Acupuncture for Pregnancy & Postpartum

Be confident in your choice with Joanna

2024 marked a significant milestone as Joanna celebrated 20 years of clinical practice in Traditional Chinese Medicine (TCM). After several years of working with pregnant women through TCM and massage, Joanna attended a seminar in 2008 led by Debra Betts (https://acupuncture.rhizome.net.nz/), one of the leading experts in modern pregnancy acupuncture. It was at this seminar that Joanna felt a strong sense of purpose and knew that this was the path she wanted to pursue for her career.

Since then, Joanna has participated in nearly every professional Western lecture on TCM for pregnancy and postpartum care, both in-person and online, to enhance her knowledge and clinical skills. This dedication has enabled her to treat hundreds of women and families throughout her practice.

From 2022 to 2024, Joanna attended the Maternity Acupuncture Mentorship Program (MAMPs https://www.mamps.org/), further enriching her education and clinical experience. As a member of the Obstetric Acupuncture Association (OBAA https://ob-acupuncture.com/), she stays current with the latest research in her field.

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From the beginnings…..

Acupuncture and Traditional Chinese Medicine (TCM) have been utilized in pregnancy for centuries, and there is extensive documentation of their practices. Three of the oldest texts from classical China include:

1. 'Taichanshu' - 'Book on the Fetus and Gestation' (163BCE)

2. 'Qianjinfang' (652 C.E.), which was translated from 'Bei ji qian jin yao fang' - 'Essential Formulas for Emergencies Worth a Thousand in Gold,' translated by Sabine Wilms (https://www.happygoatproductions.com/).

3. 'Ishimpo' - 'Prescriptions from the Heart of Medicine' (982 C.E.).

These texts discuss proper maternal behaviours, dietary recommendations and prohibitions, herbal prescriptions for pregnancy-related conditions, and channel theory, providing month-by-month guidelines for usage or restrictions throughout the pregnancy.

To modern day…… Acupuncture Professional Guidelines & Research

In today's world, pregnancy acupuncture is regarded as a safe complementary treatment alongside standard obstetric care and is practised in many hospitals worldwide, including China, Germany and the USA. A growing body of research consistently reinforces the safety of acupuncture during pregnancy, which should be very reassuring for mothers seeking this type of care.

Top obstetric colleges worldwide recognise acupuncture as an effective treatment for various pregnancy and birth conditions. The American College of Obstetricians and Gynecologists (ACOG) suggests that acupuncture has the ‘potential to assist in labour progression during labour dystocia’, which involves incorrect birth positioning. While ACOG found ‘no significant impact on cesarean delivery rates, there is evidence indicating that acupuncture may enhance patient satisfaction with these interventions’(1).

In the UK, the Royal College of Obstetricians and Gynaecologists (RCOG) recommends non-pharmacological interventions, such as acupuncture and massage, as first-line treatments for pregnancy-related headaches, lower back pain, and pelvic pain before considering analgesic options(2). In their ‘Information for You - Patient Handout - June 2015’, they include acupuncture as a treatment option for pelvic girdle pain in pregnancy(3).

The Royal Australian and New Zealand College of Obstetrics and Gynaecologists (RANZCOG), in their 2016 Patient Handout titled "Pain Relief in Labour & Childbirth," notes that natural pain relief options like acupuncture, acupressure, touch, and massage can be effective but should only be administered by qualified practitioners(4).

Additional professional documents, such as "The Australian Pregnancy Care Guidelines," recommend acupuncture as a treatment for pelvic girdle pain during pregnancy (5). Furthermore, the Royal College of Midwives (UK) discusses the potential benefits of acupuncture and moxibustion for addressing breech presentation(6).

