Debra Betts - Acupuncture and Acupressure for Pregnancy and Childbirth

Book Reviews

Heiko Lade, President New Zealand Registrar of Acupuncturists

It was a couple of years ago that I received an email from Debra Betts asking me if I was interested in helping her with proof reading of her forth coming book on acupuncture and pregnancy. Time restrictions prevented me from helping out at the time and but now having one of the first printed copies in my hands I bring much honour in reviewing her book.

In New Zealand and I expect much of the western world, acupuncture has become famous for treating musculo-skeletal disorders and gynaecology problems.

“Acupuncture in Pregnancy and Childbirth” is a book that is long over due for the acupuncture profession and is destined to become a standard text in acupuncture colleges around the world especially with the interest of practitioners in TCM gynaecology.

Many acupuncturists in the modern clinic still rely on limited TCM knowledge when it comes to treating pregnancy such a neiguan for morning sickness and moxa on zhiyin to turn breech babies. More and more pregnant mothers to be are coming to the clinics of acupuncturists with a host of problems where acupuncture can provide invaluable help.

Most practitioners feel confident in treating for example urinary infections or anxiety when presenting in clinic but often become cautious if the patient is also pregnant and suffers from these conditions.

This book has 18 chapters devoted solely in the treatment of different disorders commonly seen with pregnancy including examples such as anaemia and constipation. Each of these chapters has an introduction covering western medical information before going into the Chinese medicine viewpoint.

The associated patterns are then differentiated covering the treatment principle and followed by a discussion of points.

The many years of experience is also exemplified in Debra’s extra notes on patient advice and case histories. It is the case histories that are discussed that make this book a gem. Having been a teacher in TCM for a number of years, one of the criticisms of students is that there are relatively few books discussing real case histories and plenty of books reiterating the same old TCM theories. Debra Betts also draws on cases from her students and midwifes which enlighten the reader and bring practicality to the theory she has written about.

Throughout the book there are coloured boxes in the margins bringing to attention cautions, special notes and summaries making the book very user friendly so it can be used as a quick reference text in the clinic.

Acupuncture in Pregnancy and Childbirth goes well beyond acupuncture, in particular there is an extensive chapter on diet and an excellent appendix on antenatal tests.

The whole process of birthing is reviewed and explained from a western and Chinese medical viewpoint and Acupuncture in Pregnancy and Childbirth outlines everything you need to know from diagnosis to treatment and allows you to familiarize yourself with all the appropriate western medical terms and knowledge to become a successful TCM obstetrician.

Jennie Longbottom, Lecturer, Physiotherapy and Acupuncture, Coventry University

I felt very privileged when asked to review this long awaited clinical approach to a subject I have particular interest in. I am far from disappointed in the waiting. As the title announces, this is an essential clinical guide, crossing professional disciplines and encompassing clinical answers to the management of the Mother and the foetus, whether you are a professional acupuncturist, midwife, physiotherapists or doctor working with acupuncture in the field of gynaecology and obstetrics.

Within the realms of physiotherapy, I would fully recommend this text as essential reading matter if practitioners are about to embark on further advanced acupuncture training in Womens’ Health, provided they have a fundamental knowledge of Traditional Chinese Medical (TCM) philosophy.

The book is divided into a number of conditions, such as nausea and vomiting, musculoskeletal conditions, insomnia and anxiety, to name a few. These are presented at pre partum, during labour and post partum, with a chapter dedicated to each. Within each chapter the author has integrated Western Medical diagnosis with a TCM framework, whilst using succinct, manageable language; something I find lacking from several other texts in this subject, and something I welcome within our clinical practice.

This book has an added advantage in that treatment protocols are provided within each subject matter; the anatomical positions of relevant points are superbly illustrated by Peter Deadman, Mazin Al-Khafaji and Kevin Baker, whilst providing in- depth clinical reasoning for their use. The added bonus is encompassed within Chapter 26, citing the review of current research with clinical application to acupuncture in pregnancy.

Debra Betts has provides clinical experience and knowledge within this subject matter, which speaks to the reader from each page. I am grateful for this knowledge and for the ease with which it has been written; for the added opportunity to use this experience for the dual benefit of my clinical reasoning and for my patients’ recovery. I welcome texts that provide the clinician with enhancement of patient care, and problem solving skills within an evidence base that is effective, relevant and pertinent to current health care. This book provides all these qualities and more.

Sharon Yelland, Midwife and Acupuncturist, Derriford Hospital, Plymouth UK

As a practicing acupuncturist midwife I value this book greatly. Debra Betts has condensed all her knowledge of this specialized field to produce a brilliant tool with which we can enhance our clinical practice.

However The Essential Guide to Acupuncture in Pregnancy & Childbirth is certainly not just for currently practicing midwife/acupuncturists. It is also invaluable for those midwives and doctors who are presently studying acupuncture to enhance their practice, whilst at the same time it is essential reading for any acupuncturist who works in the field of pregnancy and childbirth or who comes into contact with childbearing women.

When I began using acupuncture in midwifery 14 years ago, there was a dearth of up-to-date, practical resources. I, like many others, often had to experiment with my treatments to discover what was most effective; indeed I am still learning today, as pregnancy never ceases to offer surprises. We know however, that acupuncture has been used in China for obstetrics for many hundreds of years, particularly for delayed or difficult labor. It is from this history that we learn, but it is not until one has been practicing for several years that clinical confidence ripens. Even so a fear of ‘getting it wrong’ and causing a problem in a pregnancy may remain. It is a book like this which helps us enormously to overcome these anxieties that are to some degree inevitable when we are involved in treating two lives at the same time.

In The Essential Guide to Acupuncture in Pregnancy & Childbirth, Debra Betts comprehensively deals with every major area of this subject. It covers most of the conditions commonly found in pregnancy and childbirth including miscarriage, nausea and vomiting, heartburn, varicose veins, hypertension, musculoskeletal problems, anemia, insomnia, anxiety and depression, constipation, itching, oedema, malposition and malpresentation, induction and difficult delivery. Other chapters cover treatment guidelines in pregnancy, pre- and post- natal treatment, a review of current research and detailed dietary advice. Appendices offer well thought out Western and Chinese medicine glossaries that make the book more useful for both non-medical and medical acupuncturists. Particularly valuable is the appendix offering clear illustrations and locations for all the points used in the text.

Each subject is introduced by giving the Western medicine description, explanation and guide to management, then the traditional Chinese medicine differentiation, aetiology and treatment. Treatment emphasizes both clinically proven points as well as points selected according to differentiation of patterns, followed by clear explanations of the points used and much invaluable discussion from the author’s clinical experience. Most clinical chapters end with case histories from the author’s own practice as well as from many of the midwives whom she has trained. Many pages have coloured inset boxes emphasizing cautions, important features of clinical management, and key point selections for the disorders discussed.

The reader is helped throughout by the use of clear language, well-drawn diagrams and clever photographs as well as comforted by the weight of the book and the fine layout, making its referencing and content easy to use.

There are specific areas in the book that I wish to particularly commend. The chapter on induction is excellent, with much clinically useful information and patient advice. This is an area that I get asked to help with more than any other. I also particularly like the chapter on acupressure during labour and especially the idea of teaching women’s partners or helpers how to use it, although sadly I think that British maternity units are not quite so open to integrated therapies as those in New Zealand.

Debra Betts’ sensitivity as a practitioner also shines through and I find it very much a ‘client-led manual’ which considers all aspects of care. Combined with its academic knowledge and experience, this book has everything that one needs to know in one place.