Moon, H.Y., Kim, M.R., Hwang, D.S., Jang, J.B., Lee, J., Shin, J.S., Ha, I. and Lee, Y.J., 2020. Safety of acupuncture during pregnancy: a retrospective cohort study in Korea. BJOG: An International Journal of Obstetrics & Gynaecology, 127(1), pp.79-86.
Park, J., Sohn, Y., White, A.R. and Lee, H., 2014. The safety of acupuncture during pregnancy: A systematic review. Acupuncture in Medicine, 32(3), pp.257–266. Available at: <http://dx.doi.org/10.1136/>
Royal College of Obstetricians and Gynaecologists, 2016. The Management of Nausea and Vomiting
of Pregnancy and Hyperemesis Gravidarum. RCOG Green-top Guideline No. 69. Available at:<http://www.missionmrcog.com/home/images/Library/Greentop_Guidelines/2016/005_GTG_69_HYPEREMESIS.pdf>
Safety of acupuncture in pregnancy
A large retrospective cohort study concluded that acupuncture during pregnancy was safe and did not negatively impact delivery outcomes (Moon et al., 2020).
A systematic review of research studies examined the safety of acupuncture and moxibustion for any health conditions in pregnancy (Park et al., 2014).The review concluded that adverse events (AEs) were rare when acupuncture was delivered correctly. The authors added that most AEs connected to acupuncture treatment during pregnancy were mild and in the very few cases of serious AEs, acupuncture was unlikely to have been the cause (Park et al., 2014).
The Royal College of Obstetricians and Gynaecologists guidelines for the treatment of nausea and vomiting in pregnancy list acupuncture and acupressure as safe treatments, based on high level research evidence (Royal College of Obstetricians and Gynaecologists, 2016)
ACUPUNCTURE FOR PREGNANCY
MSc. BA. LicAc. MBAcC
Member of the Obstetrical Acupuncture Association
01392 221122
Helen is registered with SImplyhealth
EXETER ACUPUNCTURE CLINIC
Bookings: 01392 221122 Enquiries: 07814 304424
Based at the Cathedral Chiropractic and Acupuncture Clinic
Helen Stafford MSc, BA, LicAc, MBAcC
Exeter Acupuncture Clinic @
Cathedral Chiropractic and Acupuncture Clinic
6 Southernhay West,
Exeter, EX1 1JG
Bookings: 01392 221122
Enquiries: 07814 304424
During pregnancy your body works very hard as your baby develops. It is a time of vital importance for the long term health of yourself and your child. Traditional Chinese medicine has a long tradition in the areas of gynaecology and obstetrics. It places much emphasis on maintaining optimum health during pregnancy, through dietary therapy, acupuncture and lifestyle advice.
MOXIBUSTION FOR BREECH PRESENTATION
In breech presentation, your baby’s buttocks, foot or feet are positioned at the base of the uterus, rather than the head. Caesarian section is recommended for birthing breech babies. It is therefore, preferable to encourage the baby to turn. External cephalic version (ECV) is offered from 36-37 weeks of gestation. ECV is a procedure carried out by an experienced obstetrician, to manually turn a breech baby into a head down position. Although most women tolerate ECV, it can be a painful experience.
The Royal College of Obstetricians and Gynaecologists (RCOG) (2017) suggest that women with uncomplicated pregnancies might consider moxibustion for breech presentation, under the guidance of a trained practitioner, prior to a planned ECV. Midwives often refer women to acupuncturists prior to trying other interventions such as an ECV. Moxibustion is a safe and simple technique in which an acupuncture point on the little toe (UB67) is gently heated using a stick made of the Chinese herb known as mugwort. Although the mechanism of action of moxibustion is unclear, it is thought that the heat from the moxibustion has the effect of releasing hormones which relax the uterus and stimulate the baby to move (Cardini and Weixin, 1998).
When you come for treatment, I will take a full case history and you will receive acupuncture and moxibustion. You will be taught how to safely use moxibustion at home. It is recommended that you use the technique for 20 minutes a day for 10 days. It is important to complete the 10 days. If your baby turns within that time you can reduce from 20 to 10 minutes. Women often describe moxibustion treatment as pleasant and relaxing and may feel an increased connection with their partner when they help to administer the treatment. Acupuncture and moxibustion will complement other techniques such as positional exercises or chiropractic treatment. Moxibustion can be used to help correct breech presentation from week 34-38. However, the optimal time is from week 34 as the baby has more room to move.
