ļ»æEpisode 172 - Do I have to consume raspberry leaf tea and dates
[0:00] Welcome to the Great Birth Rebellion podcast. I'm your host, Dr. Melanie Jackson. I'm a clinical and research midwife with my PhD, and each episode, I cast a critical eye over current maternity care practice by grappling with research and historical knowledge to help you get the best out of your pregnancy, birth, and postpartum journey.
[0:24] Welcome to today's episode of the Great Birth Rebellion podcast. I'm your host, Dr. Melanie Jackson. I'm a clinical and academic midwife and today I want to draw on both experiences and talk about drinking raspberry leaf tea in your pregnancy and also eating dates. And because each of them are not too long a topic, I've put them both together because often women will use raspberry leaf tea and consuming dates in their pregnancy for the same sort of reasons. A lot of midwives and women will talk about raspberry leaf tea and dates having an impact on the outcome of your pregnancy and labor. So let's explore if there's any truth to this idea. Can drinking raspberry leaf tea and eating dates through your pregnancy actually change how your body will respond? We're going to jump straight in today. So let's get started.
[1:17] I will talk about raspberry leaf tea first and then we'll talk about dates. All right, raspberry leaf tea. So the short of it is that many midwives, including myself, for a long time in my career, I just suggested women go ahead, drink raspberry leaf tea. We will tell women, midwives, will tell women at some point, usually somewhere between 32 and 35 weeks, that they can start drinking raspberry leaf tea. And we usually suggest starting with one cup and then moving up to three or four cups a day.
[1:51] The suggested dosage of raspberry leaf tea is about four grams daily. I could not find any information regarding how we came up with that dose of four grams daily but that seems to be what some of the research indicates is what we would call a therapeutic dose of raspberry leaf tea. And so the idea is that you build up to how many cups a day you have ending up at four grams which somewhere along the line we decided was three or four cups of raspberry leaf tea. I really wish I had a lot more solid evidence about this, but you'll see through the episode that there actually is not a lot to go off. And you know, when you're using herbs and any type of medicine, that you need to achieve a therapeutic dose. And so any research or use of a herb that is underneath a therapeutic dosage would not be considered effective. Now, raspberry leaf tea is thought to act on your uterine muscle, on your uterus. And in fact, some women drink the tea and feel the immediate effects of raspberry relief tea. I know that happened to me. Whenever I would drink it in my first pregnancy, I didn't end up drinking it in my second. Whenever I would drink it, I'd start to feel sort of Braxton Hicks and tightenings in my uterus. That was the effect that I knew it had on me. And I just put a little mental note against that thinking maybe I could use it in labor if I needed it or for the birth of my placenta.
[3:17] So I didn't ever get to sort of a full doses of large relief tea personally because of the impact I felt that it had on my uterus. And in fact, I did end up using it to give birth to my placenta after my first baby. Having said that though, I was sipping raspberry leaf tea and smelling clary sage and the acupuncturist put a needle in to help the placenta come out. So, you know, it was all part of the package. But let's have a look. Is there any evidence that raspberry leaf tea could be of benefit to you? I will say my experience of raspberry leaf tea was not traumatic, but it's got a really grassy taste. It's not particularly flavorful. If you're planning on drinking it, you might want to consider adding other teas or maybe some honey. I don't know, something to make it a bit more palatable, but it's a mild flavor, a little bit grassy. So as usual, I do a fair bit of reading and research around each topic that we do on the Great Birth Rebellion podcast. And today is no exception. If you want to have a look at the actual papers that I found and you're on the mailing list, then that comes to you in an email. You'll have access to the resource list for the podcast for this episode and all previous other episodes. But if you want to get on that mailing list, just go to melanethemidwife.com. All the links are below in the show notes and you can have a look at the actual paper. It's.
[4:39] So the first one I'm going to talk about is a systematic review, and I'll do this one first because it covers the bulk of the historical research. But just remembering as we go through this, this is just the information from modern day Western style science. So there is a raft of traditional medicine practices that relied heavily on herbs for medicinal purposes.
[5:03] And a lot of this information was passed down through oral histories. Some of it's been lost through time, but there was a time where herbal medicine was the only option for medical care. And this traditional knowledge is not something that I can cover in this podcast. I can really only draw on Western research from most recent sort of medical history. So there are definitely herbalists and traditional medicine practitioners out there who have a knowledge base about raspberry leaf tea and other herbal remedies that I'm not going to be able to touch on today, unfortunately. I did start my career as a naturopath, but I realized how difficult it is to draw that knowledge into modern Western ways of knowing. It's not considered authoritative by a lot of medical texts. And so what I'm saying is that that historical knowledge is not wrong. It's not wrong for your clinician to offer you raspberry leaf tea for pregnancy certainly there are Chinese medicine practitioners and herbal medicine practitioners who use this for uterine function but if we are looking at modern medicine and western scientific research from this perspective which is what I'm doing today mostly because that's what I have access to.
