Ask an expert - body - women's health - pregnancy

24 questions

As long as you are planning to have a natural labour for your baby and your midwifery team and specialists are not preparing you for another C-section there is nothing to stop you asking for an acupuncture practitioner to assist you in the labour as they would for any pregnancy.

We prefer not to say 'acupuncture for induction' because this implies a direct causal relationship which isn't quite how we perceive what we do. We prefer to think in terms of helping the body through the natural stages of labour as smoothly as possible. The process is a very gentle one, and carries little risk as far as we are aware. It certainly isn't going to generate sudden results. The only caution we tend to apply is checking that the facilities are ready and in place in case the process really does accelerate the labour. This is especially the case if the process kicks off over a weekend.

Although we regard ourselves as generalists obstetrics is an area where we are well advanced in our recognition of specific postgraduate training which would allow someone to lay claim to expert practice. There are four or five specialist courses which are very popular, and although we cannot name them you will find that our members who advertise themselves as specialising in working with fertility and pregnancy issues will invariably have taken this training. You can rest assured that if they have then they will have covered areas such as yours in great depth and know exactly what they are doing when treating someone with a previous C-section in their history.

We hope that all goes well for you and your baby.


There is very little risk associated with the treatment of low back pain in pregnancy. In this journal article from Acupuncture in Medicine

http://aim.bmj.com/content/acupmed/21/1-2/36.full.pdf

the house journal of the British Medical Acupuncture Society, the author makes it quite clear that low back pain in pregnancy is one of the more frequent problems addressed by acupuncture in pregnancy, alongside morning sickness and migraine. He also spells out the key risk factors, namely using some of a series of 'forbidden' points, especially during the first trimester. No properly qualified practitioner would ever use these points anyway, but it has to be said that there are very few western practitioners who needle points as vigorously as the Chinese for whom these proscriptions applied.

The treatment of back pain generally is one of the better proven uses of acupuncture (by the rather inappropriate research measures which are in the ascendant in the west). Research into the use of acupuncture for back pain in pregnancy is limited, but that which exists is largely positive. 

Although we have not yet finalised our work on specialist practice, we are looking at recognising postgraduate qualifications in obstetric acupuncture. If you are looking for a practitioner it may well be using a google search under acupuncture and pregnancy alongside your home area to identify someone who has had specialist training. There are some advantages from visiting someone who spends more time than the average practitioner treating pregnant women. We are all generalists, but there are times when a more in depth knowledge of a field of expertise is valuable.

Trigger point therapy itself is a slightly more western approach to acupuncture with slightly different diagnostic principles. In practice the needles tend to get inserted in the same place but for different reasons, but if trigger point needling is what you specifically want then you may have to check out the registers of the medical acupuncturists (BMAS and AACP) who use this technique as a stock intervention. However, we are confident that the use of traditional acupuncture would prove equally as effective, and potentially more so insofar as it looks at the performance of the whole system, not simply the presenting symptom. 

 

q:

Hi. I have a.bmi of 46.and am.currently 22 weeks pregnant and have pgp. Does bmi.effect how acupuncture works?

 

a:

We can say categorically that someone's BMI has no impact at all on whether acupuncture works. From a Chinese medicine perspective the body is seen as a complex flow of energy, called 'qi', and putting a needle into a point will have an effect whether the person's BMI is 15 or 50. Generally speaking there are often energetic reasons why someone gains a great deal of weight, over and above lifestyle considerations and straightforward heredity, and these may have an impact on how much progress someone can make, but that will all be a part of the picture which the practitioner builds up and works with.

Indeed, there is some very good evidence that acupuncture can help with PGP. Studies such as this one published in the BMJ

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC555858/ seem to be very encouraging. In fact the same researcher went on to look at whether there was any potential for harm and concluded that while there may be some minor transient effects there was no serious risk

https://www.ncbi.nlm.nih.gov/pubmed/18582370

We are by nature a generalist healthcare modality, i.e. we treat the person, not the specific problems they have. In practice, of course, we are all able to go after specific symptoms as well as balancing up the whole system, but we believe that treating a symptom without regard to the whole is leaving things half finished. This means that we regard all of our members as capable of treating any patient who comes to them. However, we are close to reaching agreement on the treatment of pregnant women as an area of expert practice for which we have recognised postgraduate training. In the circumstances it would be highly advisable to go to someone who has had this kind of training and who has spent more time looking at the specific issues of pregnancy.

Unfortunately we haven't signed this work off yet, but we are pretty sure that if you type into google your place of residence, acupuncture and pregnancy it will generate a number of hits of our members who specialise in fertility and pregnancy issues. Failing that you could always call a local BAcC member and ask them to point you towards someone locally who has these skills. We are always very keen to see patients get the exact care they need.
 

 

 

 

 

Q: I am very interested in Acupuncture.

I am 32+ weeks pregnant and I was thinking to begin acupuncture in the 37+ week. I read it can relief a lot the pain in labour and helps deliver quicker. Could you please advice me? Because it seems that midwifes and GPS don't know much about it.

