Castor Oil for Induction of Labor: A Safe and Effective Method: A Large Retrospective Cohort Study in a University Hospital Setting

<b>Background/Objectives:</b> Castor oil has long been used as a traditional method for inducing labor, but evidence regarding its safety and effectiveness remains limited. This study aimed to assess the efficacy and safety of castor oil for labor induction in a large cohort within a high-risk university hospital setting. <b>Methods:</b> A retrospective analysis was conducted on women who underwent labor induction between January 2017 and June 2018 at the Department for Women's Health, University Hospital Tübingen. Outcomes of women induced primarily with castor oil-based induction cocktail and their offspring were compared with those induced using standard methods (prostaglandins, oxytocin, ripening balloon). Primary outcomes included induction-to-delivery time, need for additional induction methods, mode of delivery, and maternal/fetal complications. <b>Results:</b> A total of 1015 women were included; 824 (82.1%) received castor oil, and 191 (18.8%) underwent standard induction. The mean induction-to-delivery interval was 26.9 h in the castor oil group versus 19.0 h in the standard group. Additional induction was required in 50.5% of the castor oil group compared to 37.2% of the standard group. No significant differences were observed between groups regarding delivery mode or maternal/fetal complications. <b>Conclusions:</b> Castor oil appears to be a safe but slightly less effective option for inducing labor close to the calculated due date, even in a high-risk population. Large-scale prospective randomized trials are warranted to further evaluate its role in clinical practice.