Giving 'delivery date' a whole new meaning,
this video looks at the potential benefits of dates
for labor and delivery during childbirth.
Check it out.
"Best Food for Late Pregnancy, Labor, and Delivery"
In the 19th chapter of the Koran, Mary is giving birth to Jesus.
I didn't even know Jesus was in the Koran.
The things they don’t teach you in Hebrew school.
It says, “The pains of childbirth
drove her to the trunk of a palm tree.”
She cries out, and she is answered by Gabriel, Archangel and,
evidently, obstetrician—who knew?
Shake the tree, he says, and it will drop
upon you ripe, fresh dates and you’ll be all better,
no epidural necessary.
Do dates really help with labor and delivery?
It would take a little over 2,000 years,
but researchers finally decided to put it to the test.
They had some anecdotal evidence that dates might be helping,
but they wanted to know for sure whether the addition of date fruit
for the last few weeks of pregnancy would reduce
the need for labor induction or augmentation.
That’s where you give drugs to induce uterine contractions,
to initiate or accelerate labor.
It’s one of the most commonly performed obstetrical procedures
in the U.S., dramatically increasing over the last few decades—
from less than 10% of deliveries to now nearly a quarter.
There are certainly legitimate medical indications,
but are often done just for convenience,
and not necessarily the convenience of the patient,
but the provider may also have perverse financial incentives
and other reasons to want to speed things along.
Dates might not help with those factors but might they
help foster a normal spontaneous delivery?
Let’s find out.
A prospective study: women eating six dates a day—
that’s totally doable— during their last month
of pregnancy versus no dates at all, and….
the women who consumed date fruit had
significantly better cervical dilation,
significantly higher proportion of intact membranes.
That’s a good thing.
And, spontaneous labor occurred in 96%
of those who consumed dates, compared to 79% of women
in the non-date group, with significantly less drugs used.
And the labor was shorter, as in about seven hours shorter overall.
It is therefore concluded that the consumption of date fruit
in the last four weeks of pregnancy significantly reduced
the need for induction and augmentation of labor.
The results warrant a randomized, controlled trial.
Wait, what?!
The women weren’t randomized?
They even talk about how it was hard to find women who
would agree to not eat dates because it’s part of their
cultural beliefs.
So, you can totally imagine how there could be all sorts
of differences between the women who ate dates and those who agreed
to go without that could account for the findings.
Maybe the date eaters were more religious,
or higher socio-economic status, or who knows.
Yeah, you can argue what’s the downside,
might as well give dates a try,
but that’s not good enough.
I want to know if they actually work.
But there had never been a randomized, controlled trial...
until three years later.
The effect of late-pregnancy consumption of date fruit
on so-called “cervical ripening” in first-time mothers.
In the last few weeks of pregnancy hormonal changes
cause the cervix, the opening to the uterus,
to start to ripen, to soften, so that when the contractions
start it can more easily dilate open.
At this stage, the cervix loses its integrated structure,
and therefore, it becomes soft and dilated
as soon as strong contractions begin.
Through a ripe cervix you can push a baby out
with like 20 pounds of pressure per square inch,
but if the cervix isn’t there yet
it can require more like 200 pounds of pressure.
So, it goes without saying that cervical ripening
before the onset of labor is important if
you want a normal vaginal delivery.
The search for a safe, inexpensive, and easy method
of facilitating cervical ripening is therefore
of great interest.
So, let’s randomize a few hundred women
starting at like the 37th week to eat about six dates a day—
or not—until their first contraction.
Cervical ripening is rated with a Bishop score.
Normally, a score of 5 or less indicates an unfavorable cervix,
whereas 8 or more and you’re good to go, and…
the average Bishop score in the women randomized
to the date group was significantly higher, closer to 8,
whereas the date-free group was down at around 5,
and the cervix was more dilated in the date group.
And hey, dates are healthy anyway, so maybe dates should be recommended
for pregnant women to help with cervical ripening,
particularly in the last weeks of their pregnancy.
