Acupuncture for Pregnancy Support
"For over 3000 years Traditional Chinese Medicine has promoted treatment for women in pregnancy care and postpartum recovery."
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Today Acupuncture for pregnancy is becoming increasingly popular and used by acupuncturists and specially trained midwives in countries such as Denmark, England, France, Germany, Holland, Norway, Sweden, and New Zealand, Australia. Pregnancy, childbirth and postnatal recovery are viewed in traditional Chinese medicine as a window of opportunity to enhance the woman’s well being. Conversely if adequate care is not taken the resulting problems may continue long after the birth. Value is therefore placed on promoting preventive care to strengthen the mother and baby as well as dealing with problems as they occur during pregnancy. Acupuncture may be used in a variety of ways to promote foetal and maternal health Including Nausea during Pregnancy, Muscular-Skeletal Pain, Breech and Posterior Babies, Hypertension, Labour Preparation, Induction, Pain Relief during Labour
Postnatal care
Acupuncture has techniques to promote recovery; these include “mother warming” treatments that can be given by a partner, advice on diet and the use of specific strengthening and blood building herbs. Other conditions that may be helped by acupuncture include; insufficient lactation, wound healing and scar tissue repair, postnatal depression and urinary incontinence.
Other pregnancy problems
Treatment may be used to relive a variety of conditions including:
Anaemia • Anxiety • Constipation • Carpal Tunnel syndrome • Heartburn • Haemorrhoids and Vulval varices • Insomnia • Oedema • Headaches • Sinus problems • Threatened miscarriage • Tiredness and exhaustion • Thrush
Acupuncture may offer an effective and drug free treatment option during pregnancy when used in conjunction with modern medical approaches.
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Nausea during Pregnancy
Acupuncture may be very effective in reducing both the severity and incidence of nausea and vomiting during pregnancy. Research from Australia [1] highlighted that women receiving traditional acupuncture (where points where chosen according to an individual diagnosis) experienced faster relief when compared to those groups receiving routine prescribed points or “sham” acupuncture. This research also looked at the successful pregnancy outcomes for the women involved, concluding that “acupuncture is a safe and effective treatment for women who experience nausea and dry retching in early pregnancy” [2]
1. Smith C, Crowther C, Beilby J. (2002). “Acupuncture to treat nausea and vomiting in early pregnancy: a randomized trial”. Birth. 29(1):1-9.
2. Smith C, Crowther C, Beilby J. (2002). “Pregnancy outcome following women’s participation in a randomised controlled trial of acupuncture to treat nausea and vomiting in early pregnancy”. Complement Ther Med. 10(2):78-83.
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Muscular – Skeletal Pain
Back pain, rib pain, sciatica and symphysis pubis pain are common in pregnancy and may all be markedly reduced with acupuncture. Research from Sweden [1] concluded that when compared to physiotherapy, acupuncture was the treatment of choice for symphysis pubis and sacroiliac pain.
1. 1. Elden H, (2005) Ladfors l, Fagevik Olsen M, Ostaard H, Hagberg H. “Effects of acupuncture and stabilising exercises as adjunct to standard treatment in pregnant women with pelvic girdle pain: randomised single blind controlled trail”. British Medical Journal;330(7494):761
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Breech and Posterior Babies
After consulting with your medical practitioner or gynaecologist breech babies may be assisted with acupuncture. Mums with breech babies are ideally treated between 34 - 36 weeks gestation. This is often a one off treatment with women being shown how to continue treatment at home with a moxa stick (a herb that has been shaped into a cigar like stick). The moxa stick is lit and held over specific places in the body to stimulate the acupuncture points which may help the baby to move.
The New Zealand Evidence Based practice guidelines for care of women with Breech presentation [1] recommends that moxibustion may be offered to women from 33 weeks gestation. This follows research from Italy [2] that demonstrated moxibustion may have a significant effect in helping to turn breech babies. Ideally treatment is at 34 –35 weeks, but can still be useful when used later in the pregnancy. Techniques may also help babies that are not in the optimal position prior to birth, such as those in a posterior position
1. http://www.nzgg.org.nz/guidelines/dsp_guideline_popup.cfm?guidelineCatID=26&guidelineID=74
2. Cardini F, Weixin H. (1998). “Moxibustion for correction of breech presentation”. Journal American Medical Association. 280:1580-1584.
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Research on Breech and Posterior Babies
Cardini et al. in 1998[4] had the following randomised controlled trial published in the Journal of American Association (JAMA).
Summary
The objective was to evaluate the efficacy and safety of moxibustion on Zhiyin BL-67 to correct breech presentation.
