Debra Betts - Acupuncture and Acupressure for Pregancy and Childbirth

Acupuncture Research

The research articles outlined below can be used to promote the use of acupuncture/acupressure  in pregnancy. Some like the articles on pelvic pain, nausea and vomiting and breech presentations have been selected for their publication in medical and midwifery journals readily accessible to medical professionals. Others such as the prebirth and cervical ripening articles are included as they represent the research available to date.

While clinical practice does not always reflect the methods used in research and questions remain over the use of methods such as a placebo in acupuncture, or the use of prescribed points rather than an individual diagnosis, western medical research does offer opportunities to discuss and promote acupuncture to medical professionals and the community. This is especially relevant in the area of obstetrics were safety and evidenced based practice are primary concerns.

Acupuncture or Acupressure for pain relief in labour

A Cochrane review of 13 trials involving 1986 women, reported that acupuncture or acupressure may help relieve labour pain.

Summary and conclusion

Nine trials reported on women receiving acupuncture and four trials reported on the use of acupressure, with the finding that women receiving acupuncture or acupressure reported benefits in terms of reduced pharmacological analgesia, less intense pain and increased maternal satisfaction. However due to the small number of trials and the poor quality of reporting within some of these trials further high quality research is required. View Cochrane Report

 

Impact of acupressure on onset of labour and labour duration: A systematic review

Mollart L J , Adam J,  Foureur M.

Summary and conclusion

The authors search the available studies in the literature on th euse of acupressure for starting labour or the duration of labour. They found seven trials reporting on 748 women using different acupressure points. One study examined the initiation of labour and six studies examined labour duration and/or pain levels. Results suggest acupressure may reduce the length of labour particularly in the first stage but further research is required.

http://www.ncbi.nlm.nih.gov/pubmed/25911499

 

Acupressure to reduce labor pain

Hjelmstedt A, Shenoy ST, Stener-Victorin E, Lekander M, Bhat M, Balakumaran L, Waldenström U. Acupressure to reduce labor pain. Acta Obstet Gynecol Scand. 2010 Nov;89(11):1453-9.

A randomized controlled trial within an Indian public hospital to evaluate the effect of acupressure on pain levels when administered during the active phase of labor with women having their first baby

Summary

213 women having their first baby were randomized to receive either

  1. Acupressure at SP6 (Sanyinjiao) on both legs during contractions over a 30-minute period
  2. Light touch at SP6 (Sanyinjiao) on both legs during the same period of time
  3. Standard care

Their experience of labor pain was assessed by visual analog scale at baseline before treatment, immediately after treatment, and at 30, 60 and 120 minutes after treatment.

Treatment Methods

The study was conducted in a large public hospital in India where epidural analgesia is not an option in normal labor and where women cannot bring a companion. All women in the study had uncomplicated pregnancies and been transferred to the labor room with a cervical dilatation between 3 and 7 cm. The women in the acupuncture group were treated with acupressure at SP6 (Sanyinjiao) on both legs simultaneously during each contraction over a period of 30 minutes.

Conclusion

A reduction of in-labor pain was found in the acupressure group and was most noticeable immediately after treatment. Retrospectively (2–24 hours after birth), the women in the acupuncture group remembered having had less pain during labor and said they coped better with their labor pain compared with the standard care Compared to the women in the touch group, those in the acupuncture group remembered having coped better with the pain. The authors concluded that acupressure seems to reduce pain during the active phase of labor in women having their first baby and that that acupressure may be most effective during the initial phase of labor.

Clinical Perspective

This study reinforces a previous study that also found the use of acupressure on SP 6 (Sanyinjiao) reduced pain for women during active labour. While it is positive that these studies are exploring the use of acupressure as pain relief for women, it is very disheartening that they focus only on the use of a specific point. Clinical experience suggests that there are a variety of acupressure points that a woman may find useful. The reality of following up hundreds of women from clinical practice, after having taught them nine acupressure to use, has been that very few that found SP6 (Sanyinjiao) the most useful point for pain relief. It may be that there are greater benefits than those found in the study through letting women and their support people select the acupuncture points they find most suitable for the different stages of labour.

http://www.ncbi.nlm.nih.gov/pubmed/20822474