Acupuncture for Pregnancy related conditions
- Acupuncture for pregnancy
- threatened miscarriage
- Morning sickness
- Musculoskeletal conditions
- Breech position
- Labour induction
Acupuncture for Pregnancy
Acupuncture is becoming popular treatment for pregnancy-related conditions as acupuncture during pregnancy is safe and effective.
There are a variety of conditions that acupuncture is effective, including prevention of miscarriage, morning sickness, muscle pain, heart burn, constipation, varicose vein, urinary tract infection, fatigue, insomina, anxiety, sinusitis, hypertension, oedema, breech positions, and labour induction.
Please find a registered acupuncturist. Non-registered practitioners who use "dry needling" may not understand how to use needles safely for pregnant women. Registered acupuncturists use many different techniques and these may be required for safety as well as to gain the best results.
Western medical information for threatened miscarriage
A threatened miscarriage is one where there are warning symptoms and signs such as bleeding, lower back pain and abdominal cramps. With a threatened miscarriage the cervis is still closed and there is evidence that the foetus is viable, usually via an ulstasound or Doppler device.
In the threatened miscarriage a women is usually advised to rest and to refrain from sexual activity.
Not all vaginal bleeding indicates a potential miscarriage. In early pregnancy it is common for bleeding to occur when the embryo implants in the uterus and also when the woman would have expected her first period, and for some woman their subsequent periods.
TCM view point for threatened miscarriage
With the threatned miscarriage, we consider any underlying disharmonies that the mother may present with.
These can be devided to deficiency (of Kidney, Spleen, Qi or Blood) and blood heat. In both groups, there are often emotional factors that cause Liver and Heart heat.
Western medical information for morning sickness
Nausea and vomiting during pregnancy is generally called "morning sickness". It is said to occur in about one half of all pregnancies,
usually between 6 weeks and 16 weeks.
There are a number of theories as to why nausea occurs in pregnangy:
- Hormone levels. Rapid increase of hCG and oestrogen may contribute to the nausea to occur.
- The brain stem respond to the hormones that influences the levels of nausea and vomiting.
- Fatigue and stress. It is thought to increase the symptoms if she is stressed and fatigued prior to becoming pregnant.
Antiemetic medication that is considered to be safe for pregnancy may be offered and admission to hospital for intravenous fluids will be an option if the woman becomes too dehydrated.
TCM view point for morning sickness
After the conception occered, the Penetrating vessel changes dramatically as menstruation stops.
And the blood and essence of the Penetrating vessel are now required to nourish the foetus.
The Penetrating vessel is close relationship with the uterus and the Stomach channel, and disorder of the Penetrating vessel can lead to rebellious qi which interferes with the descending action of Stomach, leading to nausea and vomiting.
Below are some of the patterns of disharmony that are often seen in the practice.
- Stomach qi deficienty
- Stomach defency cold
- Spleen qi deficiency
- Liver qi stagnation invading the Spleen
- Stomach heat
- Accumulation of phlegm
Western medical information for musculoskeletal conditions
There are a lot of musculoskeletal conditions during pregnancy such as sciatica, leg, hip, pelvic and back pain
that are considered as "normal" conditions for pregnant woman.
Musculoskeletal problems are often present due to the hormonal effects of progesterone on the ligaments.
As the pregnancy progress these conditions become more prevalent. Weight gain also affect the musculoskeletal conditions.
Pressure on the limited physical space also bring on the specific problems.
Western medical treatment usually involves physiotherapy and specific exercises. If it is severe, bed rest in hospital, medication or a medical induction may be considered.
TCM view point for musculoskeletal conditions
Musculoskeletal pain is seen as a stagnation of qi or blood in the channels passing through a specific area.
This also arise from invasion of pathogenic factors such as wind, cold and heat, overuse, trauma or from internal organ disharmony
(such as Kidney deficiency and Liver qi stagnation).
The etiology is often mixed in practice.
