Aromatherapy for Induction of Labour

The essential oils of Sandalwood, Ylang-Ylang and Patchouli have been companions of mine for around 30 years and just a couple of months ago I discovered that they can be incredibly valuable in your preparation for birth generally and particularly if you are preparing for a scheduled birth such as an induction of labour or an elective caesarean section.

The reason I suggest them particularly for a scheduled birth is that they are deeply relaxing and capable of producing a meditative, transcendent state of mind. Sandalwood and other fragrant woods and resins are used in places of worship all over the world. Interestingly they are also used as aphrodisiacs due to the very same properties and this is why I first thought of them as late pregnancy oils. On a hormonal level, birth and sex are very alike and they each unfold best when you can get out of your head and into your body. If you skip those last few days or weeks of pregnancy your body won't be in the same hormonal state as it would be in a spontaneous labour. Using the more sensual oils can be helpful in creating situations where your body releases oxytocin. It may not be the same gradual rise in the full spectrum of birth hormones but I have found these oils to be able to elicit beautifully relaxing dream like states. 

In my observation women who access a standard maternity service often get brought into their heads a lot, particularly if they are trying to protect themselves and their babies from unnecessary meddling from overly keen practitioners. As a result they don't get to enjoy the heady, liminal state of mind that occurs naturally in late pregnancy as much as those few women I have witnessed who sidestep the system entirely. Regardless of how 'low risk' a pregnancy starts out as in the system, there are very few women who won't have to navigate decisions around induction of labour or at least around membrane sweeping. NICE (The National Institute for Health and Care Excellence) now stipulate that your providers should talk to you about induction of labour right from the start of pregnancy.

There is great power in suggestion and on a subconscious level every single woman is told that it is fairly likely that her body won't know when or how to go into labour. 

Whether you choose to decline induction of labour or not, the external suggestion of something being wrong (hence we induce) interferes with your emotional landscape. The underlying emotion is generally fear. Fear produces adrenaline and adrenaline will not allow you to enter the headspace that leads you into labourland. 

I have watched women be deeply upset after each of their late pregnancy appointments and needing some time to regulate again. It can be hard work to break down the adrenaline that's released in a mere ten minutes with an insensitive practitioner. 

Enter Ylang-Ylang, Sandalwood and Patchouli. 

Personally, I have loved these oils for how they combine so perfectly into a grounded heady scent. I first discovered them in a book about aromatherapy, spirituality and sensuality. The book explored a variety of essential oils and I made a list of the most meditative and sensual oils and went off to pick the ones I loved the most. If you have been following me for a while you’ll know that for a few years in my early twenties I worked in an aromatherapy shop decanting essential oils into brown glass bottles and serving customers. It was the perfect job for me and I absolutely loved it. I didn't just work with essential oils, I walked the walk; All the way. Once I had identified my favourite oils, everything smelled of Sandalwood or Patchouli with just a hint of Ylang-Ylang.

Everything!

I blended my three favourite oils into massage oils, shower gels, body lotions, perfume creams, deodorants, my shampoo and laundry detergents. I remember this time as a time of being absolutely certain about who I am and I often wonder if this is due to being surrounded by those scents literally non-stop. I was known by my scent then and (for a hot minute) by the jingle bells I wore around my ankles. The 90s saw a true revival of the Hippy movement and I went all in! The aspect that I enjoyed most about having discovered aromatherapy was that I was totally self sufficient when it came to looking after my own health.

I frequently helped my family and friends, too. 

It occurs to me that the longer I had been socialised into the medical system during my years as a medical midwife, the more prepared I was to swap my essential oils for pharmaceuticals. I started to favour paracetamol over clary sage and lavender for period cramps or peppermint for headaches. My resistance to using pharmaceuticals for minor issues like thrush, which could easily have been treated with garlic and tea tree oil, waned slowly.

I got lazy and complacent.

Leaving registered midwifery has led me back to being true to myself again. My essential oils have slowly been reclaiming their space in my day to day life. I carry my oils home after each Essentially Birth clinic so I can be ready to combat whatever might ail me or my family.

I haven't touched paracetamol or any other pharmaceutical pain relief in over two years.

No Lemsips, no cough syrups, just aromatherapy.

My three favourites are featuring heavily again and recently when I was making a little sandalwood/ylang-ylang blend it occurred to me that they are perfect for late pregnancy. Sandalwood, particularly, is associated with mental clarity. It can help you with decision making if you are at a crossroads.

Observing the way in which women are so casually swept up by the medical model at the end of their pregnancies I felt that there needed to be some support for those women who decided to go ahead with an induction of labour. Looking on I can see how hard it is to decline inductions and though I know that there is little to no evidence to suggest that any of the inductions I have witnessed recently potentially improved the odds for the baby, I can see how difficult it is for women and their partners to see the wood for the trees. We are living in a society where our conditioning to see pregnancy and birth as a medical event is strong. Very few women dare to do their own thing entirely and I totally get it. Particularly when they are told their baby's life hangs in the balance if they don't agree. My role is to offer information nothing else. I wouldn't dream of influencing someone one way or another, I cheer you on in any decision you make.

