Does Acupuncture Really Turn a Breech Baby?

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By Mary Sabo, L.Ac DACM

It may seem somewhat strange, but acupuncture and particularly a technique called Moxibustion, has been used for thousands of years to help a breech baby find the right position for birth. In fact, a recent meta-analysis showed that it is not only helpful to correct a breech baby’s position, but may also reduce the need for pitocin during labor.[i] Working with an acupuncturist in the weeks leading up to labor and delivery is safe and helpful for supporting late pregnancy symptoms like back pain and fatigue and can also help your baby and your body prepare for a healthy labor and delivery.

Moxibustion, also called Moxa, is a warming technique used in conjunction with acupuncture to promote healing and change in the body. It involves warming specific acupuncture points with a medicinal dried herb called mugwort (Artemisia vulgaris). It is typically a pleasant experience and does not hurt. To encourage a breech baby to turn, a dried (sometimes also charred) roll of moxa is lit and used to warm an acupuncture point on the pinky toe. While it may seem strange that warming your toe will turn your baby, it has scientific evidence to back it up![ii]  Researchers speculate that applying moxa to this particular area stimulates the baby to move, signaling a malpositioned or breech baby to move into the (likely most comfortable) head down position. Moxa does not hurt the mother or baby and if a baby cannot change position for some reason (cord positioning, fibroid, etc.), it will not turn. Clinically, I have found that moxa often does the trick, but patients who are eligible for an external cephalic version (ECV) who perform moxa in the weeks leading up to the procedure seem more likely to have it work. 

Moxa is typically performed during acupuncture sessions in the weeks leading up to a woman’s due date starting around week 34 or 35. Because moxa is fairly easy to perform, I also give my patients moxa sticks to take home with instructions so they can continue to stimulate the baby to turn. They warm their pinky toes 20 minutes once or twice a day until the baby is in the correct position. This can take only one session or weeks, but once the baby is head down, it often stays that way until birth. It is recommended, however, to discontinue moxa once the baby is in position. 

For more information, contact us at info@marysaboacupuncture.com or to set up an appointment, click here!

 

[i] Qin-hong Zhang, Jin-huan Yue, Ming Liu, Zhong-ren Sun, Qi Sun, Chao Han, and Di Wang. Moxibustion for the Correction of Nonvertex Presentation: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Evid Based Complement Alternat Med. 2013; 2013: 241027.

[ii] Neri I1, Airola G, Contu G, Allais G, Facchinetti F, Benedetto C. Acupuncture plus moxibustion to resolve breech presentation: a randomized controlled study. J Matern Fetal Neonatal Med. 2004 Apr;15(4):247-52.

 

Complementary and Alternative Therapies Assist in Easing Anxiety During Assisted Reproductive Technology Treatment.

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By Mary Sabo, L.Ac DACM and Joseph Lee, B.A.

Heighted stress and anxiety is a common hardship for couples finding it difficult to conceive. It can be a daunting process as they understand the reason for their infertility and navigate therapy options. As patients begin this process, it is important for them to find ways to cope as their physiological and psychological well-being directly influences the quality of their life and treatment outcomes during the patient journey. [i]

We recently presented a study at a national conference for The American Congress of Obstetricians and Gynecologists (Washington D.C.) on patient perception when Acupuncture and other Complementary and Alternative Medicine (CAM) techniques are utilized in tandem to Assisted Reproductive Technology (ART) treatment[ii].  Conducted in collaboration with The Icahn School of Medicine at Mt. Sinai, Reproductive Medicine Associates of New York and the YinOva Center; the study included a 40-question survey that focused on patient demographics, medical history, lifestyle choices, CAM experience, and stress levels. Findings from the study demonstrate a reduction in patients’ stress levels and increased comfort when pursuing CAM therapies while engaged in IVF cycles.  Patients noted that there was a significant reduction in workplace strain and enhanced partner relationships.   

