![]() Red raspberry leaves are used to enhance uterine contractions once labor is initiated. Black cohosh has a similar mechanism of action, while blue cohosh may stimulate uterine contractions. Black haw, which has been described as having a uterine tonic effect, 6 has been used to prepare women for labor. Although evening primrose oil is the remedy most commonly used by midwives, 5 it is unclear whether this substance can ripen the cervix or induce labor. Commonly prescribed agents include evening primrose oil, black haw, black and blue cohosh, and red raspberry leaves. Given rapid growth in the herbal-supplement industry, it is not surprising that patients request information about alternative agents for labor induction. When the Bishop score is favorable, the preferred pharmacologic agent is oxytocin. Pharmacologic agents available for cervical ripening and labor induction include prostaglandins, misoprostol, mifepristone, and relaxin. Of these nonpharmacologic methods, only the mechanical and surgical methods have proven efficacy for cervical ripening or induction of labor. ![]() Nonpharmacologic approaches to cervical ripening and labor induction have included herbal compounds, castor oil, hot baths, enemas, sexual intercourse, breast stimulation, acupuncture, acupressure, transcutaneous nerve stimulation, and mechanical and surgical modalities. When the Bishop score is less than 6, it is recommended that a cervical ripening agent be used before labor induction. Assessment is accomplished by calculating a Bishop score. Therefore, cervical ripening or preparedness for induction should be assessed before a regimen is selected. In the absence of a ripe or favorable cervix, a successful vaginal birth is less likely. ![]() ![]() According to the most current studies, the rate varies from 9.5 to 33.7 percent of all pregnancies annually. Induction of labor is common in obstetric practice. ![]()
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