easier shorter safer birth

Easier, shorter and safer birth

www.MaternityAcupressure.com

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Easier, shorter and safer birth A Golden Publishing House book November 2006 All rights reserved Copyright ©2006 by Golden Publishing House Pte No part of this book may be reproduced, transmitted or sold in any form or by any means, electrical or mechanical, including photocopying and recording, or by any information storage or retrieval system without permission in writing from the publisher. For information address: www.GoldenPublishingHouse.com Catalog in Publication Data: (National Library Board, Legal Deposit Office, Singapore 486548) Leino, Lena Easier, shorter and safer birth ISBN 981-05-7211-5



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The information provided in the “Easier, Shorter and Safer Birth” book is for educational and informational purposes only and in no way should be considered as an offering of medical advice. The reader should regularly consult a licensed health care professional in matters relating to her pregnancy, labor and health and particularly in respect to any symptoms that may require diagnosis or medical attention.



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Acknowledgments I wish to thank all the people who have been part of the creation process of this guide and who have helped to publish and to share a small portion of the power of acupressure. I am especially thankful to Debra Betts (NZ Reg. Nurse, Lic. Acupuncture British College, Diploma of Acupuncture, MNZRA) for her superior help. Her knowledge about labor acupressure is extraordinary. By sharing her vast knowledge, she remarkably expanded my understanding about this wonderful method of acupressure. I am also grateful to the wonderful models who feature in this guide; Mrs. Beatrice Stirrup and Mr. Juha Ylitalo.

Finally, I sincerely wish that as many people as possible come across this effective and safe technique and take advantage of the benefits acupressure has to offer. Lena Leino November 2006, Singapore



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Content:

Remarkable benefits of Labor Acupressure 6

About Labor Acupressure 6

Is it safe for the mother and the baby? 7

High blood pressure and diabetes of the mother 7

VBAC and acupressure 8

Medical induction, pain medication and acupressure 9

Acupressure and medical doctors 10

Effectiveness of acupressure 10

Appropriate time to induce labor using acupressure 11

How fast does it work? 11

What if I don't have any experience in acupressure? 12

How do you know that you are working on the right spot? 13

How much pressure should be applied? 14

Applying acupressure: the technique 14

Pressure-applying techniques

Firm pressure with rotation 15

The pressure-release procedure 16

Rubbing 16

Acupressure tools 16

The specific points for induction and pain relief 16

Acupressure points:

Induce labor 18

Turning a posterior baby 28

Labor pain relief 31

Anxiety and nervousness 40

Relaxation 42

Nausea and vomiting 45

Make better progress with labor

Strengthen contractions 49

Dilate better 49

Better progress during the second stage 50

References 53



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Remarkable benefits of Labor Acupressure Acupressure is extremely effective for inducing labor, giving pain relief and helping at any stage at which the mother may get stuck. Some acupressure techniques are helpful in more specific situations, for example, in turning the posterior baby into the right position, vomiting, and in slow labor. The father, significant other or any other supporting person is able to support the birthing mother in labor using acupressure with very little practice – or in some cases without having any previous acupressure experience. Many birthing mothers have been surprised how effectively their partners were able to use some acupressure techniques on them in order to get the labor started when they were threatened with medical induction. These women were also impressed at how effectively their partners were able to apply acupressure for pain relief during labor. In addition, many fathers and supporting persons have said it was a real help to be able to focus on the mother and the baby in a simple, practical way, rather than relying on machines. They felt great to have a means of being helpful, to be able to give pain relief and make the birth proceed more smoothly and with less medical intervention. Acupressure can help to induce labor naturally, provide effective pain relief and reduce the need for medical intervention. Given the many benefits of this simple and flexible technique, the question should really be: why aren’t more people using acupressure?

About Labor Acupressure Acupressure is a simple technique for enabling parents to experience as natural and uncomplicated a birth as possible. The technique is very straightforward: it is just a specific way of touching the body. Acupressure works on a similar principle to acupuncture, but instead of needles only pressure is applied to various points on the body in order to enable it to work better. Thus the key feature of acupressure is the use of pressure, which is usually experienced as calm and relaxing sensation even though it works deeply on the body. The practitioner uses the hands, especially the thumbs and palms, to apply pressure on specific spots located all over the body. Both acupressure and acupuncture work using the self-adjusting and natural self-healing mechanisms of your body. These mechanisms are mediated by the nervous system, spinal cord and midbrain. In addition to these, the benefits of acupressure and acupuncture are mediated by the neurohumoral and immune systems, meaning cellular chemical messengers, neurotransmitters and



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hormones, antibodies, interferon, etc. Chinese medicine is founded on the idea that stimulating the body’s own energy reserves enables it to function more effectively.

Is it safe for the mother and the baby? Naturally, the first concern of any expectant parent is for the wellbeing of both mother and child. Ever since acupressure has been being used during labor it has yielded only positive results. Midwives closely monitor the behavior of the baby throughout the birth. This is the case with midwives using acupressure as well. Any signs of distress, or sensation that the labor was moving too fast and they would, naturally, abandon the practice of acupressure immediately and would not advocate it as a birth aid. On the contrary, experienced midwives have been amazed at how helpful acupressure has proved to be, with many reporting how acupressure helped the birthing woman’s cervix to dilate, made contractions more frequent and gave remarkable pain relief for the mothers. Many have used acupressure for inducing overdue pregnancies. Furthermore, studies where groups of expectant mothers have had one or two pressure points stimulated during labor have shown absolutely no negative feedback. Acupressure never works against your body – it just encourages it to work better and more efficiently. Thus acupressure doesn’t overstimulate the uterus or cause precipitate labor - in precipitate labor the mother gives birth so quickly that both she and the new baby go into shock, this is sometimes a feature of a medical inducement. Indeed, the beauty of acupressure is that it is a way of working with the body; effectively helping the body to help itself. It simply doesn’t have the power to overwhelm the body, unlike some of the oxytocin drugs used as conventional birth aids. Thus, there is no danger that acupressure can cause any injury or distress to the unborn child or the mother. Actually, acupressure can prevent the baby from becoming distressed during labor because acupressure makes the birth easier and shortens the labor in a natural way, helping to avoid medical interventions and their well-known side effects.

High blood pressure and diabetes of the mother Acupressure works with the body, enabling it to function more effectively. This means that whatever the woman’s physical condition, stimulating her body’s own



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energy will not counteract or interfere with any other treatment and can only be helpful in assisting the birth. Furthermore, in the case of a woman who is being induced because of high-blood pressure, diabetes, or any other medical condition, using acupressure is particularly beneficial and allows the medical induction to progress as smoothly as possible. Acupressure can also be used to induce labor naturally and avoid the medical induction.