A randomized, controlled trial of hundreds of pregnant women
found that having women eat around 6 dates a day
for a few weeks before giving birth can significantly
improve “cervical ripening,” the readiness of the cervix,
the opening to the birth canal.
You can also use drugs or surgery to prep the cervix.
Oxytocin is the most common agent;
you may have heard doctors talking about Pitocin—
that’s the brand name.
Although it’s effective, it’s use is associated with
multiple potential adverse side effects,
which can affect both the mom and the baby.
If only there were a safe, simple, side-effect-free solution.
Well, dates may fit the bill
The use of oxytocin for labor induction
in the date group was less than half
that of the control group, and the few on dates that were
induced had more successful deliveries.
An earlier study in which prior date consumption
appeared to shorten labor by more than six hours
speculated that maybe dates themselves have oxytocin-like effects.
All right, how about a head-to-head trial,
comparing the efficacy of dates versus oxytocin
in the management of postpartum bleeding.
Postpartum hemorrhage, excessive blood loss after birth,
is one of the major complications of pregnancy
and the leading cause of maternal mortality.
As the placenta peels off, the uterus is supposed
to contract to staunch the bleeding,
and if it doesn’t—
if the uterus doesn’t have sufficient muscle tone—
you can give an injection of oxytocin
to help squeeze off the blood loss.
Like all drugs, though, it can have side effects,
sometimes causing a dangerous drop in blood pressure.
There’s also various devices that can be inserted
to apply pressure, and worst comes to worst surgery,
but why not try fruit first?
Available, cheap, side-effect free,
yeah, but does it work?
They set up a randomized clinical trial to find out.
Immediately after the placenta comes out
women were given a one-time dose of like 5 dates
or an intramuscular shot of oxytocin.
Then they just collected all the blood
to see which worked better.
Overall, three hours after delivery the blood loss average
in the date group was significantly less
than in the oxytocin group, by about a quarter cup.
Check this out.
See how the date group
was mostly in the lowest category,
under two-thirds of a cup of blood loss,
whereas the drug group was mostly about a cup… or more?
Conclusions: use of oral dates
I don’t know how else you’d take them—
after delivery, decreased bleeding more
than intramuscular oxytocin, and it’s a good alternative
in normal delivery.
But wait...
if dates have oxytocin-like effects to contract the uterus,
shortening labor by helping to induce
earlier uterine contractions, might date consumption
increase the risk of premature labor?
I guess we’ll never know…
until now.
The effect of date fruit consumption on the length of gestation.
Starting at about 38 weeks women were randomized
to eat seven dates a day or not.
And… eating dates did not affect delivery dates,
but what it did do, is significantly reduce
the need to hasten labor with drugs.
Half of the non-date group had to be drugged versus 30% less
in the seven-dates- a-day-for-a-week group.
And induction of labor is serious business.
It can increase complications such as bleeding,
C-sections, uterine hyper-stimulation, and even uterus rupture.
And apart from the complications, women who are induced tend to feel
less satisfied with their birth experience.
Therefore, date consumption in late pregnancy
is a safe supplement to be considered
as it reduced the need for labor intervention
without any adverse effect on mother and child.
The only thing we’re missing now is a double-blind study,
not just a randomized trial,
but a placebo-controlled study, right?
The women in the date group obviously knew
they were eating dates, and maybe that had some kind of placebo effect?
The only double-blind study I could find on dates and delivery
is in Arabic, but the English abstract
describes how women just entering their active labor phase
were given a date syrup or placebo.
That’s brilliant.
Hard to make a placebo date,
but you could make some kind of placebo syrup
like molasses or something.
Note when they say honey date syrup
they’re not talking about a syrup of honey and dates
but a syrup made out of honey dates
which is a soft melt- in-your mouth variety
easy to whip into a syrup.
And…
normal labor progression was evidently higher in the date group,
around 98% compared to less than 70%
in both the placebo and control groups,
and labor duration was also shorter in the date group,
like two hours shorter, so on your due date,
maybe we should give dates their due.