Acupuncture reduces epidural use
A trial carried out in Sweden has found that women who received manual acupuncture (MA) or electro-acupuncture (EA) during labour used less epidural analgesia than women who received standard care. The longitudinal randomised controlled trial recruited 303 nulliparous women with normal pregnancies who were randomised to receive 40 minutes of either manual acupuncture (MA) or electro-acupuncture (EA), or standard care without acupuncture (SC). Subjective visual analogue pain scores did not differ between the three groups, however fewer women in the EA group used epidural analgesia (46%) compared with those in the MA group (61%) and SC group (70%).
(Acupuncture with manual and electrical stimulation for labour pain: a longitudinal randomised controlled trial. BMC Complement Altern Med. 2014 Jun 9;14:187). ncbi.nlm.nih.gov/pubmed/2491370
Pre Birth Acupuncture
A study of pre birth acupuncture that was given in 14 different practices of New Zealand midwives over a 4 month period found:
- 35% reduction in induction rates
- 43% reduction in induction rates for women pregnant for the 1st time
- 31% reduction in epidurals
- 32% reduction in emergency caesarean sections
- and 9% increase in normal vaginal birth compared to the general population.
The most commonly used points were Sanyinjiao Sp6, Zusanli ST36, Yanglingquan GB34, Kunlun UB60 and Hegu LI4.
(Acupuncture for pre birth treatment: an observational study of use in midwifery practice. Medical Acupuncture. 2006; 17:3).
Acupuncture shortens labour
A Canadian team has investigated the effectiveness of acupuncture for the initiation of labour in a prospective pilot RCT. 16 pregnant women at term were randomly assigned to receive acupuncture either at sites reported to cause onset of labour or at nearby sham sites. The results showed a difference in intervention to delivery interval of 62 hours in favour of the treatment group.
Women in the true acupuncture group had shorter labours by a mean of 2 hours and 20 minutes.
(Effectiveness of acupuncture for the initiation of labour at term: a pilot randomized controlled trial. J Obstet Gynaecol Can. 2008 Dec;30(12):1118-23).
Acupuncture reduces epidurals
A Norwegian study has shown that women who receive acupuncture during labour have a significantly reduced rate of epidural anaesthesia.
(Nesheim BI, Kinge R. Performance of acupuncture as labor analgesia in the clinical setting. Acta Obstet Gynecol Scand. 2006;85(4):441-3).
Acupuncture facilitates natural birth
Acupuncture significantly reduces duration of labour and reduces the need for augmentation of labour with contraction-stimulating drugs. A study randomised 100 women with spontaneous rupture of membranes at term to either acupuncture or no acupuncture. Treatment was individualised on the basis of traditional Chinese medical diagnosis and used three points per patient from a pool of nine possible choices. Treatment principles applied were to increase energy, soften the cervix and open the Conception vessel. Although time from membrane rupture to delivery did not differ significantly between the groups, length of active labour was significantly reduced in the acupuncture group by a mean difference of 1.7 hours. In addition, significantly fewer patients in the acupuncture group required oxytocin (used to stimulate contractions) for longer than two hours. Medical induction of labour was eventually necessary in 15 acupuncture patients and 20 controls. When induction was carried out, women assigned to acupuncture completed the active phase of labour in half the time compared to controls, a statistically significant difference.
(Acupuncture administered after spontaneous rupture of membranes at term significantly reduces the length of birth and use of oxytocin. A randomized controlled trial. Acta Obstet Gynecol Scand. 2006;85(11):1348-53).
Acupuncture for labour induction
Fifty-six primigravid women at 39 weeks or greater with a singleton gestation and Bishop score (a system for predicting whether induction of labour will be required) of less than seven were randomised to usual medical care or usual care plus three acupuncture treatments. Each treatment consisted of eight needles applied bilaterally to Hegu L.I.-4, Sanyinjiao SP-6, Shangliao BL-31 and Ciliao BL-32. Mean time from randomisation to delivery occurred 21 hours sooner in the acupuncture group, but this difference did not reach statistical significance. Compared with controls, women in the acupuncture group tended to be more likely to labour spontaneously and less likely to deliver by Caesarean section.
(A randomized controlled trial of acupuncture for initiation of labor in nulliparous women. J Matern Fetal Neonatal Med. 2006 Aug;19(8):465-70).
Acupuncture effective for breech correction
A systematic review from Holland has concluded that acupuncture-type interventions (moxibustion, acupuncture, or electro-acupuncture) on Zhiyin BL 67 are effective in correcting breech presentation, compared with expectant management. Of 65 citations retrieved from various databases, six RCTs and three cohort studies fulfilled the reviewersβ inclusion criteria. In the RCTs the pooled proportion of breech presentations was 34% following treatment versus 66% in the control group. The pooled proportion in the cohort studies was 15% versus 36%. Including all studies, the proportion of breech presentations was 28% following treatment versus 56% for the control group.