[6:28] Then you'll see what I'm going to talk about. But there are other bodies of knowledge and wisdom that are just as authoritative as the stuff I'm going to talk about today. It's just hidden or intentionally silenced in this day and age. So let's have a look at what I found. This systematic review that I'm going to look at is available in the resource folder. So if you're following along with the resources, this paper is called Biophysical Effects, Safety, Efficacy of Rise Relief Tea Use in Pregnancy, a Systematic Integrative Review. And the aim of this review was that they gathered all the research papers they could find from 1941 to 2016. Obviously, they were in the English language.
[7:14] And the idea was to have a look at the evidence base on the effects, safety, and efficacy of raspberry leaf tea in pregnancy. Now, they concluded, just in the summary of this paper, if you're just going to read the front of it, that 13 studies were included in this systematic review.
[7:32] Five were laboratory studies using animal and human tissue. So, not the whole person or the whole animal, just like a tissue sample in a lab. So that was five of the 13 papers. Two were experiments using only animals and six were human studies. And they all ranged from 1941 to 2016. So not all of these are incredibly applicable or usable for our purposes to find out what raspberry leaf tea does to our uterus during pregnancy and if that has any impact on our labor and births. So based on these studies, these 13 studies, as I said, some of which were done on animals or in a lab on tissue samples, the authors concluded that raspberry leaf tea has been shown to have biophysical effects on animal and human smooth muscle, including the uterus, when tested in a lab situation.
[8:30] There was a toxicity that was demonstrated when high, high doses were injected into animals.
[8:37] However, human studies have not shown any harm, but also an unlikely benefit. One study did show, demonstrated a clinically meaningful, what they call clinically meaningful, but not statistically significant reduction in the length of the second stage. It was something like 10 minutes shorter pushing phase if you'd had raspberry leaf tea and less likely to need your labor augmented with oxytocin. But we will talk about that study as well as we go.
[9:11] The authors state though that the evidence-based supporting the use of raspberry leaf tea in pregnancy is weak and further research is needed to address the question of raspberry leaf tea's effectiveness. Basically we don't know yet and the studies that have been done are poor quality from what I could see as well and I'll keep going through them. So we'll break this down a bit and we'll see how these findings differ from the more recent studies of raspberry leaf tea that have been released. So this analysis that pulled all these 13 papers, it only collected everything up until 2016. So there's been a little bit more research since then. So we'll look at that and then we'll go on to the more recent research. So what we know of the use of raspberry leaf tea, particularly here in Australia, is that it's considered one of the top five herbs used by pregnant women. And one Australian study found that 52% of midwives, Australian midwives that they studied are recommending raspberry leaf tea to women, particularly those who are experiencing longer pregnancies or have experienced longer pregnancies in the past. So around half of the midwives in Australia agreed that they would be recommending raspberry leaf tea to women through their pregnancy.
[10:26] And raspberry leaf tea is frequently used during pregnancy and labor because it's thought to strengthen and tone the uterus. So it theoretically assists contractions and in theory could prevent postpartum hemorrhage if we're talking about the uterus contracting.
[10:44] And there seems to be a long history of raspberry leaf tea use in pregnancy. Again, as I said, traditionally, herbs were the only way of providing any therapeutic intervention. And so historically, raspberry leaf tea seemed to be one of those herbs. But there isn't much research, modern research, in relation to how it works and how effective it is, if there's potential harmful effects, and what is the therapeutic dose. We don't know how much we actually need to get the benefit, but then also avoid any potential side effects.
[11:20] So let's look at some of the studies that are in this paper, in this paper that pulled all of the research up until 2016. But I'm only going to comment on the ones that looked at raspberry leaf tea during pregnancy and their outcomes for birth. So there was only three of those of all the 13 papers. And the first one only had 34 women in it. And it found that women taking raspberry leaf tea experienced an increased rate of cesarean section, 23.5% versus 9.1% if you compare it to women who didn't use the raspberry leaf tea. But please hear me when I say this, there were only 34 women in this whole study. So even attaching percentages to the findings as a way of demonstrating the findings is really unhelpful at this number. There's not enough women in this study to have any accurate findings or make any conclusions. So please don't hear that using raspberry leaf tea is going to increase your chance of cesarean section. We cannot conclude that from a study of 34 women. But that was one of the studies that was included in this research paper.
[12:28] And the authors themselves say that this finding lacks veracity due to the small sample, the selection bias, which means that, you know, however they chose the participants, was not thorough. There's a failure to manage potential confounding factors, a lack of detail on dosage, duration, timing, and the form of raspberry leaf tea that was consumed. So not a high quality study. In fact, you may as well have not even had done it. So the next study that I'm going to focus on, raspberry leaf tea, UC pregnancy, included 108 postnatal women. So 57 of those had reported taking raspberry leaf tea in pregnancy and 51 of them said they hadn't. But the dose, the form, so whether it was a tablet or a tea, the timing and duration of raspberry leaf consumption varied considerably along across all the participants and, The researchers recorded what the women did, but they didn't have control over what the women did. So they looked back on women who'd used raspberry leaf tea. If they had used it, they went in the raspberry leaf tea group. If they hadn't, they went in the other group. But there was no control over how much they had, what type they had, when they started taking it. It was all a bit all over the place.
