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Inducing Labor with Black and Blue Cohosh

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By Marye Audet


Using black and blue cohosh to induce labor has been a tradition for thousands of years.  These two herbs, in combination, are effective in getting labor started when the baby is post term.  They can also be used to increase the strength and effectiveness of weak contractions in a labor that has been progressing slowly.

These herbs should not be used by a pregnant woman, or a woman who suspects she is pregnant until she is at least forty weeks along and has been given the o.k. by her doctor to begin the labor process.  As with any herb it is imperative that you discuss your plans to use black and blue cohosh with your midwife, doctor, or other health care provider.


What Is Cohosh?

Although they share a common name, black cohosh is a completely different plant from blue cohosh

Black cohosh, or snakeroot, is from the same plant family as the buttercup.  The roots are the part used medicinally.  The roots are gathered, dried, and then they go through various processes to be turned into the form that will be bought by the consumer.  Generally these forms are:

  • Tincture
  • Capsule
  • Tea

Black cohosh is believed to work on the body in the same way as estrogen.  Research is currently underway to either prove or disprove that fact. 


>Blue Cohosh, or papoose root, has been used by Native Americans for generations.  It is often wildcrafted.  This means that rather than being grown domestically the herbalist will go out into the wild and collect the root.  Generally blue cohosh is collected in the autumn when it is at its most potent.  Once collected blue cohosh root is dried and then turned into a tincture, capsules, or tea. 

Blue cohosh is an antispasmodic.  It can be used early in pregnancy to stop a miscarriage or premature labor.  It can be used later in pregnancy to stop uncomfortable Braxton Hicks contractions until labor is ready to begin.

So, how does it help with labor?  Simply, blue cohosh coordinates contractions and makes them more effective if they have all ready begun.  When used in combination with black cohosh, this herb can help a labor go more quickly and smoothly.

How to Use Black and Blue Cohosh to Induce Labor

Although these herbs are very effective when used properly they will normally not begin labor in a healthy pregnancy if the uterus is not ready.  For this reason it is important to wait until the mother to be is beyond the forty weeks gestation.  By doing this there is certainty that the baby is fully matured and ready to undergo the birth process.

If the mother is all ready in labor, and having weak, uncoordinated, ineffective contractions using a B & B tincture will get things moving.  B & B tincture is generally what this combination of herbs is called.  Tinctures seem to work better than teas or capsules but you should follow the suggestions of your midwife or obstetrician.

Black and blue cohosh to induce labor that hasn’t started yet is fine after forty weeks.  Unlike pitocin, B & B tincture work with your body in a natural way.  Contractions strengthen and regulate over time rather than immediately.  Labor moves along at a natural rate and the contractions are not likely to become overwhelming.

Instructions for Use

Following are the usual instructions for using black and blue cohosh for labor.  They should not be considered as medical advice, and it is important that you not try to induce labor without the advice of your health care provider.  Used incorrectly black and blue cohosh can be dangerous to both you and your baby, as can any form of labor induction.

  1. The day before you want to induce labor rest and relax.  Eat a light, healthy diet of lean proteins and vegetables and fruits.  Stay away from sugars and processed foods. 
  2. Get a full night’s sleep.
  3. Wake up at about 7 a.m. and drink 20 drops of B & B tincture in warm, not hot, water.
  4. Drink the same mixture, the same way, hourly for the next five hours.  You may have a light lunch if you wish.
  5. Starting about 1:00 p.m., you may resume taking the tincture hourly until 6:00 p.m.
  6. If you are having light contractions you can help them increase by walking, sexual intercourse, orgasm, or nipple stimulation.
  7. If you are not having contractions, stop taking the tincture and try again in three days, using the same method.
  8. It is important that you stay active while you are taking the tincture.  Activity helps contractions to begin and to regulate.


>When used for a short period of time there are rarely any side effects to black or blue cohosh.  Herbalists are in one accord that the tincture is safe to take at forty weeks gestation.  You should be aware that every woman has a unique body and therefore a unique response to pregnancy, labor, and herbs.  While conventional medicine pushes for induction at forty weeks some babies are just not ready to be born until forty-one, forty-two, or even forty-three weeks.  Be patient, do as your health care provider suggests, and enjoy the last few days of your pregnancy.  A healthy birth and a healthy baby is the most important thing.

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hananja profile image

hananja  says:
5 weeks ago

one should never use blue cohosh in pregnancy or in labour, the american indians only used it in emergency, in very rare occasions, and very carefully under supervision, can lead to congenital heart failure. cases have been linked. only use blue cohosh under supervision of someone who knows what they are doing.

hananja brice ytsma, medical herbalist.

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