Cochrane systematic reviews have demonstrated positive effects of various Traditional Chinese Medicine (TCM) modalities for different pregnancy conditions. These include:

  • Moxibustion for breech presentation (1)

  • Acupuncture for pain management during labour (2)

  • Acupuncture or acupressure for labour induction (3)

  • Acupuncture for treating low back and pelvic pain during pregnancy (4)

  • Acupuncture that improves sleep quality and appetite during pregnancy (5)

  • Acupuncture as an adjunct to usual care for depression (6)

  • Acupoint massage to prevent mastitis after childbirth (7)

These findings highlight the potential benefits of TCM in addressing a wide range of pregnancy-related issues.

In a search of the research in the last five years, numerous randomised controlled trials and systematic reviews have been conducted in this area. While many of these studies are small and further research is needed, it is encouraging to note that positive results have been found in various fields of study, including:

  • Safety of acupuncture during pregnancy (1)

  • Acupressure for pelvic and lower back pain in pregnancy (2)

  • Acupuncture for non-serious headaches (3)

  • Acupuncture, acupressure, and auriculotherapy (ear acupuncture) for nausea, vomiting, and hyperemesis gravidarum in pregnancy (4)

  • Acupuncture, acupressure, and auriculotherapy for labour pain, labour progress, and induction of labour (5)

  • Acupuncture, acupressure, and moxibustion for breech presentation (6)

  • Auriculotherapy for improving sleep quality (7)

  • Acupuncture for depression during pregnancy (8)

Many studies are also being undertaken for the postpartum period, which is great. Some of the topics being investigated include:

  • Acupuncture and acupressure for breast tenderness and lactation issues, including low milk volume. (1)

  • Acupuncture as an adjunct therapy for postpartum pelvic floor issues, including stress incontinence (2)

  • Moxibustion for uterine involution (3)

  • Acupuncture combined with exercise for diastasis recti (4)

  • Acupuncture and auriculotherapy for pain following a cesarean section (5)

  • Acupuncture for postpartum depression (6)

  • Acupuncture and cupping for postpartum back pain (7)

This research highlights the potential benefits of acupuncture and related practices during and after pregnancy.

    1. First and Second Stage Labour Management – Clinical Practice Guideline – Number 8 – January 2024. https://www.acog.org/clinical/clinicalguidance/clinical-practice-guideline/articles/2024/01/first-and-second-stage-labor-management

    2. Antenatal & Postnatal Analgesia – Scientific Impact Paper No.59, December 2018. DOI: 10.1111/1471-0528.15510

      https://obgyn.onlinelibrary.wiley.com/doi/pdf/10.1111/1471-0528.15510

    3. https://missionmrcog.com/home/images/Library/Leaflets/2015/009_pi-pelvic-girdle-pain-and-pregnancy%20_2015.pdf

    4. https://ranzcog.edu.au/wp-content/uploads/Pain-Relief-Labour-Childbirth.pdf

    5. https://files.magicapp.org/guideline/3aa6b881-4be5-4806-bb3e-e7c53b5b0bbf/published_guideline_7933-2_0.pdf

    6. Evidence Based Midwifery ISSN: 1479-4489 December 2008 Vo.6 No.4

    1. Coyle ME, Smith C, Peat B. Cephalic version by moxibustion for breech presentation. Cochrane Database of Systematic Reviews 2023, Issue 5. Art. No.: CD003928. DOI: 10.1002/14651858.CD003928.pub4. Accessed 27 May 2025.

    2. Smith CA, Collins CT, Levett KM, Armour M, Dahlen HG, Tan AL, Mesgarpour B. Acupuncture or acupressure for pain management during labour. Cochrane Database of Systematic Reviews 2020, Issue 2. Art. No.: CD009232. DOI: 10.1002/14651858.CD009232.pub2. Accessed 27 May 2025.

    3. Smith CA, Armour M, Dahlen HG. Acupuncture or acupressure for induction of labour. Cochrane Database of Systematic Reviews 2017, Issue 10. Art. No.: CD002962. DOI: 10.1002/14651858.CD002962.pub4. Accessed 27 May 2025.

