PREGNANCY & PRE-NATAL CARE

Throughout pregnancy, acupuncture is an ideal form of support and treatment. It allows women to benefit from drug-free relief for various symptoms that can be experienced throughout pregnancy and childbirth.

Acupuncture is safe in pregnancy although should be practiced by a registered Acupuncturist due to points that are contraindicated in pregnancy.

Symptoms that may be treated in normal pregnancy include:

  • Morning sickness/ Nausea.
  • Back ache
  • Sciatica
  • Symphysis Pubic pain
  • Heart burn and reflux
  • Stress relief
  • Insomnia

IDEAL TREATMENT:  Weekly until 12 weeks, then as needed up until 36 weeks (labour preparation – see below)

MISCARRIAGE

Miscarriage occurs in approximately 1 in 4 of all pregnancies. From a Traditional Chinese Medicine, perspective miscarriage can have the same physical repercussions that birth has but with the added emotional aspects of grief and loss.

Acupuncture treatment and Chinese Herbal Medicine can be used to support the mind and body during this time as well as prepare the body to begin trying to conceive again.

THREATENED MISCARRIAGE

A threatened miscarriage is bleeding in the early stages of pregnancy. Acupuncture can be used to support the mother during this time.

LABOUR PREPARATION

Pre-birth Acupuncture refers to weekly treatments beginning at 36 weeks’ gestation to prepare women for childbirth. Pre-birth Acupuncture has positive effects on a Woman’s preparation for the smoothest labour possible by preparing the woman’s body for birth with emphasis on the cervix and pelvis.

Pre-birth Acupuncture gives the opportunity to also treat pregnancy induced symptoms including hypertension, insomnia, heartburn or posterior positioned babies.Throughout Labour Preparation treatments at The Dao Health patients are educated in Acupressure and how they and their partner can use this technique as part of Labour.

IDEAL TREATMENT: Weekly from 36 weeks until baby arrives.

BREECH BABIES

Sometimes bub doesn’t quite make it into the right position before labour preparation begins. Moxibustion is often recommended at BL67 specifically. It is not fully understood from a western medical perspective; however, it has been seen that this treatment helps to stimulate the production of maternal hormones and encourages the uterus lining to contract in a way that may help turn the baby.

IDEAL TREATMENT: Moxibustion of BL67 10 minutes on each side daily. You will be given 2 moxibustion sticks to continue to use at home.

PRE-BIRTH ACUPUNCTURE

Research on the use of acupuncture to prepare women for labour first appeared in 1974 in a study by Kubista and Kucera. Their research concluded that acupuncture once a week from 37 weeks gestation was successful in reducing the average labour time of 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.

In 1998 Zeisler et al.used acupuncture  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 (Betts & Lenox) examining the effect of prebirth acupuncture. This involved 169 women receiving prebirth acupuncture who were compared to local population 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 randomised controlled study is warranted.

CERVICAL RIPENING

A randomised controlled trial into the effects of acupuncture on cervical ripening was published by Rabl in 2001.

SUMMARY AND CONCLUSION:

The objective of this study 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. The women in both groups were examined every other day for cervical length (measured by vaginal ultrasonography, 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 the overall duration of labour or of the first and second stages of labour. The authors concluded that 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.

INDUCING LABOUR

The research to date does not support that women receiving acupuncture to stimulate contractions improves labour outcomes. In contrast to the use of pre-birth acupuncture that aims to prepare a woman’s body for labour, an acupuncture induction aims to stimulate contractions. It may be that stimulating uterine contractions without an individualised approach to address factors such as cervical ripening, the baby’s position, emotional factors, and physical stamina has limited beneficial effects in terms of labour outcomes.

SUMMARY AND CONCLUSION:

A Cochrane review in 2013 evaluated 14 studies involving 2220 women. The authors reported that while there was some evidence of changes in cervical maturation and the length of labour for women receiving acupuncture, there was no difference in the number of women using an epidural, in the rate of instrumental delivery or Caesarean sections. The authors concluded that further research is required to gaining a greater understanding of the specific components of acupuncture treatment with women who are overdue.

PAIN RELIEF DURING LABOUR 

A Cochrane review of 13 trials involving 1986 women, reported that acupuncture or acupressure may help relieve labour pain.

SUMMARY AND CONCLUSION:

Nine trials reported on women receiving acupuncture and four trials reported on the use of acupressure, with the finding that women receiving acupuncture or acupressure reported benefits in terms of reduced pharmacological analgesia, less intense pain and increased maternal satisfaction. However due to the small number of trials and the poor quality of reporting within some of these trials further high-quality research is required.

POSTPARTUM SUPPORT

In Traditional Chinese medicine (TCM) the first month after giving birth is crucial to the immediate and future health of both mother and baby. A time to rest, recuperate and be supported. 

The practice is traditionally known as “sitting the month”. Originally, sitting for a month was literally what the mother would do. She would be confined inside her home, away from the wind and cold, away from people and made to rest. She would be waited on with 5-meals per day, massaged, helped with the baby, supported around the clock, commonly under strict control from her mother or mother-in-law. All of this aimed to ensure her future longevity and is still believed that without “sitting the month” negative consequences are expected. 

As with all great traditions they tend to evolve with the times. The idea of support, rest and specific diet is still of paramount importance for a woman’s postpartum body today.

IDEAL TREATMENT:  Within the first 10days of postpartum, fortnightly within the first 3 months and monthly thereafter.   

RECOMMENDED READING: 

  • Golden Month by Jenny Allison
  • The first forty days by Heng Ou
  • The Dao Health E-book – Coming soon!

// REFERENCES

THREATENED MISCARRIAGE [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3342918/

BREECH BABIES [1]  https://acupuncture.rhizome.net.nz/acupuncture/fact-sheets/evidence-base-acupuncture-and-moxibustion-breech-presintation/

PAIN RELIEF IN LABOUR [1] 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

[2] Cardini F, Weixin H. Moxibustion for correction of breech presentation. JAMA 1998; 280:1580-1584

[3] Elden H, 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 singleblind controlled trail. BMJ 2005;330:761.

[4] Kubista E, Kucera H. Geburtshilfe Perinatol 1974; 178 224-9.

[5] Smith C, Crowther C, Beilby J. Acupuncture to treat nausea and vomiting in early pregnancy: a randomized trial. Birth.2002, Mar:29 (1):1-9.

[6] Smith C, Crowther C, Beilby J. Pregnancy outcome following women’s participation in a randomised controlled trial of acupuncture to treat nausea and vomiting in early pregnancy. Complement Ther Med. 2002 Jun; 10(2):78-83.

[7] Smith CA, Collins CT, Crowther CA, Levett KM. Acupuncture or acupressure for pain management in labour. Cochrane Database of Systematic Reviews 2011, Issue 7. Art. No.: CD009232. DOI: 10.1002/14651858.CD009232.

[8] Smith CA, Crowther CA, Grant SJ. Acupuncture for induction of labour. Cochrane Database of Systematic Reviews 2013, Issue 8. Art. No.: CD002962. DOI: 10.1002/14651858.CD002962.pub3.

[9] 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.

[10] Zeisler H, Tempfer C, Mayerhofe Kr, Barrada M, Husslein P. Influence of acupuncture on duration of labour Gynecol Obstet Invest 1998; 46:22-5.