Acupuncture is beneficial for women in all aspects of labor including everything from pre-labor to delivery and beyond. Although the most utilized form of pain management during labor is still the epidural at 73%, 40% of woman also use complementary methods like acupuncture for labor pain management. Many women don’t know of the various options out there for pain management during the pregnancy and labor process, and many don’t even ask for pain management solutions during labor because they think it is too late in the birth or they are unsure. Fortunately, acupuncture and acupressure has been shown to be helpful on its own or in conjunction with traditional pain management solutions during and after labor.
Labor & Delivery Western Medicine Options
The western medicine options for managing labor pain are more well-known amongst the larger part of the population, but there are still options that many women don’t realize that they can utilize in their birth plan. Inducing labor is the first step in the labor/delivery journey, and most women want this to occur naturally in any way possible. There are options in western medicine to make this happen as well, however, there are risks to inducing. Those who should not induce labor include ones who have had a C-section which involved a classic incision or major surgery, those who have placenta previa, or those who’s baby is in the incorrect position.
Common Inducing Labor Options:
- Hormones – prostaglandins are provided at the hospital to open the cervix and initiate contractions. This will not be an option if the patient has had a C-section previously as it increases the risk of uterine rupture.
- Mechanical Dilation – a balloon catheter at the hospital. A thin tube is inserted into the vagina into the cervical opening, and then uses water to inflate the balloon at the end of the tube allowing the cervix to expand.
- Strip the Membranes – the doctor will separate the amniotic sac from the uterine wall at the cervix. This will release hormones to trigger contractions, and can be done in the office.
- Medications – this is the most well-known option amongst pregnant women. The patient takes Pitocin in order to start contractions administered in the hospital through an IV gradually increasing until the contractions are strong and frequent enough to deliver.
There are also natural ways that a patient can induce labor like herbal remedies like black cohosh, drinking a small amount of castor oil, walking, having sex, or gently stimulating the nipples. It is important for the patient to consult with their doctor before trying any of these options of course. The next stage in labor/delivery is the actual labor. There are various pain management options through the process.
Common Labor Pain Management Options:
- Epidural – the most well-known and common type of pain management used during labor. The anesthesiologist inserts a needle and catheter in the lower back numbing below the belly button. This allows the woman to be awake and aware during labor, but there is not total pain relief as there is intense pressure felt regardless.
- Potential side effects – sore back, headaches, lower blood pressure. The lowering blood pressure can potentially slow the baby’s heart rate.
- Potential side effects – sore back, headaches, lower blood pressure. The lowering blood pressure can potentially slow the baby’s heart rate.
- Spinal Block – also well-known, but there are surprisingly many women who don’t realize that this can be used not only alone but also in combination with an epidural (combined spinal epidural or CSE). This is also administered through a needle into the lower back into the spinal canal, and is immediate pain relief lasting anywhere from 1 to 3 hours. This will cause the patient to be numb from the stomach down to the legs, and can be used for both vaginal childbirth and planned C-section births.
- Potential side effects – itching, and sore back after delivery. During the labor it may decrease blood pressure potentially slowing the baby’s heart rate, and in rare cases, bad headaches.
- Potential side effects – itching, and sore back after delivery. During the labor it may decrease blood pressure potentially slowing the baby’s heart rate, and in rare cases, bad headaches.
- General Anesthesia – this is only usually utilized when a patient needs an emergency C-section or bleeding during labor.
- Opioid & Non-Opioids – these are inserted through an IV and can be either opioids or non-opioids to temporarily relieve pain. Unfortunately, this option often does little to ease the pain during labor and delivery.
- Potential side effects – nausea, vomiting, drowsiness in the patient, and can affect the newborn’s breathing and cause the baby to also be drowsy.
- Potential side effects – nausea, vomiting, drowsiness in the patient, and can affect the newborn’s breathing and cause the baby to also be drowsy.
- Nitrous Oxide – Most often referred to as “laughing gas” and is a pain reliever that is inhaled, and is a tasteless, odorless gas. This is a non-traditional option in the United States for labor, but it is becoming more common. It is more so used to reduce anxiety rather than eliminate pain, but takes effect quickly usually within a minute.
- Potential side effects – nausea, vomiting, dizziness, and drowsiness. Additional research is needed on this option and its potential side effects on the baby.
Many women don’t realize that acupuncture and acupressure are options to utilize throughout the labor and delivery process.
Acupuncture Works for Labor & Delivery
Many women are concerned with getting acupuncture and acupressure both during pregnancy and during labor and delivery, but the truth is that it is the safest option out there. It is important especially with these patients on the way to the end of their pregnancy, that we provide them with the most information possible with the process. Acupuncture works best from 34 – 36 weeks on in order to prepare the woman’s body for labor, and achieve better outcomes during labor and delivery.
Unfortunately, many women don’t think to call an acupuncturist until 40+ weeks when they are getting desperate to deliver, or are trying to avoid a C-section. However, they would benefit most, and could possibly avoid those issues altogether starting an acupuncture plan sooner in the pregnancy. There are a multitude of studies that show women who have had increased successful vaginal births and decreased medical intervention when they have seen an acupuncturist leading up to their due date.
Acupuncture Treatment Protocol from 34 – 36 Weeks:
- During this time the treatment focus should be on making sure the baby is in proper position for delivery. Alleviate tight muscles in the lower back, buttocks, and hips as well as decrease stress hormones which tend to ramp up during this period of time. It is recommended that the patient comes at least 1x per week during this time period.
Acupuncture Treatment Protocol at 37 – 38 Weeks:
- During these weeks the treatment focus should be on encouraging cervical ripening and effacement. It is also vital to continue treating the emotional aspect of pregnancy, as well as discuss hormones that are normal and in abundance these final weeks of pregnancy leading into labor. It is recommended that the patient comes twice weekly.
Acupuncture Treatment Protocol at 39 – 40 Weeks:
- Continue to relax and open the pelvis, and decrease anxiety. Also, at this point it is important to see the patient more frequently until birth to get the best results in prep and comfort before, during, and after labor. It is recommended that the patient for the final 2 weeks of pregnancy, the patient come at least every 2 -3 days or daily if possible.
When the patient is actually in labor, acupuncture has been shown to provide pain relief unobtrusively, especially when the patient can stop the treatment at any time during labor should they feel uncomfortable. Acupuncture works in the labor process because it is used externally, allows the patient to be mobile during labor, can be used in conjunction with western medicine pain relief, can be used for home births, and is safe for the mother and the baby. The American College of Obstetricians and Gynecologists says that drug-free techniques like acupuncture and massage don’t negatively affect women or their babies, and may help reduce pain.
Acupuncture Points to Regulate or Stimulate Labor:
- LI4 – *not to be used before 36 weeks as it can encourage contractions; improves circulation to the uterus, stimulates uterine contractions, pain relief during labor especially going into transition, if the patient is not pushing effectively
- SP6 – *not to be used before 36 weeks as it can encourage contractions; ripen and soften the cervix, helpful in prolonged labor, reduce after pains, strengthens contractions.
- BL60 – gets the baby in the right position, and incites the baby to descend
- GB21 – *use 36 weeks on; reduce shoulder tension to release oxytocin, sends energy down, incites baby to descend down the birth canal, and aids in expelling placenta.
- BL32 – relieve gynecological issues, trigger contractions, counter pressure during contraction, and reduce labor pains.
- KD1 – reduce anxiety and stress
- Ear Shen Men – relaxation and pain relief