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Can Acupuncture Induce Labor?

Can Acupuncture Induce Labor?

Two studies have demonstrated positive results when acupuncture was used to induce labor in women with naturally ruptured membranes.  Two studies have demonstrated negative results when acupuncture was used to induce post term pregnancies.  One meta analysis reviewing all of the literature concluded that this alternative treatment looks promising.

If you are researching the effectiveness of acupuncture to induce labor, you have likely been told by your physician that you may need to be induced.  The unfortunate answer is that though acupuncture has been effective in a few case studies, it is not yet recognized as an alternative to being medically induced through conventional means.

Inducing Labor Is Not a Casual Affair

Other than inducing labor for medical reasons under the strict supervision of a healthcare professional, it is not healthy for you or the baby to attempt to start the progression of your pregnancy.  It is healthier for both baby and mother to allow labor to begin and progress on its own.  The beginning of labor signifies that the baby has matured fully and is ready to be born and that the mother’s body is ready to begin labor. (You can read all of the reasons why you should not try to self-induce labor prematurely in Lamaze International’s paper titled “Let Labor Begin On Its Own”)

Why Induce Labor?

There are times when inducing labor is a medical necessity and in some cases, is even a life-saving procedure for mother, baby, or even both.

Ruptured Membrane: Once the membranes rupture, the common management goal is to achieve birth within 24 hours due to the risk of infection to mother and child as labor progresses.  Following the rupture of membranes, if labor is not progressing, physicians sometimes opt to induce labor to decrease this risk. [1]

Post-Term: A pregnancy that progresses beyond 42 weeks is called post-term.  Though there are greater risks to mother and child when a pregnancy continues past 42 weeks, in many cases, the due date may have been miscalculated.  Post-term pregnancies are carefully monitored by physicians, and there are cases when it may become a medical necessity to induce labor. [2]

Health Factors: You may have health factors that put you or your baby at risk such as diabetes or high blood pressure. [3]

Why Is There a Need for An Alternative to Standard Methods?

For those that are medically induced with standard methods of prostaglandins used to soften the cervix, and Pitocin used to induce contractions, the idea that acupuncture may be an alternative is a welcome relief.  Medications given to artificially induce contractions usually cause them to peak sooner and last longer than normal contractions, which equates to more pain for the mother.  Studies also show that women who are induced are twice as likely to need a c-section than those who are not. [4]

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New studies reveal that acupuncture may help alleviate back pain associated with pregnancy.

Studies Show Promise

A Norway study demonstrated positive results when they measured the use of acupuncture treatments following spontaneous rupture of membranes at term in 100 pregnant women.   As noted earlier, if delivery doesn’t progress following ruptured membranes, medical induction may be necessary.  The researchers found that among 100 pregnant women, the group receiving the acupuncture treatments and significantly reduced labor durations as well as a significant reduction in the need for oxytocin to augment labor.  Those that did require medical induction had a significantly shorter duration of active phase than those induced that had not received acupuncture treatments.  [5]

A much smaller Canadian study involving 16 pregnant women demonstrated similar results. [6]

Others Not As Confident

Two separate studies have demonstrated negative results when measuring the effectiveness of acupuncture on labor induction.  An Australian study measured acupuncture’s effectiveness of naturally inducing labor in women who were post-term and scheduled for post-term induction. Three hundred and sixty-four women received two acupuncture or two sham acupuncture sessions during the two-day period prior to their scheduled medical inductions.  They concluded that acupuncture did not reduce the need for medical induction or did not lessen the duration of labor. [7]

A similar Danish study, with 125 post-term participants, yielded similar results. [8]

What Does It All Mean?

So what does one do with all of these contradictory results—a meta-analysis of course.  A group of Australian researchers reviewed all of the existing scientific evidence on the potential role of acupuncture on induction of labor during pregnancy and concluded that though its definitive role has yet to be established, the existing studies suggest its benefit. [9]

Could it be that acupuncture may be an alternative treatment for those women that have had membranes rupture naturally but labor is not progressing?  More studies will be needed to substantiate that claim.

If you are scheduled to be induced, talk to your doctor about visiting an acupuncturist versed in inducing labor.  Who knows, you may just be one of the lucky who finds that it is an effective treatment.

 

 

Resources

[1] Marowitz, Amy CNM; Journal of Midwifery & Women’s Health
Management of Ruptured Membranes at Term
2004; Volume: 49; No: 6 [MedScape]

In this case study, Marowitz discusses at length the common factors that are considered when forming a case management plan for a delivery involving ruptured membranes.  She points out that there are important factors other than the duration of the rupture when considering risk of infection such as number of internal examinations, use of internal monitoring, maternal group B streptococcus status, presence of meconium in the amniotic fluid, and onset of labor, length of labor, and mode of delivery.

 

[2] National Institutes of Health Medline Plus
When You Pass Your Due Date
http://www.nlm.nih.gov/medlineplus/ency/patientinstructions/000515.htm

NIH’s Medline Plus cites several risk factors to mother and child in post-term pregnancies such as the child growing too large creating the need for a C-section, trouble with the placenta decreasing the oxygen and nutrients given to the baby, and the amount of amniotic fluid may decrease. On a side note, studies have demonstrated that because it is extremely difficult to determine a baby’s size prior to birth, induction actually increases the risk for a c-section, not decreases.  (Horrigan, 2001)

 

[3]American College of Obstetricians and Gynecologists [ACOG]. (2004). ACOG Practice Bulletin No. 55: Management of postterm pregnancy. Obstetrics and Gynecology, 104(3), 639–646. http://www.guideline.gov/content.aspx?id=10917

 

[4]Glantz, J. C. (2005). Elective induction vs. spontaneous labor associations and outcomes. The Journal of Reproductive Medicine, 50(4), 235–240. http://www.ncbi.nlm.nih.gov/pubmed/15916205

 

[5] Gaudernack, LC; Acta Obstet Gynecol Scand
Acupuncture administered after spontaneous rupture of membranes at term significantly reduces the length of birth and use of oxytocin. A randomized controlled trial.
2006; Volume: 85; No: 11; pp:1348-53 [PubMed]

 

[6] Gaudet LM; J Obstet Gynaecol Can.
Effectiveness of acupuncture for the initiation of labour at term: a pilot randomized controlled trial.
2008; Volume: 30; No: 12; pp: 1118-23 [PubMed]

 

[7] Smith, CA; Obstet Gynecol
Acupuncture to induce labor: a randomized controlled trial.
2008; Volume: 112; No: 5; pp: 1067-74 [PubMed]

Unlike the Danish study, the women in this study group were all scheduled for post-term induction, which makes them different candidates than those that had already had naturally ruptured membranes signifying the commencement of labor.

 

[8] Modlock J; British Journal of Obstetrics and Gynecology
Acupuncture for the induction of labour: a double-blind randomized controlled study
2010; Volume: 117; No: 10; pp:1255-61 [PubMed]

 

[9] Lim, CE; Journal of Alternative Complementary Medicine
Effect of acupuncture on induction of labor
2009; Volume: 15; No: 11; pp: 1209-14 [PubMed]

This meta analysis reviewed 10 studies that all demonstrated labor induction through acupuncture.

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