VBAC and acupressure Earlier it was widely believed that once a mother had given birth via a cesarean section that any additional babies would also have to be born via cesarean section. Nowadays, however, studies have shown that the vaginal birth is perfectly safe and 80% of mothers have successful vaginal births, despite having had a previous cesarean delivery. Vaginal birth after cesarean (VBAC) is usually safer for the mother and baby. For the mother, recovery is quicker, there's less risk of infection and blood clots, less blood loss, and for many breastfeeding will come easier after a vaginal birth (not to mention shorter hospital stay and smaller expenses). There are many advantages for the baby as well, most of which are related to the delivery process and can help the baby to prepare for life outside of the womb. For example, the immune system works better in babies who had a vaginal delivery. As with mothers with high-blood pressure, diabetes or any other kind of medical condition, acupressure is very beneficial if you wish to have a normal vaginal birth after a cesarean section. Using acupressure during labor stimulates the supply of nutrition and oxygen to the uterus by increasing the blood flow and helping the cervix to dilate. In essence, it assists in making the birth as natural as possible. The main concern where the mother has had a previous cesarean is that labor might progress too quickly, which in turn causes other problems, such as uterine rupture. Acupressure does not and cannot overstimulate the body, and so there is no risk in applying acupressure before and during a VBAC. On the contrary, labor acupressure helps your body to do its best and minimizes the need for strong pain medication, which often slows down labor and increases the risk of a cesarean section.



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Medical induction, pain medication and acupressure Where, according to some reports, up to 50% of medical inductions result in the mother having a cesarean section, acupressure is used as a way of facilitating a natural birth. The high proportion of c-sections after medical induction are due to facts like the baby not descending into the pelvis and the cervix not dilating enough for the baby to be born. In addition, the prostaglandins and oxytocin that are used in medical inductions often cause the contractions to be too intense which, in turn, increases the need for pain relief and epidurals and other complications related to these medical interventions. And sometimes even medication doesn’t start the labor. In these instances, cesarean birth becomes the safest option. Acupressure, however, is used to increase the flow of nutritious and oxygen-rich blood to the pelvic region and prime the body for birth, and thus to encourage the onset of natural labor which itself significantly reduces the likelihood of a cesarean delivery. Thus, unlike medications that force labor to start, acupressure works with your body to encourage and assist the contractions to start naturally, to get your cervix to ripen and dilate, and to get the baby to descend into your pelvis. Stimulation of specific acupressure points has been scientifically shown to induce labor (Complement Ther Med. 2005). Up to 70% of women using acupressure techniques will go into labor spontaneously. Thus simple acupressure techniques which you can do at home remarkably reduce your risk of being medically induced in a hospital. When a medical induction is unavoidable, acupressure ripens your cervix and helps it to dilate and provides extra pain relief. Thus acupressure significantly increases your chances of having a normal birthing experience with minimal medical intervention, even in cases where the labor has to be medically induced. Pain management during labor is an important issue that should be thought about in advance. It's important to use the strong pain medication wisely, due to the side effects. It is well established that epidurals commonly slow labor and increase your risk of having a cesarean birth. Acupressure is an excellent technique for giving relief from labor pains. Not only is it amazingly effective in “anesthetizing” the sensation of the contractions, but it also carries no side effects or risks. In addition, acupressure is an incredibly flexible technique; it can be used in numerous positions, in various places and it doesn’t restrict your movements. It won’t make you feel dizzy or give you a sense of being out of control with the situation.



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For many birthing mothers acupressure gives all the pain relief they need during labor and for almost all it remarkably diminishes the need for artificial pain medication. If you are planning to have an epidural in any case, use acupressure to delay the epidural until you are dilated to more than five fingers (5 cms). This dramatically reduces your risk of having a cesarean delivery. Thus, in cases where some medical interventions are unavoidable, labor acupressure works as a wonderful complementary technique. It can be used to help the cervix to dilate more and descend the baby, or to strengthen the contractions if the labor slows down. Acupressure is safe to use with medication, although in many cases it may totally prevent the need for these substances.

Acupressure and medical doctors Let your doctor and midwife, and whoever else is assisting with your pregnancy and birth, know that you are using labor acupressure. Should any there be any queries or concerns, show them this book. In addition, the acupressure studies referred to earlier can be found online at www.PubMed.com Naturally, those responsible for the care of the expectant mother and her child want to be sure that there is no risk involved with acupressure. These studies should give them reassurance and also enlighten them with regard to its potential benefits.

Effectiveness of acupressure As well as the testimonies of many happy new mothers, there has been a lot of positive feedback from midwives. Even when there is some degree of skepticism - either about the theory behind the practice, or from people who have previously been treated with acupuncture and doubt the effectiveness of the practice when not using needles - reactions have been good. The birthing women have reported feeling a real difference in their contractions when the appropriate points were being pressed. Many of the new mothers rated acupressure very highly as a form of pain relief, with comments like ‘fantastic’ and ‘couldn’t have done without it’. Many women who tried a TENS machine in addition to acupressure during labor found that acupressure was more effective than the TENS machine. This machine provides pain relief by administering a low electrical current to specific points on the birthing woman’s body. These machines, unlike acupressure, can’t be used in a birthing pool, shower, or bath. In addition to ratings varying from “very good” to “excellent” from the mothers being treated with acupressure during labor, the lower instance of medical intervention in cases where acupressure was used speaks for itself.



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Furthermore, once a woman has gone past her due date and medical induction looks increasingly likely, acupressure is helpful in inducing labor naturally. Midwives using acupressure and advising expectant mothers to apply pressure to points such as Adjoining Valley (LI4) and Three Yin Crossing (SP6) and the sacral points, two or three days before a planned medical induction, repeatedly report that the women who had been doing acupressure at regular intervals managed to go into labor naturally and avoided the medical induction. Indeed even when a woman who has been using acupressure still needs to have a medical induction there are far fewer complications and most of these women achieve a natural delivery. So, not only does the use of acupressure often mean that medical intervention is unnecessary, but should medical intervention be unavoidable acupressure can continue being applied in complete safety and usually to great benefit.

Appropriate time to induce labor using acupressure Acupressure should be used only when you are well overdue and in order to prevent medical induction. Don’t use acupressure to induce your labor just out of impatience. Even though acupressure is a natural form of induction it should only be used as such in order to avoid artificial intervention, otherwise let your body and the baby get ready in their own time. Use of acupressure causes the onset of labor in most mothers. If you are using it before your due date there is a chance that your baby will be born prematurely. However, even though induction should not be considered until the pregnancy is at least 40 weeks old, there are things you can do to prepare for labor from about 37 weeks onwards. For example, stimulating the Ciliao acupoint (BL32) regularly helps to open up the pelvis and that has proved to be very beneficial when labor begins.

