Reviewing site statistics, I have always been struck by the fact that the so-called 'DIY' Induction of Labour is always up there in the top 5 most searched terms on our Pregnancy and Childbirth information website.

As a practising obstetrician, however, I am never surprised by this. In my day to day work I am all the time encountering women at term who are otherwise well but who, after 40 odd weeks of pregnancy, just cannot wait for it to be over and done with. They are physically and emotionally drained and would happily swap that stress with the stress of looking after a fragile newborn.

It is an accepted medical scientific fact that by 37 weeks of gestation, a baby in the womb is technically at term and therefore functionally mature and able to cope with the outside world. That is true for the overwhelming majority. However, spontaneous labour may not occur for another three or four weeks, even more. For some, that is sometimes too much to cope with. It is therefore no surprise that these women clamour for labour induction.

There is almost total consensus among obstetricians and midwives that induction of labour before at least 41 weeks in the absence of a medical indication (fetal or maternal wellbeing) is not a good idea. This is for a number of quite valid and powerful reasons which are not the focus of this article.

So, what is the truth regarding do-it-yourself induction of labour at term? Is there a scientifically proven 'DIY' method that works?

METHODS:

* Spicy Food: This is stuff of folklore. There is belief that a food that is highly spicy will soon get labour going. Clearly this is based on the hypothesis that the uterus alongside every other part will be stimulated into contractions. Many might have achieved the 'runs' with this strategy but there is simply no evidence that it is an effective 'natural' induction agent.

* Acupuncture: There are a lot of claims on the effectiveness of acupuncture for induction of labour. However, this is bedevilled by the fact that the specific acupuncture technique is not standardised, the service is not properly regulated and availability is patchy in many places. This means it is difficult to evaluate and a Cochrane Review of studies on the method published in 2001 concluded that they were all poorly designed and therefore this remains unproven.

* Sexual Intercourse is another popular method that I have personally recommended to couples. Like many colleagues, I have done this partially because it is certainly harmless, may relieve some of the stress and, who knows, it might work! The logic behind this recommendation is the probability of facilitating a release of enough prostaglandins and oxytocin to get labour going. Prostaglandins are the natural chemicals that trigger labour onset and oxytocin is responsible for uterine contractions. Penetrative sex does stimulate prostaglandin release from the neck of the womb (cervix) and semen released into the birth canal contains prostaglandins. In addition, if the breast nipples are stimulated, oxytocin is released from the pituitary gland in the brain. So, the theoretical basis appears solid but actual scientific evidence that this works remains weak.

* Castor Oil: Ingesting this is claimed to stimulate the uterus lead to labour onset. Whilst this claim has been around for decades, there is actually no evidence that it works. Moreover, it can cause nausea, vomiting or even diarrhoea, not an attractive prospect for one heavily pregnant at the end of her tether.

* Reflexology: This suffers from the same weakness as acupuncture. Put simply, evidence of effectiveness in induction of labour is lacking.

* Zero balancing: In the US and Australia, alternative therapists offer 'Zero balancing'. This is described as a "hands-on method of balancing body energy with body structure that integrates a Western anatomical view of structure with Eastern concepts into a Zero Balancing protocol". This, strictly speaking, is meant to combat stress and therefore minimize the need for induction of labour.

* Hot baths: They may be good at relieving stress but there is certainly no evidence that they can help trigger labour onset.

* Herbal preparations: Many herbal preparations have been claimed to accelerate labour onset. These include evening primrose oil, red raspberry leaves extract, black cohosh etc. None of these have evidence to back up the claims. There is also the added concern that potential risks, dosage and drug interaction properties are not known.

In summary, whilst the concept of 'DIY' Induction of Labour may be attractive, reasonable and in the right conditions, harmless, there is no real proven effective method out there today that a woman can employ with confidence. It also remains true that even with the proven pharmacological induction methods that doctors use, if the cervix is assessed to be unfavourable, the risk of failure may be unacceptably high.