Acupuncture as a Pre-birth Treatment

Can we prepare a woman’s body for birth? Can we ripen her cervix so that it’s softer, easier to dilate and gentler for a baby to move through? Can we help turn a breech baby or help it descend into the pelvis? Can we have an effect on serum LH and FSH? Can we ease her tension, make her whole birth easier, shorter and safer? Can we reduce the pain? Practitioners of Traditional Chinese medicine in obstetrics believe so and there is research giving us some promising results. 

Acupuncture is absolutely safe during pregnancy. It is safe while working toward conception and through the postpartum period. It is often encouraged, by many of us who work with Traditional Chinese Medicine (TCM), to alleviate the many symptoms these wild transitions bring on. Through studying and reading from experienced TCM practitioners in the field of obstetrics I have found that there is also an abundance of observational research and records with many positive outcomes. 

As a pre-birth treatment, many women have reported simply feeling more relaxed, less pain, more energy and better overall sleep quality as they approach their birth. I have had women leave my clinic surprised at the effectiveness of it’s ability to reduce the discomforts in their ligaments and its ability to calm their nervous system or relieve digestive discomforts, after just one treatment. Regardless of the studies, these above results are formidable and worth it. 

Registered acupuncturists don’t just do acupuncture. We provide big and small lifestyle suggestions, like the importance of keeping your feet warm or your heart calm. Traditional Chinese medicine has a history in advocating that women modify their lifestyle during pregnancy and this advice changes depending on the stage she’s in.  We can offer suggestions around physical activity or an abundance of dietary information that will be supportive to you specifically and to the process of holding, birthing and breast feeding a baby. These dietary recommendations don’t just incorporate food suggestions but also cooking methods that can help reduce inflammation and nourish overall hydration and fluids in the body. This goes above and beyond the simple suggestions of just “eat more, drink more, sleep more” in context to pregnancy and postpartum. For example, what is “eating for two”? Have we acknowledged that it doesn’t stop after the baby is born but becomes more necessary through breast feeding and the full recovery after birth. How many extra calories are we talking and do we not mind the quality and nutritional density of these calories? In truth, we need to support the gut and mitigate inflammation. This isn’t new information and it certainly isn’t limited to Traditional Chinese Medicine either. Women globally, have been doing this for centuries. Ancient traditional dietary suggestions, such as these, can help build up your body, prevent depletion and support nutrient assimilation and the movement of it all through the system.  Acupuncture can enhance this process. In TCM we call this; tonifying yin, yang and blood or strengthening Qi, blood and body fluids. Sometimes it’s; clearing heat or sedating excess. The terms sound so simple in Traditional Chinese Medicine and they are effective, quite accurate and personal. According to TCM, acu-sessions before labour have been known to support and asses that the qi and blood, the five emotions and the zangfu are all in harmony. This is how we address health. 

Just recently I became a new Member of the OBAA. The Obstetrical Acupuncture Association is a support network for practitioners like myself, providing us with up to date research, resources, support and mentorship in the field of obstetrics in acupuncture. They also help individuals navigate their area for Registered Acupuncturists with these skills. This network is global and growing. Acupuncture in pregnancy is a thing! A good thing. 

Acupuncture is ancient and for quite some time a lot of people thought that it had no grounds in science. But this simply isn’t true. As a pre-birth treatment, specifically, it has promising results in; decreasing the length of active labour, lessening its intensity AND reducing the need for medical intervention, generally speaking. Let me elaborate. 

Medical intervention is valuable. It prevents suffering and it saves lives. Many allopathic induction methods are safe, extremely helpful and absolutely necessary. Many of them are gentle. So why do we need to prepare a woman for labour in a fully equipped system? Because it helps. In cases where medical induction was used alongside acupuncture and cervical ripening, results were favourable for those who received acupuncture compared to those who did not. In addition, for women who prefer birth to occur as naturally as possible, acupuncture is often desired to help in this process and potentially mitigate the use of medical interventions. Additionally, in cases where women are over the age of 36 and pregnancy is considered “geriatric” (eye roll), risk factors are believed to increase and acupuncture has known results demonstrating that it is effective in supporting vaginal births amongst these folks. 

The Science.

In China, there are a number of studies where acupuncture was used alongside medical induction methods to support and improve the process. One study compared results between patients who used a Cook double-balloon only and compared it to those who used this method alongside acupuncture. Another study compared those who received acupuncture and moxibustion alongside a Foley balloon and oxytocin to those who did not receive the acupuncture and moxa. In addition, a study tested acupuncture alongside misoprostol and compared to pregnancies who received the misoprostol alone. Several of these studies measured the cervical ripeness through the Bishop score, time of cervical dilation, length of each stage of labour, mode of birth (vaginal vs. C-section), and neonatal adverse outcomes. What showed to be true was that the acupuncture group had:

• Better cervical parameters: greater cervical dilation, more effacement, more favourable fetal station

• Higher bishop scores

• Faster dilation speed 

• Shorter first, second and third stage and total labour time

• Less blood loss during and after birth

• Higher vaginal birth rate and lower c-section rate

• Shorter induction-to-delivery birth rate

• Higher overall induction success

In addition and without doubt, acupuncture appears to be safe for pregnant women and when close to or preparing for delivery. 

