 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. Which 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. There's 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. This is one of the most commonly performed obstetrical procedures in the US, 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. This might not help with those factors, but might they help foster a normal, spontaneous delivery? Let's find out. A prospective study, women eating 6 dates a day, and 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 had agreed 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 socioeconomic status, or who knows? I mean, yeah, you could argue, you know, 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 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 caused 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 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 what's called a bishop score. Normally, a score of 5 or less indicates an unfavorable cervix, whereas 8 or more, and you're good to go. But the average bishop score on 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 few weeks of their pregnancy.