How fast does it work? Inducing labor: There are cases where a single acupressure treatment has started the labor. Therefore it’s important not to apply firm or deep pressure to the acupoints known to induce contractions, dilate the cervix and descend the baby during your pregnancy before your estimated due date, to avoid starting labor prematurely. Usually you need, however, to apply firm pressure for a minute on the specific acupoints several times every two hours to induce labor. Acupressure should start the labor at latest in 2-3 days.



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If your doctor has estimated that the induction is necessary, you should start using acupressure immediately in order to avoid the medical induction and decrease the risk of further medical interventions. In this case you can treat the appropriate acupressure points every half an hour. Turning the baby: Posterior position of the baby can delay labor. Babies in posterior position are head down, but face their mother’s tummy instead of the back. Posterior position makes it more difficult for the baby to descend properly into the mother’s pelvis. Stimulating the Reaching Inside point (BL67) can be useful in moving the baby out of a posterior position. Once the baby has turned into the right position, facing the mother’s back, stimulating the Shoulder Well point (GB21) after your due date is very effective in getting the baby to descend. If your baby is in posterior position, stimulation of the Reaching Inside point can be started weeks before the due date and should be started at the latest in week 36. Depending on the baby, he’ll take between a few days and a week to turn. Pain relief: Acupressure gives immediate pain relief. Start using acupressure at home as soon as the contractions become frequent. Most people start applying pressure on the acupoints for pain relief when the contraction begins and relieve the pressure when the contraction subsides. Others apply pressure on the point all the time; lighter between the contractions and firm during the contraction.

What if I don’t have any experience in acupressure? Many midwives and doulas know acupressure and you can always turn to an acupressure specialist. However, because acupressure is a very simple and non-invasive method, you don’t have to rely on having a professional practitioner around. The beauty of acupressure is that anybody who is willing to help can use it. Even people who have no experience and apparently no aptitude for massage can practice it, because it is simply about putting pressure on the relevant body points, nothing more. It’s a very simple hands-on (or rather, knuckles and thumbs-on) technique. You yourself, a partner, or anyone who is supporting the birth can apply acupressure safely with the instructions shown in this book. You don’t need any special knowledge of anatomy or previous experience in acupressure - you just need to press around the areas indicated in this guide. Support persons with no experience might be worried about whether they can cause any harm to the baby or the mother by pressing on the wrong spots. By



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following the instructions in this book you will be working on the right areas. Pressing on the ‘wrong points’ would simply be ineffective, and the birthing woman would soon know if there was nothing useful happening. There is no risk involved in that sense. The only warning for the supporting person is that you might not be allowed to leave the birthing mother’s side once you’ve found the right place! It is possible to stimulate your own acupoints, but it is certainly more satisfying and more effective, especially during labor, if you have someone else do it for you. Some points are, of course, easier to reach than others - particularly when you are heavily pregnant. And, in any case, acupressure is a great way for the partner to be helpful and get involved during labor.

How do you know that you are working on the right spot? This guide demonstrates how to localize the areas where the specific acupressure points lie. You simply follow the instructions and press around the area with your fingertip or thumb.

Please note that the measurement of a “finger-width” means the finger-width of the person who is being treated. Thus the supporting partner should calibrate his or her finger-width with birthing mother’s fingers. One finger-width is as much as the thickness of one of the birthing mother’s fingers and three finger-widths is as much as thickness of three of the birthing mother’s fingers together.

Acupressure points often feel a little bit sore when pressure is applied on them. Other common sensations are warmth, numbness, tingling or buzzing on that area. The sensation is usually fairly pleasant or, at worst, a kind of dull ache. If sharp pain is felt then pressure is being applied to the wrong place. The pressure may be being applied over a bone, in which case the thumb or finger position should be adjusted slightly until the sensation improves, or try a different acupoint. When you are pressing on the right spot the sensation is very different from when you are pressing on the spot next to the acupressure point. For repeated use, you can mark the right spot on the skin with a pen. Stimulation of labor-inducing acupoints is felt as a contraction, especially when points stimulating the womb are pressed. Treating some of the labor induction



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points doesn’t necessarily cause strong immediate sensations. However, this doesn’t mean that the point won’t be helpful in getting your labor going. When you are using acupressure for pain relief, the birthing mother can tell quickly whether the right spots are being treated, because she’ll feel immediate relief when you press there. Listening to the birthing mother is important - she can tell directly whether you are working on the right spot and whether the point you are using is helpful at that moment. If no difference is felt, try another point or adjust your position slightly. The acupoints that need stimulation might vary throughout the labor, but usually the woman is able to let you know which ones are working for her.

How much pressure should be applied? In terms of how much pressure should be applied, the birthing woman will be able to tell you that. She’ll know exactly how much pressure is needed. When it comes to pain relief, it’s very personal. Some women benefit from a light pressure being applied to an area continuously, with an increase in pressure with each contraction. Others prefer to remain mobile, and will only ask for the pressure to be applied as the contraction comes on. The important thing is that the birth partner listens and responds to the woman. A useful guide for how much pressure to apply when inducing labor is to press the relevant points with a firm pressure and a small rotating movement for about a minute every two hours. However, if a medical induction is likely to be sooner than a couple of days, you can apply the acupressure every half an hour.

Applying acupressure: the technique A key feature of acupressure is the use of pressure, which is usually experienced as calm and relaxing sensation, even though it works deeply on the body. The practitioner uses the hands, especially the thumbs, fingertips and knuckles to apply pressure on the relevant points. When it comes to doing acupressure in the right way, there are two main issues: easiness and effectiveness. You have to be able to massage without exhausting your hands and you have to do it in a way that will effectively stimulate the acupressure point. That’s why it’s so important to increase the pressure by leaning with your body weight, instead of just pressing the spot with your fingers.



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In addition to this, it’s important to save your fingers. When you use your thumb to apply pressure on acupressure points, support it with the fingers or when applicable, use paired thumbs. When you are using fingertips, always back up the fingers that are doing the massage. You can support the index finger well using your middle finger, as demonstrated. Some acupressure points can be treated using the knuckles, either the “door knocking knuckles” or the “fighting knuckles”.

In order not to injure the skin when you press, keep your fingernails short enough. If you have moderately long fingernails and you don’t want to cut them short, you can try using the “door knocking knuckles” of your thumb, index or middle finger in order to massage acupressure points.

Pressure applying techniques Firm pressure with rotation Use your thumbs, fingertips or knuckles to apply steady, firm pressure directly on a point. When using the thumb, use the outside edge of your thumb or tip of the thumb. When you massage an acupoint with your fingertips, it is recommended that you use the index finger, whilst supporting it with the middle finger. Once you have begun applying firm pressure to the acupressure point, massage the point with a slow rotating movement. Keep the circular movement small, so that you keep stimulating the right spot.



