Obstetric Acupuncture

Anastasia Baker: Many women who are having problems conceiving or problems during their pregnancy are seeking out acupuncture to help them. Well, with us to tell us more about this kind of treatment is Jani White, a traditional acupuncturist, and also one of her patients, Danielle Reid. Now, tell us why did you seek out acupuncture during your pregnancy? Danielle Reid: Well, I had a breech baby at 29 weeks, and she was still breech at 34 weeks, so I really had to do something to try to move her. Anastasia Baker: But why did you think acupuncture could help? Danielle Reid: I looked on the Internet. My midwife said there wasn’t a lot that we could do, but I thought there probably was, and so I looked on to the Internet and saw acupuncture as an option. Anastasia Baker: And how has it helped? Danielle Reid: Well, she has turned, and at 36 weeks now she is head down. Anastasia Baker: How many weeks was she the wrong way up? Danielle Reid: She was the wrong way up for about seven weeks. So that’s fantastic. Anastasia Baker: And you put that all down to acupuncture? Danielle Reid: Well, I was skeptical to start with, however, I can't see any other thing that would have turned her. Anastasia Baker: Fantastic. Jani, how could acupuncture have helped Danielle? Jani White: In terms of the breech baby? Anastasia Baker: Yes. How did you manage to turn this baby around? Jani White: That's a very good question Anastasia, a difficult one to start with. Acupuncture has been used for pregnancy and childbirth for some 2,000 years, and in Chinese medicine itself, gynecology is perhaps the most understood aspect of Chinese medicine, and this method of turning breech babies has been used for centuries. So we have a great deal of empirical knowledge, and recently there was a study done jointly in China and in Italy, and in China they had a 90% inversion rate. Anastasia Baker: But is it safe to be sticking needles into -- Jani White: It's not needles for turning breech babies, we need to be really clear about that. But certainly acupuncture antenatally and during labor and postpartum, after the baby is born, is a most wonderful therapy. It's completely safe, and I think that moms really, really appreciate it, and more and more women are turning to it, especially when they are pregnant, because they know that they can have this treatment, and the sure knowledge that it's completely safe with the baby. Anastasia Baker: Can you show us then what kind of treatment you are doing on Danielle? Jani White: Certainly. Well, if you just lie back first Danielle. So Danielle is 36 weeks' pregnant, so now her baby is the right way down, head is down. So she is cephalic presentation. So she is in an absolute perfect position. And at 36 weeks, she is going into the transition now, which is out of the development of the baby and into the prelabor phase. The pregnancy is of course divided into trimesters. So the first trimester is all about building up the center and the baby is finding its form. The second trimester is all about the development of the form. The third trimester is all about the refinement of that form. Anastasia Baker: So can you show us exactly what you are going to be doing? Jani White: Sure. From 36 weeks, we are very much turning our attention away from the development of the pregnancy, where the baby is going to be. All that this baby is going to do now is get bigger. So at this stage we really want to turn our energy to understanding what the mother needs. She has got to be prepared to deliver this baby. After 36 weeks of packing, one can feel a little bit tired. The reality is that most women these days are working through their pregnancies, and so work has a very depleting affect on energy. Pregnancy is something that requires a great deal of rest. So acupuncture antenatally is an absolutely wonderful way to help to counter that depletion. So all the way through the treatment antenatally, we like to help build the mother’s energy, and in this stage we really want to strengthen her, and make sure she has a lot of reservoir of energy to be able to have the stamina to do the labor. So in Chinese medicine one of our main diagnostic tools is the pulse diagnosis. So when you come for an acupuncture treatment, you will find your practitioner will always start with the pulses. Anastasia Baker: So this is not about sticking needles in. Jani White: Not at this stage. Anastasia Baker: Not at this stage. Jani White: What this is going to do is tell me which needles I need to use. So pulse taking is a marvelously sophisticated means of understanding how the systems in the body are communicating with each other. So in Chinese medicine, each of the Meridian systems is named for an organ. So we refer to liver energy, kidney energy, spleen energy; we are not referring to the organs specifically. We are referring to the whole Meridian system that governs the function within its realm. So the way our physiology works is a confluence, is a constant exchange of information between these energy systems. So by feeling the pulse, we are listening to 12 