    4. Liddle SD, Pennick V. Interventions for preventing and treating low‐back and pelvic pain during pregnancy. Cochrane Database of Systematic Reviews 2015, Issue 9. Art. No.: CD001139. DOI: 10.1002/14651858.CD001139.pub4. Accessed 27 May 2025.

    5. Phupong V, Hanprasertpong T. Interventions for heartburn in pregnancy. Cochrane Database of Systematic Reviews 2015, Issue 9. Art. No.: CD011379. DOI: 10.1002/14651858.CD011379.pub2. Accessed 27 May 2025.

    6. Armour M, Smith CA, Wang LQ, Naidoo D, Yang GY, MacPherson H, Lee MS, Hay P. Acupuncture for Depression: A Systematic Review and Meta-Analysis. J Clin Med. 2019 Jul 31;8(8):1140. doi: 10.3390/jcm8081140. PMID: 31370200; PMCID: PMC6722678.

    7. Crepinsek MA, Taylor EA, Michener K, Stewart F. Interventions for preventing mastitis after childbirth. Cochrane Database of Systematic Reviews 2020, Issue 9. Art. No.: CD007239. DOI: 10.1002/14651858.CD007239.pub4. Accessed 27 May 2025.

    1. (a)Tingting L, Tongou L, Mingfu L. Effectiveness and safety of acupuncture in treatment of pregnancy-related symptoms: a systematic review and Meta-analysis. J Tradit Chin Med. 2024 Feb;44(1):16-26. doi: 10.19852/j.cnki.jtcm.20231204.006. PMID: 38213235; PMCID: PMC10774725;

      (b)Park J, Sohn Y, White AR, Lee H. The safety of acupuncture during pregnancy: a systematic review. Acupunct Med. 2014 Jun;32(3):257-66. doi: 10.1136/acupmed-2013-010480. Epub 2014 Feb 19. PMID: 24554789; PMCID: PMC4112450;

      (c) Moon HY, Kim MR, Hwang DS, Jang JB, Lee J, Shin JS, Ha I, Lee YJ. Safety of acupuncture during pregnancy: a retrospective cohort study in Korea. BJOG. 2020 Jan;127(1):79-86. doi: 10.1111/1471-0528.15925. Epub 2019 Sep 19. PMID: 31483927;

      (d) Lingjing Lu, Juan Li, Yu Zhou, Hongxia Ma, Min Hu Complementary and Alternative Medicine for Threatened Miscarriage: Advantages and Risks. Evidence-Based Complementary and Alternative Medicine. VL  - 2021 IS  - 1 SN  - 1741-427X

    2. Ainun, K. The Effect of Acupressure Therapy for Lower Back Pain in Third Trimester Pregnant Women at the Marbau Health Centre Uptd in 2022, Science Midwifery, 2022, 2721-9453

    3. Phillips K, Davison J, Wakerley B. Headache in pregnancy: a brief practical guide. Br J Gen Pract. 2022 Nov 24;72(725):593-594. doi: 10.3399/bjgp22X721457. PMID: 36424161; PMCID: PMC9710804.

    4. (a) Nehbandani, S et al. The effect of ear acupressure medicine at the ‘Shen Men’ point on the nausea and vomiting durning pregnancy. PJMHS, Vol.15, NO. 6. JUN 202. DOI: https://doi.org/10.53350/pjmhs211561602;

      (b) Su-Ji Choi, Seoyoon Choi & Dong-Il Kim (2025) Acupuncture and Herbal Medicine for Nausea and Vomiting in Pregnancy: An Overview and Quality Assessment of Systematic Reviews, International Journal of Women's Health, , 1343-1361, DOI: 10.2147/ IJWH.S512247;

      (c) Ria, M. B., & Manek, B. D. (2022). The Effectiveness of Acupressure Points PC-6 and SP-3 on the Hyperemesis Gravidarum in Pregnant Women. Journal of Maternal and Child Health, 7(2), 138–147. https://doi.org/10.26911/thejmch.2022.07.02.03;

      (d) Bao Jin, Yanhua Han, Yue Jiang, Jiao Zhang, Wenjuan Shen, Yuehui Zhang, Acupuncture for nausea and vomiting during pregnancy: A systematic review and meta-analysis, Complementary Therapies in Medicine, Volume 85, 2024, 103079, ISSN 0965-2299.

