Are you pregnant and curious about safely navigating this incredible journey, naturally?
Are you experiencing aches and pains that seem pregnancy-related and wish to find a non-pharmaceutical path to relief?
Are you wondering if there is a way to promote a healthy labour?
Pregnancy is an incredible process. From conception to birth, the body and mind continually transform and adjust. These profound changes can trigger aches and pains, nausea and vomiting, fatigue, food cravings, constipation, mood swings, and what are called pregnancy complications; health issues that occur during gestation.
But rather than reaching for medications, there are evidence-based alternatives. Natural approaches to find respite. Approaches including acupuncture.
Acupuncture was first reported as a treatment during pregnancy 1600 years ago. Yet while Eastern wisdom has known about the vast benefits of this therapy for millennia, the West has been slow to catch up. In the last few decades, however, acupuncture has seen an explosion in popularity. Promulgated, no doubt, by the wish for a holistic, natural approach and the rise of supportive scientific research.
But, it’s important to understand — particularly when pregnant — what claims can legitimately be made about acupuncture and which cannot. In essence, separating fact from fiction or, at least, fact from the as yet unproven is key.
With that said, there are important reasons why my patients seek out and love the benefits that acupuncture can deliver. These include pain management, relief from anxiety, improved sleep, the promotion of a healthy labour, and the safety of this approach. Each one is steeped in evidence, as we’ll discuss in the rest of this article.
Pregnancy acupuncture at 20 weeks performed by Adam Hjort, Traditional Acupuncture Clinic.PREGNANCY ACUPUNCTURE FOR PAIN MANAGEMENT
As ligaments loosen and your centre of gravity shifts forward, the burden placed on your lower back and pelvis can create significant discomfort. Particularly in the latter stages of pregnancy, when your baby is rapidly growing in size.
It is estimated that roughly 70% of Australian women suffer from lumbo-pelvic pain during pregnancy, a prevalence that is consistent in other countries too.
Lumbo-pelvic pain includes lower back pain, pelvic girdle pain, or both. Sadly, many women are told these experiences are an expected part of pregnancy and that there is nothing to be done.
While not dangerous as such, this type of soreness can be significant. Several studies have found the average pain intensity of lumbo-pelvic pain during pregnancy to be 6.5/10.
Many women also report that pregnancy related lumbo-pelvic pain makes daily activities like exercise, self-care, sex, sitting, and walking more difficult. The limitations created by pain can reduce your quality of life, making a pregnancy more difficult than it would otherwise be.
Pregnancy related pain rarely leads to an injury of your lower back or hips. However, it can be distressing enough to leave a lasting negative perception of your body and a vulnerability to chronic pain after delivery.
Whilst pregnancy related lumbo-pelvic pain is regularly undertreated, it doesn’t have to be. There are natural, evidence-based ways to relieve your aches and pains.
A study published in the Journal of Acupuncture and Meridian Studies investigated 81 pregnant women who were experiencing lumbo-pelvic pain. Acupuncture was provided as a therapeutic intervention. A staggering 88.9% reported “a clinically meaningful symptom reduction following their treatment.” Not only was there was a significant reduction in their pain, the impact on their quality of life dropped too.
Along with lumbo-pelvic pain, headache is common in pregnancy…
Often the hormonal changes of gestation calm headache in those who’ve suffered pre-conception. But migraine and tension-type headaches can, and do, occur throughout the trimesters.
Acupuncture has a prophylactic role to play in both.
In a randomised clinical trial, the gold standard in research, acupuncture was found to decrease the frequency of migraines.
Plus, a review article published in the revered Cochrane Database of Systematic Reviews found that acupuncture offers a valuable drug-free approach for those suffering from tension-type headaches.
While this is, of course, wonderful, one condition should be noted. Headaches during pregnancy should be professionally assessed as they can signal an underlying problem. This is particularly so in two situations. One; a severe headache that occurs in someone who does not usually experience headache. Two; someone with a pre-pregnancy history of headache, but where the intensity or quality of the pain or associated symptoms have recently changed.