different pulses. Anastasia Baker: And how is Danielle, how is her pulse? Jani White: Danielle. Well, her liver energy is slightly low, her kidney energy is slightly low. Anastasia Baker: In fact, quite normal. Jani White: She is very normal, especially at this stage, and especially for a working mom. She has just finished work last Friday, so we now know she has got these four weeks to rest and prepare. So this treatment today is very much about helping to prepare her body, as I said, by strengthening and supplementing the energies that are feeling weaker. So through the pulse diagnosis, it's helping me to choose which points need to be used. Anastasia Baker: And Danielle, do you feel the baby turning was purely done to the acupuncture that you had? Danielle Reid: I do, yes. Anastasia Baker: Because a lot of people might be quite skeptical about that. What did the doctors say, for instance, yesterday when -- Danielle Reid: Well, the doctor yesterday wasn't familiar at all with moxa and the power of moxibustion with acupuncture. So she was quite skeptical about it too. But I believe that she did turn because of that. Anastasia Baker: And the doctors never gave you any others ways or other methods to try and turn your baby? Because I was told to kneel on my hands and knees. Danielle Reid: Disappointingly. Sort of the main thing they said was about the cesarean. Anastasia Baker: Do you find this more and more with pregnant women that are having these options that -- Jani White: There is very little option now. It used to be that obstetricians were reasonably skilled at delivering breech babies. These days if you have an obstetrician whose specialty is delivering twins, usually one of the twins will be in a breech position. But hospital protocol very much prefers to take cesarean as the best option for delivering breech babies, because they believe it's the safest way to deliver breech babies. Danielle's circumstance was slightly different in that her baby was bum down. So her head and arms were up and her feet were up, but her bosom was wedged in the pelvis, and this would be an impossible delivery, that there would be no option but to do a cesarean in those circumstances. Anastasia Baker: Could it turn again there, she has still got a few more weeks? Jani White: It's very, very unlikely. The best week for turning a baby is week 34, it's what's called the maximum liquor viscosity; I just like saying that. It sounds very good. It's where the baby is big enough, and there is still enough fluid, that it's very much easier for the babies to turn at that stage. Once they start to get to 36, 37, 38 weeks, the size really makes it very much more difficult for them to turn. So it's less and less likely as the weeks go by. But once a baby is head down, this is the appropriate position to be in. So we think with Danielle's baby, because the pelvis -- the baby's bottom was lodged in the pelvis, that the chances of that baby turning on her, no matter how long she lay upside down on an ironing board; don't do that at home, that it was very unlikely that the baby would have had enough impetus, but we know that doing the moxibustion treatment for breech creates a tremendous capacity in the body to signal how that baby needs to be, and cephalic is the right way down, the head needs to be down. Anastasia Baker: So let's see, I have noted you washed your hands; obviously hygiene is a critical part of this treatment. Jani White: Absolutely. As members of the British Acupuncture Council, we are bound by a code of Safe Practice, and so I have prepared a clean field here, and we of course use disposable needles. So I have everything ready to do a treatment. I have taken Danielle's pulses, so I have an idea of which points I need to do. So what I need to do first is what's called, just to do some marking up, to actually find the point that we are looking for. What I am going to do today; just lift your knee, is to use a point, which is kidney nine, which traditionally we use at 12, 24, and 36 weeks, because these are the transition moments in the pregnancy. And kidney nine, the translation of the Chinese character is building guest. So it has been understood for many centuries that by needling this point, we bring a great wealth of energy into the whole system. And it's also understood to be corrective as well, that if there is anything untoward within the development, that this is an excellent point for helping the system to send the energies in the appropriate directions, to bring the best development possible. Anastasia Baker: Would you be able to detect that if there were problems in the womb? Jani White: Absolutely not. Anastasia Baker: No. Jani White: Absolutely not. I rely on nature quite a lot. So we have our assumptions. We have all the signs and symptoms that we need to look for. So of course everything that would be naturally monitored in your antenatal process. So I am the member of the Acupuncture Childbirth Team in Oxfordshire, and we are a group of 20 acupuncturists who specialize in doing obstetric work. And we have built up a marvelous relationship