Debra Betts - Acupuncture and Acupressure for Pregancy and Childbirth

Frequently asked questions about acupressure

What exactly is acupressure?

The term acupressure refers to using pressure on acupuncture points. These points lie on energetic channels running from the surface of the skin to connect to the body’s internal organs. When stimulated they are thought to work through various processes; with western medical research demonstrating the release of beta-endorphins, serotonin, nor epinephrine and oxytocin while acupuncturists reference the effects in terms of improving and regulating; blood, energy (qi) and emotions so that the body can work more efficiently.

Although the origins of these points remain unexplained, many of the points used today were recorded in Chinese texts thought to be written in 500-300 BC.

Is there any research on using acupressure in labour?

Yes, research has been published in respected western medicine journals looking at the effect on acupressure for both induction and pain relief.

Acupressure was taught to 66 women attending a hospital outpatient’s clinic at 40 weeks gestation by a midwife. The control group consisted of 76 women attending the same clinic when the midwife was not on duty. It was statistically significantly that more women in the acupressure group went into labour naturally. Of those using the acupressure 17% more went into spontaneous labour when compared to the control group (Ingram et al).

In another stIn another study, 127 women were randomly assigned to receive either ; acupressure, light touch or no treatment during labour. Data for analysis was collected from subjective labour pain scores and external foetal monitoring strips. Findings indicated that there was a significant difference in labour pain among the acupressure group. The results of this study confirmed the effect of acupressure in lessening labour pain during the active phase of the first stage of labour (Chung et al).

When acupressure was used in a group of 75 women randomly selected to receive acupressure or light touch only, significant differences was found between the groups in subjective labour pain scores at 30 and 60 minutes after acupressure. The total labour time (3 cm dilatation to delivery) was significantly shorter in the acupressure intervention group than in the control group. The authors concluded that acupressure was effective for decreasing labour pain and shortening the length of delivery time (Lee et al).

References

Chung UL J.( 2003)Effects of LI 4and BL 67 Acupressure on Labour Pain and Uterine Contractions in the First Stage of Labour. Nurs Res. 11(4):251-60

Ingram J.Domagala C.Yates S.(2005) The effects of shiatsu on post- term pregnancy. Complementary therapies in Medicine 13, 11-15

Lee MK. Chang SB. Kang DH. (2004) Effects of SP 6 acupressure on labour pain and length of delivery time in women during labour. J Altern Complement Med. Dec:10(6):956-65

When is the optimal time to begin using acupressure for pain relief in labour?

Feedback from those using acupressure suggest that women who received the greatest benefits used it as the beginning of their labour rather than waiting till they found the labour painful or until they went into hospital. Starting early allowed the support people to become “experts” in finding the points and in using the amount of pressure that women find the most beneficial. get the pain relief when using the acupressure?

You will know that the acupressure is providing benefits very quickly, usually within one to two contractions. This is not a case of using them throughout labour hoping that they are doing something useful...women report that the intensity of contractions ease when the points are pressed and that they feel different, calmer and more in control of how the labour is progressing.

It is also obvious that the points are beneficial in that when the support people stop using the pressure women will immediately request (sometimes not that politely) that they resume at once.

When you apply pressure, when do you press, how long and how much pressure is applied?

The level of pressure applied is totally up to the birthing women.

The pressure is applied through using your fingers, thumbs, knuckles or elbows. It is important that after locating the point, pressure is applied through using your body weight to press into the point, as using pressure incorrectly (applying pressure only from the hands) will quickly result in very tired fingers and thumbs.

Correct pressure on the points may feel intense, achy, warm, or just weird but does not feel painful. These points are not to be used through gritted teeth while the woman waits to see if they are working. If the pressure is painful either the support person is in the wrong place or this is not a point the woman needs at this time.

People tend to use the points in two ways either; at the beginning of a contraction – with the support person rushing over to the women when she calls out “now” or applying gentle pressure consistently over the point, with firmer pressure applied at the beginning of each contraction.

How do you know when people are pressing in the right places?

This is a simple hands-on technique that works because when the right points are being used women will ask the support person to keep pressing or to press harder. There are several points outlined in the booklet – they all do slightly different things in terms of traditional Chinese medicine.

Some work to improve qi and blood flow to the pelvis, some to help the cervix dilate, some by helping the baby to descend into a good position and others help with emotions like fear and anxiety that inhibit labour.

The role of the person applying the acupressure is to try out the acupressure points and listen to the woman’s feedback. The points that will be the most useful to her will depend on what is happening during her labour at that particular time.

Are there certain points that should be used for the different stages of labour?

From feedback the first two points in the booklet GB-21 ( on the shoulder) and BL-32 ( on the lower From feedback the first two points in the booklet GB-21 ( on the shoulder) and BL-32 ( on the lower back ) are the points used most frequently at the beginning of labour and provide a good starting point. But its important that if these points are not felt to be effective or appear to be becoming less useful as the labour progresses the remaining acupressure points are tried.

