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Black Cohosh to Induce Labor

What it is:

Black Cohosh is another plant that has historically been used by midwives to help induce labor.  It is made from the root and is available as a tincture, capsule or tea. Not much is known about how this herb works, but it is thought to behave like estrogen.  Estrogen may help to coordinate the muscles during a contraction.  They are also important in how our bodies make progesterone, which helps ripen the cervix.

What the research says: 

Several studies have shown an increase in hormone levels, but others have shown no effect.  A new theory proposes that it helps decrease pain, but that has not been studied.  Other than that, not enough research has been done to determine whether black cohosh actually starts labor.


The amount of black cohosh to use during labor has not been studied much.  I have found varying amounts of this herb used and would advise you to discuss it with your care provider.

Possible Benefits:

If the herb acts like estrogen, it may have some ability to induce labor or prepare the woman for labor.

Side Effects:

Black cohosh may cause stomach aces and cramping.  it may also cause headaches and some vaginal bleeding.  It should not be used during early pregnancy.  May possibly cause dangerously low levels of sodium, as seen in one study listed below.

What the doula can do when her client is using black cohosh to induce labor:

-Make sure you and your client are not confusing black cohosh with blue cohosh.  Animal studies have shown more serious side effects with blue cohosh.

-Provide your client with as accurate information as possible

-Help the your client work through the pros and cons of this method

-Encourage your client to also take care of herself, as this helps the body work better regardless of what else the mom is doing

-Provide some ways to help decrease stress and anxiety as this inhibits labor and is often a part of women’s lives when they are feeling pressured(from themselves or a care provider) to have their baby soon

-Be prepared to help provide some pain relief ideas if the black cohosh is creating some cramping.  Some ideas include warm compresses, hot bath, movement, and distraction.  Remember that the moms basic needs still need to be cared for (ie eating, drinking, sleeping).

-Continue to remind them of the different ways their body is preparing to have this baby.  So often we focus on dilation, but that is really one of the last ways your body prepares, and it’s overused as a method of judging when the baby is going to be born.  Focus instead on the baby moving down, the cevix softening, any increases in contractions (even braxton hicks).

Click for more information about how doulas provide labor support.



Blitz, M. J., et al. (2016). “Severe Hyponatremia Associated with Use of Black Cohosh during Prolonged Labor and Unsuccessful Home Birth.” AJP Rep 6(1): e121-124.







Disclaimer:  I am not a doctor and recommend that anything you should choose to do should be discussed with your care provider first.


Follow Rachel Leavitt:

Rachel has worked as a register nurse (BSN from University of Utah) since 2004 with a work history in Labor and Delivery, NICU and Postpartum Care. She is also the founder of New Beginnings Doula Training which she organized in 2011. When she's not busy being a mother and grandmother, she can be found reading research papers related to some aspect of childbirth.

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