The Research
A systematic review (SR) is a comprehensive and objective review of all existing research studies on a specific subject. A SR uses a rigorous and reproducible methodology to source and analyse relevant research papers. The aim of SRs is to appraise and summarise available evidence.
The most recent SR in 2021 (Liao et al.) assessed 13 research studies with a total of 2063 participants. The authors concluded that the participants who received moxibustion treatment on the acupuncture point UB 67 had an increased rate of cephalic presentation at birth, compared to those receiving usual care. This 2021 SR and an earlier, smaller SR (Coyle et al., 2012) concluded that acupuncture combined with moxibustion led to a higher of cephalic presentation at birth compared to usual care.
Risk Factors
It is important that women have their baby’s breech presentation confirmed and that they talk to their midwife before seeking moxibustion treatment. Not all women are suitable for moxibustion treatment. Conditions in which moxibustion treatment would not be appropriate include: oligohydramnios; polyhydramnios; a history of vaginal bleeding in pregnancy, known foetal abnormalities or growth issues, history of PROM or premature labour, gestational diabetes, hypertension; placenta previa; bicornuate uterus; twins or other multiple pregnancies and women for whom ECV is contraindicated by the primary care team.
PRE-BIRTH TREATMENTS
Pre-birth acupuncture constitutes a series of treatments in the final weeks of pregnancy to help prepare women for labour.
In a research study by Kubista and Kucera in 1974, it was found that the mean labour of women treated with acupuncture was reduced. These women had a mean labour duration of 6 hours and 36 minutes, compared to the 8 hours and 2 minutes in the control group. A further study in 1998 by Zeisler et al. also produced positive results. The study concluded that the first stage of labour was shortened to a median duration of 196 minutes, compared to the 321 minutes of the control group.
In 2004, in an observational study by Lenox and Betts, 169 women receiving pre-birth acupuncture were compared to the local population. There was a reduction of 35% in the number of inductions and a 31% reduction in the use of epidurals in the acupuncture group. In this group there was also a 32% reduction in emergency caesarean delivery and a 9% increase in normal vaginal births.
Based on these studies, pre-birth acupuncture appears to offer some benefits for women and it is hoped that further research studies will be funded.
ACUPRESSURE FOR LABOUR
Acupressure is a useful tool for labour. The techniques can be taught to women and their partners in one session. Specific acupuncture points are used to help with pain relief and to promote an efficient labour. Acupressure is often very much appreciated by partners as it gives them the opportunity to provide extra support during labour.
A systematic review by the Cochrane Pregnancy and Childbirth Group in 2011, looked at 13 trials investigating the use of acupuncture and acupressure to reduce pain in labour. Four of the trials reported on acupressure. It was found that pain intensity was reduced in the acupressure group compared with a placebo control. The overall conclusion from the review was that both acupuncture and acupressure may help with pain reduction, pain management and reduced pharmacological analgesia during labour. The report recommended further research due to the positive results of the reviewed trails.
POST-NATAL TREATMENT
The time immediately following childbirth is an important recovery period. In China, there is a long documented history of a focus upon diet and rest to support recovery and to encourage a plentiful supply of breast milk. This period was called the 'Golden Month', when a woman was supported by her family to take complete rest. Nowadays, such a level of support is not always available. However, it is still as important, as it has been in the past, that women rest as much as possible. Although gentle exercise , such as walking, is a good thing during this period, embarking upon a demanding work-out programme at get back into shape, is ill advised. The body is depleted after childbirth and attention needs to be given to lifestyle and diet to help re-build energy and blood.
A treatment know as 'mother warming' can help to restore energy after labour and can help tone the uterus and aid recovery. It is done with a gentle, soothing heat applied over the abdomen.
POST-NATAL NUTRITION
During this early post-natal period, food should be slowly or lightly cooked, as it requires less energy to digest. The digestion of cold or raw food is more demanding on the system and therefore, draining rather than healing. Women need nourishing food which helps to build blood and energy, such as green, leafy vegetables, pulses and chicken.