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Start to stimulate with light pressure and gradually build up to a level that the patient feels as a little bit uncomfortable, but not too painful. Similarly, always release the pressure gradually in 2 to 3 seconds time. The pressure-release procedure With this procedure you use your thumb or fingertips in a similar manner to the firm pressure with rotation technique described above. However, with the pressure-release procedure you will be using a series of short, firm pressures lasting a few seconds. Begin building the pressure gently and deepen it gradually. Then, after increasing the pressure for about 2 to 3 seconds, release the pressure slowly. One treatment usually comprises a series of eight to twelve pressure-release cycles. Rubbing The rubbing technique is very effective on larger areas where there are many acupressure points, like the sacral area on the lower back. Use your knuckles and rub the area briskly in order to activate the acupoints and blood circulation.

Acupressure tools Regardless of the pressing technique used, the hands can get quite tired when applying acupressure during labor. It is best to start with the hands, chiefly the thumbs and the knuckles. Remember to lean your bodyweight into the acupoint, rather than to simply press down manually - you will preserve the strength in your hands for much longer. Useful tools include wooden spoons and wooden massage boards. The sea-sickness bands, which can be used for nausea on the Inner Gate point (P6) or under the foot on the Bubbling Spring (K1), and small combs that the birthing woman can grip to stimulate the points in the hand are also very helpful.

The specific points for induction and pain relief All the points do slightly different things within the body, so it really depends on what the needs of the mother are. Labor can be delayed for a range of different reasons and thus the acupoints for starting the labor will vary from mother to mother. For some, treatment of the Bigger Rushing (LV3) gives quick results, while others find the combination of the Adjoining Valley (LI4) and the Three Yin Crossing (SP6) to be the most effective for them. Luckily, it’s easy to experiment to find the best points for you - simply stimulate the points indicated in this guide and see which ones bring you the desired result!



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For pain relief, again it depends - there are some birthing mothers who enjoy the Bubbling Spring point (K1) on the sole of the foot being stimulated alone, and others who need to change points regularly throughout the labor. It is essential that, regardless of how others might advocate this or that point, you as the birthing mother concentrate on what feels right for you. If within two contractions you don’t feel any difference, ask your support person to try another point. Your body knows how to give birth and it will let you know when the right spots are being treated! However, acupoints are divided into groups. The following chapters reveal the best points for inducing labor, turning a posterior baby, getting and giving labor pain relief, relaxation, vomiting, strengthening the contractions and dilating better – overall helping you to have an easier, shorter and safer birth!



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Induce labor Stimulation of specific acupressure points has been scientifically shown to induce labor effectively (Complement Ther Med. 2005). Thus simple acupressure techniques, which you can do at home, remarkably reduce your risk of being medically induced in a hospital. Medical induction commonly results in several other medical interventions and up to 50% of medically induced labors end up being cesarean sections. Thus, if your doctor has estimated that the induction is necessary, you should start using acupressure immediately. Even if labor doesn’t start spontaneously, acupressure ripens your cervix and helps it to dilate and descends the baby. This significantly increases your chances of having a normal birthing experience with minimal medical intervention. The acupressure points shown below are the most efficient for inducing labor. You don’t have to use them all. The labor may be delayed for a range of different reasons and thus what is the most powerful combination of acupoints will vary from mother to mother. Sometimes treating only one acupoint can kick-start your labor. Treat the acupoints that you feel work best for you every 2 hours during your waking hours. If a medical induction is imminent you may stimulate the points every half an hour, but be aware that the treated areas can become sore from such frequent stimulation. Leave your body to work by itself at night. Warning: Don’t practice acupressure treatment of these points before you are well overdue, or you are booked for medical induction in 2-3 days time. Acupressure points for inducing labor:

Shoulder Well (Jianjing, GB21) Liao Point (Ciliao, BL32) Big and High (Kunlun, BL60) Three Yin Crossing (Sanyinjiao, SP6) Adjoining Valley (Hegu, LI4) Bigger Rushing (Taichong, LV3)



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Shoulder Well (Jianjing, GB21) Treating the Shoulder Well points gets the baby to descend into the pelvis (e.g. to engage better) and put the necessary pressure on the cervix. This is an essential factor in getting labor started, especially if you are having your first baby. The descending effect of the Shoulder Well points is also very helpful during the first and second stages of the labor. In addition to the descending effect, the Shoulder Well points stimulate womb contractions.

Location: The Shoulder Well points are on the thick roll of muscle on top of both shoulders. You will find the point midway between the outer tip of your shoulder and the base of your neck. The Shoulder Well points are tender in most people, therefore start with medium pressure and add more pressure later if necessary.

Treatment: You can use your fingers, thumbs, or knuckles to treat these points. Locate the points on both shoulders and apply firm downward pressure on the mother’s Shoulder Well acupoints while she is sitting with relaxed shoulders. Press firmly for a few seconds. Release the pressure slowly and then press again. Repeat eight to

twelve times. Remind the mother to breathe deeply and keep her shoulder muscles relaxed all the time you are treating the Shoulder Well points.



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Self-treatment: To treat the Shoulder Well acupoints, sit down and relax your shoulder muscles. Support your index finger by crossing the middle finger on top of it. Locate the point and press firmly for a few seconds. Release the pressure slowly and then press again. Repeat eight times on both shoulders. Remember to breathe deeply all the time you are treating the Shoulder Well points.

Another technique for treating the Shoulder Well points is to grasp your left shoulder muscle with your right thumb, index and middle finger. Squeeze the Shoulder Well point gently while you exhale, and release slowly while inhaling. Repeat eight times on the Shoulder Well points on each side.



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Liao Point (Ciliao, BL32) The large bony area near your tailbone, called the sacrum, contains as many as four pairs of important acupressure points that are helpful in labor. Massaging the sacral acupressure points, especially the acupressure point pair called the Ciliao (BL32) helps the pelvis to open, which is essential for the labor to start.

Location: The sacral points are all on the base of the spine, on the large bony area on both sides of the lumbar spine. The Ciliao points lie midway between the dimples above the buttocks and the spine. If the dimples are not visible, measure one length of the mother’s index finger (appr. 2.6” or 7 cm) above the top of the buttock crease and along the spine. The Ciliao points are one thumb’s width from this point, on both sides of the spine. If the mother is relatively slim, you can feel a small depression in the sacral bone where the Ciliao point is located.

Treatment: The sacral points, including Ciliao, can be treated in various positions: when the mother is standing, kneeling against a bed, sitting, or lying on her side. The easiest way to treat all the Liao points on the sacral area is to rub the sacral

area briskly with your knuckles. Rub the area vigorously enough to stimulate these acupressure points. If you want to be more accurate, locate the Ciliao points on both sides of the spine and press them firmly, or massage using small rotating movements, with your thumbs for up to 2 minutes. When you are pressing on the right spots, the mother feels



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sensations of warmth, numbness, tingling or buzzing in that area. If she feels sharp pain, you are pressing on the sacral bone instead of the acupressure point.

