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MotherCare
MAYAN MIDWIFE CONGRATULATIONS on your recent pregnancy! Finding out that you are pregnant can be a bit of an emotional roller coaster. You may be feeling excited, anxious, happy and overwhelmed all at the same time. Many women wonder how they will cope with pregnancy never mind caring for a newborn. Don’t worry it is normal to have these feelings. Along with all the excitement of pregnancy can come some unwanted symptoms like nausea or back pain. These symptoms arevery common during pregnancy and acupuncture is a safe treatment that has been used for over 2000 years to safely alleviate the following conditions during pregnancy, labour and postpartum:
Essence Healing Treatment Plan for a Healthy, Natural Pregnancy First Trimester Weekly acupuncture treatments until week 12 of your pregnancy. Acupuncture can help prevent miscarriage, manage nausea and vomiting, increase energy, prevent constipation and bloating, and reduce anxiety and help with sleep. Second Trimester Every 7 weeks or weekly acupuncture treatment depending on individual needs. Acupuncture can help maintain health and prevent common pregnancy symptoms like back pain, hip pain, Headaches, stress, pelvic pain, sciatica, indigestion, insomnia. Third Trimester Weekly treatments starting at 32 weeks if your baby is in the breech presentation, otherwise weekly treatments at 37, 38, 39, 40 weeks. Acupuncture can help optimally position the baby, ripen the cervix, increase energy, reduce anxiety, manage oedema and reduce high blood pressure. Fourth Trimester Weekly treatments at one to two weeks postpartum to help increase milk production, prevent postpartum depression, restore energy, support the healing process from tearing or Cesarian birth. Common Acupuncture Points used During Pregnancy: Zhubin (K 9) – 'beautiful baby point' Zusanli (St 36) Neiguan (P6) – 'morning sickness and motion sickness point' Research Studies Lim CE et al. Effect of acupuncture on induction of labor. J Altern Complement Med 2009;15:1209-14. A systematic review of the existing scientific evidence on the potential role of acupuncture for induction of labour during pregnancy. Ten studies were identified. The duration of labour as a result of acupuncture treatment ranged from 10 hours 20 minutes to 29.1 hours. All of the studies demonstrated labour induction by acupuncture treatment. However, because two (of the five) randomised controlled trials reported that there was no statistically significant effect of acupuncture, these results are more suggestive than definitive. The reviewers concluded that, although the definitive role of acupuncture in inducing labour is still yet to be established, the existing studies suggest that acupuncture may be beneficial in labour induction. Vas J et al. Correction of nonvertex presentation with moxibustion: a systematic review and metaanalysis. Am J Obstet Gynecol 2009;201:241-59. A systematic review including 6 randomised controlled trials and a total of 1,087 pregnant women that assessed moxibustion for breech presentation. The rate of cephalic version among the moxibustion group was 72.5% versus 53.2% in the control group (relative risk, 1.36; 95% CI 1.17-1.58). In terms of safety, no significant differences were found in the comparison of moxibustion with other techniques. The reviewers concluded that moxibustion at acupuncture point BL67 has been shown to produce a positive effect, whether used alone or in combination with acupuncture or postural measures, in comparison with observation or postural methods alone, for the correction of breech presentation. Li X et al. Moxibustion and other acupuncture point stimulation methods to treat breech presentation: a systematic review of clinical trials. Chin Med 2009;4:4. A systematic review that evaluated the efficacy and safety of moxibustion to treat breech presentation. Ten randomised controlled trials involving 2,090 women and 7 controlled clinical trials involving 1,409 women were included. Meta-analysis of randomised controlled trials showed significant differences between moxibustion and no treatment (RR 1.35, 95% CI 1.20 to 1.51; 3 RCTs), but not between moxibustion and knee-chest position. Moxibustion plus other therapeutic methods showed significant beneficial effects (RR 1.36, 95% CI 1.21 to 1.54; 2 RCTs). For nonrandomised controlled trials, moxibustion was more effective than no treatment (RR 1.29, 95% CI 1.17 to 1.42; 2 CCTs) but not more effective than the knee-chest position treatment. The reviewers concluded that moxibustion, acupuncture and laser acupoint stimulation tend to be effective in the correction of breech presentation. van den Berg I et al. Effectiveness of acupuncture-type interventions versus expectant management to correct breech presentation: a systematic review.Complement Ther Med 2008;16:92-100. A systematic review of studies that assessed the effectiveness of acupuncture-type interventions (moxibustion, acupuncture, or electro-acupuncture) on acupuncture point BL 67 to correct breech presentation compared to expectant management. Six randomised controlled trials and three cohort studies fulfilled the inclusion criteria. In the former, the pooled proportion of breech presentations was 34% following treatment versus 66% in the control group (OR 0.25, 95% CI 0.11-0.58). The pooled proportion in the cohort studies was 15% versus 36% (OR 0.29, 95% CI 0.19-0.43). The reviewers concluded that their results suggest that