How to Make Labor Less Painful

 

By Danielle Lombardi, LAc, MS

Danielle is the founder & owner of Portland Healing Space, an integrative holistic health center in Portland, Oregon. She is a licensed acupuncturist certified by the Oregon Medical Board and National Certification Commission for Acupuncture and Oriental Medicine. She is also a certified Holistic Pelvic Care practitioner, specializing in women’s health, pregnancy and post-natal care. She integrates acupuncture, herbal medicine, shiatsu, Holistic Pelvic Care and qigong into her treatments.

She is an active board member of ACHS (American College of Healthcare Sciences), received her Masters of Science from OCOM (Oregon College of Oriental Medicine), and her BA in fine arts and film studies from Bard College.

Danielle was recently interviewed by Cosmopolitan Magazine for an article on pregnancy and acupuncture. Below is the full interview, here is a link to the article in Cosmo!

 

In general, how is acupuncture used to relieve pain? What, specifically, does it do and how does it work?

Acupuncture reduces pain and helps restore balance by promoting the body's natural healing process. The practitioner inserts sterile, hair-fine needles at specific points on the body to treat a variety of conditions, including many of those causing pain and discomfort during pregnancy and labor. Because each person is a unique individual, the practitioner bases diagnosis and treatment on that person’s specific presentation.

Within the context of Chinese medicine, pain is a sign of stagnation, or unbalanced energy in the body.  Acupuncture relieves pain by unblocking stagnation and balancing the flow of energy, or qi, through the stimulation of certain acupoints. From a Western perspective, acupuncture helps to improve circulation and stimulate the release of endorphins, which alleviate pain and generate an overall wellness response within the body, mind and spirit.

How can acupuncture help ease pain during pregnancy and labor?

Acupuncture promotes wellness and balance during pregnancy, helping to strengthen mother and baby as well as effectively treat many common ailments such as nausea, edema and musculoskeletal pain (back pain, sciatica, rib pain, etc.)

Acupuncture can be very effective in reducing the intensity and frequency of morning sickness in pregnant women.  In a randomized controlled trial at a teaching hospital in Adelaide Australia, acupuncture was shown to be “an effective treatment for women who experience nausea and dry retching in early pregnancy.”  The women in the study who were receiving traditional acupuncture reported significantly less nausea and faster relief than women in the other control groups who were receiving sham acupuncture or no acupuncture.*

Traditional Chinese Medicine can also be helpful in turning breeched babies with the use of moxabustion, an herbal heat therapy that is used to warm the outer edge of the little toe to stimulate the movement of the baby to the proper position. In another randomized controlled trial, [Acupunct Med. 2013], it was shown that moxabustion is a safe and effective method that can significantly increase the chances of turning a breech baby for women from 33-35 weeks gestation.

Can you give some specific examples of how you’ve used acupuncture on pregnant women -- during pregnancy and/or during labor to help them manage pain?

Acupuncture is a holistic medicine in which treatments are determined by each patient’s unique pattern differentiation.  However, there are some points that are known for specific pain patterns that can be used both with acupuncture or acupressure for general relief. For nausea in early pregnancy I often use the points PC 6, KI 27, and KI 6 with excellent results. PC 6 can be found by measuring three fingers above the transverse crease of the inner wrist, just between the two tendons in the center of the medial forearm. KI 27 is found two thumb-widths from the center of the sternum in the depression just below the clavicle. KI6 is found one thumb width below the tip of the medial ankle. Treatment for nausea with these points (and/or others, chosen based on the holistic pattern of each woman that I see) can be transformational for the women seeking treatment.  I am told again and again that it is the most effective form of relief for morning sickness.

For edema (excess fluid retention) in the legs and feet, the acupoint SP 9 can work wonders.  I have seen amazing results with just this point, often with immediate significant reduction of swelling and discomfort.

For back pain and sciatic pain, local points in gluts, hip and leg may be used, such as GB 30, located in the middle gluts, which helps to release the piriformis and it’s pressure on the sciatic nerve. For safe treatment during pregnancy, I also like to use two Master Tung points located on the lateral forearm called Shou Wu Jin (Hand Five Gold), and Shou Qian Jin (Hand Thousand Gold). With all three of these points I have seen significant relief of sciatic pain.

During labor, I have seen both acupuncture and acupressure provide a safe, effective and drug-free alternative for pain relief. Acupressure is especially helpful for partners to learn and apply if a licensed acupuncturist is unavailable for onsite treatment during labor.

St 36 (Zu san li), is amazing for long labors. It is located on the lateral leg, 4 fingers width below the lateral eye of the knee.  Zu san li, translated as “leg three miles”, brings renewed energy, strengthens the mother, and relieves pain.

The Ba liao points, located in each of the sacral foramen of the low back can be strongly stimulated while the woman is side-lying.  These points bring extraordinary relief of pain during labor, especially for women in back labor.

If the baby isn’t moving down, GB 21 and SP 6 can help move the baby with more ease and offer relief to the mama.

Are there any precautions pregnant women must take when seeking acupuncture therapy?

There are many points that are contraindicated during pregnancy that should not be used even within acupressure sessions. These include points on the top of the shoulder, hand, ankle, sacrum area, and lower abdomen. I recommend finding a skilled licensed acupuncturist who can discuss the safety precautions with you.  If you wish to learn acupressure for self-care during pregnancy, or for partner-care during labor, please consult an acupuncturist for proper training in point location and application.

How frequently do you recommend treatment?

Acupuncture is an individualized treatment for each person, and I always recommend treatment as needed, depending on the severity of symptoms and presentation of each patient. 

In pregnancy I generally recommend weekly sessions for the first trimester to support a healthy and strong foundation for the pregnancy. Second trimester treatments are based on the presentation of the mama to be, often 2-4x a month for preventative care and general wellness support. Acupuncture during the third trimester is focused primarily on preparation for labor and delivery, and weekly treatments are recommended. Studies show that women who receive regular acupuncture during the third trimester have shorter and more productive labor. (research indicates there was an overall 35% reduction in the number of inductions, 31% reduction in the epidural rate; 32% reduction in emergency cesarean delivery; and a 9% increase in normal vaginal birth for women who used acupuncture for pre birth.)

 

REFERENCES:

 

Smith C, Crowther C, Beilby J, (2002) “Acupuncture to treat nausea and vomiting in early pregnancy: a randomized controlled trial.” Birth 29(1):1-9.

 

Vas J, Aranda-Regules JM, Modesto M, et al. (2013). “Using moxibustion in primary healthcare to correct non-vertex presentation: a multicentre randomised controlled trial.” Acupuncture Medicine 31: 31-38