(Effectiveness of acupuncture-type interventions versus expectant management to correct breech presentation: a systematic review. Complement Ther Med. 2008 Apr;16(2):92-100).
Acupuncture for breech presentation
An Italian study into breech presentation compared 112 randomly selected women who were given acupuncture and moxibustion at Zhiyin BL-67, with 114 women who were simply observed. All were at 33-35 weeks of gestation. The proportion of caesarean sections required in the acupuncture treatment group was significantly lower than in the control group, (52.3% versus 66.7%).
(Journal of Maternal-Fetal and Neonatal Medicine, 15; 4: 247-252).
Acupuncture and breech presentation
A study of the effectiveness and cost of moxibustion for breech presentation compared to standard care found that the percentage of breech presentations after moxibustion was 24.5% compared to 42% for standard care, and that if only 10% of women opted for moxibustion it would overall be more effective and less costly than standard care.
(The effectiveness and cost-effectiveness of Breech Version Acumoxa compared to standard care to correct breech presentation. Focus Altern Complement Ther 2006; 11: 05).
Acumoxa for breech babies
A study has evaluated the effects of acupuncture and moxibustion on the behaviour of breech foetuses. Women were treated by stimulating Zhiyin BL-67 twice a week for 20 minutes. Fourteen cases were treated using both acupuncture and moxibustion, 15 cases by moxibustion and ten cases by acupuncture. In 56% of cases, foetal position converted from breech to cephalic (80% success rate for moxibustion, 28% for acupuncture, 57% for acupuncture plus moxibustion). Conversion, on average, was achieved after three sessions. During the process of stimulation, it was found that foetal movements were reduced by both acupuncture plus moxibustion and moxibustion alone, and that foetal heart rate was reduced only by acupuncture plus moxibustion in combination. (Effects of three different stimulations (acupuncture, moxibustion, acupuncture plus moxibustion) of BL.67 acupoint at small toe on fetal behavior of breech presentation.
(Am J Chin Med. 2007;35(1):27-33).
Moxibustion at zhiyin BL-67
An Italian obstetrician has carried out a study into the application of moxibustion at Zhiyin BL-67 for the treatment of breech presentation in pregnancy. Francesco Cardini and Huang Weixin divided 130 women (in the 33rd week of their first pregnancy) in two Chinese hospitals into two groups. Those treated with moxibustion (for 7 consecutive daily treatments with seven more if needed) experienced greater foetal movement and had significantly more normal (cephalic) births than women left untreated .
(The Journal of the American Medical Association 1998;280).
Acupuncture effective for breech correction
A systematic review from Holland has concluded that acupuncture-type interventions (moxibustion, acupuncture, or electro-acupuncture) on Zhiyin BL 67 are effective in correcting breech presentation, compared with expectant management. Of 65 citations retrieved from various databases, six RCTs and three cohort studies fulfilled the reviewersβ inclusion criteria. In the RCTs the pooled proportion of breech presentations was 34% following treatment versus 66% in the control group. The pooled proportion in the cohort studies was 15% versus 36%. Including all studies, the proportion of breech presentations was 28% following treatment versus 56% for the control group.
(Effectiveness of acupuncture-type interventions versus expectant management to correct breech presentation: a systematic review. Complement Ther Med. 2008 Apr;16(2):92-100).
Acupuncture and breech presentation
A study carried out in Croatia compared the outcome of 34 pregnant women with breech presentation treated by manual needling of Zhiyin BL-67 (with deqi), and 33 similar women not treated by acupuncture as a control. Acupuncture was given from 34 weeks, each session lasting 30 minutes, 2 sessions a week. The rate of successful conversion to vertex presentation (verified by ultrasonography) was 76.4% in the acupuncture group, and 45.4% in the control group. A mean of 6 acupuncture treatments was needed, and acupuncture was discontinued on successful outcome, or after 38 weeks if unsuccessful.
(Fetal Diagnosis and Therapy Vol. 18, No. 6, 2003).
Acupuncture and labor
A German study has compared the morphologic features andduration of labour in 878 women with at least 36 weeks of uncomplicated pregnancy after receiving a) active acupuncture (329 primiparas), b) nonspecific acupuncture (224 women), or c) no acupuncture treatment (325 primiparas). Women who received specific acupuncture experienced significantly shorter labour times (470 +/-190 minutes) compared to those who received nonspecific acupuncture (536 +/-200 minutes) and no acupuncture (594 +/- 241 minutes). Cervical maturation was also more pronounced in the treatment group. The authors conclude that uterine contractions may be”better co-ordinated” in women who receive specific acupuncture, and they suggest that “prenatal acupuncture should be considered for women with uncomplicated pregnancies as they approach term.”
(Romer A, Weigel M, Zeiger W, Melchert F. Prenatal acupuncture: Effects on cervical maturation and duration of labor. Geburtshilfe Und Frauenheilkunde. 2000;60(10):513-518).