My observation is that the end of every single pregnancy is a time of heightened anxiety regardless of which path you choose. If you have not made yourself known to any institution at all in pregnancy you'll likely feel the burden of doing something that is so counter cultural, particularly if your pregnancy is longer than average and you cross that threshold into your 43rd or even 44th week of pregnancy.  I was recently asked 'Are we doing the right thing?' and of course this isn't something I can answer for anyone. All I can do is be your soundboard, the answer is within you. This can feel like a lonely time and you need a solid network to help you figure out what you want to do. If it feels right to access routine services after all, then you have that option. Having a supportive partner and extended family really helps. 

The difference between the anxiety that is experienced in the kind of setting where a woman tailors her antenatal care to her own needs (sometimes with private scans and blood tests) and a pregnancy experienced in an NHS setting is that the fear and anxiety that is experienced outside of the system is generally your own. There's no care provider who might suggest anything to you (however your neighbour might). 'Big' babies, 'small' babies, 'too much fluid' (marginal and entirely unnoticed by the mother), 'meconium on scan' (clear waters at induction though!), 'ageing' placenta and other utter nonsense that often remains unsubstantiated once the baby is actually born will not occur to you without someone suggesting it to you. Instead you are more likely to grapple with the mysteries of birth particularly if you have opted out of all scans.

Will my baby be perfect?

If you access routine NHS pregnancy care, like the vast majority of my clients do, late pregnancy is inevitably going to involve some conversation with people who will at the very least offer induction of labour and at worst push it. If 'prolonged pregnancy' is the only 'issue' this will now be at 41 weeks on the button.

There is a lot to say about induction of labour and I personally think it is irresponsible on behalf of policy makers and clinicians to induce the labours of around half of all pregnant women. In a nutshell routine induction of labour for prolonged pregnancy does not save babies' lives but it comes at a disadvantage for both mother and baby. It is a nuanced topic that I write about in much more detail in my book 'Seven Secrets Every Woman Needs To Hear Before Giving Birth' (link below) and a topic that Dr Sara Wickham has written an entire book about ('In Your Own Time'). 

Ultimately the vast majority of women who access routine maternity services and are finding themselves in a situation where the protocol leads to offering induction of labour will agree to an induction eventually and I have all the compassion for that. I totally understand why you might choose to go ahead, particularly if you sense disapproval or fear from your practitioner when you try to explore your options with them. The end of pregnancy is not a time for fighting (which is why I fully support any woman who opts out of conventional care from the outset). Again this is a big  and nuanced topic and in some situations induction of labour might actually be the best way forward. I think it's a damn shame that women are left with trying to figure this out. Your midwives and doctors should take a more measured approach so that you don't have to find yourself in a situation of uncertainty and of having to take it all on yourself. 

Induction of labour is overall a very crude process working on the premise of 'ripening your cervix' and then 'making contractions' and as such it only works with two hormones and mechanical opening of your cervix. The other hormones, hormone receptors, neurotransmitters and endorphins in you and your baby that nature orchestrates so beautifully if the right conditions exist won't unfold the same. Induced labours are generally longer, more painful and less co-ordinated. You are more likely to have an epidural, instrumental birth, episiotomy or caesarean section. Feeding and bonding may take more time and effort to establish. 

In my R.O.A.D. To Birth community we talk openly about all of this and here's what I tell my clients:

- Regardless of which path you take, there'll be advantages and disadvantages, 'risk' is always present and it is helpful to do some work on getting to know yourself. Where do you place your trust; Do you trust yourself more or the medical system? Follow your heart when making your decisions.

- What is your lifestyle like in general? Ultimately our birth preferences will reflect our general way of life. 

- The more freedom in your choices you claim, the more responsibility you take, own your decisions whatever they may be!

- Birth is overall safe in its full spectrum and adverse outcomes are possible but unlikely to occur on each side of the continuum of choice regardless of whether you have a highly medicalised birth or a freebirth.

- Whichever choice you make, work on letting go of your fears.

- If you decide to have a scheduled birth (caesarean or induction of labour) take full responsibility for that choice and go for it with full conviction. You'll enjoy it more!

- Though induction of labour is overall harder than a spontaneous labour, you can have a positive experience. Non-pharmaceutical pain relief methods are still helpful and pharmaceutical methods are available. Be open to mix and match. 

- No intervention is entirely benign, not even a waterbirth.

- No intervention is mandatory. You always have a choice and you can walk away from institutionalised maternity care last minute if that feels like the right thing to do.