Patients noted they “highly valued” this integrative approach to treatment.  Of the 49 patients who responded, 71.47% felt it was "highly important" for their ART doctor and CAM practitioner to work together during their treatment.  It was "very important" to 81.3% of 48 answering participants for their doctor to accept the use of acupuncture during their treatments. Study participants reported feeling "empowered and reduced anxiety" with the addition of acupuncture and nearly all patients (98.1%) who answered recommend CAM treatments during ART cycles.  

Qualitative studies like this one show the value of combining conventional fertility treatments (ART) with more holistic therapies like acupuncture.  Patients can benefit by feeling empowered to seek extra support through their fertility journey to help manage stress and anxiety.  Doctors can use this information to understand how greatly their patients may benefit from an integrative approach, which might benefit their treatment outcomes.  

 

[i] Frederiksen Y, Farver-Vestergaard I, Skovgård NG, Ingerslev HJ, Zachariae R. Efficacy of psychosocial interventions for psychological and pregnancy outcomes in infertile women and men: a systematic review and meta-analysis. BMJ Open. 2015 Jan 28;5(1)

[ii] Kelly Zafman, MS, Mary Sabo, L.Ac., Emma Thake, BA, Joseph Lee, BA, Alan B. Copperman, MD, Tanmoy Mukherjee, MD.  Patients undergoing assisted reproductive technology (ART) treatments seek integrative approach to infertility.  ACOG annual meeting: Washington DC, 2016 – Poster ID#27F

Acupuncture during pregnancy…is it safe and how can it help?

Photo by Halfpoint/iStock / Getty Images
Photo by Halfpoint/iStock / Getty Images

By Mary Sabo, L.Ac DACM

I often get questions about acupuncture during pregnancy and whether or not it is safe to receive treatments during all three trimesters.  In Chinese medical theory, our training teaches us that there are certain acupuncture points and areas of the body that should not be needled during most of the pregnancy.  Experienced acupuncturists who are skilled in supporting pregnant women typically can maneuver around these restrictions and are able to support pregnant women safely during their entire pregnancy. Let’s take a look at some common symptoms that can present and be managed with acupuncture at different stages of the pregnancy.

During the first trimester, many uncomfortable symptoms can develop including morning sickness, fatigue, headaches, insomnia, heartburn, constipation, and vomiting.  Acupuncture is a useful tool in treating all of these and can be safely performed during this time by an experienced licensed acupuncturist. Some types of miscarriage may be prevented with acupuncture, so acupuncture during this time can be particularly helpful.

The second trimester is typically more comfortable for most women, but aches and pains can pop up. Hip pain, back pain, sciatica, neck and shoulder tension, headaches and sacroiliac joint pain are common as the baby grows and the hormone relaxin causes the ligaments and tendons to loosen. Pain during this time can be managed with acupuncture and is a nice alternative to acetaminophen. Mild cases of gestational diabetes can also be managed along side the dietary changes recommended by your doctor, and placenta previa may be encouraged to shift. 

During the third trimester, any of the above symptoms can come back or worsen.  As the baby puts more pressure on the pelvis, the muscles in the pelvic floor sometimes become tense or weak and circulation of the lymph slows creating water retention and swellingBack pain and sciatica are also more likely.  Working with an acupuncturist during this time not only helps manage these symptoms, it can also help prepare you for a timely labor and delivery.

If your baby is breech, it is best to start getting regular acupuncture treatments at around week 33. For breech presentation, we use a technique called moxibustion, which is a warming technique applied to specific acupuncture points and has been in use for thousands of years. Recent studies have confirmed that this method safely encourages the baby to turn[i].

As long as you are seeing your OB or midwife regularly for testing and monitoring and following his or her medical advice, incorporating acupuncture into your pregnancy care can improve your quality of life and help create a healthier pregnancy.  It is also useful during the post partum time to aid recovery, promote healing, and support lactation

For more information on how acupuncture can support pregnancy and post partum symptoms, click here!  Have some questions?  Contact us or schedule an appointment!

 

[i] Vas J, Aranda-Regules JM, Modesto M, Ramos-Monserrat M, Barón M, Aguilar I, Benítez-Parejo N, Ramírez-Carmona C, Rivas-Ruiz F. Using moxibustion in primary healthcare to correct non-vertex presentation: a multicentre randomised controlled trial. Acupunct Med. 2013 Mar;31(1):31-8.

