LABOUR & ACUPUNCTURE

The Acupuncturist’s contribution in the first instance will be pain relief and mother’s relaxation. In OP position – where the lower back is accessible – acupuncture can also be used to cope with the lower back- ache. Electro-acupuncture & TENS (low frequency type) are used to enhance analgesic effect.


‘..We are seeing interesting trends where acupuncture has been used antenatally, during labour & postnatally. A significant reduction in the number of instrumental births & a similar reduction in the number of women needing to be induced for postmaturity. Acupuncture has allowed more women to achieve normal, more natural & positive birth experiences.’

(Hutt Midwives, New Zealand)

RESEARCH TRIAL RESULTS

A number of trials have been conducted investigating acupuncture analgesia in labour, using varying methods, point selections and results. One trial examined the effect of electro-acupuncture on 168 women using an auricular & a body point bi-laterally for 30mins. It was found that the analgesic effect began at a mean of 40mins after application, and duration was a mean of 6 hours. Use of analgesic drugs was not necessary with any of those who delivered during this period of time. (Macocia:Obstetrics & Gynaecology in TCM, 1998)

MIDWIFE / OBSTRITIAN

Acupuncture can be used to induce contraction regularity. Particular points should not be used until the Midwife is satisfied conditions for labour to continue are suitable. Clear communication between the Midwife & Acupuncturist is essential in the Mother’s interest during the phases of labour.

PRE LABOUR

‘Traditionally in the western world acupuncture is known as an alternative to pharmacological pain relief. This has been particularly useful for women in labour, helping them to achieve more natural births. It is it’s other uses during pregnancy & birth that we have, as midwives, found so useful:

  • May have a mitigating effect with mild Pregnancy-induced Hypertension if used early enough. Acupuncture needs to be used with care & in conjunction with the usual screening measures. It appears that blood pressure signs can be kept normal for longer with more likelihood of Mother carrying to term.
  • Proteinurea seems less common and if present, less in severity.
  • Blood results with regular acupuncture treatments, every day or alternative days over a week, show significant biochemistry changes.
  • Raised uric acid levels are often brought back to normal range.
  • ALT’s are likely to remain normal longer reducing the need for intervention & early induction of labour.
  • It is rare in our practice to have a woman undergo induction for postmaturity at 42+ wks gestation because acupuncture done from 40+ wks has resulted in spontaineous labour by 41+ wks. The average number of treatments to achieve this is between three & seven.
  • Women who have had acupuncture preparation in pregnancy are likely to have significantly shorter labours. This is particularly noticeable with first labours where the average length of established labour is between four & six hours. It seems acupuncture helps regulate contractions & women appear to labour more efficiently.
  • Certain acupuncture points are useful managing malposition. Posterior babies & transverse arrest in labour are almost unheard of in women having had acupuncture. It does not work for a small percentage of women where there is some degree of cephalo-pelvic disproportion.
  • Women who have had regular acupuncture during their pregnancy are less likely to suffer post-partum haemorrhage at delivery because of the regulating effect it seems to have on contractions.
  • Postnatally, acupuncture can assist lactation & let-down, blocked milk ducts, restoring Mother’s energy & promoting her general health & wellbeing, reducing emotional swings & reducing the likelihood of post-natal depression in susceptible women…’
( Lisa Errol, Midwife, Hutt District Midwives, New Zealand)

Note: There are important reasons for not turning a breech & advice should be first obtained from the Midwife. Once conditions are suitable & treatment to turn begins, if the baby moves significantly treatment should be stopped. The Midwife should check the altered position. Excess treatment could turn the baby back to breech.


3 PHASES OF LABOUR:

  • First: Contractions begin to full dilation of cervix. Acupuncturist’s role is to boost/conserve the mother’s energy, keep her calm & relaxed, reduce stress levels, increasing strength of contractions to avoid prolonged labour, help control pain levels.
  • Second: Full dilation of cervix to birth. At this stage acupuncture is particularly useful when contractions stop or the interval between becomes too great, which can occur if the mother is becoming exhausted. There is no need to use acupuncture when the mother is pushing unless her contractions start to slow. It can be difficult to give acupuncture because the mother is quite disturbed, very agitated & in pain. Needles are removed at transition phase.
  • Third: Following birth to expulsion of placenta & membranes. In suitable circumstances, the acupuncturist can give a general tonic treatment to promote mother’s blood levels & recovery. If required, acupuncture is useful to help expel a retained placenta.

POST NATAL STAGE

Acupuncture can help enhance mother’s wellbeing.

Post-natal problems - Persistent lochia, breastfeeding problems, some postnatal depressions, urinary problems & common patterns of disharmony can be usefully treated.

Note: TENS (Transcutaneous electrical nerve stimulation) involves application of electrical stimulation to skin through electrodes stimulating afferent nerves to relieve pain.

    • TENS must not be used by those with heart disease, pacemakers, implant pumps, epilepsy, over carotid artery, transcerebrally or transthoracically.
    • Pregnancy: never in 1st trimester, most are safe after 36 weeks gestation.

 

PLEASE ENSURE YOU INFORM YOUR ACUPUNCTURIST IF YOU SUFFER FROM ANY OF THE ABOVE CONDITIONS

References:
Ball 1994 Reacting to motherhood, the role of postnatal care.
Macocia1998 Obstetrics & Gynaecology in TCM
West 2001 Acupuncture in Pregnancy & Childbirth
Debra Betts 2006 Essential Guide to Acupuncture in Pregnancy &Childberth
Lisa Errol, Midwife, Hutt District Midwives, New Zealand