The Essential Guide to Acupuncture in Pregnancy & Childbirth - eBook format

This is the long-awaited book by Debra Betts, author of several articles in The Journal of Chinese Medicine. Debra Betts specialises in the treatment of women during pregnancy and childbirth and in the post-natal period and has taught many courses to midwives. This book covers virtually every aspect of treatment during this time and is designed for acupuncturists, midwives, physiotherapists and medical acupuncturists, with clear glossaries and explanations of both Chinese and Western medical terminology

As a practising acupuncturist midwife I value this book greatly. Debra Betts has condensed all her knowledge of this specialised field to produce a brilliant tool with which we can enhance our clinical practice.

However The Essential Guide to Acupuncture in Pregnancy & Childbirth is certainly not just for currently practising midwife/acupuncturists. It is also invaluable for those midwives and doctors who are presently studying acupuncture to enhance their practice, whilst at the same time it is essential reading for any acupuncturist who works in the field of pregnancy and childbirth or who comes into contact with childbearing women.

When I began using acupuncture in midwifery 14 years ago, there was a dearth of up-to-date, practical resources. I, like many others, often had to experiment with my treatments to discover what was most effective, indeed I am still learning today, as pregnancy never ceases to offer surprises. We know however, that acupuncture has been used in China for obstetrics for many hundreds of years, particularly for delayed or difficult labour. It is from this history that we learn, but it is not until one has been practising for several years that clinical confidence ripens. Even so a fear of ‘getting it wrong’ and causing a problem in a pregnancy may remain. It is a book like this which helps us enormously to overcome these anxieties that are to some degree inevitable when we are involved in treating two lives at the same time.

In The Essential Guide to Acupuncture in Pregnancy & Childbirth, Debra Betts comprehensively deals with every major area of this subject. It covers most of the conditions commonly found in pregnancy and childbirth including miscarriage, nausea and vomiting, heartburn, varicose veins, hypertension, musculoskeletal problems, anaemia, insomnia, anxiety and depression, constipation, itching, oedema, malposition and malpresentation, induction and difficult delivery. Other chapters cover treatment guidelines in pregnancy, pre- and post- natal treatment, a review of current research and detailed dietary advice. Appendices offer well thought out Western and Chinese medicine glossaries that make the book more useful for both non-medical and medical acupuncturists. Particularly valuable is the appendix offering clear illustrations and locations for all the points used in the text.

Each subject is introduced by giving the Western medicine description, explanation and guide to management, then the traditional Chinese medicine differentiation, aetiology and treatment. Treatment emphasises both clinically proven points as well as points selected according to differentiation of patterns, followed by clear explanations of the points used and much invaluable discussion from the author’s clinical experience. Most clinical chapters end with case histories from the author’s own practice as well as from many of the midwives whom she has trained. Many pages have coloured inset boxes emphasising cautions, important features of clinical management, and key point selections for the disorders discussed.

The reader is helped throughout by the use of clear language, well-drawn diagrams and clever photographs as well as comforted by the weight of the book and the fine layout, making its referencing and content easy to use.

There are specific areas in the book that I wish to particularly commend. The chapter on induction is excellent, with much clinically useful information and patient advice. This is an area that I get asked to help with more than any other. I also particularly like the chapter on acupressure during labour and especially the idea of teaching women’s partners or helpers how to use it, although sadly I think that British maternity units are not quite so open to integrated therapies as those in New Zealand.

Debra Betts’ sensitivity as a practitioner also shines through and I find it very much a ‘client-led manual’ which considers all aspects of care. Combined with its academic knowledge and experience, this book has everything that one needs to know in one place.

Sharon Yelland
Midwife and Acupuncturist-Derriford Hospital, Plymouth UK

xi Foreword
xiii Preface
1 Chapter 1 Introduction to acupuncture treatment
during pregnancy and childbirth
1 Safety of treatment
2 Point selection: contraindicated points
3 Needling techniques
3 Number of needles
3 Needle technique
4 Deqi
4 Tonification method
4 Reducing method
4 Even method
4 Ear press needles on body points
5 Moxibustion
5 Positioning and comfort for treatment
5 Working with midwives and doctors
6 Physiological changes in pregnancy
7 The pulse in pregnancy

8 Chapter 2 Miscarriage
8 Western medical information
8 Threatened miscarriage
8 Inevitable miscarriage
9 Missed miscarriage
10 Bleeding in pregnancy
10 Ectopic pregnancy
10 Trophoblastic disease
11 Placenta previa
11 Abruptio placenta
11 A traditional Chinese medicine viewpoint
11 Threatened miscarriage
14 Inevitable or missed miscarriage

19 Chapter 3 Nausea and vomiting during pregnancy
19 Western medicine information
20 A traditional Chinese medicine viewpoint
33 Chapter 4 Heartburn
33 Western medical information
34 A traditional Chinese medicine viewpoint

37 Chapter 5 Constipation
37 Western medical information
37 A traditional Chinese medicine viewpoint

41 Chapter 6 Varicose veins, haemorrhoids and vulval varicosities
41 Western medical information
41 Varicose veins
41 Thrombophlebitis and deep vein thrombosis
42 Haemorrhoids
42 Vulval varicosity
43 A traditional Chinese medicine viewpoint

49 Chapter 7 Urinary tract infections
49 Western medical information
50 A traditional Chinese medicine viewpoint

55 Chapter 8 Musculoskeletal conditions
55 Western medical information
55 A traditional Chinese medicine viewpoint
57 Rib pain
57 Pain of the symphysis pubis
58 Pain of the neck and upper back
58 Lower back pain and sciatica
59 Carpal tunnel syndrome
60 Leg cramps

