Q: Iam 34 weeks pregnant but because my waters broke when I was 30 weeks, I will need to be induced at 36 weeks. I would like to know whether inducing labour with acupuncture could work that early. If so, can you please advise me on when is good time to start and whether I can go to any acupuncturist or shall I look for a specialist for inducing labour?
A: The issue of early induction has been the subject of some very heated debate within the profession in the last few years, brought about by a request made to a member to try to induce a birth pre-term because it would be more convenient for someone's holiday arrangements to be carrying a baby than a large bump. The issue boiled down to whether someone could exercise their own right to have a baby whenever they chose, or whether the medical team retained control of the pregnancy to birth and afterwards.
Our decision was very clear. The only basis on which our members are allowed to use acupuncture to help to facilitate or speed up the delivery process is when it is medically necessary, when the medical team are considering either a drug-driven induction or a C-section and when the medical team have given someone express permission to go ahead. In this last condition it is important that the practitioner is able to speak to the midwife or consultant directly. I'm afraid this caution is a direct result of one patient telling one of our members that the doctor had OK'd an intervention when they hadn't.
We are always a little cautious too about the evidence for acupuncture and induction of labour. It is a matter of terminology. Acupuncture treatment can facilitate or speed up a natural process, but this is not quite the same as a direct causal relationship between a specific set of points and a defined outcome. The research studies which have been done, and most of which are inconclusive or report no effect, tend to be based on formula treatments which may not be appropriate for all of the subjects in the trial.
In an earlier response to a question about the safety of acupuncture as a potential inducer of labour we wrote:
There was considerable debate inside the BAcC some years ago about whether this could or should be done independently of the medical team looking after the mother, but our view was that it is far better for all efforts to be co-ordinated at this point than to have someone operating outside the system. In our experience most conventional teams are happy for the mother to have acupuncture as a means of avoiding medical induction or C-sections, and the crucial things is that if the labour does kick in then all of the next steps are already in place for the birth to take place.
Acupuncture for the induction of labour is a very gentle process and if it works is probably a little less of a jolt to the system than drugs which tend to kick in very quickly, so we would always recommend using it first if the medical team are OK with this. Many of our members now focus their work very much on treating pregnancy and late-stage pregnancy, and checking the websites of a few BAcC members local to you will quickly reveal who has this focus and often what postgraduate training they have had in this field.
This advice still holds good. Although we do not yet recognise specialisms, we have spent a great deal of time trying to define what counts as expert practice for those members who spend most of their time working with pregnant woment and who have undertaken postgraduate training in the field. When we ahev finally agreed standards we may be able to make definite recommendations, but in the interim a google search of 'BAcC member' with 'pregnancy' and the area where you live will almost certainly generate a number of options.
We wish you a safe and happy delivery, and a healthy baby!