Acupuncture in Pregnancy

Pregnancy acupuncture in Exeter.
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 Whittington NHS Hospital in North London set up its Maternity Acupuncture Service in 2005. The hospital finds that women who opt for acupuncture undergo fewer surgical interventions and spend less time there.

Complaints commonly treated in pregnancy include nausea and vomiting (see more on this below), fatigue, insomnia, heartburn, constipation, lower back pain, sciatica, symphysis pubis pain (also known as SPD pain), itching, anxiety and depression.

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 .

There are also other conditions about which women enquire. Breech presentation is one. Provided a case seems suitable, I will show women a treatment which from week 34, they can administer themselves at home. (See the research article below, entitled “Treatment of Breech Presentation”.)

Teaching acupressure to assist in labour.

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 been taught by midwives at Derriford Hospital in Plymouth. As a result, partners consistently reported feeling more involved and useful in the birth.

Pre-birth treatments are something else we can do at this stage. 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.

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. Occasionally I might ask you to refer specific matters to her for further advice.

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 more gentle treatment. There exist a few acupuncture points which it is considered best practice not to use in pregnancy. Lastly, 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). 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

Acupuncture helps Depression & Stress in Pregnancy

Acupuncture in Exeter: acupuncture helps depression & stress in pregnancy. Acupuncture helps depression and stress in pregnancy, whilst also being well-tolerated and free from adverse events, according to an Australian team.

The researchers, from Western Sydney University, undertook a pragmatic trial with 57 pregnant women suffering from depression. The women were randomised to receive either acupuncture plus usual care, progressive muscle relaxation plus usual care, or usual care alone. Treatment was given from 24 to 31 weeks gestation. Acupuncture was individually tailored to each patient.

Significantly lower depression scores were observed in the acupuncture group compared with the other two groups. The same was true of scores for stress and psychological distress.

(The feasibility of acupuncture as an adjunct intervention for antenatal depression: a pragmatic randomised controlled trial. Journal of Affective Disorders, 1 October 2020.)

Acupuncture helps Birth Preparation

Data from the NHS Whittington Maternity Acupuncture Service, suggests that acupuncture normalises birth and reduces costs to the NHS. Records on over 6000 births from a two year period, were examined to quantify the effect acupuncture had on labour and delivery outcomes. The service is free to users, and women self-refer to receive weekly traditional acupuncture from 37 weeks gestation, as routine birth preparation. Data on women who received treatment was compared to that on women who did not.

Analysis showed women receiving acupuncture had fewer births requiring surgical intervention, and required less analgesia during birthing, fewer induction components and a shorter hospital stay. Women valued the availability of acupuncture highly.

(Birth preparation acupuncture for normalising birth: An analysis of NHS service routine data and proof of concept. Journal of Obstetrics & Gynaecology, 23 January 2020.)

Moxa to Turn Breech Babies

Using moxa on a point on the toe

Italian hospital and university researchers studying the use of moxa to turn breech babies, have concluded it is an effective and low-cost treatment. In a pilot study, 93 women in the 32nd to 35th week of pregnancy and confirmed breech by ultrasound, were given moxa to use at home once a day for two weeks. If babies remained breech after this, women were given an additional thirty minutes of moxibustion, plus some acupuncture, for three additional days over the course of one week. Cephalic version and natural childbirth was subsequently observed in 62% of all treated women. Acceptability was very high at 98.9% and compliance for moxibustion was 91.4%.

(Turning Foetal Breech Presentation at 32-35 Weeks of Gestational age by Acupuncture and Moxibustion. Evidence-Based Complementary & Alternative Medicine, 9 June 2019.)

Episiotomy Pain

Acupuncture research from Croatia: episiotomy pain. Researchers at the University Hospital Center Sestre Milosrdnice in Croatia, have shown that adding ear acupuncture to analgesics is helpful in managing episiotomy pain. A total of 60 women who had undergone episiotomy were randomised to receive either acupuncture plus oral painkillers on request (29), or painkillers alone (31).

Results showed that in the acupuncture group, women’s subjective experience of pain was significantly reduced on the second and third days postpartum, although they did not show a corresponding significant reduction in use of analgesics. No adverse effects of acupuncture were noted. The researchers say that the results prompt the question of whether current ‘best practice’ may yet be improved.

(Auricular acupuncture as effective pain relief after episiotomy: a randomized controlled pilot study. Archives of Gynecology & Obstetrics, November 2019.)