until symptoms are gone. How does it work?
Antimicrobial (Bacteria, Viral, and Fungi)
As an antimicrobial that can affect bacteria, viruses, and fungi, echinacea can be used for a variety of infections including: respiratory, urinary, candida, herpes, skin infections, and preventing infections in wounds. The Native Americans wound grind the roots and mix into a paste with water and apply it to skin infections and wounds.
Echinacea was traditionally used by the Native Americans to relieve the swelling and inflammation associated with injury, specifically insect and animal bites. Not planning on playing with any snakes, well it can also be used to reduce the inflammation of arthritis, muscle pain, acute burns, and acute tendon injury (sprains)
Dosage and Preparations
There are several ways that you can take your beautiful Echinacea bounty and use it or store it. You can use it fresh, dry it, or make tinctures. Because so many parts of the plant are medicinal, and making a tea (which you can out of just the leaves and flowers) out of the whole plant can be a little difficult, I like to make tinctures.
The flowers can be harvested during their bloom and hung upside down to dry. You can then vacuum seal them and store them in the freezer until you need them. Remember that the active ingredients in the leaves and flowers if fragile and once picked they need to be dried in a dark room (sunlight will destroy them), and then after packaging, be kept in a dark, dry place.
The roots are collects in the fall, after the growing season, usually after the first frost. Dry them, also, in a dark and well ventilated room.(remember on the E. augustifolia, and E. pallida have tuber roots.) Don't be in a hurry, they normally take a couple of days to dry (If you are impatient, you can cut them and dry them in a dehydrator.) Once dry, (and make sure they are fully dry, or they will rot in the bags), you can vacuum seal them, or seal them in dark bags and store in a dry place. If you have air tight class jars, those will also work if stored in a dark place.
For the best potency you should wait until the plant is 3 years old before harvesting the roots.
The Fun Part (Making Medicine)
This is probably the most practical for the majority of gardeners. You cut and dry the flowers and leaves, and when you want you add them back to some warm water, and enjoy. The only downside to tea is that they tend to have the least amount of medicinal properties, although they do have some. Teas from the flowers and leaves are pleasant and mild in flavor.
Decoctions are a concentrated tea (if you have ever taken bulk herbs, this is the way you have made them). They are most often made with the root of the Echinacea plant. They are very strong in taste, and are often used as a medicine not as an enjoyable beverage. "A spoon full of sugar helps the medicine go down." Just like the fun saying, a little bit of raw honey may make the drink a little more bearable for those you just can't take the herbal taste.
Buying tinctures in the stores, if you are capable of making them on your own, is a waste of money. They are often very expensive, and the quality can sometimes be questionable. I prefer to make my own when I can. The use of alcohol not only preserves the medicinal qualities, but extracts and concentrated it. A Tincture will also keep its medical effectiveness longer than a dried herb will. Tinctures are easier to store and transport, and can be packed about in emergency kits. Alcohol based tinctures can have a shelf life of 3 years.
Topical ointments are easy to make and use, if you have already made a tincture.
Contraindications and Precautions
When taken correctly Echinacea is a safe herb, but there are some conditions and times when it is not appropriate.
Echinacea and Pregnancy
Echinacea is considered safe to take during pregnancy, if taken correctly. To date, the only major study done to test the safety of Echinacea for pregnant women was published in a 2000 issue of "Archives of Internal Medicine." This study examined the effects of Echinacea on 206 pregnant women, including 112 who took the herb during the first trimester. Women taking the herb did not have an increased risk of having a miscarriage or fetuses with defects as compared to women who did not take Echinacea.
I am often asked questions about what a person can take at home to alleviate specific ailments. This is a great question, and one that I love to answer. Kitchen medicine is one of my favorite topics, and those who have seen me regularly may know that I often tell you to take herbs that you can buy at the grocery store. Why would you buy expensive pills (even herbal supplements) when you can get the same or better remedies at home. This is the first of many to come that will highlight some of my favorite kitchen medicines.
We all (well, most of us) enjoy eating and cooking with garlic, or alum, on a regular basis. (I personally feel you can never have too much garlic in a meal) Did you know that garlic can be used to fight infections, among other things?
One of the active ingredient of garlic is Allicin. To get allicin you must take fresh garlic and SMASH IT, CHOP IT, MINCE IT, PUREE IT, whatever to break it apart. This creates an enzymatic reaction between the precursor Alliin and the enzyme Alliinase. It is this compound that gives garlic is sharp smell and taste, and what leaves you smell, well garlicky when you eat large amounts.