 

The Benefits of Combining Acupuncture with your IVF & IUI

Photo by ktsimage/iStock / Getty Images
Photo by ktsimage/iStock / Getty Images

By Mary Sabo, L.Ac DACM

There are many scientific studies demonstrating the benefits of combining acupuncture with Assisted Reproductive Technologies (ART) such as In Vitro Fertilization (IVF). Let’s look at the current research so you can understand how to optimize this integrative approach.

Going through ART cycles can be incredibly stressful and anxiety provoking.  Almost all women undergoing IVF report some level of anxiety. These cycles are costly, not always covered by insurance, and statistically results can range from 3.5% to 36.6% success per cycle depending on maternal age[i]. One study found that stress and anxiety levels were high whether patients were experiencing their first IVF or were on subsequent cycles. However, women in this study who reported lower stress and anxiety levels on the day prior to oocyte retrieval had higher pregnancy rates.[ii] Another study showed that techniques to reduce stress in couples struggling to conceive resulted in improvements to both pregnancy outcomes and quality of life.[iii]  Acupuncture has not only been shown to reduce stress and anxiety, but has also demonstrated positive impacts on reproductive health.[iv] 

Many fertility doctors are becoming aware of the benefits their patients experience with the addition of acupuncture to their ART cycles. Some clinics have even made acupuncturists available onsite. Receiving acupuncture treatments during an IVF (including during oocyte hyperstimulation phase, before retrieval, and before and after embryo transfer) has shown improved pregnancy rates in several different studies. However, a more recent study showed that working regularly with an acupuncturist who gives customized care, including prescribing appropriate herbs and supplements in the months leading up to and during an IVF, resulted in even higher live birth rates. [v] 

If you are struggling to conceive or have just started the process and are feeling anxious about it, you should consider adding acupuncture and Chinese medicine to your care. It can not only increase the odds of conceiving, but can also improve your quality of life by reducing stress and anxiety while you try to get pregnant.

 

TIMING TREATMENTS WITH YOUR ART CYCLES:

In most cases, weekly acupuncture sessions are recommended. If you start using ART, you can speak with Mary about the ideal schedule to support you during your cycle. During an IVF the following schedule is typically most helpful:

  • weekly acupuncture leading up to the start of your medications
  • twice a week during the ovarian stimulation phase, timing one before the retrieval
  • before and after embryo transfer
  • a session one week after the transfer to support a potential pregnancy

During an IUI, weekly sessions are recommended with one timed around the day of the IUI. This schedule is a bit more flexible as the cycle is not as controlled.  

If you have any questions, please contact us!

 

[i] Society for Assisted Reproductive Technology statistic. (June 15, 2016) https://www.sartcorsonline.com/rptCSR_PublicMultYear.aspx?ClinicPKID=0

[ii] Kathy TurnerMargaret F. Reynolds-MayEmily M. ZitekRebecca L. TisdaleAllison B. Carlisle, and Lynn M. Westphal, Stress and Anxiety Scores in First and Repeat IVF Cycles: A Pilot Study PLoS One. 2013; 8(5): e63743.

[iii] Frederiksen Y, Farver-Vestergaard I, Skovgård NG, Ingerslev HJ, Zachariae R.  Efficacy of psychosocial interventions for psychological and pregnancy outcomes in infertile women and men: a systematic review and meta-analysis. BMJ Open. 2015 Jan 28;5(1)

[iv] Suzanne Cochrane, Caroline A Smith, Alphia Possamai-Inesedy, Alan Bensoussan. Acupuncture and women’s health: an overview of the role of acupuncture and its clinical management in women’s reproductive health. Int J Womens Health. 2014; 6: 313–325. Published online 2014 March 17

[v]Lee E. Hullender RubinMichael S. OpsahlKlaus WiemerScott D. Mist, and Aaron B. Caughey Impact of Whole Systems Traditional Chinese Medicine on In Vitro Fertilization Outcomes Reprod Biomed Online. 2015 Jun; 30(6): 602–612.