Self-treatment: The easiest self-treatment method for stimulating all the Liao points on the sacral area is to stand with your back against a wall and massage the sacral area with a tennis or hard rubber ball pressed between your body and the wall. Lean against the wall and rock back and forth a little bit in order to apply pressure on the points. Other option to treat these points is to rub the sacral area briskly with your knuckles, with your palms facing out. You can also localize the points with your thumbs and massage them using firm pressure.

Big and High (Kunlun, B60) The Big and High acupressure points are effective in descending the baby, like the Shoulder Well (GB21) points. Thus they are useful for inducing, and in the first stage of labor as well.

Location: There is one Big and High acupressure point on the back of the both ankles. The point is in the hollow between the tarsal bone, i.e. the most prominent bone on the outer side of the ankle, and the Achilles tendon.



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Treatment: Apply firm pressure or small rotating massage movements to the Big and High acupressure points whilst gripping the mother’s ankles. You can do this when the mother is sitting or lying on her side. Repeatedly press firmly and then release the points, or massage them with small rotating movements for 1 minute.

You can either treat both ankles at the same time or focus on treating the Big and High point on one ankle and then switch to the other.

Self-treatment: Sit down and reach your ankle with your hand, in whichever position is most convenient for you. Locate the Big and High point with your index finger or thumb and then apply pressure to the point. Repeatedly press firmly and release, for 1 minute, and then switch and treat the Big and High point on your other ankle.



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Three Yin Crossing (Sanyinjiao, SP6) The Three Yin Crossing point helps the cervix to dilate and labor to get started. Mothers having their first baby and mothers whose cervix hasn’t dilated efficiently in a previous labor should find this point especially useful.

Location: The Three Yin Crossing point is on the inner side of the lower leg, four of the mother’s finger-widths above her inner anklebone. The acupressure point is next to the back of the shinbone. The Three Yin Crossing points are usually very sore, so the tenderness of the points confirms that you are working on the right spot.

Treatment: Grip the mother’s lower legs when she is sitting, or on her knees leaning against a chair or bed. Press the points with your thumbs firmly for a few seconds. When you are treating these points to induce labor use only medium pressure. Release the pressure slowly and then press again. Repeat eight to twelve times. Remind the mother to breathe deeply during the treatment.



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Self-treatment: Sit down and bend your right leg over your left, so that you can reach your lower leg with your hand. Locate the Three Yin Crossing point with your right thumb and then use your thumb or knuckle to apply pressure on the acupressure point. Repeatedly press firmly and release, for 1 minute, and then switch and treat the Three Yin Crossing point on your left leg.

Adjoining Valley (Hegu, LI4) Treating the Adjoining Valley point has proved to be successful in getting the womb to contract and in strengthening the contractions during labor when necessary. In addition, the Adjoining Valley acupressure point is also one of the most effective points for sedating pain and calming the mind.

Location: The Adjoining Valley acupressure point is in the webbing between the thumb and index finger. The easiest way to locate this powerful point is to bring the thumb and index finger close together, so that a fleshy mound pops up next to the thumb.

The Adjoining Valley acupressure point is on the highest spot, in the middle of the mound. Squeeze in the center of the mound with the tip of your thumb. The soreness of the point confirms that you are working on the right spot.



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Treatment: Press the Adjoining Valley acupressure point firmly with the tip of your thumb, towards the bone of the index finger. Maintain pressure for around 1 minute and then repeat the treatment on the other hand. Tell the mother to breathe deeply while you press the points.

Self-treatment: Due to its location on the hand, the Adjoining Valley acupressure point is one of the easiest points to treat by yourself. Locate the point and press it firmly with the tip of your thumb, towards the bone of the index finger. Hold the pressure while you breathe deeply, twelve times. Repeat the treatment on the other hand.

Bigger Rushing (Taichong, LV3) The Bigger Rushing point might not be the most commonly used for inducing labor, but it works wonders for some pregnant women.

Location: The Bigger Rushing point is two finger-widths up from the web between the big toe and the second toe.



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Treatment: Apply firm pressure on the spot with your thumbs or knuckles. Make a small rubbing movement towards the bone for around a minute to stimulate the point.

Self-treatment: If you can, bend your leg over the other one, reach your foot with your hand and rub the Bigger Rushing point using your thumb. If this is too difficult you can also apply pressure on the point with your heel or big toe.



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Turning a posterior baby before labor Many difficult labors result from malpresentation, where the baby's position makes it hard for the head to move through the pelvis. The ideal position for the birth is when the baby is head down and facing your back (the 'occiput anterior' position). In this position, the baby's chin is tucked onto his chest, so that the smallest part of his head will be applied to the cervix first. When the baby is head down, but facing your tummy, the position is called the 'occiput posterior'. Often posterior babies do not engage (descend into the pelvis), which means that it's harder for labor to start naturally. If your baby is posterior, you might suffer from bad backache during late pregnancy, because the baby’s back is being pressed against your spine (of course, many pregnant women suffer from backache anyway). So, when your baby starts to engage during the last six weeks, if it’s your first pregnancy, or the last two or three weeks of subsequent pregnancies, pay attention to his position. If your baby is in posterior position, use acupressure to help him to move into the right position. Traditionally, posterior babies have been helped to turn by stimulating the Reaching Inside point with heat, in a procedure called ‘moxibustion’. Good results, however, have also been achieved by simply placing pressure on the point. The stimulation of the Reaching Inside point can be safely started weeks before the due date. Reaching Inside (Zhiyin, BL67)

Location: The Reaching Inside acupressure point is on the outside of the little toe, at the base of the toenail.



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Treatment: Locate the point and apply pressure to it with fingernail or with a small blunt object, like a ballpoint pen. Stimulate the Reaching Inside point for up to 5 minutes, several times a day, until the baby has turned.

Turning a posterior baby during labor Note: Don’t use the Big and High (BL60) and Three Yin Crossing (SP6) points for turning the baby before the labor starts, or before your pregnancy is well beyond full term! If the baby is in posterior position when the labor starts, the baby can be helped to turn using the Big and High and Three Yin Crossing points together, in addition to the Reaching Inside point. First, treat the Big and High (BL60) point in the mother’s ankles and then the Three Yin Crossing (SP6) point in her lower legs. As well as being effective in turning the posterior baby, treating the Big and High and Three Yin Crossing points will reduce the back pain commonly caused by the posterior position of the baby. Big and High (Kunlun, BL60)

Location: The Big and High acupressure point is on the back of the outer ankle, in the depression between the ankle bone and the Achilles tendon.



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Treatment: The positions which give the baby space to turn are where the mother is on all fours or kneeling against a bed or a chair. The points can also be treated when the mother is lying on her side. In order to help the baby to turn, press the Big and High points on both ankles firmly, for up to 2 minutes.