[13:48] So anyone who had had any type of raspberry leaf tea, even if it was one a week or one a day was included in the raspberry leaf tea group. They were all analyzed as one. So this study simply asked women, did you take raspberry leaf tea? If they said yes, they were in the raspberry leaf tea group. And if they said no, they were in the control group. But the dosage and usage was not standardized. So women using it frequently and consistently were included in the same data as women just randomly or flippantly using it. The study didn't differentiate. So already, we're seeing some issues. Not standardized dosage, a small group of women who actually used it, 57 who actually used raspberry leaf tea. So they looked at lots of different outcomes for this group of women and they found no difference in either group, which is no real big surprise because the quality of this study, again, was incredibly poor. There weren't many women in it. The group that was using raspberry leaf tea was not standardized.
[14:49] And the thing with herbal medicines, as I said before, is you have to achieve a therapeutic dose and often that's over time. Sometimes the effect of herbal medicine is compounding. You might not notice the changes for some time after having a therapeutic dose systematically and consistently. So it's entirely possible that none or very few of the women in the study were even consuming a therapeutic dose of which we don't really know because the studies on raspberry leaf tea seem to be poor, especially we don't actually have a clear indication of what a therapeutic dose would be. So the authors say that the null findings, so found nothing, the null findings of this study relate to the inadequate power with the small sample size so the 57 women versus 51 women. The veracity of these findings is also impacted by selection bias and lack of control for other important potential confounders. So other things that may have interrupted their labor and birth or changed the outcome of it.
[15:51] Now, the next study and what's considered at this time as the best available evidence on the effect of rise relief T on pregnancy outcomes comes from a double-blind placebo-controlled randomized control trial. Great. This is how we probably should be testing medicines in a randomized control trial where you can control dosage and usage in one group, adjust for confounding factors, make sure the groups are two really similar groups and having a control group. And then you can adequately see what's the impact of using this medicine, herbal medicine as it is, versus not using it at all. So this was a double-blind, placebo-controlled, randomized control trial.
[16:36] So good quality. And it was called Raspberry Leaf in Pregnancy. It's Safety and Efficacy in Labor. And this is the only randomized control trial to be conducted on humans in this area. So they included low-risk women who had not had a baby before, but they only had 192 women. And they were randomized to receive two daily doses of raspberry leaf tablets. That totaled to 1.2 grams per day. So already, again, they're using a dosage that we don't know, is that the right dosage to be therapeutic? We don't really, really know, but that's what they studied it on. And so the women were taking 1.2 grams of raspberry leaf tea a day from 32 weeks gestation, or they were taking a placebo. They didn't know which one they were having.
[17:26] The findings were that they had no statistically significant differences between the groups. Either adverse effects didn't seem to occur. There was no change in maternal blood loss after birth, no change in blood pressure issues, no change in neonatal birth weight or the outcomes for the baby. There was also no statistically significant difference between the groups for gestation, how many had their labor augmented with artificial oxytocin, the number of women who had artificial rupture membranes or used epidural, or the length of any stage of labor or difference in the mode of birth, whether or not it was vaginal, cesarean, or forceps.
[18:08] The only potentially clinically meaningful difference that they found was a shorter second stage or pushing phase of labor, which was around 10% difference. For the women who'd used raspberry leaf tea, their pushing phase was about 10 minutes shorter on average when you compared it to the women who didn't have raspberry leaf tea.
[18:34] There was also a small difference in the number of women who had forceps birth. And I guess if you on average have a shorter second stage, you're less likely to be exposed to a forceps birth. So 19.3% of women who had the raspberry leaf had forceps and 30% had, oh, if you didn't have raspberry leaf tea, which is so high. Anyway, in this particular study. Now, the authors still called these null findings. The null findings returned for this study may result from the sample size, which was powered, which was, it was underpowered. Again, not enough women to make a conclusive statement about the effect of raspberry leaf tea. The other possible reason for the outcome is there was a sub-therapeutic dose of raspberry leaf tea that was used in this study. So what they're saying is the dosage that they were giving to the women who had the raspberry leaf tea was sub-therapeutic. it didn't reach a therapeutic dose. So women who were randomized to the treatment group were given 2.4 grams of risbutee and what they've said is that it's less than the recommended dose of 4 grams daily.
[19:48] So this is the study that offers the strongest available evidence and I'm putting that in inverted commas but obviously it has some limitations including lack of detail about the randomization process. And also there were more participants in the Raspberry Leaf Tea Group who had private maternity care with a midwife. So in the Raspberry Leaf Tea Group, 11.5% of those women also had care with a private midwife versus 5.2% of those having continuative care with a midwife. And so already that's a confounding factor because we know that women who have continuity of care with a midwife already have better outcomes. So that could be a thing that just explains the better outcomes in the raspberry leaf tea group, but really we can't really know this. Study is too small, 192 women in total. There was a subtherapeutic dose of raspberry leaf tea that was used and also the groups were not evenly matched. It wasn't a good quality randomised control trial. And so the final conclusion from this systematic review is that the body of evidence informed by human studies on raspberry leaf tea use in pregnancy does not show any benefit. There is scant evidence from these works to suggest that raspberry leaf tea may have some.
