A new study from NICM researchers has found acupuncture may help prepare pregnant women for labour by increasing the readiness of the cervix, although more research is needed to determine if the therapy can decrease the need for medical inductions.
Induction of labour – such as membrane sweeping and the use of prostaglandins – is sometimes needed to ensure the safety of mother and baby. However, these interventions can have side effects and women may seek to avoid them.
Some pregnant women – and their midwives – look to complementary medicines and therapies as a safe and natural alternative during pregnancy and childbirth.
Early studies have suggested acupuncture is safe and potentially effective in inducing labour, however the evidence is limited.
In a recent review, researchers from NICM assessed evidence comparing acupuncture or acupressure with placebo or other labour induction methods.
The researchers examined 22 trials – ranging from low to high quality – involving 3456 women.
Participants were low risk full term pregnant women who had either never carried a pregnancy beyond 20 weeks or who had given birth once before.
The trials included manual acupuncture, laser acupuncture, electro-acupuncture, or acupressure compared to membrane sweeping, sham controls or usual care.
Treatment methods were diverse, including a mix of fixed points or flexible approaches, and the number of treatments varied from one to three or more.
Overall, the researchers found acupuncture showed some benefit to improving cervical maturity, however there was no evidence of benefit for acupuncture or acupressure to reduce the need for caesarean section. More evidence is needed to determine if acupuncture of acupressure can reduce the need for labour induction.
Professor of Clinical Research at NICM and the lead for the systematic review Caroline Smith said as more pregnant women and their carers turn to complementary medicine, it was important to examine its safety and effectiveness for both mother and baby.
“For some women with a prolonged pregnancy, an induction of labour may be perceived to intervene in the natural process of pregnancy, and may drastically change their expected plan of care during pregnancy,” Professor Smith says.
“They may seek to avoid these methods of induction, finding them uncomfortable, unacceptable, or both.”
Professor Smith, whose research focusses on women’s health and reproductive health, said to date, acupuncture has not been subjected to consistent rigorous study, however the quality of reporting seems to be improving.
“Our analysis, which follows on from a similar review we conducted in 2004, did show acupuncture and acupressure to be safe and revealed some potential benefits, however the specific timing and how many treatments remain unclear.
“The trials varied in the delivery of acupuncture and acupressure, the comparison groups, and the outcomes looked at.
“These variations mean that we have to be careful in how we interpret the findings.
“More studies are needed to determine if acupuncture or acupressure increases the number of women who experience vaginal deliveries within 24 hours, thus reducing the need for medical inductions,” she said.
The study forms part of a series review which looks at methods of cervical ripening and labour induction.
Published in the Cochrane Database of Systematic Reviews, the paper “Acupuncture or acupressure for induction of labour” is available online at http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD002962.pub4/full