Western medical information for breech positions
It is expected that a baby will settle into a head down position within the pelvis around the 34th to 36th week of pregnancy. The best positions is termed a "well-flexed anterior position". Not all babies will be in the anterior position, and there may be either malposition or alpresentation of the foetus.
In malposition, the baby's head is the presenting part into the pelvic outlet, but it is not in the best position:
either the occiput will be presenting as posterior, or the baby will have its head deflexed.
Posterior position can be either Left Occipital Posterior (LOP) or Right Occipital Posteior (ROP).
Malpresentation is the situation where a foetus is in any position that is not cephalic - i.e. head down. The most common malpresentation is a breech presentation, occuring in 3% of term births. With a breech presentation there are three possibilities:
- Full (complete/flexed) breech (10-15%): hips and legs flexed
- Frank (extended) breech (45-50%): hips flexed and legs extended over anterior body surface
- Footling breech (35-45%): foot or knee presenting
If it is confirmed that the baby is in a breech position, a specialist or a doctor may attempt an external manual version.
TCM view point for breech positions
In TCM, the root cause of malposition and malpresentation is considered to Kidney qi deficiency that lead to deficiency
or stagnation of uterine qi and foetal qi and blood.
Breech presentation is successfully corrected by stimulating acupuncture points with moxibustion.
At the three year study, 28 weeks pregnant or later with breech presentation were divided to control group (n=224) and
treatment group (n=133). With moxibustion, treatment group had a spontaneous correction rate of 92.4%, and control group had a rate of 73.66%.
Another randomized, controlled, open clinical trial showed moxibustion for 1 to 2 weeks increase fetal activity during the treatment period, and 75.4% (98 of the 130) in the intervention group were cephalic at birth vs 62.3% (81 for the 130) in the control group.
Moxibustion treatment of breech presentation
Moxibustion for correction of breech presentation: a randomized controlled trial
At the clinic, smokeless moxa may be applicable, and a smokeless moxa stick will be given for homework. The moxa stick is held over the points bilaterally once a day for ten days. Optimum time of teatment is 34 weeks, but it is still effective as late as 38 weeks.
Western medical information for labour induction
Medical induction refers to artificial start of the birth process through medical interventions.
This usually involves the use of prostaglandins and possibly oxytocin (syntocinon).
The first step is to give synthetic prostaglandin to induce labour by acting on the cervix in an attempt to ripen it. This may require the woman to stay in hospital overnight.
If the woman's cervix has began to ripen but there is not significant progress, her membranes are usually artificially ruptured by using a small plastic hook to the cervix to rupture the membranes. Once the fluid has been discharged, the baby will move down into the pelvic cavity, that cause more pressure on the cervix to increase further dilation.
If labor still fails to progress, syntocinon is then commenced to induce contractions.
The advantage of artificial rupture of the membranes is that labour may be shortened, the amniotic fluid can be examined for the presence of meconium, and the heart rate can be monitored with direct access to the baby's scalp.
The disadvantage of hormonally-induced labor is that women often find the contractions too intense, painful and difficult to cope with, and often require epidural anaethesia to deal with the pain of labour. This increase the risk of further interventions such as the use of forceps or a caesarean delivery. Infection also may occur if there is too much time between rupture and birth.
TCM view point for labour induction
In TCM, labour is expected to start when three factors occur at once:
- Yang activity relaces Yin material growth
- Qi and blood flow freely
- The door of the uterus opens
When these three factors occur, a harmonious labour follows with the onset of contractions, dilation of the cervix, rupture of the waters and explusion of the foetus.
There are combination of acupuncture points that induce labour, such as CO4 and SP6. BL32 is really helpful in case of blood stasis in the uterus. Emotions such as frustration and fear can overwhelm women as thei approach their due date, especialy if they have suddenly been told by doctor that their labour needs to be induced. Acupuncture can be used in these
I normally recommend pregnant woman to have acupuncture weekly from week 36 for labour preparation.