How Acupuncture Can Help During your Third Trimester and during Birth

As an acupuncturist who often works with pregnant patients, I have at times been amazed by the significant physical and emotional shifts acupuncture and Traditional Chinese Medicine modalities can make. The positive impact of acupuncture during the third trimester and labor can be truly remarkable. I’ve seen a case of severe sciatic pain that resolved after only one session; a tense, anxious mom who walked out relaxed and laughing. So many breech or transverse babies who ended up turning into the vertex (head down position), that I’ve lost count!

While it’s not always an immediate, dramatic change, even the subtle, more gradual shifts are wonderful to see and appreciated by my patients. Patients tell me that they love having a practitioner they can see for regular care and support throughout pregnancy. Here are some of the ways acupuncture and Traditional Chinese Medicine can support you during your third trimester and your baby’s birth.

Week 33-34 
Focus on Optimal Positioning- Breech or Transverse Babies

Around weeks 33-34, your care provider is likely to determine the position of your baby. If they are breech (butt first) or transverse (laying sideways), this is the best time to try and signal them to turn to head-down. At this point most babies who would turn on their own already have, but with a gentle nudge in the right direction babies can turn since they’re still small enough that there’s plenty of room for maneuvering. Acupuncture plus moxibustion (burning a stick of mugwort herb over an acupoint on the pinky toe) has been shown to help babies turn into the ideal position for birth. For pregnant people who want to have a vaginal birth and who prefer to avoid or use an ECV (external cephalic version) procedure as a last resort, acupuncture plus moxa can be a good option to explore.

OB’s and midwives routinely recommend this to their patients and some studies show good success rates. One recent patient of mine used this technique twice successfully, turning her breech baby at 34 weeks (in both pregnancies!)

This technique can be used up to about 38.5 weeks, keeping in mind that success rates go down later in pregnancy because there is less room for the baby to maneuver. All people, especially those with twins, should check in with their care provider first to make sure that acupuncture for turning the baby is indicated.

Weeks 36-37
Acupuncture for Labor Preparation

I am a huge proponent of what’s called Labor Preparation Acupuncture, and feel it’s an especially good idea if it’s your first pregnancy (you’re more likely to go past your due date) or you’ve been dealing with pregnancy issues such as lower back or pelvic pain, digestive problems, fatigue, swelling or anxiety and/or depression. During labor preparation treatments, your acupuncturist can address any of these concerns. When these symptoms are reduced, you should have more stamina for the birth and feel better. 
Starting around week 36, I encourage pregnant people to begin having one or two treatments per week to also focus on optimizing baby’s position, increasing your body’s own release of oxytocin and stimulating points for cervical maturity. You can continue the effects of the treatment at home by using certain acupressure points.

The research supports this approach too! A study in the British Medical Journal showed that a combination of acupuncture, acupressure and other mind/body techniques decreased c-sections, epidural use, labor augmentation using artificial methods and decreased the rate of babies’ needing resuscitation. A 2017 Cochrane Review found that “Acupuncture showed some benefit in improving cervical maturity, however, more well-designed trials are needed."

In an ideal world, labor preparation treatments are preferred, as opposed to suddenly using  a few closely spaced treatments to try and induce labor at week 40. But maybe you’re 40+ weeks and reading about acupuncture for the first time! A last-minute appointment will still have many benefits.

Week 39+
Focus on “Labor Induction” or Continued Labor Preparation

Can acupuncture really start contractions and help you avoid induction? It depends. Although I’m not a fan of the term “Labor Induction Acupuncture” (It’s not Pitocin after all!), there are certain acupuncture points that can cause uterine contractions and help initiate active labor. However, I only use these points on patients whose bodies are ready for that to happen. The baby is low, their position is good (head is down and putting pressure on the cervix), and (if your OB or midwife is doing cervix checks) there is some dilation and effacement already present. If a pregnant person is approaching or is past their due date and all of these things are in place, sometimes the acupuncture is all it takes to help set the labor process into motion and it can work beautifully!

But what if your baby is still high in the pelvis and there are no cervical changes? In this situation I’ve found that doing acupuncture points that cause contractions usually don’t help much. Or, contractions might begin but then nothing productive ends up happening because the cervix needs to be soft and effaced before efficient contractions can occur. So instead of stimulating the points that create contractions, I focus more on points that help with optimal positioning of your baby, cervical maturity and oxytocin production. This can help to create the shifts needed for you to either go into labor on your own or help you adapt more easily if you are medically induced.

During Labor
Focus on Pain Relief, Efficient Contractions and Dilation and Optimal Position (Again!)

Did you know that acupuncture during labor and delivery is commonly performed by midwives in the hospitals of Germany and in Scandanavian countries? It’s not easy to find a hospital in the US that offers it (or for home births, experienced acupuncturists who will attend), but you don’t have to. Acupressure has powerful benefits on its own (see this review of studies)- there’s a good reason why most doulas have some training in it! An acupuncturist who specializes in perinatal care will be able to teach you and your partner which points to use.

The Take-Home Message

Acupuncture and other modalities within Traditional Chinese Medicine (TCM) are very safe and can be a valuable part of your pregnancy wellbeing plan. When you receive support throughout pregnancy from your community and have the help of a team including (but not limited to!) acupuncturists, childbirth educators, doulas and a midwife or OB with a track record of low intervention births, you are positioning yourself for an empowering birth.

Susan Wallmeyer is a Licensed Acupuncturist and founder of NY Chi Acupuncture, a practice in the Chelsea/Flatiron neighborhood of Manhattan focused on women’s health and wellness. In practice over a decade, she has completed an additional two years of specialized training in perinatal care.