Background: Castor oil is one of the most popular methods for labour induction. The use of castor oil to induce labor is controversial. The irregular, painful contractions of castor oil-induced labor can be stressful on the mother and fetus. The use of castor oil may stimulate passage of meconium, and thus, neonatal respiratory distress that may result from meconium aspiration. So, the aim of this study was to assess safety and effectiveness of castor oil on labour induction and neonatal outcome. Subjects and Methods: a quasi-experimental design was used. The study was conducted in a private hospital at Makkah Al Mukaramah. One hundred pregnant women who attended the hospital for giving birth was selected from the previously mentioned setting. The sample was divided as follow: 50 women already took castor oil and 50 women didn't take castor oil at the time of birth. Results: there were a lot of maternal complications that had been occurred among castor oil group in comparison with control group such as fatigue (12.0%), nausea & vomiting (20.0%) and excessive uterine activity (12.0%) compared to (8.0%, 4.0% ,4.0%) from the control group respectively. About one fifth 18 % of castor oil group had amniotic fluid mixed with meconium. In addition, a highly statistical significant difference was found between the two groups at the first minute APGAR score (t=2.65 at p=0.009). Conclusion: It can be concluded that, the probability of labour initiation increases during the first 24 hours after using castor oil. In addition, taking castor oil increases the chances of meconium stained amniotic fluid. Most side effects caused by taking castor oil are fatigue, nausea, vomiting and diarrhea. Also, castor oil affected newborn's APGOR score at the first minute. Key words: Castor oil, labour induction, neonatal outcom
