January 10, 2014

Acupuncture and Moxabustion for Breech Birth

 

One of the most common questions I get asked is “can acupuncture help with breech birth”, the simple answer is yes it can but I use Moxabustion (Moxa) and Acupuncture.

From a western medical perspective a breech presentation is when the baby exits the pelvis with the buttocks or feet first as opposed to the normal head-first presentation, and there are a number of presentations:

  • Frank breech – where the baby’s bottom comes first with their legs flexed at the hip and extended at the knees so that the feet are near the ears and approximately 65–70% of breech babies are in the frank breech position.
  • Complete breech –  the baby is sitting cross-legged, with feet beside the bottom.
  • Footling breech – one or both feet exit first and the bottom is at a higher position; this is more common with premature foetuses than full term births.
  • Kneeling breech – the baby is in a kneeling position, with one or both legs extended at the hips and flexed at the knees; this is extremely rare.

 

In most cases by week 37 most breech presentations will turn naturally and no intervention will be needed. However if the breech presentation persists then depending on where you live it may be possible to find a Doctor or mid-wife who will be willing to perform a vaginal breech birth but these are rare in my experience.

A bottom-down position presents some hazards to the baby during the process of birth, and the mode of delivery (Vaginal versus Caesarean) is controversial in the fields of obstetrics and midwifery and though vaginal birth is possible for the breech baby, certain foetal and maternal factors influence the safety of vaginal breech birth which leads to the vast majority of breech babies born, in the west, being delivered by Caesarean section mainly due to the lack of training and experience within western medical practitioners.  It should be noted that in most cases a breech birth, if handled by a suitably experience doctor or mid-wife can be safely delivered vaginally.

Generally in England mid-wife’s will attempt an EVC (External cephalic version) in an attempt to turn the baby by manipulating the baby through the mother’s abdomen. ECV has a success rate between 40–70% depending on practitioner.

For centuries traditional practitioners from East Asia have been using Moxa (Moxibustion) to turn breach presentations with out the need to manipulate the mother and thus avoid any stressors that may be incumbent in an EVC.

Moxibustion is a type of Chinese medicine which involves burning a herb (Mugwort or Artemisia vulgaris) close to the skin over the acupuncture point Bladder 67 (BL67) (Chinese name Zhiyin, Reaching Yin), located at the tip of the fifth toe, has been proposed as a way of correcting breech presentation.  The Cochrane Library (which can be found here), in 2012, conducted a gold standard review of the evidence and concluded that:

There is some evidence to suggest that moxibustion may be useful for turning babies from breech presentation (bottom first) to cephalic presentation (head first) for labour when used with either acupuncture or postural techniques of knee to chest or lifting buttocks while lying on the side.

Moxa brings energy in to the Foot Taiyang (Greater Yang) Meridian (often called the Urinary Bladder Channel (UB)) at the point where the Foot Taiyang meets the Foot Shaoyin (Lesser Yin) Meridian connect, helping to regulate and tonify Qi. If the Qi is not sufficient or is exhausted  will be difficult to maintain the fetus in the correct position as the foetus requires both Shaoyin Qi and Taiyang Qi.

A deficiency of Qi also causes lack of strength, making the labor difficult. UB 67 regulates and tonifies Qi.

Click here for my definition of Qi

See here for Wikipedia definition of Qi

It is important to understand that in any treatment there are certain factors that can be contraindications and moxa is no different so it is important to establish that there is no:

  • Recent uterine surgery, including Caesarean section
  • Low-lying placenta, placenta previa
  • Uterine or pelvic abnormalities, eg uterine fibroids, septum: obstetric staff clearance advised
  • Insufficient liquor (oligohydramnios) or excessive liquor (poly-hydramnios): obstetric staff clearance advised
  • History of any bleeding in pregnancy, antepartum haemorrhage
  • Threatened premature labour
  • Any query about ruptured membranes
  • Any fetal distress
  • Fetal abnormality, any sign of compromised foetus
  • Multiple pregnancy
  • Significant maternal hypertension, any signs of pre-eclampsia, diabetes, cardiac problems or thyroid disease: obstetric staff clearance advise
  • Rh negativity
  • Where Caesarean section is to be performed for other reasons

 

The best results are seen when Moxa is used for a 10 day period for 20 mins per day, now clearly that would be beyond most peoples finances to visit an acupuncturist for 10 days in a row so I have developed a special package where I come to your home and teach the mother and partner how to apply the moxa treatment and provide 10 days of moxa at a cost of £50.

If you would like to contact me to book your treatment or if  you have any questions please contact me here.

I completed my Acupuncture and Moxabustion CPD training with Jani White in 2011