[21:18] But this only came from the study with 192 women, and we already just discussed some of the shortfalls of that randomized control trial. But possibly it shortens the second stage of labor and therefore also reduces the chance of forceps birth. But there's really not good enough evidence to say that confidently. We need a better quality study in order to answer that question. On the plus side, they also didn't really see any major issues in terms of side effects. that could be owing to the fact that the doses were inappropriate or inefficient. So based on what I could read from this systematic review, we can't as midwives in Western English speaking countries recommend this to women because there's just no real evidence of there being much benefit. Of course, they also did not identify any actual risks. So if you want to drink it, you can if you feel that there's going to be some benefit or if you have some kind of other knowledge or wisdom that lends itself to encouraging you to use raspberry leaf tea, there's no problem with that. I'm just saying there's no current English language, Western style testing of raspberry leaf tea that would make it so conclusive that we can recommend that women use it.
[22:37] But we can also now look at more recent research to see if there's anything new that we've learned since 2016. And there was actually a study done in 2024 by the same authors who completed the systematic review that I was just talking about.
[22:54] And again, unfortunately, it was small. It wasn't a randomized control trial, which is really what is needed if we're going to test a medicine, albeit it's a natural medicine. But if you want to test the impact of a medicine, a randomized control trial is the way to go. So this one that was done in 2024 was an observational study and it was called Raspberry Leaf Use in Pregnancy, a prospective observational study. Again, you can read it in full in the resource folder. And this study aimed to determine associations between Raspberry Leaf use in pregnancy and augmentation of labor. So augmentation means you've already started labor and then they also start oxytocin drip to keep your labor going if for some reason the contractions slow down or they're less effective. And they also had a look at some other outcomes. But data was derived from questionnaires which captured demographic information about the women and herbs they used in their pregnancy. But only 91 women in it, in the whole study. 44 of those were exposed, what they call exposed to raspberry leaf tea, and 47 were not exposed. So this is the size of the study done in 2024.
[24:14] So there was a smaller proportion of women in the raspberry leaf cohort that ended up having augmentation of labor, epidural, instrumental birth, caesarean section, and postpartum hemorrhage. And more of them had a vaginal birth and their labours were shorter than the women who reported not to have used raspberry leaf tea.
[24:38] And it said, the findings were, under these conditions, the use of raspberry leaf was strongly predictive of women not having their labors medically augmented. But don't just go off that one sentence. If we were to go off that one sentence, we would say, great, raspberry leaf tea is strongly predictive of women not having augmented labor. But just remember there's only 91 women in this study and the data was collected by questionnaire so you know if a medical drug was tested in this way we would never accept it as adequate clinical evidence of its benefit or harm so as much as I would love as a naturopath and a midwife to be able to say yes raspberry leaf tea is where it's at if you want to have a shorter labor with less medication and a more likely chance of vaginal birth. I'd love to be able to say that.
[25:39] But with the quality of this evidence, I really just can't. This paper doesn't really help add data to the raspberry leaf tea argument. They did see a benefit and no risk of harm. But again, only 47 women actually used it. So based on this paper, I can see there's no reason to use or not to use raspberry leaf tea. And women are encouraged to do whatever they see fit now that you know what I've shared but we don't know for sure in a western context where the truth lies in what raspberry leaf tea can do and how big an impact it can have and also if there's any harms so you know I'm a huge proponent and user of herbal and complementary medicines I was a naturopath myself through my early 20s but I'm just not convinced of this one unfortunately. I really I did really want to be on the side of raspberry leaf tea but I can't in good conscience recommend it and some women might be really happy because you might be struggling through your three to four cups of raspberry leaf tea hoping it'll make a difference. I'm here to tell you if you really weren't on board but you're doing it out of obligation you do have permission not to keep using your raspberry leaf tea.
[26:52] Actually though if you really want to keep using it and you believe it's had an impact for you in the past or you've got some other knowledge that you're tapping into please also know that they haven't really found any issues of harm with raspberry leaf tea mostly because the studies are so poor that they can't make any conclusions at all so that's a level of knowledge we have of raspberry leaf tea.
[27:15] Okay, after dropping that bombshell, now we will move on to the consumption of dates. Eating dates during pregnancy in the hope that it will have some kind of impact on your labor and birth. More specifically, the consumption of dates is thought to have an impact on the function of your cervix. So some women will use it to impact how their cervix works. Raspberry leaf tea, I mean your cervix is part of your uterus, but raspberry leaf tea thought to have an impact on the uterine muscle and how your uterus contracts and acts and how many contractions it'll have and how strong they are.
