Acupuncture in Pregnancy
Acupuncture offers effective, drug-free relief for a multitude of medical problems during pregnancy. From preventing miscarriage to morning sickness, anxiety and depression, insomnia, fatigue, musculoskeletal conditions including Pelvic Girgle pain, rib pain, carpel tunnel syndrome, small for date babies Iintrauterine growth retardation), breech and posterior positions, etc.
Morning sickness/ Hyperemesis gravidarum
There are a number of factors as to why nausea and vomitting occur in pregnancy: hormone imbalance, anxiety and stress etc. From Chinese Medicine point of view, the commonly seen patterns are Liver Qi attacking Stomach, Stomach heat(Ginger actually worsens this type of morning sickness). This condition responds to acupuncture extremely well. Research Smith et al.(2002), published two articles which looked at the effectiveness and safety of acupuncture in early pregnancy. Conclusion: Acupuncture is a safe and effective treatment for women who experience nausea and dry retching in early pregnancy.
Case History
L, 33. L had hyperemesis gravidarum with her first pregnancy. Her hyeremesis came back at 7 weeks in her second pregnancy. She had been tried on Cyclizine and Buccastem, neither of which had touched it. And then she was put on Ondansetron which is only used for nausea and vomiting caused by chemo or surgery for 5-10 days, but she was on it for 4 weeks. The sickness was reduced but doctors were concened she had been on it for too long and suggested large dose of Piriton. She was nearly 15 weeks when she came to me. To my surprise her vomiting stopped after the first session of acupuncture! Her nausea completely stopped at 18 weeks. She continued with acupuncture for the rest of her pregnancy to manage heartburns, constipation and pelvic pain. She had a healthy baby boy at 35 weeks, weighed 2.55kg, who was "an absolute delight". The slightly early birth might have been to do with the flu jab she had a few days before I suspect.
Musculoskeletal conditions
There are a variety of musculoskeletal conditions such as backache, sciatica, rib, hip and pelvic pain that are all too often viewed a s part of the ‘normal’ discomforts of pregnancy. Among them pelvic girdle pain (PGP), which used to be known as symphysis pubis dysfunction (SPD) can be debilitating. It is estimated that PGP affects up to one in five pregnant women to some degree. It is mainly due to the hormonal effect on the ligaments.
In Chinese Medicine these conditions are viewed as manifestation of blockage or stagnation in the channels. Acupuncture works by facilitating the flow of energy. I find acupuncture provides a very effective and safe treatment for PGP. As it addresses the hormonal factor it provide a more lasting effect than manipulative treatment. Research Elden et al.(2005) published a trial in the British Medical Journal (BMJ) which looked into Acupuncture and pelvic pain in pregnancy. Conclusion: Acupuncture is superior to stabilising exercises in the management of pelvic pain in pregnancy.
Case history
C, 35, twin pregnancy. She developed hip pain on both sides around 20 weeks, probably due to increasing weight of her bump and being on her feet all day at work as a primary school teacher. Acupuncture had kept her going. Beautiful twin girls were born at 37 weeks, weighed 6lb9 and 6lb4.
A, 37, twin pregnancy. After the positive test from her first IVF, A continued to use acupuncture to maintain the health of her pregnancy. She hardly had any complications at all. She gave birth to two healthy boys- 6lb7oz and 6lb3oz.
Small-for-dates babies (intrauterine growth retardation)
There are a variety of reasons why a baby may not be growing as expected, age, low BMI, and unknown causes. In Chinese Medicine, during pregnancy a mother’s blood and Kidney energy are diverted to nourish the foetus. In clinic I find acupuncture tends to make big babies!
Case history
N, 37, came to me at 16 weeks pregnant. She has history of ME. Her PAPP-A had been low (associated with Down syndrome, miscariage, severe intrauterine growth retardation, premature birth etc), and there was hardly any bump. The hospital was unable to expain the blood test. She was anxious not knowing whether she should keep the pregnancy. Since she started acupuncture, her sleep and energy had much improved and her baby started to grow well. Her 20 weeks scan was normal. She continued with acupuncure and delivered a health baby boy at 37 weeks, weighed 5lb13oz.