with the local midwives, and we all have contracts with the local hospital to be able to do acupuncture and labor in the hospital. Anastasia Baker: To help with pain. Jani White: Indeed. Actually, to help with pain is a bit misleading. I would never choose to say to women that I think acupuncture is good for pain relief in labor. What I would always say about labor and having treatment in labor is that, it is most excellent for your stomach, is most excellent at helping you keep calm and focused, and it really brings an edge of power to your focus, because the more inward a woman can be during her labor process, the more intuitively she can respond, and the much easier it is for her to cope with her labor. So it's not about pain relief per se, it's very much about really enhancing your coping capacity. Most of the girls who we treat do say that they experience much less pain. So I am just gently placing the needle against the points, and Danielle, take a breath in, and down. Anastasia Baker: Does that hurt Danielle? Danielle Reid: No, not at all. Jani White: So I am just going to place the needle here, and I just want to feel the pulse, and get a sense of how the body has responded to having that point needle, which is very nice indeed. So I am going to work bilaterally. Most of the Meridians are bilateral on both sides of the body. So this is a measuring tool that we use. So the way that we find the points, they have very specific anatomical locations all over the body, and points which are between landmark bones need to be measured. So this is a measuring system which allows us to know where on the body we need to find this point. So that's just given me a marker to my distance, and now I am able to find the channel. So they always work with disposable needles. Take a breath in. Anastasia Baker: What about those people who may be concerned about having this sort of treatment when there is a baby inside them in the room? Could it be harmful to the baby? Jani White: Just a moment, take a breath in, and out. The way that acupuncture works is about the governance of the natural flow and movement of energies in the body, and the natural exchange which must occur for the physiological process to work. So acupuncture, it's extremely difficult, if not impossible to do a wrong treatment, because if you were ever to do a point which the system couldn’t cope with, if it was asking the body to do something that it was not able to do, the body would just say no and literally reject the treatment. So that might create some small repercussion. You might just feel very, very tired, or you just get the sense that you want to be still or quiet, or you just need time to recover while your body says, get back to homeostasis. But, what we will always do after needling a point is check the pulse. So if there has been an untoward response to the acupuncture, then we will instantly feel that the system is agitated by this. So when somebody comes in for a treatment, we will work until the pulse is nicely supplemented, and everything is calm and relaxed and harmonized. Anastasia Baker: Can you show us how it actually works within the whole body in the system? Jani White: I can. I need Danielle to sit up. This is a chart that shows the Meridian systems. There are 12 main Meridians and 2 Meridian lines right up the front and back of the body, so 14 Meridian lines in all, and everywhere that you see these dots are the acupoints. There are over 500 acupuncture points on the body, 365 on the Meridian channels. So this is a very well understood map. Looking at this map is like looking at a map of the London underground. So when you look at your map of the London underground and you figure out which station you need to go into and how you have to maneuver it to get to where you want to be. Anastasia Baker: For pregnant women or women trying to conceive, there must be certain areas that you deal with them. Are there, at the back? Jani White: There are points which are forbidden during pregnancy, so it's very, very, important. If you are looking for an obstetric acupuncturist, you definitely want to refer to the British Acupuncture Council, and you definitely want to find a practitioner who has done postgraduate study of pregnancy, because it is entirely safe, but as I said, this is very well understood in Chinese medicine, and it's terribly important that the acupuncturist knows which points may be not be used. Anastasia Baker: Like which points on the body can’t be used, which ones? Jani White: Well, the first rule of thumb, there are many points that -- I am not used to any specific months, but certainly the rule of thumb has to be the height of the fundus. So as the pregnancy develops, wherever we can find the height of the fundus, that’s the top edge of the uterus, then we cannot needle below that. So we would never ever needle in the abdominal region, and as the pregnancy develops, we would become more and more restricted. So in early pregnancy, we would be very happy about using all of these points in the upper abdomen, which are marvelous for settling morning