[27:53] But dates are thought to have an impact on the dilation and softening and ripening of your cervix. So they're kind of both related. Women will often use them interchangeably or for the same reason. So here they are combined to present you the research now on dates. Now, firstly, let's remember that every body is different. We all require different nutrients depending on where we were born and on our genetics. And traditionally, before international air travel and mass food production, many people groups weren't even having access to dates. They don't grow everywhere. It's not part of every culture's cuisine. So that's one thing. It's not as though everyone should be eating dates in pregnancy. If that were the case, they would be evenly distributed across the whole world, but they're not. There are people groups that don't have dates in their diet. So what happens for them? So we wouldn't even be having this conversation if it weren't for global distribution of dates.
[28:55] So if you're living in a location that doesn't grow dates and you are part of a culture, it's not part of their cuisine, purchasing them might be expensive, they might be hard to find and you in particular will be glad for this conversation. So if, as many women do now, if you were to go ahead and Google and have a look for AI information on date consumption during pregnancy, it will give you this broad answer and if you went by this answer, every woman would be off buying dates and adding them to their shopping cart to eat them through their pregnancy. Here's what AI says about consuming dates through pregnancy.
[29:40] Consuming dates during late pregnancy, especially 6 to 8 dates per day from 36 weeks, can help with cervical ripening, potentially shortening labour, increasing spontaneous labour, where you just give birth without any interventions, and it may reduce the need for intervention like oxytocin and reduce the risk of postpartum hemorrhage. Dates are nutritious, true, providing fibre, true, energy and essential nutrients. Like folate. I do like the last sentence. That is true. They're a highly nourishing food. So yes, there is some truth to this and there is actually a lot of research about the impact of consuming dates during pregnancy.
[30:26] The problem is, while I found some papers, probably all the good research is not in English because eating dates in pregnancy seems to be rooted in traditional medicinal cultures of the Middle East and Persia, India, Iran, Israel, and just places where dates grow and are part of the usual cuisine. And it's become part of the cultural practice to eat dates later in pregnancy. All the women just know to do this. So obviously I could only access the research that's either been translated or is published in English and in Western journals. And although I found quite a lot of papers the problem is is again like raspberry leaf tea the research groups are just really small so that while some good effects were reported the study samples so how many women were in each study were small by western scientific standards and this is not to debunk the traditional knowledge that a lot of cultures still have and hold and use throughout their pregnancies. I'm just saying from a Western medical perspective, the research papers have not caught up or not captured the true impact of dates on pregnancy and birth.
[31:45] I have had clients who swore by the use of dates in their pregnancy. One client who had a really long six or seven day early labor and ended up with a cesarean section after just not progressing in labor.
[31:58] And she had dates for her next pregnancy and had the almost complete opposite. Not saying it doesn't work. I'm just saying there's not a stack of research behind it that I can say conclusively that this is going to be the thing that does the trick on your cervix.
[32:12] So for example, there were some research projects that had 70 participants. So 35 of them ate dates and 35 of them didn't. So those are the type of research numbers we're dealing with. And there again is a collection of the research papers in the resource folder for you to have a good look at. If you really want to explore this topic more fully, you can read the papers for yourself. But the paper I'm going to draw from today it was published in 2020 so it's a pretty recent research paper 2020 and luckily it was a systematic review and a meta-analysis of the past 20 years of research about date consumption and the possible impact that that will have on labor and birth and what that means again is that they've pulled the last 20 years of research about date consumption in pregnancy into one paper so that they can give a broad overview of the research findings collectively. So this works perfectly for our purposes today to just have a broad sweeping look at what the research is. So the title of this particular paper is called The Effect of Date Fruit on Labor and Delivery Outcomes or Birth Outcomes. It's a systematic review and a meta-analysis And they talk about how they did this study. So they found a heap of studies, but they only included eight that met their particular criteria.
[33:36] And in a total of the eight studies on date, when they pulled it all together, they had a total of 653 participants across all the studies.
[33:46] So that's the limitation of this study on dates is that they're yet to do a very big trial or a very big randomized control trial with many thousands of women where they might be able to compare the outcomes for women who ate dates versus who didn't eat dates. So 653 women and they would have been divided into two groups, a group that ate dates and a group that didn't. So there was 325 participants in what we would call the intervention group, the date eating group. And then there was 328 in the control group, the did not eat dates group. And this represents women who just weren't given any instruction, just carry on, do whatever you want. And so they compared the two.
[34:30] And so what they wanted to ask was, does eating dates have an impact on labor and birth outcome? And before everyone, everyone's probably wondering how many dates did they get the women in the date eating group to eat, it's about six or seven dates. And we're talking those big, chunky, yummy, major dates. They're really like fresh ones, not those dried little shiveled up ones. That's what they would have eaten, six to seven dates a day from 35 or 36 weeks. So that's the dosage.
[35:03] So what they found was for women who did this, who ate the six to seven dates a day from about 35 or 37 weeks, those plump major ones, they found that the date fruit can significantly reduce the duration of active labor, so shorter labors, and it can also improve the ripening of the cervix, so how soft and ready your cervix is to respond to labor and to respond to contractions. And this idea can be very enticing to women who have had longer labors or whose cervix just didn't respond to labor. I have had clients who cervix got stuck at seven centimeters or stuck at nine centimeters and just didn't progress. And they're interested, they're very invested in what else they could possibly do for their next birth to change things. And for some of these women, they're very inspired to eat six to seven dates a week from 35 to 36 weeks in order to maybe impact the outcome of their next birth.