Alternatively, you can massage the points deeply with small rotating movements. After treating the Big and High points, treat the Three Yin Crossing points. Three Yin Crossing (Sanyinjiao, SP6)

Location: The Three Yin Crossing point is on the inner side of the lower leg, four of the mother’s finger-widths above the anklebone. The acupressure point is next to the back of the shinbone. The Three Yin Crossing points are usually very sore, so the tenderness of the point confirms that you are working on the right spot.

Treatment: Grip the mother’s lower legs when she is on all fours or kneeling against a bed or a chair. Press the points firmly with your thumbs for up to 2 minutes. Remind the mother to breathe deeply during the treatment. You can repeat the procedure in 30 minutes’ time.



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Pain relief during labor Acupressure gives immediate relief from labor pains. The best results are achieved when acupressure is used from early on in the labor. This gives the body plenty of time to build-up endorphins and natural pain-relieving chemicals. So, as soon as labor begins, start experimenting with the various points to work out what feels good. And, because all you need is a pair of helping hands, acupressure can be applied wherever you are – it’s very flexible. Acupressure is so effective that the contractions may feel like they have diminished but it is just that your body is coping better with the sensation. Acupressure never works against your body, so it would never inhibit labor in a birthing woman. The seven acupressure points demonstrated in this guide have been found to be the most effective ones in relieving labor pains. However, different acupressure points might give more effective pain relief in different stages of labor. In addition to this, these points may vary from one birthing mother to another. You may only want to have one of the points stimulated, while someone else utilizes them all during her labor. Trying the different points during labor and finding whichever one is most effective at a particular stage and then switching to another as the labor proceeds, usually gives the most effective pain relief. Acupoints for labor pain relief: Three Yin Crossing (Sanyinjiao, SP6) Adjoining Valley (Hegu, LI4) Handpoints Liao Point (Ciliao, BL32) Circling Jump (Huantiao, GB30) Bubbling Spring (Yongquan, K1) Big and High (Kunlun, BL60) Shoulder Well (Jianjing, GB21)



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Liao Point (Ciliao, BL32) The large bony area near the tailbone, called the sacrum, contains as many as four pairs of important acupressure points that are helpful in labor. One of these four Liao points, called the Ciliao, is one of the most commonly used acupressure points during labor. Stimulation of the Ciliao point effectively suppresses the pain that is caused by contractions.

Location: The sacral points are all on the base of the spine, on the large bony area on both sides of the lumbar spine. The Ciliao points lie midway between the dimples above the buttocks and the spine. If the dimples are not visible, measure one length of the mother’s index finger above the top of the buttock crease, along the spine. The Ciliao points are one thumb’s width from this spot, on both sides of the spine. If the mother is relatively slim, you can feel a small depression in the sacral bone where the Ciliao point is located.

Treatment: The sacral points, including Ciliao, can be treated when the mother is on her knees leaning against a birthing ball, bed or the wall of the birthing pool. Other possible positions are when she is leaning against a wall or lying on her side on a bed. The easiest way to treat all the Liao points on the sacral area is to rub the area briskly with your knuckles. Rub vigorously enough to stimulate these acupressure points.

If you want to be more accurate, locate the Ciliao points on both sides of the spine and press them firmly with your thumbs.



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When you are pressing on the right spot, the mother feels sensations of warmth, numbness, tingling or buzzing in that area. If she feels sharp pain, you are pressing on the sacral bone instead of the acupressure point. When the birthing mother tells you that the contraction is beginning, press the Ciliao points firmly. Listen to the mother regarding whether or not she wants you to add to the pressure during the contraction. After the contraction subsides, usually in 60 seconds’ time, either decrease or totally release the pressure. As the labor proceeds, the other Liao points below the Ciliao usually become more effective. You’ll find the

next Liao point by moving down the spine one thumb’s width from the Ciliao point and slightly closer to the spine. If the birthing mother tells you that the Ciliao point doesn’t feel efficient, try the next Liao points by moving one thumb’s width down at a time. Bubbling Spring (Yongquan, K1) The Bubbling Spring point alone can be very useful during labor for pain relief. This point also relaxes the perineum, which eases the birth of the baby and might help to avoid tears and episiotomy. What’s more, stimulating the Bubbling Spring point can have a powerful calming effect. Location: The Bubbling Spring point is located in the center of the sole of the foot, a third of the way down from the toes. The point can be easily located when the toes are pulled towards the sole, as the point lies in the depression that is then formed.



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Treatment: Press the points firmly inwards and towards the big toe with your knuckles for a few seconds and then release the pressure. Repeat this eight to twelve times. Remind the mother to breathe deeply throughout the treatment.

The Bubbling Spring points can be treated with sea sickness wristbands as well. You can buy these bands from a chemist’s. Instead of wearing the band on your arm, put it on your foot (in the appropriate position, as demonstrated) and walk around. The plastic button on the band will stimulate the acupoint as you walk.

Big and High (Kunlun, BL60) and the Big Stream (Taixi, K3) The Big and High and the Big Stream acupressure points are effective in giving pain relief, especially for pain in the lower back and hip area, and in activating blood circulation. Treating them both can assist with a difficult labor. Massaging these two acupressure points simultaneously maximizes the effect of the treatment. Double treatment is easy, because both points are located in the ankle: the Big and High point is on the outer side of the ankle, while the Big Stream acupressure point is opposite it, on the inner side of the ankle.



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Location: The Big and High acupoint is behind the prominent ankle bone in the depression on the outer side of the ankle. The Big Stream point is in the hollow between the tip of your ankle bone and the Achilles tendon, on the inner side of the ankle.

Treatment: Locate these ankle points while the birthing mother is kneeling against a bed, birthing ball or the wall of a birthing pool. Massage the acupoints with a firm rotating movement using your thumb and fingertips, for 1 minute on both ankles.

Shoulder Well (Jianjing, GB21) Treating the Shoulder Well points has a pain-relieving effect, although it’s useful in descending the baby and stimulating the womb contractions as well.

Location: The Shoulder Well points are on the thick roll of muscle on top of both shoulders. You will find the point midway between the outer tip of the shoulder and the base of the neck.



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Treatment: You can use your fingers, thumbs, or knuckles to treat these points. Remember to support your index finger by crossing the middle finger on top of it or using your thumb with your index finger. Apply firm downward pressure on the mother’s Shoulder Well acupoints while she is kneeling against a bed or a birthing ball.

Press firmly until the contraction subsides or use a press-release technique. Remind the mother to breathe deeply and keep her shoulder muscles relaxed all the time you are treating the Shoulder Well points. Adjoining Valley (Hegu, LI4) The Adjoining Valley acupressure point is one of the most effective in sedating pain. In addition, the Adjoining Valley point is also useful in getting the womb to contract and in strengthening the contractions during labor when necessary.

