Labour
Electro-acupuncture as effective as drugs for labour induction – Journal of Chinese Medicine, Feb 2012
A Brazilian group has shown that electro-acupuncture (EA) can be used to promote labour as efficiently as the prostaglandin analogue misoprostol, but with fewer obstetric complications. Sixty-seven pregnant women in labour were randomised to receive either EA or misoprostol. Women who received EA experienced significantly fewer obstetric complications, along with a significantly higher frequency of vaginal deliveries. Although they tended to have a longer duration of labour, there was also a tendency to higher patient satisfaction among patients of the EA group. (Electroacupuncture for cervical ripening prior to labour induction: a randomized clinical trial. Arch Gynecol Obstet. 2011 Jun;283(6):1233-8).
Moxibustion shortens labour and reduces pain – Journal of Chinese Medicine, Feb 2012
Moxibustion at Sanyinjiao SP-6 may be able to markedly shorten the active phase of the first stage of labour and decrease pain due to uterine contractions, according to Taiwanese researchers. Sixty primipara women in labour were equally assigned, according to their choice, to three groups: bilateral moxibustion at Sanyinjiao SP-6 for 30 minutes, moxibustion at non-acupoints for 30 minutes and no moxibustion. The researchers found that the duration of the active phase of the first stage in the moxibustion group was significantly shorter than that in the other two groups. Visual analogue pain scores after moxibustion were also significantly lower in the this group compared with the no moxibustion group. (Effect of acupoint Sanyinjiao (SP6) moxibustion on the first stage of labor and uterine contractive pain in primiparae. Chin J Integr Med. 2011 Jun;17(6):464-6).
Acupuncture for labour pain management – Journal of Chinese Medicine, Oct 2011
A Cochrane Database systematic review has concluded that acupuncture and acupressure may have a role in reducing pain, increasing satisfaction with pain management and reducing use of pharmacological management for women in labour. Thirteen trials with data on 1986 women were included. Nine trials reported on acupuncture and four on acupressure. Less intense pain was found with acupuncture compared with no intervention. One trial showed increased satisfaction with pain relief compared with placebo. Reduced use of pharmacological analgesia was found in one trial of acupuncture compared with placebo and one compared with standard care. Fewer instrumental deliveries were found with acupuncture compared with standard care. Pain intensity was reduced with acupressure, compared with placebo and control and a combined control. Trials showed significant heterogeneity and all showed some risk of bias. (Acupuncture or acupressure for pain management in labour. Cochrane Database Syust Rev. 2011 Jul 6;(7):CD009232).
Acupuncture helps with labour pain – Journal of Chinese Medicine, Oct 2009
Danish clinicians carrying out the largest randomised controlled trial of acupuncture for relief of labour pain have found it to be a good supplement to existing pain relief methods, reducing the need for pharmacological and invasive methods during delivery. A randomised controlled trial was conducted with 607 healthy women in labour at term who received acupuncture, TENS, or traditional analgesics. Acupuncture was individualised, based on women’s mobility and localisation of pain, with points chosen from a list of 34 specified points. Although pain scores were comparable across the three groups, the use of pharmacological and invasive methods was significantly lower in the acupuncture group. Acupuncture did not influence the duration of labour or the use of oxytocin. In addition, indications of neonatal wellbeing (Apgar score and umbilical cord pH value) were significantly better among infants in the acupuncture group compared with infants in the other groups. (Acupuncture as pain relief during delivery: a randomized controlled trial. Birth. 2009 Mar;36(1):5-12).
Acupuncture facilitates 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).