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Welcome to pain relief options during childbirth

Acupuncture


Bhavani Shankar Kodali MD, Associate Professor

Karl Frindrich MD, Clinical Fellow

Acupuncture has been used for thousands of years to assist with pain control, addiction, nausea/vomiting and many other purported uses. There have not been very many good studies to date of the effectiveness of acupuncture regarding pain control in labor. In theory, there are more than 365 points along the 12 'meridians' (energy paths) of the body. Interruptions of energy flow (surgery, labor, etc.) along meridians breaks up the harmony of the body producing feelings of pain or uneasiness. Very fine needles are placed at specific points to redirect energy to correct paths that have been interrupted by surgery or labor. Modern sciences hypothesis of how acupuncture works includes the interruption or inhibition of pain impulses sent to the brain or the stimulation of natural painkiller production by the body. 

Techniqur

Very fine sterile needles are placed just under the skin at strategic points along the body by a trained acupuncture professional. These needles are left in place for varied amounts of time and are often connected to a small electrical current to assist in pain control. Acupuncture may be done for several weeks prior to delivery in weekly hour long sessions. 

Limitations 

  • Needles need to be placed by a acupuncture professional 

  • Risk of infection at needle site 

  • Placement in labor may limit the mobility of the mother 

  • Some studies indicate acupuncture might be more effective for nausea and vomiting of labor than pain relief 

  • Acupuncture has not been shown to decrease the utilization of pain medications or regional anesthesia 

While most studies have shown no difference in the production of endorphins (natural painkillers) some suggest there is a shortened 1st stage of labor when acupuncture is administered over multiple sessions several weeks before birth. The reported shorter 1st stage of labor could be inaccurate as these studies were not consistent in measuring the 1st stage of labor. Therefore, better studies need to be done to clear up this question. 

In a recent Swedish study, acupuncture was administered by midwives who had gone through a 4-day course on the use of acupuncture during labor. This study found that "women who received acupuncture were half as likely to request an epidural during labor, and less likely to ask for other types of pain relief, such as nerve stimulation therapy or a warm rice bag. However, the treatment appeared to have no significant effect on how much pain the women said they were feeling, according to the report in a recent issue of the British Journal of Obstetrics and Gynaecology." 

The above information was obtained from the following publications. If you would like more information on acupuncture we suggest reading the papers and discussing this with your obstetrician. 

Gorski T. Does Acupuncture Affect Labor and Delivery? Sci Rev Alt Med 3(1):42-45, 1999. (c) 1999 Prometheus Books 

Ramnero A, Hanson U, Kihlgren M. Acupuncture treatment during labour--a randomised controlled trial. BJOG (England), Jun 2002, 109(6) p637-44 

Eappen S, Robbins D. Nonpharmacological means of pain relief for labor and delivery, Int Anesthesiol Clini. 2002 Fall; 40(4): 103-14, Review 

Murray Enkin, A Guide to Effective Care in Pregnancy and Childbirth, 3rd Ed., Oxford University Press, 2000

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