Labour Prep Acupuncture

What is labour prep acupuncture (LPA)?

LPA is an acupuncture treatment with specific acupuncture points used, beginning at 36 weeks in pregnancy, and occurring 1-2x/week until delivery. The points are located in the hands, feet, legs and additional areas as needed based on presentation and current symptoms. Electroacupuncture can be used, which involves the use of low frequency electrical stimulation to each acupuncture point to 'up the ante.' Electrical stimulation may sound scary, but it is safe, just a common technique to provide the brain with a stronger, continuous signal.

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The goal of LPA is to, as the name implies, prepare the uterus and body for birth in order to try and optimize birth outcomes. It is a more common practice

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The proposed mechanism is that when a needle activates a particular nerve, it leads to hormonal/neurotransmitter release in specific brain areas, like the hypothalamus, which then can influence target tissue function. Different points can activate different centres in the brain leading to different physiological outcomes. Acupuncture also increases parasympathetic tone in the body, which besides lowering stress, is also thought to be involved in the initiation of labour. The combination of increased parasympathetic tone and central oxytocin release from acupuncture is thought to improve/strengthen uterine contractions so influence on blood flow is yet another mechanism at play.

Benefits of LPA:

-Shortening the time of labour

-Less medical intervention (forceps, vaccuum, etc.)

-Avoiding post-term dates or induction

-Reducing post-partum bleeding

-Cervical ripening (for labour induction)

-General relief of pregnancy-related symptoms like insomnia, back pain, and depression.

What does the research show? 

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-Electro-acupuncture vs. regular acupuncture had a stronger effect on reducing rates of caesarean section, use of instruments in vaginal births, and improving spontaneous vaginal births.

--> 'Regular' acupuncture without electrostim did not decrease rates of C-sections.

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-Higher satisfaction with their birthing experience reported by moms who used acupuncture leading up to labour and delivery.

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-Less use of pain medication compared to those who don't use acupuncture *especially true when electro-acupuncture is used

--> Note: electro-acupuncture DOES not have equivalent pain reduction effects compared to an epidural. In one study, 50% of 'acupuncture-only' group for main management requested an epidural. Also noteworthy: this was use during labour, not LPA.

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-Electro-acupuncture has less side effects compared to use of pain medications (nausea, newborn breathing difficulty, maternal itching, etc.) 

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In the last several years, at least one benefit on labour outcome has been reported in randomized control trials involving acupuncture.

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General limitations around acupuncture research:

-It's very hard to have a 'control group' in these type of studies. We can't clone ourselves and then compare outcomes to not receiving acupuncture. Comparisons in studies are between groups of women who either got the intervention or didn't - not ideal.

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-Similar to above, we know there is an end date to pregnancy. Based on Evidence Based Birth (the best resource if you haven't checked it out...) 50% of women will naturally go into labour on their own by 40 weeks 5 days (first pregnancy) and 40 weeks 3 days (second pregnancy) so if we are simply just using it for avoiding post-term, it's really hard to know.

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-Pregnant women aren't common study subjects - for fear of adverse outcomes but then also openness for them to be involved in studies.

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-This is why most will say "the evidence regarding the clinical effectiveness of this technique is limited and more high quality studies are required before recommending it routinely in practice."

My Humble Opinion/Thoughts:

Having previously given birth, I can appreciate that it's an intimidating experience with a lot of unknowns. Part of it involves letting go of control and trusting your body to do the work it knows to do while experiencing some very uncomfortable sensations. I'm also the type who finds giving up control a tad scary (lol, anyone else?) So, if I know there's a chance an intervention that is feasible, safe, and can potentially lead to more favourable birth outcomes, that's very comforting for me as I value a positive birth experience so it allows me to prepare for birth with more confidence. Going into labour with confidence and believing in your body is huge for mindset, which I feel is a separate variable that likely has impact too.

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There is still a lot we don't understand about labour initiation, due dates and I acknowledge that as much as we love to try and influence outcomes, there is a bit of natural magic in the baby coming 'when they are ready.'

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At the end of the day, having a healthy baby is all that matters so LPA should definitely be seen as more of an 'add on' service if feasible and it fits your values in terms of birth outcomes vs. an absolute requirement or something that should be done in pregnancy.

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How to schedule:

More questions? Book HERE for a 15min complimentary consult.

To get started, Book HERE to access schedule to online booking - I'm available in Bracebridge on Tuesdays and Thursdays.

Cost:

If you aren't a patient, I require an Initial Acupuncture/Cupping appointment: 1hr for $150. Note, this is billed as a Naturopathic Medicine Service (not Acupuncture) and be covered by many extended health insurance plans

Otherwise, 30min appointments are $75. It's recommended to do 1-2x/week starting at 36 weeks until labour.

Resources:

https://evidencebasedbirth.com/evidence-on-due-dates/#:~:text=25%25%20gave%20birth%20by%2037,and%20zero%20days%20after%20ovulation

https://evidencebasedbirth.com/acupuncture-and-acupressure-for-pain-relief-during-labor/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6953318/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6795272/

https://www.hindawi.com/journals/ecam/2014/672508/

https://acupuncture.rhizome.net.nz/media/cms_page_media/146/Prebirth%20Acupuncture.pdf

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