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Category Archives: Pregnancy
This section is intended to tell you more about receiving acupuncture in pregnancy. Many women now know that acupuncture can be very helpful for morning sickness, but that is often as far as their knowledge extends. So please read on, and I will try to answer some of the most common questions.
Firstly, acupuncture is a safe, drug-free treatment ideally suited to pregnancy, and it is actually capable of dealing with a multitude of conditions which can arise. This is why for example, the Lister NHS hospital in Hertfordshire set up its Maternity Acupuncture Support unit in 2012. Complaints commonly treated include nausea and vomiting (see more on this below), fatigue, insomnia, heartburn, constipation, varicose veins, haemorrhoids, lower back pain, sciatica, symphysis pubis pain, itching, anxiety and depression.
There are also other conditions about which women enquire. Breech presentation is one, and provided a case seems suitable, I will show women a treatment they can then continue to administer themselves at home; this should be done from week 34. (See the research article below, entitled “Treatment of Breech Presentation”.) Prebirth treatments are another: beginning by week 36, these are given on a weekly basis to prepare in body and mind for labour, and specifically to help prepare the cervix and pelvis.
Morning sickness is a symptom which has been described by Chinese doctors in their medical texts for centuries: Zhu Dan Xi wrote on it in 1347, and The Foundations of Medicine described its causes in 1575. Whereas in western medicine there is just “morning sickness”, in acupuncture, by questioning and examination, we refine our diagnosis to one of six different kinds of morning sickness. From this follows the best choice of acupuncture points, and the most appropriate self-help advice. To see a patient’s experience of acupuncture for morning sickness, go to http://youtu.be/tbJWrMt05LU .
Towards the end of pregnancy I can also teach you and your partner, some simple acupressure techniques for use from 36 weeks onwards: the application of finger or thumb pressure to specific acupuncture points can help your body prepare for labour, enhance contractions, help dilation, and assist delivery of the placenta. These are safe, comfortable techniques, which in the past have also been used and taught by midwives at Derriford Hospital in Plymouth, where as a result, partners consistently reported feeling more involved and useful in the birth.
Your midwife remains at all times the person ultimately responsible for the care of you and your baby, and I always encourage women to let their midwife know they are receiving acupuncture. There are occasions in pregnancy where I might ask you to refer specific matters to her for further advice, and so we remain alert to such situations arising.
Finally, does acupuncture treatment differ when it is given in pregnancy? In my own practice, there are four broad differences: I reduce the number of needles I use in each session; I devise a generally more gentle treatment; there exist a few acupuncture points which it is considered best practice not to use in pregnancy; especially as pregnancy progresses, I have to pay increasing attention to patient comfort (treatment position, room temperature etc.).
I hope this has answered some of your basic questions, and as usual, you are welcome to call for further information. Meanwhile, below you will find the results of some research conducted into acupuncture in pregnancy.
Before finishing though, you may be interested in an ancient Chinese medical and cultural teaching known as taijiao, whereby a mother’s emotional states, diet and general wellbeing through pregnancy, have always been considered to influence the health of the baby through infancy onwards and throughout the rest of its life. Over the last 25 years, evidence has been published in respected journals such as The Lancet, to support some of what Chinese doctors have written in the previous 1500 years.
In essence, stress, depression or anxiety in pregnancy, affect the baby’s wellbeing and can contribute to a more difficult pregnancy and labour; two reviews published in 2007(1,2) parallel seventh century writings(3) on this by Sun Simiao. Chinese clinicians also offered pregnant women dietary advice over 1300 years ago(3), and in 2013, a study was published linking even maternal weight with cardiovascular health when the baby reaches adulthood(4). So there really is much you can do to give your child the best start plus an improved chance of good health for years ahead.
(1) Journal of Child Psychology & Psychiatry, 48(3-4):245-261
(2) Journal of Maternal-Fetal & Neonatal Medicine, 20(3):189-209
(3) Bei Ji Qian Jin Yao Fang, Vol 2
(4) British Medical Journal, 347:f4539
A study on acupuncture for pain in pregnancy undertaken at a New Zealand hospital, shows a clinically meaningful symptom reduction in women with lower back and pelvic pain. The observational study looked at data on 81 women with lumbopelvic pain, who received traditional Chinese acupuncture weekly. In all, 89% of patients reported a clinically meaningful symptom reduction following treatment.
The authors conclude that this study supports existing clinical trial results indicating the benefits of acupuncture in reducing symptoms. The nature and extent of adverse events were consistent with those found in reviews whose authors have concluded that acupuncture in pregnancy is safe overall. Tailoring the treatment to the concerns of pregnancy may help clinicians feel more confident in acupuncture as a safe and effective treatment.
(Treating Pain in Pregnancy with Acupuncture: Observational Study Results from a Free Clinic in New Zealand. Journal of Acupuncture & Meridian Studies, February 2018.)
Acupressure at the point sanyinjiao or SP-6, just above the ankle, decreases maternal anxiety and analgesic consumption during labour, Iranian researchers have found. A total of 131 women in labour at Maryam Hospital, Tehran were randomly allocated to receive acupressure, touch applied as a control, or routine care. Within 30 minutes of starting the intervention, mean anxiety in the acupressure group was significantly less than both control groups, and it remained so 30 minutes after finishing the intervention. Sedative and analgesic consumption was also significantly lower in the acupressure group compared with the control groups.
The researchers conclude that acupressure at SP-6 could be considered an alternative method to decrease maternal anxiety and use of sedative and analgesics, especially pethidine.
(The Effect of Acupressure at Spleen 6 Acupuncture Point on the Anxiety Level and Sedative and Analgesics Consumption of Women during Labor: A Randomized Single-blind Clinical Trial. Iranian Journal of Nursing & Midwifery Research, March – April 2018.)
Researchers in Australia studying acupuncture for depression in pregnancy, report that it could be a valuable and supportive intervention. In a small study, eight women took part in a pragmatic, randomised, controlled trial and were subsequently interviewed about their experiences. They reported that conventional treatments had been inadequate or unsatisfactory, or were now unacceptable in pregnancy. They experienced not only symptom relief, but also described benefits from acupuncture which enabled them to better manage their lives and the changes brought about by pregnancy.
(Women’s experiences of having depression during pregnancy & receiving acupuncture treatment – A qualitative study. Women & Birth – Journal of the Australian College of Midwives, 15 November 2017.)
An integrative medicine programme which includes acupressure can significantly reduce epidural use and caesarean section rates, when added to standard antenatal care. Doctors in Australia randomised 176 first-time mothers attending two public hospitals in Sydney, to either standard care, or standard care plus a two-day antenatal education programme in six evidence-based complementary medical techniques (acupressure, relaxation, breathing, yoga, massage and partner support).
Whereas epidural use in the standard care group was 69%, that in the intervention group was significantly lower at 24%. The intervention group was also observed to have lower rates of caesarean section, medical or surgical assistance in labour, length of second stage, perineal trauma, and need for resuscitation of the newborn.