acupuncture-type interventions on BL 67 are effective in correcting breech presentation compared to expectant management. van den Berg I et al. Cost-effectiveness of breech version by acupuncture-type interventions on BL 67, including moxibustion, for women with a breech foetus at 33 weeks gestation: a modelling approach. Complement Ther Med 2010;18:67-77. A modelling study to estimate the effectiveness and costs of breech version with acupuncture-type interventions, including moxibustion, on BL67 compared to expectant management for women with a foetal breech presentation at 33 weeks gestation. The results suggested that such an intervention would reduce the number of breech presentations at term, thus reducing the number of caesarean sections, and so would be cost-effective compared to expectant management, including external cephalic version. Ee CC et al. Acupuncture for pelvic and back pain in pregnancy: a systematic review. Am J Obstet Gynecol 2008;198:254-9. A systematic review that looked at the effectiveness of acupuncture in treating pelvic and back pain in pregnancy. Two small trials on mixed pelvic/back pain and one large high-quality trial on pelvic pain met the inclusion criteria. Acupuncture, as an adjunct to standard treatment, was superior to standard treatment alone and physiotherapy in relieving mixed pelvic/back pain. Women with well-defined pelvic pain had greater relief of pain with a combination of acupuncture and standard treatment, compared to standard treatment alone or stabilizing exercises and standard treatment. Few and minor adverse events were reported. The reviewers concluded that limited evidence supports acupuncture use in treating pregnancy-related pelvic and back pain. Smith CA et al. Complementary and alternative therapies for pain management in labour. Cochrane Database Syst Rev 2006 Oct 18;(4):CD003521. A systematic review that examined currently available evidence supporting the use of alternative and complementary therapies for pain management in labour. It included three trials of acupuncture involving 496 women. These showed a decreased need for pain relief. The reviewers concluded that acupuncture may be beneficial for the management of pain during labour, but the small number of women studied was a limitation. Smith CA, Cochrane S. Does acupuncture have a place as an adjunct treatment during pregnancy? A review of randomized controlled trials and systematic reviews. Birth 2009 Sep;36(3):246-53. A review that summarised the evidence examining the effectiveness of acupuncture during pregnancy and birthing. All placebo-controlled randomised trials of parallel design, and systematic reviews that evaluated the role of acupuncture during pregnancy and birthing were included. A critical appraisal of clinical trials and systematic reviews was undertaken. The summarised findings indicated that there is some evidence suggesting a benefit from acupuncture to treat nausea in pregnancy, and promising evidence for the effectiveness of acupuncture to manage back and pelvic pain, acupuncture-type interventions to induce change in breech presentation, and pain relief in labour. The reviewers concluded that evidence is beginning to consolidate that shows acupuncture may assist with the management of some complaints during pregnancy. However, they sated that more evidence is needed to confirm this. Wang SM et al. Auricular acupuncture as a treatment for pregnant women who have low back and posterior pelvic pain: a pilot study. Am J Obstet Gynecol 2009; 201:271.e1-9. A randomised controlled trial that examined whether 1 week of continuous auricular acupuncture could reduce low back and posterior pelvic pain associated with pregnancy. 159 women were assigned to an acupuncture group, a sham acupuncture group, or a waiting list control group. All participants were monitored for 2 weeks. The changes from baseline to day 7 showed significant group differences in pain (F = 15; p<0.0001) and in the disability rating index score f="7;" p 0 0001 participants acupuncture group reported a greater reduction pain improvement of functional status compared with those sham control groups The researchers concluded that one week of continuous auricular acupuncture decreases the pain and disability experienced by women with pregnancy-related low back and posterior pelvic pain. Elden H et al. Acupuncture as an adjunct to standard treatment for pelvic girdle pain in pregnant women: randomised double-blinded controlled trial comparing acupuncture with non-penetrating sham acupuncture. BJOG 2008;115:1655-68. A randomised controlled trial that investigated whether acupuncture has a greater treatment effect than non-penetrating sham acupuncture in 115 women with pelvic girdle pain during pregnancy. Women were allocated to standard treatment plus acupuncture or to standard treatment plus non-penetrating sham acupuncture for 8 weeks. The main outcome measure was pain. After treatment, median pain decreased from 66 to 36 in the acupuncture group and from 69 to 41 in the non-penetrating sham group (p=0.493) as assessed on a VAS. Women in the acupuncture group were in regular work to a higher extent than women in the sham group (p=0.041). The acupuncture group had superior ability to perform daily activities measured with the disability rating index (44 vs. 55, P = 0.001). The researchers concluded that acupuncture had no significant effect on pain compared with non-penetrating sham acupuncture, but that there was some improvement in performing