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 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
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.
A UK feasibility study suggests that acupuncture adds benefit to standard care for back pain in pregnancy. The randomised trial allocated 125 women with pregnancy-related back pain, to one of three treatment groups: standard care alone (advice plus physiotherapy); standard care plus true acupuncture; standard care plus sham acupuncture. Participants received between six and eight treatment sessions over a six week period. The researchers found pregnant women were keen to take part, and they and their midwives had few concerns about acupuncture.
Patient-reported outcome measures of pain, function and quality of life, favoured the addition of true acupuncture to standard care. An economic analysis showed that although the addition of acupuncture lead to a higher total cost of care, it also achieved higher quality-adjusted life-years gains. There was no evidence of serious adverse events for mothers, birth or neonatal outcomes. The researchers conclude that a future, large randomised controlled trial is desirable and feasible, and would be welcomed by pregnant women and clinicians.
(Evaluating Acupuncture and Standard Care for Pregnant Women with Back Pain: a feasibility study and pilot randomised trial. Health Technology Assessment, April 2016.)
A pilot study undertaken at Guangzhou Medical University in China, suggests acupuncture may be helpful as an adjunctive treatment to bring down blood pressure in women with pre-eclampsia. Pregnant women in the study were given the choice of ten acupuncture sessions over a period of a fortnight plus usual care, or just usual care alone. Each group comprised eleven women. Patients in the acupuncture group were found to have significantly lower blood pressure at delivery and 24 hours postpartum, compared with patients in the control group.
(Effects of acupuncture on preeclampsia in Chinese women: a pilot prospective cohort study. Acupuncture in Medicine, 29 October 2015.)
Researchers in Iran are the latest to demonstrate how acupuncture can be of assistance in labour, by showing its use can lead to a significant shortening of the process. They randomised 63 women who were having their first child, to receive either acupuncture (32 women) at two well-known points for this purpose, or sham acupuncture (31 women) at the same points. The study was conducted at two main childbirth centres in Shiraz.
The duration of labour was found to be significantly lower in the group receiving real acupuncture (162 minutes) compared with the control group (280 minutes). Cortisol and labour pain did not vary significantly between the two groups. The authors point out that shortening the active phase of labour can decrease foetal complications such as low Apgar score, nerve injury, infections, and also maternal complications including puerperal infection and postpartum haemorrhage.
(Effects of LI-4 and SP-6 Acupuncture on Labor Pain, Cortisol Level and Duration of Labor. Journal of Acupuncture and Meridian Studies, October 2015.)