One of these studies even had a follow-up paper by the same team looking at the same double-acupuncture protocol’s influence on serum LH and FSH suggesting significant hormone modulation during induction. The effect acupuncture has on these hormones will play a significant role in hormone health in general! 

Recent well-conducted trials suggest pre-birth acupuncture is a safe and acceptable option that can help facilitate the body's natural labour process, potentially reducing the need for medical interventions, especially in cases of overdue pregnancies.

In another study, almost 90% of the women declared that acupuncture supported them and prepared them psychologically and physiologically for labour. Birth isn’t just body. It’s mind too. Midwives and doulas have declared countless cases where the hesitation, fear or worry of a woman held her back from moving through certain stages of labour or even into labour at all. In the process of labour prep we have to consider the state of mind of the patient. Are they feeling anxious, nervous or irritable which all have the potential of blocking the free flow of Qi and inhibiting the onset of labour. The most significant finding in randomized controlled studies is that acupuncture does show a trend of increased rates of spontaneous labour. 

From a Traditional Chinese Medicine Perspective. 

The points we use play major roles in; softening the cervix by tonifying yin and reaching the uterus, moving Qi and Blood if stasis is present, loosening and nourishing the tendons and ligaments and tonifying the qi and blood of the body. Some points might have a descending action to encourage the baby to drop, if this has not occurred. They can promote the dilation of the cervix, offer an anesthetic effect, calm the mind and begin to gently stimulate the beginning of contractions. Some points also offer support in moving the position of the baby into a more optimal position. 

If you are pregnant and seeking support in this process let me give you an idea of what a treatment may look like. Treatment typically begins at 36 weeks and occurs weekly up until birth. Often (but not always), only 4 points are needed for a pre-birth treatment and the treatment is gentle. Strong stimulation at these points is not required. There is one on each hand and one just above each ankle. Occasionally they will also place one or two just below each knee. The practitioner will do an intake with you to understand your overall well being in current time as well. If you are open to it they may add in another point or two to support your system. Sometimes supporting your system is all that is required. Bringing your body into balance and finding a homeostasis is what is important in health and in birth. 

Conclusion.

More studies are still required, always. Blinded and randomized controlled studies need to be done with higher numbers in test subjects. The ones we are currently seeing are very promising but they could use more thoroughness and a larger amount of comparisons. We know for sure, that acupuncture and many of it’s umbrella modalities like cupping and moxibustion are safe during pregnancy. We also know, even through the record keeping of practitioners, that it is also effective. Effective at reducing the length of labour and reducing the need for further medical intervention. Effective at improving cervical parameters and the outcome of medically induced births as well. In clinical practice acupuncture is an ideal method to help women prepare themselves to have the most efficient labour possible. Reach out to myself or your closest acupuncturist if you have questions. Trust that there are available techniques that can help support your birthing experience. 

In Love and in Light,

Shelby 

References:

Betts, D. (2006). The essential guide to acupuncture in pregnancy & childbirth. The Journal of Chinese Medicine Publications.

Liu, X., Li, L., Shi, C., He, L., & Liu, X. (2021). 双针刺疗法联合米索前列醇在118例孕足月产妇催产中的应用及对产妇宫颈成熟的影响 [Application of double acupuncture therapy combined with misoprostol in 118 term pregnant women undergoing labor induction and its effect on cervical ripening]. 世界科学技术—中医药现代化 (World Science and Technology–Modernization of Traditional Chinese Medicine), 23(10), 3528–3533.

Schlaeger, J. M., & Carvalho, B. (2017). Acupuncture and acupressure in labor. Journal of Midwifery & Women’s Health, 62(1), 12–28. https://doi.org/10.1111/jmwh.12567

Smith, C. A., Armour, M., & Dahlen, H. G. (2017). Acupuncture or acupressure for induction of labour. Cochrane Database of Systematic Reviews, 2017(10), CD002962. https://doi.org/10.1002/14651858.CD002962.pub4

Smith, C. A., Collins, C. T., Levett, K. M., Armour, M., Dahlen, H. G., Tan, A. L., & Mesgarpour, B. (2020). Acupuncture or acupressure for pain management during labour. Cochrane Database of Systematic Reviews, 2020(2), CD009232. https://doi.org/10.1002/14651858.CD009232.pub2

Wang, X., Li, L., Liu, X., Shi, C., He, L., & Liu, X. (2022). 双针刺疗法对孕足月催产的作用及对血清LH、FSH水平影响 [Effect of double acupuncture therapy on labor induction at term and its influence on serum LH and FSH levels]. 中华中医药学刊 (Chinese Archives of Traditional Chinese Medicine), 40(4), 195–198.

West, Z. (2001). Acupuncture in pregnancy and childbirth. Thorsons.

Wu, D., Duan, Y., & Liang, L. (2024). 针刺联合COOK双球囊对足月妊娠催产及新生儿结局的影响[Effects of acupuncture combined with a Cook double-balloon catheter on labor induction and neonatal outcomes]. 上海针灸杂志 (Shanghai Journal of Acupuncture and Moxibustion), 43(3), 272–277. https://doi.org/10.13460/j.issn.1005-0957.2024.03.0272