    5. (a) Yi Y, Ju W, Fu D, Chen R, Bai X, Zhang S. Effect of traditional Chinese medicine therapy on labor pain in patients with natural childbirth: A network meta-analysis. Medicine (Baltimore). 2024 Oct 25;103(43):e39425. doi: 10.1097/MD.0000000000039425. PMID: 39470555; PMCID: PMC11521081;

      (b) Lokugamage AU, Eftime VAI, Porter D, Ahillan T, Ke SX. Birth preparation acupuncture for normalising birth: An analysis of NHS service routine data and proof of concept. Pre-production Article. J Obstet Gynaecol. 2020 Jan 23:1-6. doi: 10.1080/01443615.2019.1694878;

      (c) Raana HN, Fan XN. The effect of acupressure on pain reduction during first stage of labour: A systematic review and meta-analysis. Complement Ther Clin Pract. 2020 May;39:101126. doi: 10.1016/j.ctcp.2020.101126. Epub 2020 Feb 29. PMID: 32379664; Jiang

      (d) SL, Jiang XM, Zheng QX, Liu XW. Auricular bean embedding improves urination in epidural labor analgesia: A single center randomized controlled study. Technology and Health Care. 2023;31(4):1119-1127. doi:10.3233/THC-220660;

      (e) Luis Sanchez-Ramos, Lisa D. Levine, Anthony C. Sciscione, Ellen L. Mozurkewich, Patrick S. Ramsey, Charles David Adair, Andrew M. Kaunitz, Jordan A. McKinney, Methods for the induction of labor: efficacy and safety, American Journal of Obstetrics and Gynecology, Volume 230, Issue 3, Supplement, 2024, Pages S669-S695, ISSN 0002-9378, https://doi.org/10.1016/j.ajog.2023.02.009;

      (f) Vakilian, K., Ghaemmaghami, M., Sheikhganbari, N. et al. Reducing Labor Anxiety with Auriculotherapy: A Randomized Clinical Trial Study. Chin. J. Integr. Med. 28, 440–444 (2022). https://doi.org/10.1007/s11655-021-3452-0;

      (g) Hamideh Torkiyan, Sedigheh Sedigh Mobarakabadi, Reza Heshmat, Alireza Khajavi, Giti Ozgoli, The effect of GB21 acupressure on pain intensity in the first stage of labor in primiparous women: A randomized controlled trial, Complementary Therapies in Medicine, Volume 58, 2021, 102683, ISSN 0965-2299;

      (h) Arumugam, V et al. Auriculotherapy for Labour Pain Management: a Systematic Review and Meta-Analysis. J Acupunct Meridian Stud 2024; 17(5): 158-164. Published October 31, 2024;

      (i) Zuarez-Easton, S eta l. Pharmacologic and nonpharmacologic options for pain relief during labor: an expert review. American Journal of Obstetrics and Gynecology, Volume 228, Issue 5, Supplement S1246-S1259 May 2023;

      (j) Chen Y, Xiang XY, Chin KHR, Gao J, Wu J, Lao L, Chen H. Acupressure for labor pain management: a systematic review and meta-analysis of randomized controlled trials. Acupunct Med. 2021 Aug;39(4):243-252. doi: 10.1177/0964528420946044. Epub 2020 Aug 18. PMID: 32811182.

