Acupuncture as an alternative to an epidural for labor pain (Study)

Acupuncture is often used at varying stages of pregnancy and the birthing process.  Commonly treated conditions include morning sickness, back pain, breech position and aiding with labor itself (among many others).

There are a number of studies that have established the effectiveness of acupuncture for pain reduction generally and for pain reduction and labor promotion specifically.  The study I'm discussing today looked at the effectiveness of a specific protocol in the reduction of labor pain to see if it can be limited without side effects to mother or baby.

Epidurals are commonly used in the US, fairly well used in western europe and used less elsewhere.  While the statistics vary even from state to state in the US, generally epidurals during labor are used in at least 80% of deliveries in the US, ~60% in Canada, ~35% in the UK.  They are generally considered safe, but there are both potential complications and they may slow delivery.  So in the US where so many women simply have scheduled c-sections and perhaps don't even consider trying a natural childbirth the epidural rates are higher and then in other countries with more natural childbirths and/or medical systems that can't or won't pay for "unnecessary" medications they are less commonly used.

It might be worthwhile to explore why you would want to go without the epidural.  To start, in many places they may simply not be available or affordable whereas acupuncture is far more cost effective.  Then there are the women who would like to have completely natural childbirths for any number of their own reasons.  These two reasons are important enough to pursue alternatives.

But what about side effects of an epidural?  The most commonly described issues are described below:

• Your epidural may make pushing more difficult requiring further medications and/or procedures to help move delivery along.
• You may experience significant blood pressure drops which can both provide less energy to muscles to push and perhaps more importantly to your baby.
• General side effects such as headache, back pain, shivering, tinnitus, problems urinating and/or with feeling in the bottom part of your body and legs.
• In very rare cases, permanent nerve damage is possible.

Potential issues for your baby from your epidural:

• Your baby may have more difficulty latching on initially.  Which is an important part of the bonding experience.
• Other issues may be respiratory distress, heart rate variability, malpositioning due to not moving as well (thus increasing the chances for other medical interventions).

In general if you are going to attempt a natural childbirth (i.e. non c-section), it is best to avoid the epidural.  Training such as that provided by in bradley method classes, as an example among many others, can be very helpful to better prepare the mother (and father) for the birthing process and to better explain how and why to be your own advocate in the process of childbirth.

But what if there is pain and the methods you have used to help are not providing enough help?  This is where acupuncture fits in...

As the usefulness for pain reduction during labor is already established, this study is discussing a specific protocol utilizing electroacupuncture (EA).  Publishing in the Chinese Acupuncture & Moxibustion journal, researchers from China recruited 84 woman who had no contraindications for a vaginal delivery.  They evenly divided them into a control and a treatment group.  The treatment group received acupuncture at ST 36 and electroacupuncture at LI 4 and SP 6.  Treatment was offered until the cervix was opened at transition was started.  Treatment continued into the second stage of labor and the analgesic effect was measured as well as notation of any side effects.

The researchers found that at all points of measurement and at all stages of labor the measure of pain was lower in the treatment group than in the control group.  There were no significant differences in the time of labor stages, transition, etc.  This aspect is important as besides major side effects this shows you are able to obtain pain reduction without slowing delivery as you often do with epidurals.

The researchers concluded that this protocol, "effectively alleviates labor pain and has no maternal and child complications."

While it may be a number of years before acupuncturists are commonly seen in the delivery rooms across the US and other countries.  It is nice to know that if women start to trend back towards more natural childbirth that there are options that are safe and cost effective that can ease the process.  The use of these techniques will simply be if people demand their use instead of following the modus operandi of western medicine.  While western medicine is an amazing option to have when things go completely wrong, it is arguably overused in the process of childbirth.