Location: The Adjoining Valley acupressure point is in the webbing between the thumb and index finger. The easiest way to locate this powerful point is to bring the thumb and index finger close together, so that a fleshy mound pops up next to the thumb.

The Adjoining Valley acupressure point is on the highest spot, in the middle of the mound. Squeeze in the center of the mound with the tip of your thumb. The soreness of the point confirms that you are working on the right spot.



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Treatment: Press the Adjoining Valley acupressure point firmly with the tip of your thumb, towards the bone of the index finger. Hold the pressure for around 1 minute and then repeat the treatment on the other hand. Tell the mother to breathe deeply while you press the points.

Hand Points Stimulating the hand points for pain relief is incredibly easy and the birthing mother can do it without a supporting partner. In contrast to the other acupressure techniques, you need a tool for this one - two ordinary combs (small enough to hold in your hands) - in order to stimulate the hand points.

Location: The hand points are along the hand’s crease where the fingers join the palm. Hold a comb in both hands so that the comb’s teeth touch the crease. Treatment: Grip the combs when the contraction begins and hold them with whatever strength feels best for you. Relieve the pressure as the contraction subsides.



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Three Yin Crossing (Sanyinjiao, SP6) The Three Yin Crossing point is helpful in producing a pleasant “anaesthetizing” effect on the contraction pains.

Location: The Three Yin Crossing point is on the inner side of the lower leg, four of the mother’s finger-widths above the anklebone. The acupressure point is next to the back of the shinbone. The Three Yin Crossing points are usually very sore, so the tenderness of the points confirms that you are working on the right spot.

Treatment: Grip the mother’s lower legs when she is on her knees, leaning against a birthing ball or a bed. When the birthing mother tells you that the contraction is beginning, press the Three Yin Crossing points firmly. Listen to the mother regarding whether or not she wants you to add to the pressure during the contraction.

Remind the mother to breathe deeply during the contraction. After the contraction subsides, usually in 60 seconds’ time, either decrease or totally release the pressure.



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Circling Jump (Huantiao, GB 30) The Circling Jump point on the buttock can be used when the mother enters transition phase in labor. It’s beneficial to combine the use of strong downward massage of the Liao points on the sacral area with the stimulation of the Circling Jump points.

Location: The point is located in the center of each buttock, about a third of the distance between the hip bone and the tailbone and at the same level as the most prominent part of the upper thigh bone.

Treatment: Place your hands on the mother’s hips while she is kneeling against a birthing ball or bed. Press the Circling Jump points on each buttock with your knuckles or fists when the contraction begins. The Circling Jump point is hidden under the overlying muscle and fat padding, so, depending on the thickness of the covering tissues, you might have to press this point quite hard. You can help the mother to make rotating movements during the contraction while pressing these points, if she finds the movement helpful.



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Anxiety and nervousness The more relaxed the birthing mother is the better the experience will be for her. The Bubbling Spring point (K1) on the sole of the foot seems to be particularly useful for inducing calm. The acupressure point called the Inner Gate (P6) on the wrist can also alleviate symptoms of stress, particularly nausea and palpitations. Bubbling Spring (Yongquan, K1) The only acupressure point located on the sole of the foot is the Bubbling Spring point. It has a powerful relaxing and calming effect, and can be used at any time during your labor – or before it - when you might feel anxious or nervous. Location: The Bubbling Spring point is located in the center of the sole of the foot, a third of the way down from the toes. The point can be easily located when the toes are pulled towards the sole, as the point lies in the depression that is then formed.

Treatment: Press the points firmly inwards and towards the big toe with your knuckles for few seconds and then release the pressure. Repeat this eight to twelve times. Remind the mother to breathe deeply throughout the treatment.



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The Bubbling Spring points can be treated with sea sickness wristbands as well. You can buy these bands from a chemist’s. Instead of wearing the band on your arm, put it on your foot (in the appropriate position, as demonstrated) and walk around. The plastic button on the band will stimulate the acupoint as you walk.

Inner Gate (Neiguan, P6) The Inner Gate point on the wrist gives relief from feelings of stress and nervousness, especially when the heart is pumping too fast. This point is also very efficient in alleviating nausea as a symptom of stress, as well as palpitations.

Location: The Inner Gate point is on the inside of the wrist, three finger-widths below the wrist line, in the hollow between the two bones of the forearm.



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Treatment: Measure three finger-widths, equal to the mother’s fingers, from her wrist line and place your thumb between the bones. Locate the slightly sore point in the middle of the tendons and press the point firmly as the mother breathes out slowly. Release the pressure when she inhales. Repeat this eight to twelve times on each wrist. Another option is to place pressure on the Inner Gate point and hold it for up to 2 minutes.

Relaxation Tension works against labor. The neck is an area of the body where tension easily accumulates, causing discomfort- a literal “pain in the neck”. The following acupoints relieve tension and thus help the labor to proceed smoothly. Wind Pond (Fengchi, GB20) Acupressure can be remarkably beneficial in releasing tension in the neck area, whatever the initial cause is. A pair of acupressure points called the Wind Pond points are very effective in treating all kinds of neck tensions.

Location: These acupressure points are located in the hollows between the two large upright neck muscles, at three finger-widths’ distance from the earlobes. You can find the Wind Pond points in these depressions, at the edge of the skull.



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Treatment: Use your thumb and middle finger to treat these acupressure points. Avoid applying too much pressure, because the Wind Pond points are against the bone and respond well to light pressure. Tell the mother to breathe deeply and calmly while you massage these points for up to 2 minutes with a gentle rotating movement.

Heavenly Pillar (Tianzhu, BL10) Tension shortens the neck muscles and tense neck muscles diminish energy levels, thus causing fatigue. Massaging the important Heavenly Pillar acupressure points in the neck will relieve any stiffness and help release the body’s energy resources.

Location: There is a thick, ropy muscle on both sides of the neck. The Heavenly Pillar points are in the middle of these neck muscles, about three finger-widths below the base of the skull.



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Treatment: Ask the mother to bend her head backwards slightly, so that her neck muscles are relaxed. Massage the Heavenly Pillar points with your thumb and fingertips using a small rotating movement. Because these acupoints are in the middle of muscle tissue, use firm pressure in order to stimulate them effectively.

One Hundred Meeting Point (Baihai, GV20) Massaging the One Hundred Meeting point is great for the mother when she is relaxing in the birthing pool or resting. This acupoint is wonderful for inspiring relaxation and in encouraging the body to recover, thus restoring its energy, during the labor.

Location: The One Hundred Meeting point is on the top of the head. Locate the point by following an imaginary line from the highest point of the ears upwards and slightly backwards until these lines meet on the top of the head in a swallow hollow.