Allicin is VERY FRAGILE and will break down with processing and heat, so cooked and dried garlic have very low potency.
World's Oldest Antibiotic
Thats right, antibiotic. For thousands of years, several different cultures, from the Chinese to the Romans, knew that garlic was a powerful anti-microbial, killing viruses, bacteria, parasites and fungi. In this way it can be used topically for wounds, ringworm, and athlete's foot. As a rinse to treat mouth sores, gingivitis, and chronic tooth decay. And internally to treat and prevent roundworm, ulcers, urinary tract infection, and vaginitis. The great thing about using garlic as an antibiotic, is that it does not kill off the good bacteria in the body. I have seen garlic and probiotic supplements (in the refrigerated section of health stores, or pharmacies) that I just love. (remember that they NEED to be refrigerated or they rapidly lose allicin.
Got a cold? Mayo clinic is currently doing a study to determine garlics effectiveness on combatting the common cold. As of now, the results are very promising, showing that those consuming raw garlic during cold and flu season had fewer, and less severe symptoms.
Promotes Cholesterol Balance
Garlic was once hailed as this amazing heart health miracle. While it does have great heart health benefits, It was a little hyped up (as have many other great food medicines, like Acai). Don't get me wrong, I love garlic and it is wonderful for you heart, but I dislike when huge health claims are applied to a single product. It often come out that this product wasn't quite as great as we made it out to be, when to product talk about is still a very important, good for you medicine.
What garlic does is block the excessive production of LDL cholesterol by the Liver. What this means is that if there IS an excessive production of LDL, garlic can balance it out. But, it should be noted that garlic intake alone will cure the cause of the excessive LDL production. For those of you who are not 100% on the understanding of the Liver and LDL/HDL and what they do exactly....here is a crash course....deep breath....and....go...When the inner lining of the blood vessels is damaged by some toxic, foreign substance, such as free radicals or chemicals, this lining sends an SOS to the Liver. The Liver then sends in the paramedics (LDL Cholesterol) to mend to damage, so YES while they are working to repair the damage done they accumulate in that location which can lead to a blockage in the blood vessel. When the injury is healed, they return home to the Liver as HDL Cholesterol. So, really there is no good or bad cholesterol, just an imbalance in the levels due to an underlying cause. This is why garlic will not against nature and lower LDL level when they are not out of balance.
Garlic can also benefit LDL cholesterol when the presence of free radicals oxidizes the LDL cholesterol. This causes the LDL cholesterol to act out of their natural and attack the lining of the blood vessel causing instead of healing damage. Garlic contains several antioxidants which help to prevent and stop cholesterol oxidation.
You may be asking yourself right now, "These free radical things sound horrible, but what exactly are they?" A Free radical is a molecule that has lost an electron. How do they lose these electrons you ask. Rarely do normal molecules split in this way leaving a loose electron, when it is weakened this may happen. Free radicals are very unstable and are on the look out for other stable molecules that they can steal an electron from. This new hijacked molecule now becomes a free radical. The body makes SOME free radicals naturally as an immune response to kill bacteria and viruses. HOWEVER, when environmental factors such as pollution, pesticides, fertilizers, cigarette smoke, and other chemicals enter the body they can cause an excess of free radicals in the body. Antioxidants neutralize free radicals by giving up an electron to the rouge molecule.
Reducing Blood Pressure
Garlic lowers blood pressure by dilating blood vessels, especially those of capillaries (the smallest blood vessels) The dilation of the blood vessels lets the blood flow more smoothly. Garlic also reduces the rate at which platelets stick together. The combination of these two functions allows for easier pumping of the heart, lower blood pressure, and in turn less stress on the heart.
Dosage and Use
To achieve the medicinal properties of garlic, it must be used fresh. Cooking and processing loses potency. If you are buying a garlic supplement the bottle should read 6,000 mcg of Allicin potential. Note that these do not contain actual allicin, but the precursor that must be processed and broken down in the body. Allicin is very fragile and is not shelf stable. This is why I prefer to get it from fresh garlic!
For topical applications crush one clove of garlic and mix with 1/3 cup of water. Use this within 3 hours, or its potency will begin to diminish (the allicin is super unstable remember). You can up this on a bandage and put directly on a cut to prevent infection, or increase dosage to make a foot soak for athletes foot. You can also put drops into the ear to help fight ear infections, or gargle to prevent and treat gingivitis.
Contraindications and Precautions
YES, even garlic has some contraindications. I have heard people say that kitchen medicine doesn't have side effects, or contraindications (I've even heard people say this about herbs in general, man are they misled). Even things they we consume as food can have precautions.