Natural Induction of Labour with Acupuncture
Acupuncture is a safe, effective and unmedicated approach to stimulate labour contractions for women who have reached or indeed, gone past their due date. A 2008 Cochrane library review, stated that in clinical trials acupuncture was shown to be useful for natural induction of labour.
The World Health Organisation have stated that when a woman goes past 41 weeks gestation, induction should be considered, as this practice is associated with fewer perinatal deaths.
However, while artifical induction in a hospital setting is associated with an increased risk of further medical interventions e.g. Epidural, Episiotomy, Ventouse or Forceps delivery and increased risk for C-section,
Induction via electro-acupuncture mirrors what would happen for that women if her contractions had started spontaneously as natural labour.
While it is important to recognise cases where there is a genuine need for medical induction, in most cases a natural induction or spontaneous labour is always preferable.
What is involved in a hospital based induction?
- Pitocin (synthetic oxytocin) is used to stimulate contractions that are stronger and peak more quickly than natural contractions.
- Between contractions, the uterine muscles never fully relax, increasing stress levels for mother & baby and resulting in the need for foetal monitoring.
- Pitocin does not cross the blood-brain barrier, which means the woman does not secrete her own natural pain-killing endorphins and hence she will find it much harder to manage her pain, often resulting in the need for an epidural.
- An epidural will elongate the first and second stage of labour and increase the likelihood of an instrumental delivery and/or episiotomy.
How is a natural induction performed?
Acupuncture needles are placed in points located on the hands, lower leg, shoulder and lower back while you are seated and resting your head and arms on the treatment couch in front of you. A TENS machine is used to stimulate the acupuncture points with a rhythmical 'heart-beat-like' electro-pulse. This is the same machine that a physio would use for musculo-skeletal injuries. The acupuncture needles are very slim and are nothing like the hypo-dermic needles used for taking blood samples, that you would be accustomed to during your pregnancy. Most women experience only a mild sensation when the acupuncture needles are inserted while the TENS machine causes a gentle 'twitching' feeling in muscles surrounding the needle.
Am I a suitable candidate for natural induction with acupuncture?
Most pregnant women will be eligible for this treatment. However, if you have a history of kidney disease, heart conditions, gestational diabetes, are pregnant with twins, have had a previous C-section (unless approved for VBAC), bleeding during pregnancy or history of haemorrhage, then hospital management of your induction would be advisable.
What symptoms am I likely to experience during the treatment?
Women may often feel increased foetal movement when the needles are inserted before the TENS has even been turned on. Contractions are typically felt after 20-30 minutes of retaining the needles when combined with the TENS machine. However, in the same way that no two labours are ever alike, so too every woman will respond differently to the induction treatment.
Some women may only experience foetal movement, with no contractions at all. However, when queried, the woman may note that the foetal movement is occurring at precisely timed intervals, the same as you would expect with a contraction.
Other women may experience lower back ache akin to 'period pain', mild nausea, dizziness, tightening of the top of the belly that gradually converts into a full contraction or a heavy sensation in the groin area. These are all common and normal symptoms of early labour.
In some cases, contractions may become established, but may peeter out once the treatment is finished. In these cases, it is not uncommon for the woman to spontaneously begin labour that night or within 24-48 hours of the treatment.
How many treatments will I need and when should I start?
The amount of treatments required may be more readily assessed after the initial treatment has been completed.
For 70% of women who are at or over 40 weeks gestation, one treatment may be all that is required to stimulate natural labour, either on the day or within 48 hours of the treatment.
For the remaining 30%, most will enter labour after the second treatment and three treatments would be the maximum that is ever required.
Ideally, treatments would begin from the 36th week of pregnancy to prepare the body for labour, help the cervix to efface and encourage the endocrine system to be responsive. If labour does not spontaneously occur by the due date, induction treatment should be considered as a viable alternative to hospital-based induction.
Mary* attended for an induction treatment on her first pregnancy at 40 weeks 4 days. Her pregnancy had been unremarkable with no major health complaints and she had been scanned the day prior to treatment to check the baby was presenting in the correct position. Her baby had not engaged, her cervix had not effaced and she was told she would need to attend the hospital for a medical induction if she had not gone into labour spontaneously within the week.
The first acupuncture treatment she had, produced contractions within 20 minutes that were a steady 5 minutes apart. These faded later that afternoon, so she decided to come back for a second treatment the following day.
During the second treatment, contractions became very well established but a bathroom break unfortunately broke the momentum and again her contractions abated.
On the third treatment, the contractions were not as pronounced but she was feeling much more foetal movement and felt as if the baby's head was 'hanging between her legs'.
The next day she went in for a check-up to be told that her cervix had fully effaced. She went into labour a couple of hours later and gave birth that evening without requiring any medical intervention.
Case example 2
Suzanne* attended for an induction treatment on her second pregnancy at 40 weeks 1 day. She had had a negative experience with her first labour, which involved an artificial induction with a long, protracted labour and was not keen to repeat the process.
The needles were inserted at 11am in combination with electro stimulation from the TENS machine. For the first 20 minutes she noted a feeling of extreme relaxation and thought she may go to sleep. At 35 minutes her contractions began and very quickly progressed to strong, rhythmic contractions, four minutes apart.
She was very relaxed during the treatment, breathing deeply and exhaling at the peak of the contractions and then chatting in between them. After 90 minutes the needles were removed and the contractions continued unabated. She was advised to contact her husband and her daughter was born by 3pm that afternoon. Suzanne* reported that the labour was an 'utterly different experience to the first time around' and that she would come back for treatment if she needed to with baby no.3.
(* names have been changed to respect the privacy of the patients in question)
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"I went to Jessica when I was three days overdue on my second child. I had been induced in hospital on my first and was trying to avoid that situation second time round, if at all possible. After my afternoon appointment with Jessica my beautiful baby girl was born that same evening! I had never had acupuncture before and Jessica made me feel relaxed and was very professional at the same time. The results I think speak for themselves!"