A: As you can see from our factsheet on obstetrics

https://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/1592-obstetrics.html

there has been a considerable amount of research into many areas of pregnancy, from early stage morning sickness through breech presentation and on to delivery itself. While the evidence is a long way from conclusive (it does tend to be, but this is more a reflection of the standards used in the West which may not be the most appropriate for evaluating acupuncture treatment), it does show a trend towards acupuncture treatment being worth a try for many of the problems/challenges associated with pregnancy/delivery.

Although we describe ourselves as generalists - we primarily treat people, not diseases or conditions - there are one or two areas where the training which we all have can be usefully supplemented by postgraduate training. In two of the most clear-cut cases, obstetrics and paediatrics, the training is now sophisticated enough to warrant a decision on recognising expert practice, i.e. someone can legitimately claim within our rules to be an expert at treating these specific patient groups. While we are not yet yet in a position to do this, ultimately it will mean that we can specify which training people have had and point to providers who all keep lists of their graduates and affiliates. In the absence of this, the best that we can say is that if you use google and search on 'acupuncture pregnancy' and your home area you will without doubt generate a number of hits, most of whom will be BAcC members.

There are a number of websites associated with the training providers which can be very helpful, often addressing many of the questions which people bring and have brought to their practitioners. The best advice we can offer, though, is that having located a person or people in your area who may be able to help you should arrange to see them for an informal chat to see how they can help you and also to see whether they are people you feel comfortable with. In most cases we would say that one practitioner is as good as any other, but childbirth  is a very intimate process and it would be especially good if you have confidence in and rapport with the practitioner. The earlier you establish this contact the better, even though you may not call on their services until near due date.

We are sorry that there is such a dearth of provision within the NHS. There have been a few hospitals like the Derriford in Plymouth which had a remarkable unit which incorporated acupuncture in all aspects of pregnancy, but that unit, like many others, has closed. The problem for NHS professionals is that most provision is evidence based, and as we said at the top, the evidence for the benefits of treatment is not quite good enough for NHS providers to bring acupuncture treatment within mainstream care. You may find some midwives with training in the basic skills, but these are few and far between.

We hope that you do manage to locate a good practitioner locally, and wish you every happiness with your baby's birth.

Q: I am seeking a bit of advice. I suffer from migraines and acupuncture has been extremely helpful to me which was suggested by my neurologist. I am now 16 weeks pregnant and I am having another episode where I am struggling to function the same as they were 12 months ago. The physiotherapist that treated me with acupuncture previously has refused to treat me this time due to the risks of miscarriage due to where the needles should be placed. Could you advise me if this is the case and that I should avoid for the foreseeable future?

A: The BAcC has been giving advice on its website for years which says:

How can acupuncture help during pregnancy?
Many conditions which routinely crop up during pregnancy would benefit from a natural solution. Acupuncture, when provided by a trained practitioner, can give relief for a range of pregnancy related conditions:

  • Morning sickness
  • High/low blood pressure
  • Anxiety
  • Tiredness
  • Constipation
  • Tender breasts
  • Migraine and other headaches
  • Back ache
  • Pelvic pain (Symphysis Pubis Dysfunction)
  • Varicose veins

This very much reflects what Debra Betts, one of the leading acupuncture experts in the field of obstetrics says on her own website

https://acupuncture.rhizome.net.nz/acupuncture/pregnancy-childbirth/acupuncture-use-pregnancy/

The problem usually arises when people use formula acupuncture, that is a kind of 'cookbook' approach where each condition with which someone presents has a specified group of points which a practitioner can use. There are, indeed, a number of points which we avoid during pregnancy because they have a strongly downward and expulsive effect, and it is highly likely that some of these are in the cookbook which the physiotherapist is using.

However the great strength of traditional acupuncture is its self-contained and completely systematic understanding of the system which means that there are many alternative ways of addressing the imbalances in the system which are causing the migraines. This may mean that you have to seek treatment with another acupuncture practitioner, but we have always taken the view that in the hands of a properly qualified and trained practitioner there should be no risks at all in treating migraines and many other conditions during pregnancy.

There are an increasing number of BAcC members who now take specialist postgraduate training in obstetrics, and in the foreseeable future we expert to recognise them as 'expert practitioners.' When this happens we will be able to offer a list of possibilities, but for now you will find that using google and searching under 'acupuncture and pregnancy' alongside your area will generate a number of hits of our members with specialist training. These may be the best bet, because they will probably have a more in depth understanding of the energetics of pregnancy.

We mean no disrespect to the physio, by the way, but because the majority of their work is western medical acupuncture and within their scope of practice it is not surprising that they are cautious when taking on more specialist areas of practice, and for that your practitioner should be commended.

We wish you a peaceful and stress-free pregnancy, and hope that treatment brings you the relief you need. We also hope that if you do see a BAcC member with specialist training they can perhaps help you with some of the later stages of the pregnancy.

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