Dates, edible sweet fruits, are put to the test in a randomized, controlled trial for cervical ripening.
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. “And the pains of childbirth drove her to the trunk of a palm tree.” She cries out and is answered by Gabriel, an Archangel and, evidently, an 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? As I explain in my video Best Food for Late Pregnancy, it took a little over 2,000 years, but researchers finally put it to the test. They had some anecdotal evidence that dates might be helpful, 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,” which is when drugs are administered to induce uterine contractions to either initiate or accelerate labor. It’s one of the most commonly performed obstetrical procedures in the United States and has increased dramatically over the last few decades—from less than 10 percent of deliveries to now nearly a quarter. There are certainly legitimate medical indications, but they are often done just for “convenience”—and not necessarily the convenience of the patient. 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?
In a prospective study, women either ate six dates a day during their last month of pregnancy or none at all. Those who consumed the fruit had significantly better cervical dilation compared with the non-date subjects and a significantly higher proportion of intact membranes, which is a good thing. And, with significantly fewer drugs administered, “spontaneous labour occurred in 96% of those who consumed dates, compared with 79% women in the non-date fruit consumers.” What’s more, labor for those in the date group was also shorter—about seven hours shorter overall. Therefore, “it is concluded that the consumption of date fruit in the last 4 weeks [of pregnancy] before labour significantly reduced the need for induction and augmentation of labour….The results warrant a randomized controlled trial.” Hold on. The women weren’t randomized? Indeed. In fact, the researchers even commented on how difficult it was to find women who would agree not to eat dates because consuming them “is a part of the cultural beliefs of the population under study.” You can imagine how there may be a variety of differences between the women who ate the dates and those who agreed to go without them that could account for the findings. Maybe the date eaters were more religious, of a higher socio-economic status, or something else completely. Who knows? You could argue you might as well give dates a try since there doesn’t seem to be a downside, but that isn’t good enough for me. I want to know if they actually work, but we didn’t get a randomized, controlled trial until three years later.
Researchers studied 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 it can more easily dilate open when contractions start. “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 out a baby with about 20 pounds of pressure per square inch. If the cervix isn’t there yet, it can require more like 200 pounds of pressure. So, “cervical ripening before the onset of labor is an important factor” if you want a normal vaginal delivery. “The search for a safe, inexpensive, and easy method of [facilitating] cervical ripening is of great significance.” What happened when a couple hundred women were randomized to eat either six or so dates a day or none at all from around the 37th week of pregnancy until their first contraction?
Cervical ripening is rated with a Bishop score. Normally, a score of 5 or less “indicates an unfavorable cervix,” whereas you’re good to go with a score of 8 or more. The average Bishop score in the women randomized to the date group was significantly higher, closer to 8, whereas the date-free group scored down around 5. And, for those in the date group, their cervix was more dilated, too. The researchers concluded that since date fruit is healthy anyway, “full of energy and nutrients, it is recommended for pregnant women to help with cervical ripening, particularly in the last weeks” of their pregnancy.
What about the effects of dates on spontaneous delivery, premature delivery, labor time, and postpartum bleeding? I cover all of that in my video Best Food for Labor and Delivery.
I love to eat dates as snacks, but I also use them in recipes. Here are two from my How Not to Die Cookbook: Date Syrup and a Balsamic Date Glaze. And, as always, all of my proceeds from book sales are donated to charity.