sickness, which most women now suffer as all day sickness, and some sadly have what we call 24X7, where they just are feeling unwell all the time. The great thing about Chinese medicine is that it has the power to differentiate. I am going to do some points on Danielle’s back, because at this stage of the pregnancy I know that these points that I am going to be using aren't the best possible points to supplement her energy, but they are completely safe in the context of the pregnancy. And otherwise, certainly during pregnancy, the majority of the points on the arms and hands and the lower leg are absolutely safe, but there are specific points which much never be used during the pregnancy, but we do use those for induction treatments. So there are points which we will stimulate later. So what I am going to do now, from having felt Danielle’s pulses, is I am going to do a process which is called marking up the back. So I am marking out the vertebra on her back, so that I have my landmarks as to where I am going to find these acupuncture points. I know that by doing this that Danielle is going to feel a real difference in her energy. Can you explain how you felt after the last treatment that we did? Danielle Reid: Completely energized. I think there is always a day afterwards where you feel slightly more tired than you would normally, and then progressively from there, over the next sort of five to seven days, my energy level has just soared, which has helped a great deal in having to work so far -- Anastasia Baker: So how many treatments have you had? Danielle Reid: I have had a couple of treatments now, and then the Moxi treatment for the breech as well. Anastasia Baker: So three in all? Danielle Reid: Yes. Jani Baker: Well, when we do moxibustion for turning breech babies, I bring the parents into the clinic, as any practitioner does, and we teach the dads how to do this, and the moxibustion for turning breech needs to be done twice a day, for seven to ten days, and in Danielle’s case, it was day 9 that she moved her baby. Danielle Reid: It was, it was. Anastasia Baker: What was your husband doing? How does that work? Danielle Reid: Well, we would clear some time twice a day, and then he would perform the moxa treatment. Anastasia Baker: What is that? Danielle Reid: The stick of Chinese moxa. You light the end of it, and then it's placed on a post point, which Jani had already shown me, and then post against it. Anastasia Baker: What was your post point? Danielle Reid: On the corner of each little toe. Anastasia Baker: I mean, it does sound extraordinary. Danielle Reid: It does sound bizarre. Anastasia Baker: But it works. Danielle Reid: But it works, and the movement of the baby during those treatments was phenomenal. Anastasia Baker: But who is to say it wouldn’t have happened naturally? I mean, how can you tell, how can you say it worked? Danielle Reid: I think your body tells you a lot. My body was telling me, my baby was telling me that she wanted to move, and whether it was an accident or whether it was a coincidence, I don’t know. Anastasia Baker: So you don't know, you do fully attribute acupuncture to the success of this. Danielle Reid: I do. Anastasia Baker: you do. Danielle Reid: I do. Yes, I can't see any reason why she would have moved after such a long period of time in that position. Jani White: It's very clear when doing the treatment, the patient is turning, we used this, this is the Mox of roll, the Mox is used down below at 67. This is a point which is absolutely forbidden to needle during pregnancy. Anastasia Baker: So what is this Moxa? Jani White: Moxa is a herb and this has been used for centuries in China and using Moxibustion is – Anastasia Baker: Not making you sick. Danielle Reid: Oh, it really just smells. Anastasia Baker: I mean it smells really heighten during pregnancy, this would really – Danielle Reid: I am very lucky that it's been such a great liver, and that I've been able to do outside. Anastasia Baker: Really good because it doesn't -- Danielle Reid: It is very strong. Anastasia Baker: How long you have been burning it for? Danielle Reid: On average 10 minutes twice a day. Each time say 20 minutes of time. Anastasia Baker: And what does your husband think? Did he think of this as mumbo jumbo or was he really behind it? Danielle Reid: It just start with, I think he was quite skeptical but as time progressed and I was really feeling its movements and he believed it. Anastasia Baker: So how many weeks to go, 3, 4? Danielle Reid: 4 weeks. Anastasia Baker: 4 weeks, it's going to be before your due date? Cleanse this area. Danielle Reid: Hopefully. Jani White: Well, there is no reason, I told to you I expect that Danielle would need a Cesarean for any reason. Anastasia Baker: Are you going to continue the treatments though? Danielle Reid: Yes, I am for the energy and those afterwards as well. Anastasia Baker: You are going to continue after it. Danielle Reid: Yes. Anastasia Baker: Why? Because you feel like it gives you – Danielle Reid: Because I do feel difference, I do feel energize. Jani White: Danielle, take