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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 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, varicose veins, haemorrhoids, lower back pain, sciatica, symphysis pubis 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”.)
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
Researchers interested in acupuncture for morning sickness, have undertaken a network meta-analysis comparing treatments. Acupuncture, acupressure and methylprednisolone for hyperemesis gravidarum, the severe form of morning sickness, offered better therapeutic benefits than standard care. Acupressure also reduced the need for rescue antiemetics.
(Interventions for treating hyperemesis gravidarum: a network meta-analysis of randomized clinical trials. Journal of Maternal-Fetal & Neonatal Medicine, 25 September 2018.)
Researchers in the Department of Nursing at the Federal University of Ceará, Brazil have found that a course of acupuncture offers significant analgesic effects for women experiencing lower back pain in pregnancy. A total of 56 women between 14 and 37 weeks pregnant, and mean age 25, were given up to six acupuncture sessions. Pain scores showed a statistically significant reduction in lower back pain as early as the second session, with further gradual improvements following. The women also reported improvements in relaxation, stress, sleep and anxiety. The researchers concluded that acupuncture “has the potential to promote health in a pleasant, simple, convenient, practical, risk-free and cost-effective manner”.
(Acupuncture treatment: multidimensional assessment of low back pain in pregnant women. Revista da Escola Enfermagem da USP, 11 June 2018.)
Researchers from the Obstetrics and Gynaecology Department at the University of Modena in Italy, have found that acupuncture given regularly from full term, may be effective in reducing the rates of labour induction performed for women whose pregnancies are running on significantly past their due dates. A total of 375 women at 40 weeks gestation received either acupuncture or routine care. Acupuncture was given on alternate days from 40 weeks plus 2 days, up until 41 weeks plus 4 days. Acupuncture points were chosen from those traditionally indicated to enhance uterine activity, ripen the cervix, relax the muscles and reduce anxiety.
Compared with the control group, women who received acupuncture: experienced a higher rate of spontaneous delivery (75% versus 53%); delivered on average two days earlier; had lower rates of labour induction (20% versus 38%); needed less oxytocin to strengthen their contractions; had lower rates of operative delivery (6% versus 11%). The researchers point out the significance of the reduced demand for oxytocin, in the context of a recent study suggesting adverse effects of oxytocin on birth outcomes.
(Acupuncture in Postdate Pregnancy Management. Journal of Acupuncture & Meridian Studies, October 2018.)
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.)