67 Chapter 9 Fatigue and exhaustion
67 Western medical information
67 A traditional Chinese medicine viewpoint

75 Chapter 10 Anaemia
75 Western medical information
76 A traditional Chinese medicine viewpoint
79 Western dietary advice
79 Chinese dietary advice

82 Chapter 11 Insomnia
82 Western medical information
82 A traditional Chinese medicine viewpoint

87 Chapter 12 Anxiety and depression in pregnancy
87 Western medical information
87 A traditional Chinese medicine viewpoint
94 Chapter 13 Vaginal discharge and itching
94 Western medical information
95 A traditional Chinese medicine viewpoint

99 Chapter 14 Itching in pregnancy
99 Western medical information
99 PUPPP (pruritic urticarial papules and plaques of pregnancy)
99 Papular dermatitis of pregnancy
99 Prurigo gestationis
100 A traditional Chinese medicine viewpoint

104 Chapter 15 Sinusitis
104 Western medical information
104 A traditional Chinese medicine viewpoint

108 Chapter 16 Pregnancy-induced hypertension
108 Western medical information
108 Blood pressure changes
109 Protein
109 Oedema
109 A traditional Chinese medicine viewpoint

117 Chapter 17 Oedema
117 Western medical information
117 A traditional Chinese medicine viewpoint

122 Chapter 18 Small-for-dates babies
(intrauterine growth retardation)
122 Western medical information
122 Maternal illness
122 Pregnancy related illness
122 Maternal lifestyle factors
123 A traditional Chinese medicine viewpoint

128 Chapter 19 Breech and posterior positions
128 Western medical information
129 Malposition
130 Malpresentation
130 Breech presentation
130 Other malpostitions and their complications during labour
131 Correction of foetal position
131 A traditional Chinese medicine viewpoint
135 Clinical studies

139 Chapter 20 Acupuncture as a routine prebirth treatment
139 Western medical information
140 A traditional Chinese medicine viewpoint
148 Chapter 21 Induction
148 Western medical information
149 Reasons for induction
150 A traditional Chinese medicine viewpoint
150 Acupuncture points to promote labour

160 Chapter 22 Intrauterine death
160 Western medical information
160 A traditional Chinese medicine viewpoint

165 Chapter 23 Acupressure in labour
165 Using acupressure to promote an efficient labour
166 Teaching acupressure
167 The acupressure points
171 Feedback on using acupressure

173 Chapter 24 Labour and delivery
173 Western medical information
173 The first stage of labour
175 The second stage of labour
175 The third stage of labour
176 Medical intervention in labour
177 A traditional Chinese medicine viewpoint
177 Uterine contractions in a labour with failure to progress
178 Unfavourable cervical dilation and effacement
178 Malposition
178 Premature rupturing of the membranes
179 Retention of the placenta
179 Clinical practice: points to promote labour
183 Research and experience from midwives
183 Comments by women on their experience of having
acupuncture during labour

189 Chapter 25 Postnatal treatment
189 Western medical information
190 Possible complications
190 Retained products
191 The development of a deep vein thrombosis
191 Infection of the caesarean scar
191 Mastitis
192 Depression
192 A traditional Chinese medicine viewpoint
192 Postnatal tonification treatment
193 Mother warming
193 Other tonification treatment
195 Persistent uterine bleeding
197 Afterpains
199 Night sweats
199 Perineal discomfort
199 Breast-feeding problems
199 Insufficient lactation
201 Mastitis
202 Postnatal depression

210 Chapter 26 A review of research into the application of acupuncture in pregnancy
210 Acupuncture and pelvic pain in pregnancy
212 Acupuncture and morning sickness
214 Moxibustion for breech presentation
216 Prebirth acupuncture
218 Acupuncture for cervical ripening

221 Chapter 27 Dietary advice during and after pregnancy
221 Western medical information
223 Protein
224 Fats
225 Carbohydrates
225 Vitamins
225 Minerals
226 Diet during pregnancy
227 Recommended nutrients during pregnancy
233 Foods to be avoided or approached with caution in pregnancy
235 A traditional Chinese medicine viewpoint
235 Nutrition according to Chinese medicine
235 The five flavours and the four natures of food
236 Strengthening the Spleen
238 Diet during pregnancy

251 Appendix 1 Moxibustion therapy
251 Guidelines for using moxa
252 How to use the moxa stick

253 Appendix 2 Determining a pregnancy and estimating the due date
253 Determining a pregnancy
254 Estimating the date of delivery

256 Appendix 3 Antenatal tests for foetal abnormalities and maternal problems
256 Ultrasound
257 Nuchal ultrasound
257 AFP (alpha fetoprotein) test
257 Chorionic villus sampling and amniocentesis
258 Antenatal tests for maternal problems
258 Blood tests
258 Urine tests
259 Blood pressure readings
259 Vaginal swabs

260 Appendix 4 Western medicine glossary

266 Appendix 5 Chinese medicine glossary

278 Appendix 6 A pictorial representation of pregnancy and birth

283 Appendix 7 Location and needling of points used in the text
283 Area 1: Points of the hand (dorsum)
285 Area 2: Points of the medial and lateral forearm
287 Area 3: Points of the face and head
289 Area 4: Points of the back
294 Area 5: Points of the lower abdomen
295 Area 6: Points of the upper abdomen
297 Area 7: Points of the anterior and lateral lower leg
and the foot (plantar)
299 Area 8: Points of the medial and posterior lower leg
301 Area 9: Points of the top of the foot
303 Area 10: Points of the medial and lateral foot and ankle

305 Appendix 8 Developing an acupuncture practice for pregnancy and childbirth

307 Appendix 9 Acupuncture in midwifery practice (by Lisa Errol)

310 Bibliography

313 Index

319 Point location index

Chapter 19: Breech and posterior position