Imagine you are 40 weeks pregnant, give or take a few days and the text messages and phone calls start coming in: Have you had that baby yet? Are you still pregnant? When are you going to have that baby?
We are generally not patient with pregnant women in our culture. No pressure or anything, but why can’t you have this baby “on time?”
Of course this is slowly shifting as more people become informed around the outdated belief and structure of due dates. If you have yet to jump off the “due date” train, the time has come. I’m not going into that now, but you can find more information here.
What I do want to go into is how acupuncture supports women leading up to childbirth. If you haven’t read the last post I wrote around acupuncture during pregnancy, I suggest going back and reading that first. It’s a good place to start to understand how acupuncture can play a role in prenatal care.
What is labor induction?
I think we have to start by defining induction, which according to the American Congress of Obstetricians and Gynecologists (ACOG) “is the use of medications or other methods to bring on (induce) labor.”
This often happens when labor does not start on its own by a certain point in time, which is determined by both the woman and the care provider she is working with (or in many cases, the law). Labor induction methods may also be used if there is another health concern with the mother or the baby that requires delivery before 40 weeks. Ideally, in a medical context this decision is coming from a place of informed consent and compassion instead of fear and impatience.
Medical inductions do come with risks, which is why many women seek alternatives. Women may also seek support if they are attempting a VBAC (vaginal birth after cesarean) or having an out of hospital birth where certain methods for induction are not available.
What about natural ways to induce labor?
This is where it gets more interesting, well at least for me! First, I must say that inducing labor is not really a natural, physiological process in my opinion. The way I see it many induction methods are a form of intervention. That does not mean that these interventions are inherently good or bad. It just means that we should all be honest with ourselves, make informed decisions and, I might add, be curious as to why women aren’t going into labor easily on their own.
Depending on how you view the term “natural,” there are many articles and resources available for natural ways to induce uterine contractions. Some are straightforward, like walking or nipple stimulation, and some come with other inherent risks, like castor oil (which I generally do not recommend).
Acupuncture is also a common way to induce labor and the risks associated with it are low. Acupuncture does not work in the same way as common medical interventions, like cervidil or pitocin (synthetic oxytocin). This method of labor induction cannot force your body into labor or generate uterine contractions on command. It often takes more than one treatment to feel a shift in your body and notice labor signs increasing.
This is because it’s a slower process that works with the body to soften the cervix, release muscular tension in the pelvic floor, stimulate uterine contractions and regulate the nervous system. The truth is that labor begins in some form in the weeks before the onset of active labor. It’s ideal to seek acupuncture treatment during this time, especially if there are concerns about going post-term (beyond 42 weeks gestation according to ACOG).
Acupuncture for labor preparation
Problems can arise when we apply a western way of thinking to an eastern medical system. It happens. A lot. I especially notice it being applied to the topic at hand.
For example, a woman does not go into labor naturally and she is 41 weeks pregnant. She wants to have a home birth in the state of California, so by law she has to deliver before 42 weeks gestation if she is being attended by a midwife who is practicing with a license under state regulations. Her other option is to have her care transferred (and most likely have a medical induction) or have an unassisted birth.
This becomes a stressful situation pretty quickly, which is not conducive to starting labor. This is way worse than getting a few text messages from in-laws. She wants to try everything so she gets acupuncture and hopes for the best. She maybe has time to get 3 treatments in before the 42 week deadline. For some women that will be enough to push them into labor land, but for others it won’t.
The reason for that is complex. I will say that it usually has something to do with imbalances that have been present throughout the pregnancy or even before conception. It’s also important again to consider if the estimated due date is accurate.
So, let’s say this woman doesn’t go into full active labor. Then there is all kinds of doubt around if acupuncture is effective for labor progression or not. What remains unseen or unspoken is the fact that we are taking the idea and definition of a modern medical procedure and applying it to an ancient healing system. One does not equal the other. Acupuncture does not equal pitocin.
In my experience and from the knowledge that has been passed down to me, the best way to prepare a woman to go into labor physiologically is not 3-5 treatments after 40 weeks of pregnancy. As I said, yes this can work; however, it’s not an ideal situation really for anyone involved.
The best practice for women who are concerned about going post-term, is to start getting regular treatment by 36 weeks of pregnancy, if not earlier. At this point, it is not a labor induction treatment and does not include commonly used acupuncture points to induce labor. Instead, the focus turns to the mother, her baby and what is best suited for her state of well-being.
This often includes acupuncture points that regulate the autonomic nervous system and promote softening of the cervix. Furthermore, women can also get support around any challenges they have – insomnia, anxiety, sciatica, acid reflux or other aches and pains.
In this case, the acupuncturist has time to get to know this woman, offer emotional support, suggest potential lifestyle changes and teach her about acupressure points that can be used during labor. My vision is for every mother to have this kind of support as she prepares for childbirth and early mothering.
In many cases women who have been getting regular treatment will go into labor without needing to use typical labor induction points. They also often experience shorter labors and have effective labor patterns.
But really, can acupuncture induce labor?
Yes and I’m going to give you some information that supports that. This is all found in The Essential Guide to Acupuncture in Pregnancy and Childbirth.
- A study cited in this text shows that bilateral acupuncture of two commonly used points to induce labor for 20 minutes every second day from a woman’s due date promoted cervical ripening and shortened the time between a woman’s expected due date and actual delivery.
- Debra Betts includes many counts of case histories from midwives who are using routine labor preparation acupuncture. One midwife says: “I have found that the women who have had this preparatory acupuncture usually come into labor before 42 weeks gestation and have an efficient labor.”
- One study from Germany showed that women giving birth for the first time who received acupuncture for labor preparation had a shorter labor. The labor time for the control group (70 women) was 8 hours and 2 minutes, while for the group that received acupuncture (70 women) was 6 hours and 36 minutes.
Acupuncture is really supportive for the end of pregnancy and the transition into labor. It’s minimally invasive and when provided by a qualified practitioner, it has minimal risks as well.
While I remain curious as to why more and more women are not going into labor physiologically (naturally) on their own, I also remain optimistic that this ancient healing system of medicine can offer solace for women who are considered post term by the modern medical paradigm.
Take it from a first time mother that I just saw this afternoon, who is preparing for a home birth: “I don’t think acupuncture does anything forcefully. It’s a slow, comfortable process.”
Indeed, it can be just that.
If you loved this article and found it informative, please share it with midwives, birth workers, obstetricians and mothers! I would be so grateful to be able to share this information with a wider audience.
Here are a couple of resources I used for this post:
The Essential Guide to Acupuncture in Pregnancy and Childbirth by Debra Betts
Supporting the Transition from Pregnancy to Parenthood: Labor Preparation and the 8 Extras (a class taught by Dr. Yvonne Farrell and Laura Erlich)
ACOG: FAQs Labor Induction