Pregnancy: The use of maternity acupuncture within a New Zealand public hospital 2018-08-30T04:55:32+00:00

The use of maternity acupuncture within a New Zealand public hospital: Integration within an outpatient clinic.

Debra Betts A, B RN, BHSc, PhD • Jo McMullan C RCpN, BM, DPH • Leonie Walker D PhD, Dip Ac, MBAC

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The use of acupuncture for a wide range of conditions related to pregnancy is detailed in acupuncture text books (Betts, 2006; Maciocia, 1998; West, 2001). There is a growing interest from pregnant women in seeking acupuncture as a treatment (Adams, Sibbritt & Lui, 2011; Steel et al., 2012) and a willingness from Western health practitioners to refer pregnant women (Stewart, Pallivalappila, Shetty, Pande, & Mclay, 2014). In addition to their seeking private treatment, acupuncture is also available to women in selected United Kingdom maternity units (Yelland, 2005). Acupuncture treatment in pregnancy is provided by midwives in hospitals throughout Denmark, Finland, Germany, Norway, Sweden and Switzerland (Mårtensson, Kvist, & Hermansson, 2009; Roemer, 2005). A recent review evaluated acupuncture during pregnancy and labour as safe when administered by a suitably qualified practitioner (Park, Youngjoo, White, & Hyangsook, 2014).

There is some evidence that acupuncture is beneficial in pregnancy. This includes beneficial reduction in pregnancy-related pelvic pain (Liddle & Pennick, 2015). The largest randomised controlled trial (RCT) to date to assess the effect of acupuncture for pelvic pain involved 386 women receiving either standard treatment (pelvic belt and home exercises) alone, standard treatment plus acupuncture, or standard treatment plus physiotherapy stabilising exercises. The authors reported acupuncture as the treatment of choice for one-sided sacroiliac pain, one-sided sacroiliac pain combined with symphysis pubis pain and doubled-sided sacroiliac pain (Elden, Ladfors, Fagevik Olsen, Ostaard, & Hagberg, 2005). Acupuncture has also been reported as beneficial for treatment of nausea in pregnancy. The largest RCT to date of 593 women reported a faster response in nausea reduction and improved quality of life for those women receiving individualised acupuncture treatment compared to a single, universally accessed acupuncture point, sham treatment, or no treatment (Smith, Crowther, & Beilby, 2002). Beneficial effects for women diagnosed with depression during pregnancy have also been reported (Manber et al., 2010). Acupressure and acupuncture may also help relieve labour pain (Smith, Collins, Crowther, & Levett, 2011). There is no quality evidence that acupuncture improves labour outcomes when used as an induction treatment prior to a medical induction of labour (Smith, Crowther, & Grant, 2013). However, the use of acupuncture over several weeks from 36 weeks gestation in one study reduced labour time and medical intervention (Romer, Weigel, Zieger, & Melchart, 2000). The use of moxibustion (providing heat over acupuncture points through a moxa stick) has been reported as beneficial over usual care for breech presentation at 34 weeks (Cardini & Weixin, 1998) and is listed as a possible treatment in the New Zealand Evidence Based Guidelines for women with breech presentation (New Zealand Guidelines Group, 2003).

A table in this article describes the treatments provided at this clinic in 2013/14. 261 clients were seen for Pre-birth, Back pain,pelvic/hip pain, Other, nausea, Varicosities, Emotional, Breech, Induction,  Insomnia, Headache/ migraine, and Heartburn.

The heading of “Other” included a variety of presentations where women mentioned they also were experiencing or had been diagnosed with a pregnancy related condition such as: rib pain, upper back pain, wrist pain, carpal tunnel syndrome, uterine pain, gestational diabetes, hypertensive disorders, bleeding in early pregnancy, requiring early pregnancy support, oedema, cholecystitis, pregnancy rashes, eczema, thrush, sinus pain, chest infections and diarrhoea.