Not only can acupuncture be useful to help women achieve and maintain pregnancy, but it can also help women proceed naturally into labor when the time is right. Ultimately, babies know when they are ready to emerge from the safety of the womb. Medical science has not yet unraveled the complex array of hormones and other chemicals that signal the body to initiate birth. Unless there are specific medical reasons a woman should give birth early, we recommend simple patience during those last few weeks of pregnancy. For our pregnant patients, monthly acupuncture during pregnancy and weekly acupuncture after 36 weeks often results in a relatively smooth initiation of labor without a lot of medical intervention.
However, there are times when a woman’s doctor considers it important that she give birth by a certain date. We occasionally get calls from new patients who may be close to term and have a scheduled induction date in the near future. These women are often anxious to begin labor naturally in order to avoid the well-documented cascade of interventions that can follow medical induction. The way we approach these cases is actually the same way we approach everything else in Chinese Medicine–we assess how the body is out of balance and try to move it gently toward homeostasis.
In the most general sense, there are two basic reasons labor may be delayed. The most common diagnosis we see in women at term is qi stagnation caused by stress and tension. When a woman is still working full time at 40 weeks, when she is nervous about the birth itself or the mystery of motherhood, she tends to hold her body very tightly. Her muscles are tense, her mind is racing, she is often overwhelmed by the physical and emotional toll pregnancy takes. In this case, our role is to calm her sympathetic “fight or flight” system. When your body is receiving the message that you are running for your life, it wisely decides that stopping to have a baby should be postponed. The problem with this is that our culture values this fast-paced, over anxious, do-it-or-die mentality in most arenas. We don’t learn how or when to slow down. Stopping long enough to breathe and relax is a foreign concept for many of us.
Babies need to know that you will make room for them–that you are willing to put other things aside to care for them. “The exact mechanism, which triggers the onset of labour is not fully understood, however, research involving animal models and humans has shown that it is the fetus which initiates a train of physiological interactions which initiate labour” (J. Harrison, Bristish Journal of Midwifery, May 2000). High cortisol levels (which indicate that your body is under stress) may interfere with the process that initiates labor, and have been shown to inhibit lactation once the baby’s born. If you are planning to breastfeed, being able to relax becomes absolutely crucial.
As your due date approaches, it can only be helpful to slow down and welcome this new person into your life. Acupuncture can help teach the body how to slow down and relax. It can relax muscles, it can stimulate endorphin release, it can facilitate release of hormones. Stress and tension in the neck and shoulders is just a symptom of tension in the whole body…including the cervix and pelvic floor muscles. To give birth you have to be able to let go and let down your defenses. Untreated, these women may have very strong contractions but without much dilation of the cervix. Often, when a woman presents with this diagnosis, one or two acupuncture treatments is usually enough to relax the body enough and labor often begins within 24 hours.
The second general reason labor may be delayed is caused by what we call a deficient condition. In other words, she may be too physically tired to be able to mount the kind of energy needed in order to give birth. Often, this woman already has one or more children at home and is sleep deprived. Her resources have been stretched to the limit and she simply doesn’t have the available qi and blood to begin contractions. Further, when she does have contractions, they may be weak and non-productive making her labor prolonged. In this case, we use acupuncture and moxibustion (a point-warming technique) to try to re-vitalize her system and support her innate energy. Sometimes, these treatments may take a little longer. She may come in daily for a week, or we may teach her and her partner acupressure and moxibustion to do at home. But with this support, labor can become more productive and mom will have a better postpartum experience as well.
Tips for a better labor experience:
If you can work it out, plan to stop working before your due date. Give yourself some time to wind down and relax before you begin the intense work of parenthood. You are about to have a life-changing experience…take just a little while to slow down and appreciate it.
Do yoga. We advise prenatal yoga throughout pregnancy, but even if you haven’t been doing that, it’s never too late to start. Yoga will help you relax into parasympathetic mode. It will stretch and strengthen the muscles you’ll be using to labor and will help you recover faster after birth. It will help keep the baby in an optimal position for birth.
Practice some form of silence / meditation / prayer every day. Settle into yourself and become quiet. Listen to what your body wants. Listen to your innate wisdom. Set your intentions: what do you want from your birth and postpartum experience. Envision your ideal scenario. What qualities do you want to bring to the experience, no matter what happens?
Eat well, sleep a lot, and have fun- you need to be well-nourished to have the energy to give birth, you need to be well-rested, and you need to be relaxed. Throughout your pregnancy, you should become over-protective of your sleep. If you are still working, take 20 minute naps at your desk or in your car at least once a day. You are creating a human being from scratch and that is hard work. Don’t let well-meaning others keep you out too late or ask you to engage in activities you aren’t absolutely invested in. Watch lots of funny movies or talk on the phone with the friend who makes you laugh the most. It is almost impossible to be tense and tight while laughing.
Decide who you want to attend the birth (and who you don’t want to attend!). This is perhaps one of the most memorable moments of your life. Don’t let the desires of others override yours. Some women don’t mind having an extended family party while giving birth, but if you want it to be an experience shared with only a small few, don’t be afraid to say so. Having people in the room you don’t feel 100% comfortable with can actually cause your body to tighten up and slow labor.
Hire a doula. A good doula can be invaluable during your labor experience. Not only can she help your medical providers understand your wants and needs, but she plays a central role for you and your birth partner as well. She has attended many births and she will stay by your side throughout your entire birthing experience. She can be a source of guidance and reassurance. When the new mom is in the “zone” of giving birth, the husband or partner can feel a bit lost. It becomes difficult for both of you to know the difference between what is normal and what isn’t. A doula can be the person responsible for sounding any alarms if needed. She can help you make decisions about interventions and she can provide that much needed reassurance that you are doing everything just right. This frees the partner up to simply be there and be supportive. For a list of doulas in this area, check out www.pada.org.
In parts of Asia, acupuncture has been used for centuries to jump-start labor. Researchers at the University of North Carolina completed a small study to test whether this method has real benefits. The study involved 56 women who were 39 ½ to 41 weeks pregnant. (Forty weeks is full term.) Half of the women received three acupuncture sessions, while the other half did not.
Among those who received acupuncture, 70% went into labor without medical intervention. This compares to 50% of those who received standard care. The women who got acupuncture were also less likely to deliver by cesarean section– 17% compared to 39% of the women who did not receive acupuncture.
“We had almost a 50% reduction in the C-section rate,” researcher Terry Harper, MD, tells WebMD. Harper, who now practices maternal fetal medicine in Albuquerque, says the small size of her study means additional research is needed. She hopes acupuncture might one day help more women give birth vaginally.
The study appeared in the August 2006 issue of /The Journal of Maternal-Fetal and Neonatal Medicine/. A larger study is currently underway, also at the University of North Carolina. http://www.webmd.com/baby/inducing-labor-naturally-can-it-be-done
The following came from a meta-analysis of several different studies:
“Our search identified a Cochrane systematic review that included 3 trials with 212 women that focused on acupuncture for induction of labour [41 <#B41>]. Compared with standard care (oxytocin, prostaglandins, or “routine care”), more women undergoing acupuncture did not require the use of other induction methods (2 trials, 147 women, 49/73 versus 34/74; RR 1.45, 95% CI 1.08 to1.95; NNT = 5). No differences were found in time to delivery, rates of caesarean delivery, instrumental vaginal delivery, or epidural anesthesia. Fetal or neonatal outcomes were not estimable [41 <#B41>].” http://www.biomedcentral.com/1471-2393/11/84