    6. (a) Kemal Sarsmaz,Belkiz Berna Kulah, Gokcen Orgul, Nazan Vanlı Tonyalı, Aykan Yucel, Ozlem Moraloglu Tekin. Effectiveness of Moxibustion for Breech Presentation: A Prospective Study. Z Geburtshilfe Neonatol 2022; 226(02): 112-120 DOI: 10.1055/a-1579-1436;

      (b) Coyle ME, Smith C, Peat B. Cephalic version by moxibustion for breech presentation. Cochrane Database Syst Rev. 2023 May 9;5(5):CD003928. doi: 10.1002/14651858.CD003928.pub4. PMID: 37158339; PMCID: PMC10167788;

      (c) Azam Hamidzadeh, Zeinab Tavakol, Maryam Maleki, Sakineh Kolahdozan, Ahmad Khosravi, Mahdieh Kiani, Mojtaba Vaismoradi, Effect of acupressure at the BL67 spot on the spontaneous rotation of fetus with breech presentation: A randomized controlled trial, EXPLORE, Volume 18, Issue 5, 2022, Pages 567-572, ISSN 1550-8307.

    7. Gilmara Holanda da Cunha, Ane Kelly Lima Ramalho, Maiara Bezerra Dantas, Maria Elisa Curado Gomes, Vanessa Sousa dos Santos, Ivana Cristina Vieira de Lima Maia, Carolina Maria de Lima Carvalho, Wilson Correia de Abreu, Auriculotherapy for people with sleep disorders: A systematic review, Complementary Therapies in Clinical Practice, Volume 59, 2025, 101976, ISSN 1744-3881.

    8. (a) Gilmara Holanda da Cunha, Ane Kelly Lima Ramalho, Maiara Bezerra Dantas, Maria Elisa Curado Gomes, Vanessa Sousa dos Santos, Ivana Cristina Vieira de Lima Maia, Carolina Maria de Lima Carvalho, Wilson Correia de Abreu, Auriculotherapy for people with sleep disorders: A systematic review, Complementary Therapies in Clinical Practice, Volume 59, 2025, 101976, ISSN 1744-3881;

      (b) Ormsby SM, Smith CA, Dahlen HG, Hay PJ. The feasibility of acupuncture as an adjunct intervention for antenatal depression: a pragmatic randomised controlled trial. J Affect Disord. 2020 Oct 1;275:82-93. doi: 10.1016/j.jad.2020.05.089. Epub 2020 May 24. PMID: 32658830.

    1. (a) Chang YC, Wang YA, Chang ZY, Liao JA. Acupoint stimulation for postpartum breastfeeding insufficiency: a systematic review and meta-analysis. Syst Rev. 2025 Feb 3;14(1):32. doi: 10.1186/s13643-025-02773-8. PMID: 39901246; PMCID: PMC11789303;

      (b) Liu, Jingying, Chen, Hua, Wang, Wei, Zhao, Dan, Application of Traditional Chinese Medical Science Characteristic Nursing Mode Based on Evidence-Based Medicine to Puerperal Breast Tenderness and Pain, Evidence-Based Complementary and Alternative Medicine, 2022, 7527890, 7 pages, 2022. https://doi.org/10.1155/2022/7527890;

      (c) Bao QN, Yin ZH, Zhou YF, Li YQ, Zhang XY, Xia MZ, Chen ZH, Zhong WQ, Yao J, Wu KX, Zhang ZY, Xu SJ, Liang FR. Efficacy and safety of acupuncture for postpartum hypogalactia: A systematic review and meta-analysis of randomized controlled trials. PLoS One. 2024 Jun 6;19(6):e0303948. doi: 10.1371/journal.pone.0303948. PMID: 38843204; PMCID: PMC11156417.

      (d) Lu P, Ye ZQ, Qiu J, Wang XY, Zheng JJ. Acupoint-tuina therapy promotes lactation in postpartum women with insufficient milk production who underwent caesarean sections. Medicine (Baltimore). 2019 Aug;98(35):e16456. doi: 10.1097/MD.0000000000016456. PMID: 31464890; PMCID: PMC6736488.