Pregnancy acupuncture at 32 weeks for the management of headache.RELIEF FROM THE EMOTIONAL COMPLAINTS ASSOCIATED WITH PREGNANCY
Emotional complaints — like anxiety, depression and irritability — afflict many pregnant women. With fluctuating hormones and widespread physical and psychological changes, it’s hardly surprising. The negative effects on mood, personal relationships and quality of life can be profound and difficult to treat.
Yet, acupuncture appears to be an effective way to ease emotional symptoms and, in doing so, improve quality of life.
NATURAL, PROVEN TREATMENT FOR ANXIETY
Pregnancy can be an exciting time but real fears can become downright troubling for some. So much so that your chance of suffering an anxiety disorder during your pregnancy and postpartum period is thought to be 1 in 5.
Gestational anxiousness can have serious consequences for baby and mother. Research has shown that severe anxiety can have short and long term negative health impacts on the unborn child. In addition, mothers-to-be who experience overwhelm can struggle with tiredness, which may change the foods they eat, the quality of their sleep, and their capacity to maintain prenatal care. It is a serious condition with solemn outcomes that must be treated effectively.
Again, acupuncture provides safe, natural hope.
As the article, Acupuncture and electroacupuncture for anxiety disorders: A systematic review of the clinical research, said, “There is good scientific evidence encouraging acupuncture therapy to treat anxiety disorders as it yields effective outcomes, with fewer side effects than conventional treatment.”
With anxiety and sleep deeply linked, could acupuncture also have positive effects in treating sleep disturbances?
PREGNANCY ACUPUNCTURE FOR SOUND SLEEP
Pregnancy often triggers insomnia. In the early stages, at least 12% of women slumber poorly. But this rate skyrockets to 42.4% in the third trimester. The ramifications can be serious.
An article published in the journal, Obstetric Medicine, explained why…
“There is increasing evidence indicating that these sleep problems may be associated with adverse maternal and fetal outcomes such as depressive symptoms, increased pain during labour, more Caesarean sections, pre-term birth, and low birth weight.”
This makes prioritising slumber key. Again, acupuncture comes to the fore.
A 2020 study investigated 72 pregnant women with insomnia. They received either 10 acupuncture treatments over the course of three weeks, or remained in the non-treatment control group. In this way, both groups could be compared. The women receiving acupuncture experienced increased secretion in the sleep hormone, melatonin, and a corresponding jump in sleep quality.
At this point, you may be scratching your head and wondering… How can acupuncture deliver such impressive, even life changing results?
Acupuncture eases many protective responses controlled by your brain. One of these protective responses has great impact during pregnancy; it is involved in pain, anxiety and sleep disturbance - stress!
SOOTHING STRESS RESPONSES: A KEY TO ACUPUNCTURE’S POWER IN PREGNANCY
Stress in our modern world is endemic. The non-stop, never-ending strain changes the workings of the body and brain. This is not how we’re meant to live.
See, the stress response is useful, even lifesaving, if you are in battle or have a tiger hunting you down. That’s what the stress system was designed for; to turn up the dial on the physiological changes needed for survival, and to turn down the dial on those needed for health. After all, there isn’t much point spending energy on digestion if you’re about to be eaten. That energy is far better spent driving the muscles needed to fight or flee. This is ideal for a short lived crisis.
However, it is an expensive process that involves significant change within your autonomic nervous system; the automatic part of your nervous system. When engaged, nerves fire and hormones flood your body. Your heart races, your pulse rate and blood pressure climb, your senses sharpen, vigilance heightens, and your blood is bathed in the extra glucose required to respond. Non-essential processes — like digestive and reproductive functions — are pared back.
This is meant to be a temporary trade-off designed to increase the chance of survival. However, when the stress switch become locked on, it keenly changes how the body and mind function. We gradually run down to empty. Can you see how this might contribute to anxiety, irritability, mood changes, poor sleep, and increased pain?