your breath in and out. Anastasia Baker: And how expensive is it, Jani? Jani White: It varies all across the country. So rates are very much set, alright, this was a socioeconomic background of the area, take your breath in and out. Anastasia Baker: But it's not something that VNHS pays full. Jani White: I am not certain about obstetric acupuncture, but certainly acupuncture is so well understood for pain relief and there are many, many people who are able to receive a course of 6 treatments on the NHS. But at the moment, the department of health is working to regulate acupuncture so within 12 to 18 months, the story will change completely and acupuncture will become a registered therapy which means then that the medical community will be able to refer to acupuncture. Okay, Danielle take your breath in, and out. So we use the breaths very much to help to ease the needles in. Anastasia Baker: Does it hurt? Jani White: No. Anastasia Baker: Does that hurt, Danielle? Have you just got used to it or did it hurt initially? Danielle Reid: No, I honestly, it doesn't hurt at all. Jani White: Danielle take a breath, and out. Anastasia Baker: How does it feeling? Danielle Reid: A slight pinch. Anastasia Baker: Like a pinch. Danielle Reid: Like a pinch. Anastasia Baker: You think a lot of energy crossing through you. Danielle Reid: A very, just a very relaxed and calm after each pin, like I said. Jani White: This is a very common response. Most people do find that acupuncture is tremendously relieving stress. Stress is what happens when our body is trying to expedite something that is finding very difficult to do and so if we are asking a body to run too hard on two little reserves then you, probably you just wouldn't do that to your car, would you? Anastasia Baker: No, but I remember having it and I thought wipe out the next day, why would that be? Jani White: That's a very common response. Anastasia Baker: But you don't, you feel energized. Danielle Reid: I did feel drained for the first day. Anastasia Baker: The first day you feel -- Danielle Reid: Yes I did and then slowly progressed. Jani White: I think it's a funny kind of a tired the way I would describe it, when a people come for their first treatment, I always ask them to expect that over the next 24 to 48 hours that they may feel tired, and if you do feel tired, if at all possible get horizontal, because actually the tiredness is two things, partly it's a reality check and your body is actually feeling not it really genuinely feels, most of us feel tired most of the time and it's also a particular feeling of what's happening because your body is working. So although we are doing this treatment now, and the needles have come out and we are going to finish the treatment, Danielle is going to go home, she probably won't feel as tired as she did after the first few sessions, the body becomes accustomed to receiving the treatment. When the needles come out, the treatment merely has only just begin, and it does takes time. I started to say about looking at this is a -- imagining when you are looking at the London Underground map, well the reality of that in three dimensions is a tremendous network of tunnels and passageways and connections all the way under the streets of the city, all connected in with the sewer system as well. So again an astonishingly complicated thing to imagine how that London Underground system works, and the radiant system works in the same way. So it's all about messaging, and we use the needles to message through the body, this needs to be here that, that needs to be there, this needs to be moved, this needs to be released. It is a lot of work. Anastasia Baker: What would you say to this to girl at home that think it is a really mumbo jumbo? Jani White: Come and have a treatment is what I would say. I do this work four days a week. It's full time for me, I see on average 20 – 25 people in a week. Anastasia Baker: How do you measure the success rate? Jani White: Through the pulses. Anastasia Baker: Really? Jani White: Absolutely, through the pulses, but the way that I would really measure the success is, that I study Chinese medicine, I study from the classes which tell us that these point should do this, these point should do that, and it proves itself to me time and time again, people come back and they say, this is much better, this is really changed, I feel different. And that's what we are affecting. We are helping the body, find its resolve for helping the body move to the point where it can move with its best fluency and genuinely, in practice I see it consistently everyday. Anastasia Baker: And Danielle would you agree that? What would you say to this pregnant mothers out there who maybe having problems Danielle Reid: I think it's certainly something that you should try. I have been absolutely flabbergasted by what it has done for me. Anastasia Baker: Fantastic, well thank you very much to both, to Jani White and to the Danielle Reid, and all the best in the coming weeks. Danielle Reid: Thank you very much. Anastasia Baker: Thank you. Jenny White: Excellent