[36:04] So what this study did find is that it did have an impact on the length of labor and the ripening of the cervix. But again, it's only on around 350 women over three studies. So not all eight studies showed that. So the authors of this particular paper stated that although it might reduce the duration of labor and improve the preparedness of the cervix. The studies that they found were of low to medium quality and they suggested that better quality research needs to be done before we can confidently say to women that yes, this will definitely make a difference. So that's what we know about dates. And unfortunately, that's the limit of our Western understanding of the impact of date consumption on labor and birth. But I did start my clinical life as a naturopath. And in naturopathy, we use a lot of alternative therapies and we don't always use Western science. We can rely and lean on what some traditional uses and oral cultures have done in terms of their use of natural medicines and food for medicine. So I guess what I'm saying is that I don't want women who are listening, who have traditionally always done this, who's mum and auntie and friends and have all recommended it or you're living in a place where this is really common practice, don't have a listen to this podcast and go, oh my gosh, there's no science. What are we doing?
[37:32] Because it's okay to value traditional knowledge that you have over what I'm presenting today because I'm presenting limited, flawed, Western scientific representation of what might be known about the use of dates because we're only accessing this small Western research base of information. So just know that it's limited. It's limited to one way of thinking, one way of gathering knowledge. But there are so many other ways of gathering knowledge that science doesn't allow for. So please do value the traditional knowledge of your people and your place there's medicinal knowledge that does not translate into western culture and it's knowledge that's been gathered over time and over years and there's still value in this the other amazing thing is that there's no detrimental effect to eating dates they are an incredibly nutritious food there's no bad effect for them. It's not like there's going to be harm if you eat six to seven dates from 35 to 36 weeks. You can safely consume and they're highly nourishing, lots of great minerals and vitamins. I incorporate dates into our diet every day, regardless of the medicinal value. They're just such high nutrition.
[38:51] Now, obviously they are sweet. So that's just the thing to think about is that if you're working at controlling your blood sugar levels, then your consumption of dates probably needs to be monitored. But you're probably already doing that. If you've got something like pre-existing diabetes or gestational diabetes, you're already in the practice of monitoring your blood sugar level. So it's okay to do a bit of comparing and see what happens when you eat dates. Does this spike your blood sugar level or does it keep it nice and stable and you're free to eat those?
[39:23] So this is something to think about if you're working at controlling your blood sugar levels, but because it's a whole food, you might find that the glycemic index of dates isn't enough to spike your blood sugar. So we'll have a look at that part of it because some women and practitioners falsely assume that because dates are sweet, that they should be emitted from your diet if you're working at keeping your blood sugar stable. So although they're sweet they are not incredibly high glycemic index so I'll talk about glycemic index for a second it's just a relic of information from my time as a clinical naturopath so glycemic index it's the number given to a food that tells you if it's a high glycemic index or a low glycemic index like high sugar value low sugar value and what that means is if something has a high glycemic index that means when you put it in your body the sugars in that food can very quickly and suddenly be drawn into your bloodstream causing you to have a very big blood sugar spike so then your body reacts to the sudden increase in sugar in your blood and then it throws a whole bunch of insulin in there to help counteract it and lower your blood sugar and often this can have a seesawing effect, an up and down effect, sudden burst of blood sugar.
[40:45] Of sugar in your blood, which increases your blood sugar levels, then an immediate response by your pancreas to create heaps of insulin and try and counteract it, but then it overreacts and you get this big drop. And so you're going up and down and up and down and your blood sugar is not stable. It's just seesawing up and zigzagging. So really what you want is a low glycemic index food. And that means that the sugar in that food slowly gets absorbed into your bloodstream, hopefully preventing that huge big spike. And so if we're thinking about number values, pure glucose, so this single molecule of sugar, which is very quickly absorbed, it requires virtually no digestion. It just goes straight into your bloodstream. Pure glucose has a glycemic index of 100. So that represents the upper range of the glycemic index measurement. The GI of an apple, glycemic index of an apple, is about 35 and that's low glycemic index. Honey is around 60, which represents a medium glycemic index food. And dates sit around 50, depending on the type. The fresh ones, the nice big fresh ones, sit around 50 on the glycemic index scale. The dried fruit and dried dates will always have a higher glycemic index. So if you're diabetic or interested in keeping your blood sugar balanced.
[42:13] You will be interested in understanding the glycemic index of your food because it has an immediate effect on your blood sugar levels. You're trying to keep them stable, not swinging up and down.