A wired body — driven by a stressed nervous system and hormonal responses — is never good for us, humans, particularly during pregnancy. Yet, research has demonstrated that acupuncture holds a powerful key; one that can turn off the stress switch. As one journal article put it, “Studies have demonstrated that acupuncture can control autonomic nerve system (ANS) functions.”
There are certain areas of the brain that engage the stress response including the hypothalamus, medulla oblongata, periaqueductal gray, and the prefrontal cortex. In day-to-day life isn’t necessary to know what these areas are or what they do. Yet, when it comes to stress, research has shown that acupuncture mediates, resolves, their overstimulation; thus, promoting relaxation.
PREGNANCY ACUPUNCTURE: PREPARING FOR A HEALTHY BIRTH
As your due date comes closer, your body readies for the birth of your baby. The hormones oxytocin, noradrenalin and adrenalin, beta-endorphin, and prolactin all have important roles in the lead up to, during, and immediately following delivery.
Oxytocin, the “love” hormone, is released into the brain and the bloodstream. In the brain, oxytocin increases the feeling of calm, encourages caring, contributes to pain relief, and helps you and your baby to bond. In the blood, circulating oxytocin contributes to the rhythmic contractions the uterus needs to birth your baby and the placenta, and to let down your milk.
Adrenalin and noradrenalin, your “fight or flight” stress hormones, increase towards the end of labour. These circulating catecholamines excite the body, energising uterine contraction and urging you to push. This assists the final stage and a faster delivery. However, these hormones can — if needed — divert blood from the uterus to slow labour until a safe birthing environment is found.
Adrenalin and noradrenalin also affect your baby, protecting your little one from low oxygen levels and promoting healthy respiration. Then, after birth, noradrenalin promotes instinctual motherly behavior.
Beta-endorphin, a potent natural painkiller, occurs in high levels in pregnancy and especially through delivery. Thank goodness! This hormone helps to modify the experience of pain and elicits the euphoria of birth.
Prolactin is known as the “mothering” hormone. Encouraging the production of breast milk, breastfeeding, and motherly vigilance, it also promotes a “baby first” mindset… Though, high prolactin is also linked to anxiety.
These hormones must function well to produce what’s called an undisturbed birth; a seamless, natural delivery. But this is uncommon in Western society.
Enter acupuncture…
Acupuncture alters the synthesis, release and effects of a number of neurotransmitters (including the catecholamines, noradrenaline and adrenaline) and neuropeptides (including oxytocin) in the central nervous system (the brain and spinal cord) and peripheral nervous system. In this way, acupuncture may have benefits for pregnancy.
The authors of a review published in the journal, Translational Neuroscience, noted that acupuncture triggers the brain and hormonal system to up-regulate the level of oxytocin in the hypothalamus, an important region in the brain.
Acupuncture has a modulating effect on noradrenalin and adrenalin, which may calm the stress response and the effects it has on the body and mind.
The stimulation of certain acupuncture points has been shown to relieve labour pain through the release of beta-endorphin, the natural painkiller mentioned earlier.
Acupuncture appears to increase the hormone, prolactin, which may have important effects during and after birth.
In conjunction with oxytocin, acupuncture also appears to enhance uterine contraction, shortening the birth process.
Pregnancy acupuncture at 32 weeks with the addition of moxibustion.In addition, I often add moxibustion — the burning of dried mugwort at certain points — to enhance beneficial outcomes. In conjunction with acupuncture, I find this approach useful in promoting a healthy labour. This may be through cervical ripening, regulation of the autonomic nervous system, and encouraging a cephalic presentation — the safest delivery position of head-down, bum-up — at birth.
But what if your baby is presenting in a breech position? With bum-down instead?
A breech presentation increases the risk of pre-term labour, placenta previa (where the placenta covers the cervix), polyhydramnios (an excess of amniotic fluid), and uterine anomalies. This can make the birthing process more complex. That’s why trying to manually turn your baby or a caesarean section will likely be discussed, even recommended. But it this the only way?
