Acupressure for Pregnancy and labour

By Penny Williams

The request for this topic came up as result of a PhD study by Dr Levett
.
The PhD study was to examine whether antenatal education classes
that focused on complementary therapies could slow rates of epidural
use and caesarean sections.

The study published in BMJ Open came back with some wonderful
results in a controlled trial of 176 women having their first baby with low
risk pregnancies across two public hospitals in Sydney.

The results in this study where very encouraging. The couples who had
been taught alternative therapies in their prenatal class had dramatically
lower epidural rates (23.9% compared to 68.7%)

Fewer caesarean sections (18.2% in the study group compared to

32.5% in the control group)

Other unexpected payoffs where that the study group where less likely
to have their labour augmented by artificial means. Experienced a
shorter second stage of labour, and babies born in a better condition
than the control group.

One of the modalities used was in the complementary therapy focused

classes was Acupressure.In 2011, I did an Acubirth For Midwives
course with the Red Tent Health Centre in Sydney.
www.RedTent.com.au

It was a wonderful work shop and I can highly recommend it to any

aspiring childbirth educators. I have been using the knowledge and skills
that I gained from the Red Tent in my work as a prenatal educator,
midwife/ doula ever since.

Acupressure is a fun, safe way to add a little artichoke to your prenatal

class. The use of Acupressure points provides you with a novel,
interactive way to energise a group or transition into a different subtopic
in a prenatal program.
Importantly the knowledge of these acupressure points allows the
partners an avenue to play a pivotal and active role throughout the
labour and gives them some practical tools to practice and use.

In a prenatal class I often talk about the knowledge of acupressure

points as something that the partners can add to their tool box. This
gives them a concrete way of going about developing confidence in their
ability to support the woman.

I truly believe one of the most powerful ways you can help a woman
through her birth is to empower her partner to be the primary birth
supporter for her. Empowering the partners with this knowledge means
so much! Because it also facilitates a trust bond between the mother
and her partner and provides a platform to launch their co-parenting
relationship from.

So lets have a look at some ways that you may add these techniques to
your prenatal programs.

Acupressure is a therapy that has evolved within Traditional Chinese
Medicine (TCM) over thousands of years. It is really just focusing on the
way that energy flows in the body.

Ordinarily for optimum health and vitality you want the energy flows in
the body to be Balanced.

Pregnancy labour and birth however, are considered special

circumstances in the body. In fact the Chinese talk about pregnancy as
being a normal abnormality. Which makes acupressure a very powerful
modality to have in your Tool Box.

Our bodies have many Meridians or energy channels. These meridians

or channels are the way the body transports life giving Chi or life force
energy around the body.

Each meridian has a point or button. That act like little switch or a
signal centre to redirect energy flows and in doing so give the body the
opportunity to reorganise itself in a way that will be more useful to the
individual.

Acupressure then is a means of accessing these signal points and giving

the body information to help return itself to homeostasis, which is a
place that the body is always striving to be.

It is advised to get the partner or support person to use these

acupressure points from 37 weeks of the pregnancy onwards. This will
help with the couples skill development and confidence.

Some General points to keep in mind:

1.Acupressure is firm direct pressure to BOTH sides of the body.

2.If it feels painful ask the mother if it is Good pain or not The
points themselves are a little bit ouchy That is how you know you
have the right spot. But the pain should be manageable not over
the top.

3.In pre-labour phase use these points every couple of

hours.When in labour these points can be used as often as
needed depending upon the mothers feed back.

4.Contraindicated in pregnancy means dont use these points until

the pregnant woman is at 37 weeks as they can induce labour

5. Measurements of fingers and thumb width are always the

mothers fingers and thumbs. One Cun Is defined as one thumb
width of the woman. Three Cun is the mothers four- finger span
when they are resting side by side.
 Natural Induction
The following four points used in combination could be useful to
know if the woman is hoping to avoid a Medical Induction Of
Labour. In this situation, it is suggested that the pregnant woman
combines acupressure with acupuncture if possible.

The four-acupressure points to use for a Natural Induction are:

1. S6 -Spleen 6
2. LI-4Fleshy Thumb
3. BL-31 & Bl32 The Back points
4. GB-21 The Shoulder point

For Induction of labour it is suggested that these points be triggered

three times a day for five minutes on each point on BOTH sides of the
body.

These points can also be used during a Medical Induction as well.

Spleen 6(SP-6) Inner ankle

Spleen 6(SP-6) Inner ankle.
(This point is contraindicated up until week 36.)

What does it do?

This acupressure point helps to dilate the cervix and regulate
contractions. So use Spleen 6 if you want to increase the regularity of
contractions for example with labour that is slow to progress use this
point between contractions.

If you want to encourage the strength and effectiveness of contractions

hold the points during the contractions.
Particularly useful point for inducing labour and for labours with a long
latent phase.

Where is it?
3 cun, (Four of the womans finger widths) directly above the medial
malleolus (ankle bone) just behind the tibia bone.

How do I use it? : Apply direct pressure with you thumb or index finger
to produce an intense, tender sensation or a dull achy feeling.
Apply firm pressure on both ankles for up to 5 minutes

Large Intestine -4 (LI-4)

Fleshy thumb point

Large Intestine 4 (Li4) or The Fleshy Thumb Point.

