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

24 questions

Q:  I am currently receiving acupunture treatment for fertility and I found out I am pregnant 2 weeks ago. My acupunturist strongly advised that I do not go on my hoilday next week (2 hour flight) due to flying. Is it the general concensus among acupunturists that flying is not safe in early pregnancy?

 

A: There is no medical evidence that flying in the early stages of pregnancy causes any problems for either the mother or the foetus, and most airlines only start to become cautious if the return flight takes place in the later stages of pregnancy. The website of the Royal College of Obstetricians and Gynaecologists is one authoritative source to which you can refer. 
 
http://www.rcog.org.uk/air-travel-and-pregnancy-information-for-you
 
There are a number of practitioners who dedicate their time to working with women either trying to get pregnant or managing their pregnancy and labour with acupuncture, and some run training courses which are intended to pass on their knowledge and experience to other practitioners. One such practitioner makes recommendations to avoid flying
 
http://babyworld.co.uk/2011/07/early-pregnancy-by-zita-west/
 
and if your practitioner was trained by her it is quite possible that this is where the injunction came from. You will see from her words on the subject, though, that her primary concern is the radiation, and she is ready to admit that there is no scientific evidence to support the stance.
 
We obviously cannot give you specific advice because we have no knowledge of your individual case, but we can say that there is no general consensus amongst acupuncturists that flying in the very early stages of pregnancy is to be avoided.
 

Q. I am a student midwife and have been tasked with presenting information on the use of acupuncture for pain relief in labour. I am particularly keen to find out whether an acupuncturist would be likely to consider accompanying a woman into hospital for this purpose and whether the woman would have to remain still. Also how do acupuncturists normally manage their sharps.

Any help would be much appreciated.

 

A.  An increasing number of BAcC members now attend births at the mother's request to help her through the stages of the delivery. Most hospitals seem to be reasonably relaxed about this, and as long as the practitioner has the consent of the consultant or the midwife in charge, and of the mother, of course, it is simply a matter of doing one's job and keeping out of the way at key moments.

 

The mother does not have to remain completely still, but there will clearly be limitations on how much movement is acceptable when needles are in place, and a delicate calculation of how many needles constitute a safe amount when the labour speeds up. Rather than set somewhat arbitrary guidelines or rules for this, we leave it up to the practitioner to assess the situation and make their own professional judgement about what it is best to do. For most, less is more at this critical time.

 

All needles used now are single-use and disposable, and the majority of members use yellow sharp's boxes within their clinics for the disposal of needles and small items of clinic waste. These boxes are collected by regsitered carriers when they are three quarters full, and there are very clear guidelines which we expect members to follow. There are also very clear guidelines for using smaller transportable sharps boxes in the event that the practitioner treats away frmom their normal base.

 

You may also be interested in the (10 minute) video of BAcC member Sarah Budd at the recent ARRC symposium entitled "Maternity acupuncture in the NHS : a "MYMOP" audit" which deals with pain relief.

The BAcC's factsheet on nausea and vomiting makes the point that the research studies on the effectiveness of using acupuncture to deal with morning sickness are equivocal and need to be of better quality in order for it to be able to say without qualification that acupuncture can benefit in the case of morning sickness. Anecdotally we hear many, many stories and testimonials of how well acupuncture has been able to bring morning sickness under control, but there are a number of problems associated with setting up proper trials which mean that evidence of sufficient quality does not yet exist.

 

That said, one of the early papers produced by Dundee et al well over a decade ago

 

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1291716/pdf/jrsocmed00159-0026.pdf

 

seemed to show that acupressure on a point very commonly used in acupuncture treatment seemed to relieve symptoms for over eight hours. Many women purchase and use the anti-sea sickness bands from their chemists as a way of self-treating, and as long as the care team is aware that there is a problem and that you are using something like this to help control it then all is well.

 

The only concern which we have is that occasionally patients have such faith that treatment will work that they stick with it long after they should have sought further medical help - it is very easy to become severely dehydrated and require to be on a drip, especially in severe cases where it is difficult to keep anything down.

 

As far as safety is concerned, the points commonly used to treat morning sickness do not represent any risk to the mother or baby. There are one or two points which are contra-indicated for this stage of the pregnancy, but aside from the fact that very few British practitioners will be using techniques vigorous enough to be a risk, all BAcC members are carefully trained in the knowledge of which points are to be avoided in pregnancy and other conditions.

 

Q. I am 37 weeks + 5 days pregnant and hope to deliver vaginally. However, my baby is breech, with a nuchal cord (x1), and I am RH negative. I want to do moxibustion to try to get baby to flip, but am worried about the possibility of negative side effects, such as placenta abruption or possibly tightening the cord. I have already done one session of moxi (at home) thinking it was safe, but as I search deeper online, I find that some say not to do it if the mother is RH negative.

Any insight would be much appreciated,

Thx!

 

A. Our advice to members is certainly that Rh negativity is one of a number of conditions where we would strongly advise that they do not use moxibustion to attempt to turn a baby in the breech position. There might also be some concerns about using moxibustion at such a late stage in the pregancy.

 

 

In any case such as this our advice to members is to be guided by the midwife or consultant obstetrician in charge of the case. If they are happy for you to continue to use moxibustion, then that would based on their own clinical judgment. If they came to us for advice, however, they would be told what we have told you, advice which was put together by an expert working group of members trained both as acupuncturists and midwives, that we would not recommend to use of moxibustion in this case.

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