daily activities. Manber R et al. Acupuncture for depression during pregnancy: a randomized controlled trial. Obstet Gynecol 2010;115:511-20. A randomised controlled trial that assessed the efficacy of acupuncture for depression during pregnancy in 150 pregnant women given acupuncture specific for depression or one of two active controls: control acupuncture or massage. Treatments lasted 8 weeks (12 sessions). The primary outcome was the Hamilton Rating Scale for Depression, at baseline and after 4 and 8 weeks of treatment. Women who received acupuncture specific for depression experienced a greater rate of decrease in symptom severity (p<0.05) compared with the combined controls="controls" cohen s d="0.46," 95 ci 0 01-0 77 or control acupuncture alone p 05 92 they also had significantly greater response rate 63 than 44 3 and 37 5 symptom reduction rates did not differ between;The researchers concluded that acupuncture specific for depression reduces symptoms and increases response rate in similar amounts to those observed with standard depression treatments and could be a viable treatment option for depression during pregnancy. da Silva JBG. Acupuncture for mild to moderate emotional complaints in pregnancy-a prospective, quasi-randomised, controlled study. Acupunct Med 2007; 25:65-7. A quasi-randomised controlled study that assessed the effects of acupuncture under real life conditions, in the treatment of emotional complaints during pregnancy in 51 women (conventionally-treated with counselling by their physicians and nurses). They were either treated or not by acupuncture. Both groups presented with emotional complaints such as anxiety, depression and irritability. They reported the severity of symptoms using a Numerical Rating Scale (NRS) from 0 to 10; and they rated how much the symptoms disturbed five aspects of their lives: mood, sleep, relationships, social activities, sexual life and joy of living. Over the study period, the NRS scores of intensity of emotional distress decreased by at least half in 60% of patients in the study group versus in 26% of those in the control group (P=0.013). The impact of the distress on three out of the five aspects of life was significantly less in the acupuncture group when compared with the control group (p<0.05).The researchers concluded that acupuncture seemed to be an efficacious means of reducing symptoms and improving the quality of life of women with emotional complaints during pregnancy. da Silva JB et al. Acupuncture for dyspepsia in pregnancy: a prospective, randomised, controlled study. Acupunct Med 2009;27:50-3. A randomised controlled trial under real-life conditions that assessed the effects of acupuncture on symptomatic dyspepsia during pregnancy and compared this with a group of patients undergoing conventional treatment alone. A total of 42 conventionally-treated pregnant women were treated, or not, by acupuncture. They reported the severity of symptoms and the disability these were causing in daily aspects of life such as sleeping and eating, using a numerical rating scale. The study also observed the use of medications. Significant improvements in symptoms were found in the acupuncture group. This group also used less medication and had a greater improvement in their disabilities when compared with the control group. The researchers concluded that acupuncture may alleviate dyspepsia during pregnancy. Guittier MJ et al. Moxibustion for breech version: a randomized controlled trial. Obstet Gynecol 2009;114:1034-40. A randomised controlled trial that estimated the efficacy of moxibustion between 34 and 38 weeks of gestation to facilitate the cephalic version of fetuses in breech presentation and the acceptability of this method by women. BL 67 acupoint was stimulated by moxibustion daily for 2 weeks. The control group received expectant management care. A total of 212 women with breech presentation took part. The percentages of versions and of caesarean delivery were similar in the two groups. Acceptability of the intervention and women's perceptions of moxibustion were favourable. The researchers concluded that there was no beneficial effect of moxibustion to facilitate the cephalic version of fetuses in breech presentation. Despite this lack of proven effectiveness, women had positive opinions on the intervention. Millereau M et al. Fetal version by acupuncture (moxibustion) versus control group [Article in French]. J Gynecol Obstet Biol Reprod 2009;38:481-7. Modlock J et al. Acupuncture for the induction of labour: a double-blind randomised controlled study. BJOG 2010;117:1255-61. A double-blind randomised controlled trial that investigated whether acupuncture is effective for the induction of labour in post-term pregnancies. A total of 125 healthy women with uneventful pregnancies at gestational week 41(+6) were randomised to real acupuncture twice on the same day or sham acupuncture at the same points. The primary endpoint of labour or delivery was achieved in seven women (12%) in the acupuncture group and eight women (14%) in the control group (p=0.79). The researchers concluded that, under the treatment regimen investigated in this study, acupuncture for the induction of labour in post-term women at gestational age 41(+6) weeks may not be effective. Liu J et al. The safety of electroacupuncture at Hegu (LI 4) plus oxytocin for hastening uterine contraction of puerperants--a randomized controlled clinical observation. J Trad Chinese Med 2008;28:163-7. A randomised