[42:27] And if you're diabetic in pregnancy, you should be taking your blood sugars four times a day. So you've got a front row seat to be working out what dates are going to do to your blood sugar level. So if you want to start eating dates, it's okay to give it a go. Especially if you are testing your blood sugar, you'll easily be able to see if your body is able to manage date consumption. So consider it a little experiment. And if it spikes your blood sugar, then you know you can make some adjustments. So let's talk about how to pair dates with some fats or protein. We call this dressing up your sugars or dressing up your carbs. How do you pair dates with other foods to reduce the glycemic index? So even though it has a glycemic index of 50, you can reduce the glycemic index by how and when you eat that food. So if you do end up getting a spike in blood sugar because of dates, it gives you information. Do I dress it up? Do I avoid them? Do I need to exercise afterwards? Let's see. Here are a few things you can do to reduce the glycemic index or the glycemic load of your food in particular dates because that's what we're talking about. So even if you want to have something sweet like a date so that you can get all the benefits of the nutrients in there, there is a way to eat something sweet without getting the blood sugar spike.
[43:51] And look, what I'm about to tell you is good for everybody in life anyway. If you're a midwife listening to this, if you're diabetic or not, if you want to have something sweet, here's how you can mitigate blood sugar spikes. I think one of the key things of good health is stable blood sugar, whether you're diabetic or not. So in line with that, I'm going to plug a book and I don't know this woman, I'm not paid by her. I don't have any affiliation with her, but she's got a great book and a great social media presence. It's called, the book is called The Glucose Revolution and it's written by, if you're on her social media, she's the glucose goddess and I can't pronounce her last name, but her first name is Jessie and the book is The Glucose Revolution. And she talks about the life-changing art of balancing your blood sugar. She's a biochemist and she just speaks about nutrition from a biochemical perspective. And her main aim in her work is to help everybody balance their blood sugars. So she talks about dressing up high carbohydrate foods or sweet foods, which dates would be.
[45:02] And it's all about the food that you eat around them to slow down the digestion of the sweet food, which then reduces the glycemic index of that food and makes it less likely to spike your blood sugar. So you dress sweet foods with things like vegetables because of their high fiber, foods that have high good quality fats or protein. So if you pair something sweet or high in carbs with a protein or a fat, the sugars are absorbed more slowly into your bloodstream, which automatically creates a circumstance where your blood sugar levels will be more stable because the sugar is slowly moving into your bloodstream rather than quickly. And some of the other hacks she has in her book include the consumption of apple cider vinegar before having something sweet. So she's got a heap of stuff in her book, The Glucose Revolution,
[45:57] if you're working on blood sugar management. So Glucose on Instagram or the Glucose Revolution book by Jessie, whose last name I can't say.
[46:09] So dressing up your dates. Dates are the sweet element of your meal. So how do you pair dates with something that might be higher fat or higher protein? And here is where I shine. If you thought that my talents ended at finding, interpreting and presenting research, you were wrong. Because you might not know this about me, but I am also a ninja in the kitchen. I know how to cook and I know how to use flavor. I grew up on the kitchen bench of the household. So, you know, cooking is pretty much the reason that I garden and grow food at my house because it tastes so much better and makes my cooking better. So I've got some date recipes that I love that I've tested and maybe they're not the best showcase of my culinary talents, but here you go.
[47:04] So the dates are amazing because they become this vessel that you can, you know, you can stuff things into like a bread roll, but a mini one. So here's my first suggestion. So you just cut a slit along the top and pluck out the seed out of the middle. So this is possible if you've got those big, fresh medjol dates, they're all very plump and they should have the seeds in them. They're probably the more expensive ones, but they're the most delicious and nutritious ones as well. So pluck the seed out and you'll see it opens up like this beautiful cavernous space and they're quite malleable. If you want to make them a little bit bigger, you can kind of stretch and flex them a little bit.
[47:46] And that space is just asking to be filled with something delicious, something fatty and full of protein to dress up this carb. So open up the date and use it like a vessel to transport other nutrient-dense items that you might want to pop in your mouth for a little treat. So here we go. A few recipes for you. If you're going to try and eat six to seven dates a day, this is of interest. If you're not trying this is also just a nutritious snack that you can still enjoy so the first one ironically I'm going to give to you if you're not pregnant so this is for your kids partner any birth workers listening whoever you are listening if you're not pregnant this one's for you I don't know why I'm starting with it but it's one of my faves so the reason why it's not for you if you're pregnant is that it contains soft cheese so if you don't eat soft cheeses because you're listening to government recommendations and if you're listening to the government.
[48:49] And to the local health service, particularly here in Australia, you will not eat soft cheeses during pregnancy like I did. But if you want to go with this recipe, open up the date, take a chunk of blue cheese, be generous with it, jam it in, like really mush it in, and then pop a walnut in there and then you can add prosciutto. Okay, so another thing, deli meats, is that we're told not to eat those in pregnancy. So as I said, this is a non-pregnant recipe. so you know it's for the people around you for the people you love and maybe postnatally so breastfeeding women birth workers this is a treat for you so blue cheese walnut prosciutto oh my gosh and then the whole thing just in your mouth it's a flavor sensation but the fat offers the cheese offers some fat the prosciutto offers some protein and a little bit of fat and the walnuts It's got some protein and fat in it and the date is full of nutrition and beautiful sugars. But it's all dressed up. So hopefully that won't create a spike in your blood sugar. Delicious snack. So next option for you if you're pregnant, and this is really great for kids, it can be prepared ahead of time and frozen.