What does it Do?

Can assist with general pain relief while also strengthening contractions
and the progression of labour. Can be very useful in pre-labour or to
assist with Induction of Labour.

Where is it?
Between, the first and second metacarpal bones. It is the highest point in
the fleshy mound formed when the thumb is brought to rest against the
index finger.

How do I use it?

Apply pressure to this point during contractions in labour for increasing
contraction efficiency while also decreasing pain perception.

If you want to induce labour, get things going or if labour slows down at
any stage. Apply pressure to both hands for between three to five
minutes. Combine this with partner eye contact to enhance oxytocin
flows.

Bladder-31 and Bladder-32

(BL-31 & BL-32)

Bladder 31 and 32 (BL-31 & BL-32) The Back Points

What does it do?

These points provide pain relief and are also useful to keep labour
progressing

Where are they?

These points are located over the first and second sacral foramen. The
best way to locate them is to trace one of the womans index finger
length from the top of the buttock crease to about one cun either side
of the spine.
When you put your finger over these points and press in you will feel a
small hollow. (If you are in the back dimples you are too far lateral)

How do I use them?

Using thumbs or knuckles apply pressure to both sides for between 3 to
5 minutes. (Some mothers prefer a flat hand to apply broad counter
pressure across the whole area) If the mother is rocking, move with her
dont disrupt her rhythm.
 Gall Bladder 21 (GB-21)

Gallbladder 21- The Shoulder Point

What does it do?

This acupressure point can help the baby descend into the pelvis.
Stimulate uterine contractions and help with the delivery of the placenta.

It can also be useful to stimulating the let down reflex with

breastfeeding mothers who may be experiencing difficulties with
breastfeeding.

Where are they?

Gall Bladder 21 can be located midway between the spines process of
C7 and the tip of the acromion process (Shoulder) at the highest point of
the Trapezius muscle.

How do I use it?

Many women carry stress in their shoulders and tense their shoulders up
when they feel pain. This point can help to relax the shoulders and assist
with pain relief.

Particularly useful during second and third stages labour as this point
helps the contents of the uterus to empty!
3 Points to help turn a posterior baby.
Spleen 6 (Already covered)
Bladder 60
Bladder 67
Bladder-60

Bladder 60 or the Outer ankle point

What does it do?
This acupressure point is best known for optimal fetal positioning that is
for encouraging a late Op position (from 39 weeks) to turn.

Helps the baby to descend into the pelvis.

Where are they?

Midway between the Achilles tendon and the anklebone.
Grip the back of the womans ankles and apply firm pressure.

How do I use it?

Can be used in first stage labour to encourage the baby to move down
and apply pressure on the cervix helping it to thin and dilate.

If a baby adopts a posterior position (spine to spine) in the lead up to

labour this point can encourage the baby to turn into a more favourable
position for birth.

This point can be used daily in late pregnancy and in combination with
spleen 6 and in labour during a good contraction to help turn the baby.
Bladder 67 or The Pinkie Toe Point

Bladder- 60

What does it do?

Helps baby to move down deeper into the pelvis and turn out of a
posterior or can be combined with moxibustion to help a breech baby
turn.

Please Note
If you are trying to turn a breech baby best results are achieved if
treatment is commenced between 33 to 36 weeks of pregnancy.
(Moxa sticks and instructions can be purchased from Red Tent
www.RedTent.com.au

Where do I find it?

The usual way of locating Bladder 67 is to draw two imaginary lines. One
line along the lateral boarder of the toenail and another along the base
of the toenail. The spot where both of these lines meet is the spot.

How do I use it?

Use in combination with Spleen 6 and Bladder 60 during late pregnancy
and labour to encourage a posterior baby to turn. Hold each point on
both sides of the body for between 3 to five minutes.
Stomach 36 (Energy Point or Leg 3 miles)

What does it do?

Helps with fatigue, low appetite and constipation. However, If the mother
has reflux it is best to avoid this one) Very useful for exhaustion as the
mother approaches second stage labour.

Where can I find it?

3 cun (four finger widths) below the knee and 1 thumb width to the
outside of the leg.

How do I use it?

Useful if a mother is becoming very tired can be used in pregnancy
(3times a day) and between contractions in labour as needed.
Pericardium 6 The inner wrist point
What does it do?
Helps to ease nausea and vomiting and is safe to use in pregnancy and
labour.

Where can I find it?

You can locate this point on your inner four- finger width up the arm from
the crease on the inner wrist. The point lies between the two tendons.
You may find the tendons more easily if the mother makes a fist and
then uncurls the fist inwards.

How do I use it?

If you hear the mother say I think I need to throw up use the easiest
hand you can get to and apply deep pressure. If you are not getting any
results try the other wrist and keep pressure up for 5 minutes or until the
mother no longer feels nauseous.

In Conclusion:
There are many more acupressure points than the ones discussed here.

I am very thankful to Naomi Abeshouse and Rebecca Mar Young who

have been so generous with their Knowledge and I hope that this
inspires you to go and do one of their courses.

Reference: Acubirth For Midwives Course Handbook Written by Naomi Abeshouse and
Rebecca Mar Young