N came back 3 years later when she was 16 weeks in her second pregnancy. Blood tests and scan were all normal this time. I treated her fatigue, acid reflux, abdominal cramping, leg cramping throughtout the pregnancy. She gave birth to a health baby girl naturally at 38 weeks plus 2 days, baby weighed 7 lb 3oz.
Insufficient Lactation
Insufficient lactation may be due to an increase in oxytocin and prolactin levels. Acupuncture has a strong influence on hormone levels. In Chinese medicine, commonly seen patterns are Qi and Blood deficiency, Liver Qi stagnation( stress, emotional upset). In my practice I haven't seen any women who had acupuncture during pregnancy had any lactation problem.
Case History
N, 35. She didn't have enough milk when her first child was born 3 years ago. She has a history of Ulcerative Colitis for ten years, for which she took 1.5-3g of Mesalazine. I think her lack of lactation was due to her Qi and Blood deficinecy, which was caused by her Spleen deficiency, the cause of her UC. She had two early miscarries before her second pregnancy. She had acupuncture during her pregnancy. Whe I saw her 2 weeks after giving birth her breast feeding was going well.
Acupuncture in Childbirth
Prebirth acupuncture
Prebirth acupuncture refers to a series of treatments in the final weeks of pregnancy to prepare for childbirth. It can enhance the prospects of an efficient labour, reducing the level of medical interventions. Research (Kubista E, Kucera H, 1974; Zeisler et al. 1998) demonstrated that the mean duration of labour was reduced. A randomised controlled trial into the effects of acupuncture on cervical ripening was published by Rabl (200). Conclusion at He Gu and San Yinjiao supports cervical ripening and can shorten the time interval between the woman’s expected date of delivery and the actual time of delivery.
Breech and posterior positions
Women who have acupuncture during pregnancy don't seem to have breech babies. Combination of acupuncture and moxibustion offers high success rate of turning breech presentation. It involves the application of a moxa stick to Zhi Yin (BL-67) biliterally for 20 minutes, once a day for ten days. Optimal timing of treatment is around 32-34 weeks, before the baby has grown too large.
Research Cardini et al.(1998) publish a trial in the Journal of the American Medical Association. Conclusion: In primigravidas at 33 weeks gestation with breech presentation, moxibustion treatment for one to two weeks at Zhi Yin increased foetal activity during the treatment period, and cephalic presentation at 35 weeks and at delivery.
Case history
M, 35, second pregnancy with breech presentation confirmed by scan. She was 37 weeks plus 4 days when she came to me. After the initial acupuncture treatment I gave her moxa sticks to complete the course of treatment at home. She said she felt a strong big movement in the evening after the first acupuncture treatment. Two days later the midwife was 99.9% sure the baby had turned. It was confirmed by scan the next day, just before she was offered ECV or C-section. She had a natural delivery to a baby girl.
R, 35. Her first birth two years ago was very long. 76 hours from first contraction. Had a ventouse delivery in the end as the baby was rather large 9lb & her contractions weren’t long enough to push the baby out. Ended up with lots of stitches. This time she had some acupuncture during her pregnancy and she didn't get Polyhydramnios(too much amniotic fluid) as last time. The prebirth acupuncture had helped too. She gave birth to a little boy at 41 weeks. "All completely naturally. Thank you for all your support. The acupuncture definitely has helped. Refused induction and went into labour on Tuesday about 1pm, contractions built up continuously in a regular pattern. Went to hospital at 8pm and was already 5-6cm dilated and he was born at 10pm. So much quicker easier birth! 9lb3oz."
Postnatal Care
Acupuncture is a great way to help with postnatal health include perineal pain, postnatal depression, fatigue, insomnia, insufficient lactation, mastitis, infection of the caesarean scar, etc, if the new mums can find the time!