[50:05] So again, open up your date, open it up, pluck the seed out, and then stuff it very generously with some kind of nut butter. Peanut butter almond butter cashew butter whatever you want be generous with how much you stuff it with because the dates are quite sweet so you want to kind of keep a good balance of fats and proteins and stuffings to date ratio and if you want to increase the nutrient value mix some other things into that nut butter so I put hemp seeds in but you can put chia seeds or some kind of other nuts, protein powder. I've seen people mix into the peanut butter to increase the nutrient value of the stuffing.
[50:48] So stuff that in and then get some dark chocolate, like 80% dark chocolate. You can use vegan chocolate if you're non-dairy, but dark, dark.
[50:58] And you can either dip or drizzle it in some chocolate.
[51:03] And then again, sprinkle something on top, some pistachios, some more hemp seeds, whatever you want to sprinkle on top. And then hear me out with the dark chocolate. A sprinkle of sea salt just makes it incredible. Such nice flavor balance and you can make whole containers of these and put them in the freezer and my kids just walk past the freezer pluck one out and eat and I just clock off okay they've got some nutrients they've got some protein they've had some seeds and good fats and there's a little bit of dark chocolate in there but not too much but you can dip the whole thing in dark chocolate for an extra extra treat oh my gosh I'm salivating just talking about it all right the other thing you do is make bliss balls again to to dress your dates and these usually have coconut oil in them nuts fat seeds and and then the date is the sticky part that's keeping this all together so you know once you've eaten a few of those delicious stuff dates and you've made some bliss balls you could start to tally that maybe you've had you're coming up to your date quota you can also just eat them you know on their own but they might be harder to do that and they might peak your blood sugar.
[52:22] The other option you can add a few dates to a smoothie as the sweetness so skip out on maple syrup honey or any sweeteners and just add a few dates it'll need an extra waz like extra.
[52:35] Waz to break up the the dates and you can put protein powder in that fruits again some kind of seeds and nuts. Use a nut milk instead of dairy milk because they're lower in sugar. Also, top tip, throw in half an avocado into your smoothie. Just trust me on that. Good fats, highly nourishing. It makes it extra smooth. Once you whazz it all up, you can barely taste it. It just takes on the flavor of whatever else is in there. But two or three dates in that could be breakfast.
[53:06] The next thing you could do with dates, add two dates to porridge. So this is what I might make for my son. He likes this probably three days a week. Two dates, oats, chia seeds, cinnamon, sunflower seeds, coconut cream, bit of water, and cook that as a porridge. That's got heaps of protein, fats, and you reduce the glycemic index by adding all the coconut and the seeds in there, and it keeps them full for longer if there's a bit of extra protein and fat. And the other thing you can use dates for is a lot of cultures use dates to sweeten things like curries and tagines and things like that. So you can sprinkle them in your salad, use them as an alternative to sultanas, muffins, muesli you can make, chop it up in there. It's just a variety of things. Put it in some yogurt with breakfast and your fruit if you need to. So the short of it with dates is that yes, smaller studies have noticed a reduction in the duration of labor, So shorter labors, it can also improve the ripening of your cervix and how your cervix responds to labor, but the studies are not high quality. And as I already said, they were very small.
[54:19] Nonetheless, women in countries where dates grow plentifully and that are part of their usual cuisine, eat large numbers of dates with the intention of enhancing the function of their body during labor. So there is some ancient and traditional wisdom in that for sure.
[54:33] But we in western cultures have not tapped into that on a scientific level. So what I've suggested today based on the research that we could find that's English language and western knowledge is that there's not a lot of high quality or conclusive evidence on the use of raspberry leaf tea or the consumption of dates that would make me really confident to say that using them through pregnancy would alter your labor and birth outcomes. So if you really can't bring yourself to consume the volumes of raspberry leaf tea and the number of dates that might be required to achieve a therapeutic result, please do not feel bad about that. There is no sure evidence that I could find from a western scientific perspective so it's highly likely that you're not missing out on a magical effect of these things. Similarly though if you've had a pregnancy that went to 42 weeks or a labor that was really long and hard where your cervix didn't open.
[55:35] Dates and raspberry leaf tea might be something that you want to consider, but the research is inconclusive. But what we also know is that there's no current research on their potential harms or side effects. So this one is up for you to decide based on your feeling and intuition about what you want to do. That's it for today's episode of the Great Birth Rebellion podcast, and I will see you in the next episode of the Great Birth Rebellion.
[56:04] To get access to the resources for each podcast episode, join the mailing list at melaniethemidwife.com. And to support the work of this podcast, wear the rebellion in the form of clothing and other merch at thegreatbirthrebellion.com. Follow me, Mel, @melaniethemidwife on socials and the show @theGreatBirthRebellion. All the details are in the show notes.
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