Between 29-32 weeks 15% of all babies will be in a breech position. This means that the baby is presenting with its buttock, knees or feet pointing down. Only 3-4% of these presentations will stay in this position until labor.
As such breech presentation is considered normal in preterm pregnancies and is not generally medically diagnosed until the last few weeks of pregnancy.
While the majority of breech babies turn spontaneously before birth, the longer a baby stays in the breech position with conditions becoming more cramped, the less likely it will be to turn of its own volition.
Vaginal birth for a breech baby is uncommon as the skills to assist women have been lost. Most doctors recommend a caesaran birth for breech babies.
The remedy for this situation is to find an effective way of turning the baby quickly and safely to the physiological desirable head down position.
By the time women present at a Traditional Chinese Medicine (TCM) clinic they are usually at a crossroads. If their baby remains in breech position, their freedom of choice around birthing options is dramatically reduced and the time to turn the baby naturally is fast running out.
Moxibustion is an externally applied TCM treatment using a Chinese herb called Moxa (Artemisia argyi), commonly known as ‘Mugwort’. For external use, Moxa is compressed and rolled into a cigar-shaped herbal stick. Moxa sticks are then lit and held over acupuncture points. The radiant heat produced has the effect of stimulating the point.
During a TCM consultation to turn a breech baby the practitioner will take a comprehensive case history, make a diagnosis and apply the appropriate acupuncture treatment. They will assess if moxibustion might be helpful.
Practitioners will then instruct women on how to locate the appropriate acupuncture points and demonstrate how to safely apply moxa at home.
The acupuncture point UB 67 is the primary point selected for use because it is the most dynamic point to activate the uterus. Its forte is in turning malpositioned babies. It is located on the outer, lower edge of both little toenails.
I have found Chinese medicine to be ideal for use during pregnancy and childbirth, as it offers a safe, easy-to-administer and inexpensive treatment for women. Because of the high potential for side effects from modern western pharmaceuticals and the importance of quality pregnancy health care, many doulas, midwives and expectant mothers find it to be an effective alternative.
As an acupuncturist, I can treat a woman during pregnancy without causing harm to the mother or baby. Because acupuncture can be deeply relaxing, the pregnant woman often falls asleep during a treatment and enjoys a much-needed rest.
Massage during pregnancy is also used in Chinese medicine to relax the woman and aid balance and flow of qi in the body. Different types of massage can be administered without harming to the mother or baby, for example, reflexology. Stagnation of a woman’s qi and blood typically slows the process of labor and can make it more painful during pregnancy. Acupuncture acts to move more qi and blood through the body, thereby clearing stagnation and allowing for an easier and shorter labor.
Other conditions that I treat with acupuncture during pregnancy include nausea, heartburn, headaches, constipation, hemorrhoids, and backache. Acupuncture is also effective for turning breech presentations, inducing labor, reducing the discomfort of contractions, and helping to expel the placenta. While acupuncture can only manipulate qi that is already available in the body, moxibustion, the burning of the dried herb mugwort on or over various acupuncture points of the body, adds qi to the body. This makes it the treatment of choice for breech presentation when used during the final month of pregnancy.
Since moxibustion does not require needles, midwives and doulas can be easily trained in its application. Benefits of moxibustion in pregnancy health care include a decrease in the number of breech births and their complications, as well as potential reductions in the cesarean section rate. Pain medication and epidurals often make a woman drowsy, limit her mobility, slow down labor, lower blood pressure, and depress normal fetal respiration. Acupuncture can be an effective alternative for relieving pain during labor without these side effects. Ear points are often used, allowing the woman more mobility. The effects usually occur within 10-20 minutes. As the woman becomes more calm and relaxed, she is better able to cope with contractions, though she can still feel them.
Some of the most common postpartum difficulties I have treated with Chinese medicine include insomnia, fainting or dizziness, abdominal pain, depression, fatigue, constipation, incontinence, or insufficient lactation.
Chinese medicine is also useful for infants. In Chinese medicine, they are understood as immature both physically and functionally. Most of the common pediatric complaints are due to this immaturity. Chinese medicine holds that, because infant’s bodies are immature, and therefore inherently weak, they are susceptible to diseases which affect the lungs, the spleen (digestion) and the liver. This explains why infants often have colds, coughs, colic, vomiting, diarrhea, indigestion, and stomachaches. Generally, needles are not used with infants and small children. Instead, a japanese style of pediatric acupuncture, shonishin, which involves scrapers, combs, rollers, and brushes, is used to stimulate various acupuncture points and channels at the surface of the child’s body. This technique stimulates and balances the child’s qi without actually piercing the skin. Children typically love this treatment since it is soothing and comfortable, and I use it in combination with pediatric tui na, where areas of the baby’s body are rocked, gently pushed or kneaded.
Despite your best efforts, building a family sometimes requires outside help. Maybe you are not ovulating or your partner’s sperm numbers are low. Whatever the reasons, you aren’t alone. Many other European women will seek fertility treatment during their reproductive years, and surveys suggest one-half add acupuncture to support their conventional treatments.
1. Acupuncture improves blood flow.
One of the first orders of business in supporting reproduction is to ensure your reproductive organs are receiving adequate nourishment. Stress and/or aging can lead to a decline in blood flow to the uterus and ovaries. Acupuncture can increase blood flow by slowing down the nervous system (central sympathetic nervous system) which then causes the blood vessels to dilate. When the vessels dilate, they release a flood of nutrient-dense blood to the ovaries and uterus. Increased ovarian blood flow may help with response to fertility medications. Increased uterine blood flow ensures a thick uterine lining and sets up an ideal environment for implantation. Better response, better eggs, better lining.
2. Acupuncture reduces stress.
Couples undergoing fertility treatments experience immense amounts of stress. It is a common reason for stopping treatment altogether. Acupuncture can help reduce the stress. Research shows that when needles are placed in the skin, the body releases its own natural pain killers (endorphins). Endorphins are responsible for the relaxed feeling one gets after a session. It causes your muscles to relax, your breathing to slow, and your mind to calm. This blissful benefit from acupuncture was cited by IVF patients as helping them feel more relaxed during their fertility treatment, and as a result, many also feel more “in control.”
The ultimate goal is to have a healthy mother and baby and to give yourself the best chance of success. The acupuncture and IVF research is a little confusing, even after consulting two of the larger analyses, from Mannheimer, and Cheong, respectively. In some studies, acupuncture performed on the day the embryo is placed back in the uterus improved pregnancy rates when compared to a control, while in other studies investigators saw no difference in pregnancy rates. How can we explain this? I think we are looking at the wrong “dose” of acupuncture. Just like the amount of gonadotropins is important to ensuring egg development, so is the dose of acupuncture.
If you are interested in adding acupuncture to your IVF cycle, ask your doctor for a referral. If your doctor doesn’t have a referral or you have your own, ask your acupuncturist about their level of training and experience in treating fertility patients. They should be able to describe their cases and successes with you, and if they have not established a relationship with your doctor, they should be willing to do so.
At your initial acupuncture consultation, you can expect a review of your medical history including your blood work and tests, gynecological history, review of your partner’s sperm analysis, an interview including a thorough review of systems, and physical exams that include observing the tongue and palpating the wrist pulses. Chinese medicine practitioners will evaluate you based on the system of Chinese medicine and a treatment plan will be made. You can start treatment anytime, but at a minimum, start acupuncture treatment during suppression for the best outcomes.