    2. (a) Yao, Liping MD∗; Li, Fengzhi MD; Wang, Dandan MD; Sheng, Shaoqin MD. Evaluation of acupuncture treatments of postpartum female pelvic floor dysfunction by four-dimensional transperineal pelvic floor ultrasound. Medicine 100(42):p e27236, October 22, 2021. | DOI: 10.1097/MD.0000000000027236;

      (b) Yu-Wen Fang, Shu-Fen Chen, Ming-Ling Wang, Mei-Hua Wang, Effects of traditional Chinese medicine-assisted intervention on improving postpartum lactation: A systematic review and meta-analysis, Heliyon, Volume 10, Issue 6, 2024, e27154, ISSN 2405-8440;

      (c) Tang K, Su T, Fu L, Chen Z, Liu G, Hou W, Ming S, Song Q, Feng S, Liu X, Wang R, Liu B, Chen Y. Effect of Electroacupuncture Added to Pelvic Floor Muscle Training in Women with Stress Urinary Incontinence: A Randomized Clinical Trial. Eur Urol Focus. 2023 Mar;9(2):352-360. doi: 10.1016/j.euf.2022.10.005. Epub 2022 Oct 26. PMID: 36420937;

      (d) Wang LL, Ren ZX, Zhu JY, Zhang HL, Wu YR. [Efficacy of electroacupuncture combined with penetrating moxibustion for postpartum stress urinary incontinence]. Zhongguo Zhen Jiu. 2019 Jun 12;39(6):599-603. Chinese. doi: 10.13703/j.0255-2930.2019.06.008. PMID: 31190495.

    3. Gao L, Chen W, Gao X, Chen X, Fan Y, Yang X, Chu W, Cao Y. Postpartum uterine involution promoted by penetrating-moxibustion therapy: a randomized controlled trial. Zhongguo Zhen Jiu. 2024 Apr 12;44(4):400-404. English, Chinese. doi: 10.13703/j.0255-2930.20220609-0005. PMID: 38621726.

    4. (a) Zhang C, Yang X, Zhao Y, Xie D, Wang L. Acupuncture for postpartum diastasis recti abdominis and its effects on abdominal circumference, separation distance of rectus abdominis.

      (b) Zhongguo Zhen Jiu. 2024 Feb 12;44(2):139-143. English, Chinese. doi: 10.13703/j.0255-2930.20230626-k0004. PMID: 38373757; Sun Y, Tian H, Du S, Qi Z, Wang G, Zhao J. [Row-like needling along the spleen meridian combined with autonomous functional exercise in treatment of postpartum diastasis recti abdominis: a randomized controlled trial]. Zhongguo Zhen Jiu. 2024 Jul 12;44(7):757-61. Chinese. doi: 10.13703/j.0255-2930.20231018-k0001. PMID: 38986587.

    5. Usichenko TI, Henkel BJ, Klausenitz C, Hesse T, Pierdant G, Cummings M, Hahnenkamp K. Effectiveness of Acupuncture for Pain Control After Cesarean Delivery: A Randomized Clinical Trial. JAMA Netw Open. 2022 Feb 1;5(2):e220517. doi: 10.1001/jamanetworkopen.2022.0517. Erratum in: JAMA Netw Open. 2022 Apr 1;5(4):e229622. doi: 10.1001/jamanetworkopen.2022.9622. PMID: 35226080; PMCID: PMC8886541.

    6. TY  - JOUR, et al .EP  - 2017 Effectiveness of Acupuncture in Postpartum Depression: A Systematic Review and Meta-Analysis VL  - 36 DO  - 10.1136/acupmed-2017-011530 JO  - Acupuncture in Medicine

    7. Anna Maisaroh, Viskasari Pintoko Kalanjati, Lucky Prasetiowati, Abdurrachman Abdurrachman, Sakina Sakina. Effect of dry cupping therapy and acupuncture on the pain scale in low back pain in postpartum women: A systematic review and meta-analysis. 2025 Journal of Pharmacy & Pharmacognosy Research, 13 (1), 299-310, 2025 ISSN 0719-4250

References

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