A systematic review and meta-analysis — the type of research that combines a number of studies to increase the number of participants to gain clearer insights — investigated 2555 pregnant women with babies presenting as bum-down before birth. They found that acupuncture with moxibustion “significantly increased cephalic presentation at birth.” That’s a powerful, protective effect!
When performed by a traditionally trained expert, acupuncture can deliver a vast range of benefits during pregnancy, birth, and beyond.
PREGNANCY ACUPUNCTURE: SEPARATING FACT FROM FICTION
Acupuncture offers pregnant women incredible benefits! But it is important to understand what claims have clinical relevance — which ones can make a difference to your experience — and what claims should be dispelled.
A systematic review from the Cochrane Database, a leading scientific repository, found that acupuncture did not reduce the rate of caesarean sections, nor the need for other induction methods compared to usual care.
This means that although acupuncture has demonstrated potential to positively influence the neuro-hormonal biology of labour — in other words, the way the nervous system and hormones work — the effect may not be strong enough to be clinically relevant. This makes a myth of the idea that acupuncture is effective for the induction of labour.
However, do not click away…
Acupuncture offers other excellent benefits during pregnancy and as a pre-birth treatment.
A negative emotional and physiological state before labour, including feeling stressed, anxious, hungry, thirsty, sleepless, feeling watched or disturbed may contribute to delayed labour. This occurs because stress hormones and responses interfere with oxytocin.
Musculoskeletal pain, particularly when significant, may also contribute to a negative emotional and physiological state, because pain is associated with the brain’s perception of bodily threat.
Wonderfully, research suggests that acupuncture can relieve stress and pain, and enhance sleep management during pregnancy. Improved wellbeing at or before the onset of labour may have important implications for a positive birth experience, this is great news.
Researchers have found that acupuncture administered during labour has important benefits, too. This practice reduces the use of pharmacological pain relief, increases relaxation, and provides a greater sense of control.
Acupuncture is an evidence-based, effective intervention. One that’s also natural and safe… This brings me to my next point…
ACUPUNCTURE IN PREGNANCY: A SAFE APPROACH
During pregnancy safety become a priority. One method of symptom control, say for pain or stress, might be fine when not carrying your child. But, when pregnant, a higher level of caution is rightly deserved.
So, it’s important to note that acupuncture is safe, associated with mostly minor adverse events, and could be a useful supportive treatment throughout pregnancy. We know this because of the research.
One study called Safety of acupuncture during pregnancy: a retrospective cohort study in Korea investigated 20,799 pregnant women. Some received acupuncture, some did not. There were no significant differences in delivery outcomes between the two groups; that is, preterm delivery and stillbirth rates remained the same. This means that, in pregnancy, acupuncture is a safe approach....
As the authors said, “In pregnancy, acupuncture therapy may be a safe therapeutic modality for relieving discomfort without an adverse outcome.”
Acupuncture has an excellent safety record as a supportive treatment throughout pregnancy.PREGNANCY AND ACUPUNCTURE: THE CONCLUSION
Acupuncture has been used for centuries in the East to ease the journey of pregnancy; to soothe pain, calm emotional upheaval and anxiety, aid sound sleep, lower stress, and help pregnant women to prepare for birth.
In more recent times, Western science has proven what ancient wisdom has long known. Acupuncture is a safe and effective approach for many of the challenging associated with gestation, and beyond.
If you live on, or are happy to travel to, the Gold Coast, I look forward to helping you experience a more relaxed, enjoyable, and comfortable pregnancy and birth. Book your consultation now. I look forward to supporting you on your exciting journey!
AUTHOR
Adam Hjort is a Registered Acupuncturist and member of Australian Acupuncture & Chinese Medicine Association (AACMA). He has been practicing since 2010 and maintains a clinic dedicated to the treatment of pain located in Ashmore, Gold Coast. This article was last updated 17th February 2022.
