Acupuncture in Pregnancy

Introduction

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 it is capable of assisting in many other areas too. 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.

Conditions Frequently Treated

Complaints commonly treated in pregnancy include nausea and vomiting (see more on this below), fatigue, insomnia, heartburn, constipation, lower back pain, sciatica, carpal tunnel syndrome, 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”.)

Preparation for Labour

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

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

How does Acupuncture Treatment Differ in Pregnancy?

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. Below you can read the results of some of the research which has been undertaken into acupuncture in pregnancy. The trials vary in quality, but systematic reviews and randomised controlled trials are generally considered to provide the highest quality evidence. If you would like to read more about evidence quality, I would refer you to the British Acupuncture Council’s description of the evidence pyramid.

The Importance of Good Health 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 well being 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 for Pelvic Girdle Pain/Symphysis Pubis Dysfunction

Acupuncture research from Sweden: acupuncture for pelvic girdle pain/symphysis pubis dysfunction. Research carried out in Sweden suggests that treating pelvic girdle pain (PGP)/symphysis pubis dysfunction (SPD) with either acupuncture or TENS, enables pregnant women to remain active. A total of 113 women with PGP between 12 and 28 weeks pregnant, were randomised to receive either 10 acupuncture sessions at two per week, or daily home-based TENS therapy for five weeks.

Despite the tendency in pregnancy for PGP disability to increase, both study groups preserved functioning and physical activity levels at follow-up, with the acupuncture group showing higher satisfaction with treatment. The authors recommend either treatment as a drug-free option for pain relief to preserve physical activity in pregnancy.

(Maintenance of physical activity level, functioning and health after non-pharmacological treatment of pelvic girdle pain with either transcutaneous electrical nerve stimulation or acupuncture: a randomised controlled trial. BMJ Open, October 2021.)

Moxibustion for Breech Babies

Using moxa on a point on the toe
A team in Taiwan has undertaken a systematic review of studies on moxibustion for breech babies. Included in their meta-analysis was data from 16 randomised controlled trials, involving 2555 women. Compared with control interventions, moxibustion significantly increased head-first (cephalic) presentation at birth. The results of one trial suggested that moxibustion plus acupuncture was synergistic for correcting breech presentation. (Correction of Breech Presentation with Moxibustion & Acupuncture: A Systematic Review & Meta-Analysis. Healthcare (Basel), 22 May 2021.)

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.)