How to start labour naturally: what works, what's a myth, and what a membrane sweep does

There's no proven way to start labour naturally at home, and most natural ways to induce labour you'll hear about, from evening primrose oil and raspberry leaf tea to dates and curry, haven't been shown to work. The NHS says food, drinks, hot baths, sex and herbal supplements have no evidence behind them, and Mayo Clinic says neither exercise nor sex brings labour on. The one step with some evidence is a membrane sweep, done by your doctor or midwife: KKH says it makes labour more likely to start naturally in the next 48 hours, and a Cochrane review of 44 trials found it raised the chance of spontaneous labour and lowered the need for a formal induction. If your baby is overdue or there's a medical reason, your hospital will offer induction, which at KKH and SGH means a pessary, a balloon, breaking the waters or a drip, though most labours start by themselves. If you're well and your doctor is happy, it's safe to wait.

What works, what doesn't, and what's safe

If you want to try something, walking and sex are safe for most women, just don't count on either working. Castor oil and herbal remedies are best left alone.

What full term means, and when it's safe to try

Before trying anything to start labour, check where you are. KKH counts a pregnancy as full term from 37 weeks, and SingHealth's guide to induction calls weeks 37 to 40 the ideal time to deliver for an uncomplicated pregnancy.

What a membrane sweep is

A membrane sweep is an internal examination. KKH describes it as a gloved finger making a circular sweeping movement around the cervix to separate the membranes from it. ACOG notes it's done when the cervix is already partly open.

• KKH says it makes labour more likely to start naturally within 48 hours.
• It can be uncomfortable or painful, and you may have cramping and a little bleeding (a show) afterwards. KKH says this won't harm your baby.
• The NHS says it's usually offered after 39 weeks, and you may be offered a second sweep if labour doesn't start.

A Cochrane review of 44 trials with 6,940 women found that sweeping may increase spontaneous labour and reduce the need for formal induction, with no clear difference in caesarean rates, and that women generally felt positive about it. The evidence was low-certainty, so it helps some women and not others. Ask your gynae at your 38 to 40-week visit whether a sweep is an option for you.

When doctors offer induction

KKH says labour usually starts on its own, and induction aims for a vaginal birth when waiting is riskier than starting labour. KKH lists the common reasons:

• A medical condition such as gestational diabetes or high blood pressure
• A concern about the baby, such as growth restriction
• An overdue pregnancy

SGH adds waters that break before labour after 34 weeks. Neither hospital's page names an exact week for "overdue"; the NHS offers induction if labour hasn't started by 41 weeks because the risk of stillbirth rises, and Mayo Clinic says an elective induction should wait until at least 39 weeks. Your own doctor will tell you what they recommend for your pregnancy. The NHS also stresses that induction is your choice, and that if you decide against it after 42 weeks you should be offered extra monitoring.

How KKH and SGH induce labour

At KKH, inductions happen in the Obstetric Monitoring Unit, a 10-bed area in Ward 32, or in the Delivery Suite, and planned inductions are booked at the outpatient clinic. KKH asks you to eat before you come in.

What to expect: SGH says induction ends in a vaginal birth, normal or assisted, in about 6 to 7 of every 10 pregnancies, and that induced labour can be longer and more painful than labour that starts on its own. KKH notes that sometimes the cervix doesn't soften, in which case you may be offered another method or a caesarean, and that a small number of women react strongly and have contractions that come too often or too strong. Talk through pain relief early; our guide to epidurals and labour pain relief covers the options.

When to go to hospital

Whatever you try at home, go straight to hospital if:

• Your waters break, because SGH warns of a risk of infection for you and your baby
• You bleed as heavily as a period
• Your baby moves less than usual
• You have high blood pressure symptoms such as a bad headache or blurred vision
• Contractions come every 10 to 15 minutes for more than 2 hours

In Singapore, KKH asks women 22 weeks or more pregnant to go to its Delivery Suite, and SGH asks women from 20 weeks to go to Labour Ward 52A, open 24 hours. Our guide to the signs of labour covers timing contractions, and stages of labour explains what happens once it starts.

While you wait

The last weeks can drag. A few things that help, none of which will start labour but all of which are safe:

• Keep up gentle walks and your usual exercise if you feel well.
• Rest when you can; labour is easier if you're not already exhausted.
• Pack your bag early; our hospital bag checklist has the list.
• Keep your appointments, where your doctor checks your blood pressure and your baby.
• Count your baby's movements every day and call if they slow down.

For the full picture of the final weeks, see preparing for labour in Singapore and our 40 weeks pregnant guide.

Frequently asked questions

Can I start labour naturally at home?

There's no proven way. The NHS says food, drinks, hot baths, sex and herbal supplements have no evidence, and Mayo Clinic says exercise and sex don't start labour. Walking and sex are safe for most women if you'd like to try, but castor oil and herbal remedies aren't.

Does a membrane sweep work?

It helps some women. KKH says it makes labour more likely to start within 48 hours, and a Cochrane review found it raised the chance of spontaneous labour and lowered the need for induction, though the evidence was low-certainty.

Does pineapple or spicy food start labour?

The NHS says no food or drink has been shown to start labour. Eating them as ordinary food is fine; they just won't help.

Does evening primrose oil induce labour?

There's no evidence it does. The NHS lists herbal supplements, evening primrose oil included, among the methods with no evidence behind them and says their safety is unknown, and Mayo Clinic advises against them. Ask your gynae before taking any supplement in late pregnancy.

Can acupuncture bring on labour?

No Singapore hospital recommends it for that. Thomson Medical's TCM practitioners say acupuncture by a physician is generally considered safe in pregnancy, so if you want to try it for comfort, see a registered TCM physician trained in pregnancy care and tell your gynae.

Is it safe to have sex to start labour?

Sex is safe in an uncomplicated pregnancy, according to KKH, but there's no good evidence it brings on labour. Avoid it if you're bleeding, your waters have broken, or your placenta is low-lying.

When will the hospital induce labour?

For medical reasons such as high blood pressure, gestational diabetes or a concern about the baby, or if you're overdue. The NHS offers induction at 41 weeks; ask your own doctor what they recommend.

How long does induction take?

It varies. A pessary works over 12 to 24 hours and a balloon over about 12, before the waters are broken or a drip is started. SGH says induced labour can be longer than labour that starts by itself.