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130 women with a breech presentation and having their first baby (primigravidas) at 33 weeks gestation received moxibustion to Zhiyin BL-67 while 130 women, also with a breech presentation and who were also primigravidas, received no intervention.
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The moxibustion was administered for seven days. Women were then assessed and a further seven days of moxibustion treatment given if the baby’s position had not changed.
Outcomes were measured in terms of foetal movements, as counted by the mother for one hour each day for one week, and the number of cephalic presentations both at 35 weeks gestation and at delivery.
At 35 weeks gestation 75.4% in the intervention group had changed to cephalic (47.7% in the control). In terms of foetal movement the moxibustion group experienced a greater number of movements (a mean of 48.45 compared to the control group with a mean of 35.35).
Conclusion
That in prigravidas at 33 weeks gestation with breech presentation, moxibustion treatment for one to two weeks at Zhiyin BL-67 increased foetal activity during the treatment period and cephalic presentation at 35 weeks and at delivery.
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Hypertension
Acupuncture may have an important role in assisting to reduce high blood pressure, especially if treatment is commenced early when hypertension is first noted. The effectiveness of acupuncture will be reflected in the improved blood pressure readings and blood tests used by midwives and specialists to detect possible complications. As hypertension has the potential to escalate quickly, ongoing medical monitoring remains essential throughout pregnancy.
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Acupuncture for Pre Labour
Pre Birth treatment involves a series of four weekly treatments from 36 or 37 weeks that may help the body prepare for labour. Points are used according a woman's constitution and pregnancy history. These include points to ripen the cervix, to help position the baby in the best position for labour and to promote optimal energy and stamina for women to enter into labour.
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Research from Germany [1] indicated that pre labour acupuncture support provided the potential for a more efficient and active stage of labour. A New Zealand study with midwives [2] indicated that women who recieved pre labour acupuncture where less likely to require medical intervention, including medical induction and caesarean section.
Data on 169 women was gathered by 14 midwives as part of their midwifery practice in Wellington, New Zealand. It found that when comparing all caregivers (Midwives GP's and Specialists) to those women who had received pre birth acupuncture there was:
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An overall 35% reduction in the number of inductions (for women having their first baby this was a 43% reduction)
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A 31% reduction in the epidural rate.
When comparing midwifery only care to women receiving pre birth acupuncture there was a:
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32% reduction in emergency caesarean delivery
• A 9 % increase in normal vaginal births.
• There was no difference in the onset of early labour in those women receiving prebirth acupuncture.
For further infomation on this pre labour research and, cervical ripening please click on the link in the right hand column.
1. Kubista E, Kucera H. (1974). On the use of acupuncture in the preparation for delivery, Geburtshilfe Perinatol; 178(3):224-9.
2. Betts D, Lenox S ( 2006) Acupuncture For Prebirth Treatment: An Observational Study of its use in Midwifery practice. Medical Acupuncture. Vo 17 No 3
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Induction
Acupuncture may provide a gentle inducement to labour if the baby is overdue and may be an effective alternative to a medical induction. Research from Norway [1] on the use of acupuncture for women with premature rupture of membranes (PROM) concluded that "Ideally acupuncture treatment should be offered to all women with PROM and other women who wish to use this method to facilitate their birth and keep it normal"
1. Gaudernack L, Forbord S, Hole E. (2007) Acupuncture administered after spontaneous rupture of membranes at term significantly reduces the length of birth and use of oxytocin. A randomised controlled trial. Midirs Midwifery Digest. Vol 17, No 2.
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Pre Birth Acupuncture Research
Research on the use of acupuncture to prepare women for labour first appeared in 1974 with a study by Kubista and Kucera.[1] Their research concluded that acupuncture once a week from 37 weeks gestation using the acupuncture points Zusanli ST-36, Yanglingquan GB-34, Jiaoxin KID-8 and Shenmai BL-62 was successful in reducing the mean labour time of the women treated.
They calculated the labour time in two ways. The first was the mean time between a cervical dilation of 3-4 cm and delivery. In the acupuncture group this was 4 hours and 57 minutes compared to five hours and 54 minutes in the control group.
The second was the mean subjective time of labour, taken from the onset of regular (10-15 minute) contractions until delivery. The acupuncture group had a labour time of 6 hours and 36 minutes compared to eight hours and 2 minutes in the controls.
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In 1998 Zeisler et al.[2] used the acupuncture points Baihui DU-20, Shenmen HE-7 and Neiguan P-6, treating from 36 weeks gestation.
