I feel compelled to write down my feelings about using acupuncture to induce labour. This is my 21st year as a midwife, and I have had very little success with my clients using acupuncture to induce labour. For the purpose of this blog, I am referring to incuction of labour over 41 weeks gestation, when a woman’s membranes remain intact.
I have recently had some incidences that have prompted me to write a blog. Just the other day I had a client choosing to go privately with a private obstetrician who was recommended induction of labour at over 41 weeks (41+1). My client was keen to try everything a few days before the induction date to see if she could avoid a medical induction of labour. Her acupuncturist told her that she should have come from 36 weeks so that she could ‘prepare’ her body using acupuncture mothods (well I’m sorry, but in my view, the body and baby know how to prepare themselves without any help from acupuncture or any other means). My client had 2 acupuncture sessions 24 hours apart at 40+6 and 41+0 weeks gestation. What was to follow is once again what I have seen happen so many times with acupuncture…15 minutely contractions for DAYS! Exhausting, tiring, painful, pre labour possibly and probably triggered by the acupuncture, but without established labour to follow. So what ended up happening was my client, exhausted, presented to the hospital, and had a medical and surgical induction of labour. She eventually had a vaginal birth of a healthy baby girl, but labour didn’t start out well for her as she was EXHAUSTED!
Another client of mine used acupuncture to induce her labour with her first baby at 40+0. She didn’t tell her health care providers. She had a long pre labour, in fact for her, at 41+ weeks, after days of irregular contractions, it was decided that rupturing her membranes in hospital may help to ‘get things going’. No, actually after 24+ hours of medical intervention, she never got into established labour. With her second pregnancy, she decided she would like to have a VBAC, and I recommended staying well away from those acupuncture needles. At 41+4 she spontaneously laboured, and had a spontaneous VBAC of a healthy 4kg baby girl!
The question is, firstly why all the pressure to be induced at 41 weeks? Why not wait until 42 weeks and make a decision at that time whether or not a medical and/or surgical induction of labour is the best choice for the woman and her baby (this is the topic for another blog post!) There is so much focus on going ‘over due’ from the time the woman is ‘due’ to have her baby. What are the real issues with going over 42 weeks gestation? (once again, the topic for another much needed blog post).
If it is decided that a medical or a surgical induction of labour is necessary, then would it be best to use these methods alone, without the assistance of acupuncture a few days leading up to that ‘end’ date? Would the woman be in better condition to labour if she hasn’t been in pre labour for 48 hours leading up to the induction (I’d say Yes)? If yes then would she cope with labour better emotionally and physically, would baby cope better with labour if baby hadn’t already been subjected to days and days of pre labour (I’d say Yes)?
So what does the evidence say about the use of acupuncture to induce labour after 41 weeks of pregnancy, when a woman’s membranes are intact? The consensus is that there is not enough evidence to support the use of acupuncture to induce labour. This doesn’t necessarily mean that acupuncture is ineffective in the induction of labour after 41 weeks with intact membranes, it just means that there has not been enough research to recommend its use. The best summary of the research that has been done to date is in the Cochrane Collaboration Review into the use of Acupuncture to induce labour