controlled trial that investigated the safety of electroacupuncture plus oxytocin for uterine contraction in 276 puerperants with difficult labour. The women were allocated to intravenous oxytocin, or electroacupuncture plus intravenous oxytocin. During labour, heart rate, respiratory frequency, blood pressure, fetal heart rate and the birth process, were all within the normal range in all of the women, with better effects in the acupuncture plus oxytocin group. The researchers concluded electroacupuncture plus intravenous oxytocin can intensify uterine contraction, shorten the birth process to avoid probable systemic exhaustion consumption, and with no side effects in either puerperants and newborns. Smith CA et al. Acupuncture to induce labor: a randomized controlled trial. Obstet Gynecol 2008;112:1067-74. A randomised controlled trial that compared the clinical effectiveness of real acupuncture to with sham acupuncture to induce labour. A total of 364 women who were scheduled for a post-term induction with a singleton pregnancy and cephalic presentation were included. There was no difference in need for induction methods between groups: prostaglandin induction: relative risk (RR) 1.20, 95% CI 0.96-1.51; artificial rupture of membranes only: RR 0.93, 95% CI 0.72-1.20; oxytocin only: RR 0.89, 95% CI 0.60-1.32; artificial rupture of membranes plus oxytocin: RR 0.87, 95% CI 0.57-1.33; prostaglandins, artificial rupture of membranes, and oxytocin: RR 0.84, 95% CI 0.37-1.91. The median time from acupuncture to delivery was 68.6 hours compared with 65 for women in the control group. The researchers concluded that two sessions of manual acupuncture, using local and distal acupuncture points, administered 2 days before a scheduled induction of labour did not reduce the need for induction methods or the duration of labour for women with a post-term pregnancy. Labor pain A randomised controlled trial that evaluated the effect of acupressure given during the active phase of labour on nulliparous women's ratings of labour pain. In all, 71 women were given acupressure at acupuncture point spleen 6 (SP6) on both legs during contractions over a 30-minute period (acupressure group), 71 women received light touch at SP6 on both legs during the same period of time (touch group) and 70 received standard care (standard care group). Labour pain intensity at different time intervals after treatment was compared with before treatment. A reduction of in-labour pain was found in the acupressure group and was most noticeable immediately after treatment (acupressure group vs. standard care group p < 0.001; acupressure group vs. touch group p < 0.001). The researchers concluded that acupressure seemed to reduce pain during the active phase of labour in nulliparous women giving birth, but that the treatment effect was small. Ma SX et al. Effect of moxibustion at Sanyinjiao (SP 6) for uterine contraction pain in labor: a randomized controlled trial [Article in Chinese] Zhongguo Zhen Jiu 2010;30:623-6. A randomised controlled trial to investigate the effect of moxibustion at Spleen 6 (SP 6) for uterine contraction pain in labour, and evaluate its safety. In all, 174 women with singleton pregnancies and cephalic presentation were allocated to a moxibustion group, a placebo-treated group and 'blank' group. Moxibustion was applied for 30 minutes when the cervix was 3cm dilated. The uterine contraction pain was assessed using a Visual Analogue Scale (VAS). The VAS scores in the treatment group were obviously decreased after 15 and 30 minutes of moxibustion (both p<0.05), but there were no obvious changes in vas scores placebo treated group and the blank decreased more with moxibustion than other two groups all p 0 05 after 30 minutes of effective rate labour analgesia was 69 5 vs 45 6 43 1 postpartum haemorrhage less apgar score newborn higher. The researchers concluded that moxibustion at Spleen 6 can relieve uterine contraction pain, and is not associated with side effects in either the mother or infant. EA. Kindberg S et al. Ear acupuncture or local anaesthetics as pain relief during postpartum surgical repair: a randomised controlled trial. BJOG 2009;116:569-76. A randomised controlled trial that evaluated two methods of pain relief during postpartum surgical repair in regard to effectiveness, wound healing and patient evaluation. A total of 207 primiparous women with a vaginal delivery at term who needed surgical repair of lacerations to the labia, vagina or perineum were allocated to receive ear acupuncture or local anaesthetics, Pain during surgical repair was more frequently reported by participants given ear acupuncture than those given a local anaesthetics (89% versus 54%, p<0.01). pain intensity was also reported as higher visual analogue scale score 3 5 vs 1 p 0 01 and the ear acupuncture group received more additional relief 53 versus 19 no difference observed in wound healing comparable proportions of participants dyspareunia at 6 months patient satisfaction with allocated pain-relief method lower 69 91 fewer women would recommend to a friend 74 The researchers concluded that ear acupuncture as used in this trial was less effective for pain relief compared with a local anesthetic, and patient satisfaction with allocated pain-relief method was lower in the ear acupuncture group. Essence Healing, LLC | Evanston, IL | Phone: 847.491-1122x21/847.525.1309 | Fax: 847.570.6083 © Essence Healing, LLC |
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