I have also had feedback where women found the most effective technique was being able to wear a sea sickness band so that the button on the band applied pressure to the point on the sole of the foot (KID-1) while she walked around.

OOthers that the most effective point for them was strong pressure applied to KID-1 (on the sole of the foot) , LI-4 ( on the hand) or BL-60 ( on the outside of the ankle) as they approached transition, as it changed the overwhelming, out of control nature of their labour at that stage.

Midwives have also commented that they have founds these points to be useful in helping women as they approach and move through transition Usually people will start using acupressure on BL 32 (on the lower back ) and then try out the Tens machine as labour progresses. Feedback has been that often the Tens machine is removed as women preferred the acupressure. Acupressure also offers the advantage that it can be used in water.

Some women find it useful to use the Tens machine on their lower back while using acupressure on other points sucSome women find it useful to use the Tens machine on their lower back while using acupressure on other points such as their hand (LI-4) or shoulders (GB-21).

How easy is this to do for someone without any experience in using acupressure? ure required.

This technique relies on the woman’s support person locating the point by palpating in the area as given in the booklet, the woman will then be able to tell them when they are pressing over the most useful point due to the achy, numbing or weird feeling that she feels as the correct acupressure point is located.

The support person then simply has to apply pressure to that point to the level the woman finds useful.

Can anything go wrong if the wrong points are pressed?

As the only points being used are those that women find useful during labour pressing the “wrong” points does not in theory become an issue.

In over 15 years of promoting these points I have had no negative feedback from women or midwives that using acupressure was linked to any problems during labour. It is also interesting that there were no associated problems in the research to date (as outlined above in question 2) when evaluating the effects of acupressure.

Do you need any special tools to use acupressure?

The booklet does feature the use of plastic combs for points on the hands and a sea sickness band to have available to use on Kid 1 ( under the sole of The booklet does feature the use of plastic combs for points on the hands and a sea sickness band to have available to use on KID-1 ( under the sole of the foot ) or PC-6 ( on the inner forearm ) if needed during labour.

I have also had feedback that people have used the ends of wooden spoons to apply pressure to GB-21 ( on the shoulders) if their hands became too tired and have used wooden massage tools ( that come with small balls attached ) to apply pressure to BL-32 ( on the lower back ) with success.

Personally I think it is nice for the women to feel her support peoples hands on her (at least to begin with), progressing on to massage tools if it found that these are beneficial. ge can be used from 37 / 38 weeks over the points BL 32 (on the lower back) and GB 21 (on the shoulders).

To prepare for labour some gentle massage can be used from 37 / 38 weeks over the points BL-32 (on the lower back) and GB-21 (on the shoulders).

Position yourself sitting comfortably so that your lower back and shoulders are easily accessible. can then be used. The massaFive minutes of massage (with or with out oil) in a downwards direction over the BL-32 (on the lower back) and down into the buttocks can then be used. The massage can also travel from the spine out into the points termed "buttock points". The technique can be firm but should not be painful. Starting gently the massage can increase in pressure over time as tension is released in this area.

Five minutes of massage can also be used over the GB-21 point – massaging along the top of the shoulders and releasing any tension in this area.

An ideal situation would be to receive massage over these areas three times a week from 37 weeks.

FuIf you experience any pain resulting from these techniques, stop and consult a professional acupuncturist or massage therapist for further advice.

If you want to induce labour with acupressure, when is the appropriate time?

Although acupressure may be seen as more natural than a medical induction the reality is that it is still an intervention. have if the labour had commenced spontaneously.

Just because you are approaching your due date does not mean you can safely stimulate labour because you baby is due any day now. In reality a due date is really referring to an expected time that covers several weeks.

The safest time to use acupressure to induce as outlined in the booklet is to begin using the points LI-4( on the hand) , SP-6 ( on the inside of the leg) and BL 32 ( on the lower back )The safest time to use acupressure to induce as outlined in the booklet is to begin using the points LI-4 ( on the hand) , SP-6 ( on the inside of the leg) and BL-32 ( on the lower back ) three to four days prior to a medical induction.

The points can then be used 2 hourly while you are awake to stimulate the onset of labour.

If you knowIf you have been told that your baby has not yet descended far enough into the pelvis GB-21 (the shoulder point) can be added to these points for stimulation.

If you know that your baby is in a posterior position BL-60 (on the exterior ankle) and BL-67 ( by the corner of the nail of the little toe) should be added to the points LI-4 ( on the hand), SP-6 (on the inside of leg) and BL-32 ( on the lower back).

If you have had a negative experience with a previous labour and feel fearful or very anxious about going into labour massaging KID-1 (on the sole of the foot) or using the sea bands to apply pressure to this point may also be useful.

Ideally if you require a medical induction you will also be able to access a qualified acupuncturist 2 - 3 days prior as there are other acupuncture points that can be used depending on the woman’s presentation and underlying constitution.