- The blueprint of undisturbed birth physiology is intricate and perfect and it cannot be improved upon, knowing it well will help you make adaptations when you choose medical interventions. 

- There is no right or wrong way to give birth. The experience of it will stay with you for a lifetime. Spend time to prepare and put thought into your birth plan. You are entitled to value your experience of birth, it is not selfish. How you feel during birth will impact your early weeks and even years of parenting, it'll impact your child; State your non-negotiables to your birth team and advocate for yourself. Nominate a person to advocate on your behalf when you are deeply in labour, consider a doula.

- Remember that every baby will be born and therefore so will yours! Whatever your choices are around the birth of your baby, celebrate them!

So let's get to how you can use aromatherapy to support yourself throughout the process of a medical induction of labour. Whilst it won't turn an induction into a spontaneous physiological birth, you can help yourself before, during and after an induction, here's how:

From around 37 weeks make an aromatherapy bath salt and a body oil with the essential oils of Sandalwood and Ylang-Ylang. Take your bath before bedtime. In the tub do five to ten minutes of deep breathing with your eyes closed. If you are into affirmations, why not affirm that you are making oxytocin receptors at hyperspeed (you need those for the synthetic oxytocin to bind to for the induction of labour to work). Rub your body oil all over and go straight to bed or, better still, give it to your partner and get them to massage you with it. Enjoy some sensual couple time together. 

Be sure to have a bath and massage the night before your induction of labour and take your oil with you to the hospital. Put it on your wrists and chest and top it up frequently so you can be transported back to your soothing bath times. Sleep as much as you can in the early stages of your induction of labour. Bring some of your favourite foods.

As you move along in the process, give yourself credit for the fact that this kind of labour is unlikely to tip you into the same hormonal processes that happen in an undisturbed labour. For that reason engage with the idea of using pharmaceutical pain relief alongside your hypnobirthing techniques. Still keep your room dark, voices hushed and have soothing sounds around you.

Whilst you might breathe your way through an induction (and I have seen this happen many times), it is also possible that you need other forms of pain relief. Generally this is because the beta-endorphin receptors haven't had the time to fully optimise yet and you also might not enter the feedback loop that makes your body release endorphins to bind on to the receptors. Endorphins are natural opiates and they help you experience less pain in a physiological labour. Don't be hard on yourself if this occurs. You have chosen a medical pathway, make use of those medical interventions that can help you through if you need to. Having to resort to pharmaceuticals for pain relief in an induction of labour doesn't have anything to do with your 'pain threshold' but rather with the fact that your body may not be ready to initiate the response that normally helps you through labour. There's no shame in this. 

After the labour, particularly if you have had an epidural, instrumental or caesarean birth, keep your baby skin to skin for hours and hours. I love the story that Dr Buckley tells in the context of bridging hormonal gaps of a woman who had had the experience of undisturbed birth and then had a caesarean section next time. She said that after three days of (more or less) uninterrupted skin to skin she felt that she was in the same oxytocin induced blissful state that she had known from her undisturbed births. 

For the first couple of weeks avoid the scented oils in your bath and on your skin so your baby can smell just you. However, why not take a few minutes each day smelling your bath salts or massage oil and doing your deep breathing. In reality that is likely going to be while your baby is glued to you. Nevertheless, even a short practice of three to five minutes can help you access the deeply relaxing state that you experienced in the lead up to your birth. 

Finally, prepare some cold packs for your perineum in your freezer just in case you are going to be healing from an episiotomy. 

Also (and this is true for any birth) have some pre-cooked nutritious meals stocked in that freezer. Healing from any birth and particularly from a long labour or caesarean section will take time and it requires nourishment. Good fats, good proteins and lots of greens on a daily basis will help you heal your tissues and make milk if you are breastfeeding your baba. 

At around four to six weeks after giving birth most of my R.O.A.D. To Birth clients enjoy a mama/baby aromatherapy session with me. One of my clients who had a fairly difficult induction of labour and then caesarean section had this to say:

We used the essential oil of Roman Chamomile at a dilution that is suited for a baby and the two of them just drifted off skin to skin. I could hear the baby drink his milk. It is a time of pure connection and of letting go. Processing after any kind of birth, particularly if it's been a difficult birth, happens in layers. I really believe in being realistic about what birth might look like in each setting and breaking down whatever fears may come up for you in the context of your choices. This mama told me that the 'Bridging Hormonal Gaps' session that I offer to all my clients as part of R.O.A.D. To Birth made all the difference to her before, during and after her induction of labour. 

Did you find this helpful? 

If you would like to learn how to use aromatherapy safely in pregnancy and with a newborn baby, send me an email to [email protected]. I will be running a workshop on aromatherapy in late pregnancy and early parenthood at the end of May. I also have two spaces in my R.O.A.D. To Birth community. write me a note If you would like one of them!