This study concluded that acupuncture treatment had a positive effect on the duration of labour by shortening the first stage of labour, defined as the time between 3cm cervical dilation and complete dilation. The acupuncture group had a median duration of 196 minutes compared to the control group time of 321 minutes.
In 2004 there was an observational study looking at the effect of prebirth acupuncture together with Sue Lennox, a midwife[3].
169 women who received prebirth acupuncture were compared to local population rates for gestation at onset of labour, incidence of medical induction, length of labour, use of analgesia and type of delivery.
In the acupuncture group there was an overall 35% reduction in the number of inductions (for women having their first baby this was a 43% reduction), 31% reduction in the epidural rate.
When comparing midwifery only care there was a 32% reduction in emergency caesarean delivery and a 9% increase in normal vaginal births.
The conclusion was that prebirth acupuncture appeared to provide some promising therapeutic benefits in assisting women to have normal vaginal births and that a further randomized controlled study is warranted.
1. Kubista E, Kucera H. Geburtshilfe Perinatol 1974; 178 224-9.
2. Zeisler H, Tempfer C, Mayerhofe Kr, Barrada M, Husslein P. Influence of acupuncture on duration of labour Gynecol Obstet Invest 1998; 46:22-5.
3. Betts D, Lennox S. Acupuncture for prebirth treatment: An observational study of its use in midwifery practice. Medical acupuncture 2006 May; 17(3):17-20
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Cervical Ripening
A randomised controlled trial into the effects of acupuncture on cervical ripening was published by Rabl in 2001.[1]
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Summary
The objective was to evaluate whether acupuncture at term can influence cervical ripening and thus reduce the need for postdates induction.
On their due dates 45 women were randomised into either an acupuncture group (25) or a control group (20). The acupuncture group received acupuncture every two days at the acupuncture points Hegu L.I.-4 and Sanyinjiao SP-6.
The women in both groups were examined every other day for cervical length (measured by vaginal trasonography, cervical mucus and cervical stasis according to Bishop’s score).
If women had not delivered after 10 days labour was induced by administering vaginal prostaglandin tablets.
The time from the woman’s due date to delivery was an average of 5 days in the acupuncture group compared to 7.9 days in the control group, and labour was medically induced in 20% of women in the acupuncture group compared to 35% in the control group.
There were no differences between overall duration of labour or of the first and second stages of labour.
Conclusion
Acupuncture at the points Hegu L.I.-4 and Sanyinjiao SP-6 supports cervical ripening and can shorten the time interval between the woman’s expected date of delivery and the actual time of delivery.
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1. Rabl M, Ahner R, Bitschnau M, Zeisler H, Husslein P. Acupuncture for cervical ripening and induction of labour at term – a randomised controlled trail. Wien Klin Wochenschr 2001; 113 (23-24): 942-6.
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Pain relief during Labour
Acupuncture offers drug free alternatives for pain relief during labour [1] Acupressure provides similar results [2] with the advantage that support people can use it during labour. A free booklet on using acupressure can be down loaded here
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1. Hantoushzadeh S. Alhusseini N. Lebaschi A. (2007) The effects of Acupuncture during Labour on Nulliparous Women: A Randomised Controlled trial. Australian and New Zealand Journal of Obstetrics and Gynaecology. 47:26-30
2. Chung UL J.( 2003) Effects of LI 4and BL 67 Acupressure on Labour Pain and Uterine Contractions in the First Stage of Labour. Nurs Res. 11(4):251-60
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Pain relief during Labour
Acupuncture offers drug free alternatives for pain relief during labour [1] Acupressure provides similar results [2] with the advantage that support people can use it during labour. A free booklet on using acupressure can be down loaded here
1. Hantoushzadeh S. Alhusseini N. Lebaschi A. (2007) The effects of Acupuncture during Labour on Nulliparous Women: A Randomised Controlled trial. Australian and New Zealand Journal of Obstetrics and Gynaecology. 47:26-30
2. Chung UL J.( 2003) Effects of LI 4and BL 67 Acupressure on Labour Pain and Uterine Contractions in the First Stage of Labour. Nurs Res. 11(4):251-60
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*Acupuncture for Fertility Brisbane clinic is a fertility clinic based in Annerley offering Natural Fertitliy, IVF and Pregnancy support using Acupuncture, Chiropractic, Naturopathy and Herbs. It currently services surrounding suburbs including Annerley, Fairfield, Greenslopes, Salisbury, Holland Park, Buranda, Stones Coner, Yeronga, Yeerongpilly, Moorooka, Tennyson, Tarragindi, Dutton Park, Highgate Hill and West End. Other services include acupuncture for pregnancy.