Evidence
Let's explore complimentary therapy and how it can help improve your birthing experience. Evidence is super important in showing us which treatments work best. A mix of evidence from Chinese medicine and modern English studies; let's dive in and explore together!
Empowering Birth Experiences Through Holistic Care
Bright Birthing Support is committed to empowering expectant mothers with natural and holistic approaches to childbirth. Through our educational teachings in acupressure and moxibustion, we aim to create a supportive and nurturing environment for women on their journey to motherhood.
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Theories and Evidence Behind Acupressure
Chinese medicine
According to chinese medicine, the body is made up of meridian lines. Along these lines lie the acupressure points that are similar to gates, they can close and prevent 'Qi', blood and fluids from flowing. By targeting these points, they open again allowing the body to return to how it should be.
Encouraging endorphin production
Acupressure is thought to release anti-inflammatory and pain-relieving molecules, endorphins also promote the feelings of love and understanding.
Western evidence
Many researchers have investigated the effectiveness of acupressure and tried to identify how and why it works. Many studies have proven that acupressure is an effective pain relief for both active and transitional stages of labour (Smith et al., 2011; Dabiri and Shahi, 2014; Makvandi et al., 2016; Raana and Fan, 2020) with no impact on neonatal outcomes, meaning that using acupressure as a form of pain relief has no negative impact on your baby, unlike many medications. It is important that proper teaching is accomplished as it was found that sham acupressure (acupressure either in the wrong place or at the wrong pressure) had no impact on pain relief. A subsequent finding in some of the studies was that the first stage of labour was shortened with acupressure (Makvandi et al., 2016; Raana and Fan, 2020).
In terms of acupressure for non-pain relief reasons, it was found that acupressure significantly reduced the symptoms of hyperemesis gravidarum (Adlan, Chooi and Mat Adenan, 2017).
Theories and Evidence behind Moxibustion Usage
Western evidence
Moxibustion is an evidence based, non-invasive method of turning a breech baby. The exact percentage of successful rotations solely due to moxibustion ranges depending on the study, the lowest reported success rate was 73% (Vas et al., 2009) and the highest being 80% (Neri et al., 2007). Other findings showed that moxibustion was twice as likely to be successful when involving someone else in the usage, such as a partner (Manyande and Grabowska, 2009) and that it’s most effective when used at 33 weeks (Cardini and Weixin, 1998). It is recommended to be used between 33 and 35 weeks by the Royal College of Obstetricians and Gynaecologists (RCOG, 2017). The alternative option provided is typically an ECV which involves manually rotating the baby from the outside, however this carries risks of placental abruption and cord prolapse (Zanchin, 2021).
Chinese medicine
In Chinese medicine, the explanation behind moxibustion is that the burning of moxa improves the flow of qi and blood which allows the body to heal and balance itself. It simultaneously tonifies and purges the body which encourages this "returning to natural" state. The acupressure point is thought to give energy to the baby which encourages hem to have increased movements and, with sustained usage, completely turn into a head down position. Interestingly, many women report increased fetal movements after treatment.
Evidence Used...
Moxibustion
Cardini, F. and Weixin, H. (1998) ‘Moxibustion for Correction of Breech Presentation’, JAMA, 280(18), p. 1580. Available at: Moxibustion for Correction of Breech Presentation: A Randomized Controlled Trial | Pregnancy | JAMA | JAMA Network.
Manyande, A. and Grabowska, C. (2009) ‘Factors affecting the success of moxibustion in the management of a breech presentation as a preliminary treatment to external cephalic version’, Midwifery, 25(6), pp. 774–780. Available at: Factors affecting the success of moxibustion in the management of a breech presentation as a preliminary treatment to external cephalic version - ScienceDirect.
Neri, I., De Pace, V., Venturini, P. and Facchinetti, F. (2007) ‘Effects of Three Different Stimulations (Acupuncture, Moxibustion, Acupuncture Plus Moxibustion) of BL.67 Acupoint at Small Toe on Fetal Behavior of Breech Presentation’, The American Journal of Chinese Medicine, 35(01), pp. 27–33. Available at: Effects of Three Different Stimulations (Acupuncture, Moxibustion, Acupuncture Plus Moxibustion) of BL.67 Acupoint at Small Toe on Fetal Behavior of Breech Presentation | The American Journal of Chinese Medicine (worldscientific.com).
RCOG (2017) Breech baby at the end of pregnancy, RCOG. Available at: Breech baby at the end of pregnancy | RCOG
Vas, J., Aranda, J.M., Nishishinya, B., Mendez, C., Martin, M.A., Pons, J., Liu, J.P., Wang, C.Y. and Perea-Milla, E. (2009) ‘Correction of nonvertex presentation with moxibustion: a systematic review and metaanalysis’, American Journal of Obstetrics and Gynecology, 201(3), pp. 241–259. Available at: https://doi.org/10.1016/j.ajog.2008.12.026.
Acupressure
Adlan, A.-S., Chooi, K.Y. and Mat Adenan, N.A. (2017) ‘Acupressure as adjuvant treatment for the inpatient management of nausea and vomiting in early pregnancy: A double-blind randomized controlled trial’, The Journal of Obstetrics and Gynaecology Research, 43(4), pp. 662–668. Available at: https://doi.org/10.1111/jog.13269.
Dabiri, F. and Shahi, A. (2014) ‘The Effect of LI4 Acupressure on Labor Pain Intensity and Duration of Labor: A Randomized Controlled Trial’, Oman Medical Journal, 29(6), pp. 425–429. Available at: https://doi.org/10.5001/omj.2014.113.
Makvandi, S., Mirzaiinajmabadi, K., Sadeghi, R., Mahdavian, M. and Karimi, L. (2016) ‘Meta-analysis of the effect of acupressure on duration of labor and mode of delivery’, International Journal of Gynecology & Obstetrics, 135(1), pp. 5–10. Available at: https://doi.org/10.1016/j.ijgo.2016.04.017.
Raana, H.N. and Fan, X.-N. (2020) ‘The effect of acupressure on pain reduction during first stage of labour: A systematic review and meta-analysis’, Complementary Therapies in Clinical Practice, 39, p. 101126. Available at: https://doi.org/10.1016/j.ctcp.2020.101126.
Smith, C.A., Collins, C.T., Crowther, C.A. and Levett, K.M. (2011) ‘Acupuncture or acupressure for pain management in labour’, Cochrane Database of Systematic Reviews, 7. Available at: https://doi.org/10.1002/14651858.cd009232.
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