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Treatment: Massage the point with small circular movements for up to 2 minutes. If the mother is sitting, support her head throughout the treatment.

Nausea and vomiting Inner Gate (Neiguan, P6) The Inner Gate point is amazingly helpful for the feelings of nausea and vomiting which sometimes occur during labor. This technique works by blocking the signals that trigger the nausea response.

Location: The Inner Gate point is on the inside of the wrist, three finger-widths below the wrist line, on the hollow between the two bones of the forearm.



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Treatment: Measure three finger-widths, equal to the mother’s fingers, from her wrist line and place your thumb between the bones. Locate the slightly sore point in the middle of the tendons and press the point firmly as the mother breathes out slowly. Release the pressure when she inhales. Repeat this eight to twelve times on each wrist. Another option is to place pressure on the Inner Gate point and hold it for up to 2 minutes.

The feelings of nausea usually stop in 5 to 10 minutes. If necessary, you can repeat the treatment. Bigger Rushing (Taichong, LV3) For some types of nausea the Bigger Rushing point is the most effective one. Try treating this point alone or in combination with the Inner Gate (P6) point for relief from nausea and vomiting.

Location: The Bigger Rushing point is two finger-widths up from the web between the big toe and the second toe.



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Treatment: Apply firm pressure on the Bigger Rushing points with your thumbs or knuckles. Make a small rubbing movement towards the bone for around a minute to stimulate the point.

Big Stream (Taixi, K3) and Big and High (Kunlun, BL60) In addition to giving relief from nausea, the Big Stream point is effective in relieving lower back pain especially when treated together with the Big and High point. The Big Stream acupressure point is opposite the Big and High point on the inner side of your ankle. Massaging these two acupressure points simultaneously maximizes the effectiveness of the treatment.

Location: The Big and High acupoint is behind the prominent ankle bone in the depression on the outer side of the ankle. The Big Stream point is in this hollow between the tip of your ankle bone and the Achilles tendon on the inner side on the ankle.

Treatment: Massage the acupoints, using a firm rotating movement, with your thumb and fingertips for 1 minute in any position that the birthing mother feels comfortable in and that enables you to reach the points easily. You can either treat the Big Stream and the Big and High points on both ankles at the same time or focus on one ankle and then the other.



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Make better progress with labor

Strengthen contractions In cases where the labor is not progressing, even though the baby is in the right position and has descended well into the pelvis, using a combination of the Adjoining Valley (LI4) and the Three Yin Crossing (SP6) points helps make the contractions stronger and more frequent. Treat the Adjoining Valley point on one hand, while at the same time stimulating the Three Yin Crossing point on the opposite leg for several minutes. If simultaneous treatment is not possible, focus on the Adjoining Valley point first, followed by the Three Yin Crossing point. If necessary, repeat the treatment after 10 minutes for the other Adjoining Valley - Three Yin Crossing point combination. Adjoining Valley (Hegu, LI4) The Adjoining Valley acupressure point is in the webbing between the thumb and index finger, in middle of the fleshy mound that is formed when the thumb is brought next to the index finger. Squeeze in the center of the mound with the tip of your thumb. The soreness of the point confirms that you are working on the right spot. Press the Adjoining Valley acupressure point firmly with the tip of your thumb towards the bone of the index finger. Tell the mother to breathe deeply while you press the points.

Three Yin Crossing (Sanyinjiao, SP6) The Three Yin Crossing point is on the inner side of the lower leg, four of the mother’s finger-widths above the anklebone. The acupressure point is next to the back of the shinbone. The Three Yin Crossing points are usually very sore, so the tenderness of the points confirms that you are working on the right spot.



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Press the Three Yin Crossing points firmly inwards and towards the shinbone Listen to the mother regarding whether or not she wants you to add to the pressure. Remind the mother to breathe deeply during the treatment.

Dilate better If it happens that the birthing mother feels the urge to push, but the cervix is not yet fully dilated, the combination of the Three Yin Crossing point (SP6) and the Ciliao point (BL32) can solve the problem (especially when the cervix has formed a swollen “lip”, making it difficult to achieve a full dilation.) Stimulate the Ciliao points in the lower back using the knuckles and applying firm pressure, for up to 10 minutes, while at the same time treating the Three Yin Crossing points in the lower legs. If simultaneous treatment is not possible, treat the Ciliao points first, followed by the Three Yin Crossing points. Ciliao Point (BL32) The Ciliao points lie midway between the dimples above the buttocks and the spine. If the dimples are not visible, measure one of the mother’s index finger lengths (appr. 2.6” or 7 cm) above the top of the buttock crease. The Ciliao points are one thumb’s width on both sides of this spot. If the mother is relatively slim, you can feel a small depression in the sacral bone where the Ciliao point is located. Press firmly with your knuckles. When you are pressing on the right spots, the mother feels sensations of warmth, numbness, tingling or buzzing in that area. If she feels sharp pain, you are pressing on the sacral bone instead of the acupressure point.



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Three Yin Crossing (Sanyinjiao, SP6) The Three Yin Crossing point is on the inner side of the lower leg, four of the mother’s finger-widths above the anklebone. The acupressure point is next to the back of the shinbone. The Three Yin Crossing points are usually very sore, so the tenderness of the points confirms that you are working on the right spot. Press the Three Yin Crossing points firmly inwards and towards the shinbone. Remind the mother to breathe deeply during the treatment.

Better progress during the second stage In cases where the cervix is fully dilated, but it’s difficult to push the baby through the birth canal use a combination of the Shoulder Well (GB21) and Adjoining Valley (LI4) points in order to move the baby downwards and strengthen the contractions.



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Apply firm pressure to the Shoulder Well points while the Adjoining Valley point on the hand is treated as well. If possible, stimulate the Adjoining Valley points and the Shoulder Well points simultaneously, for up to 10 minutes. Shoulder Well (Jianjing, GB21) The Shoulder Well points are on the thick roll of muscle on top of both shoulders, midway between the outer tip of the shoulder and the base of the neck. Press the mother’s Shoulder Well acupoints firmly with your thumbs and knuckles. Remind the mother to breathe deeply and keep her shoulder muscles relaxed all the time you are treating the Shoulder Well points.

Adjoining Valley (Hegu, LI4) The Adjoining Valley acupressure point is in the webbing between the thumb and index finger, in middle of the fleshy mound that is formed when the thumb is brought next to the index finger. Squeeze in the center of the mound with the tip of your thumb. The soreness of the point confirms that you are working on the right spot. Press the Adjoining Valley acupressure point firmly with the tip of your thumb towards the bone of the index finger. Tell the mother to breathe deeply while you press the points.



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References: Betts D (1999) Acupressure analgesia for use in labour. Journal of Chinese Medicine 59: 25. Betts D (2003) Natural pain relief techniques for childbirth using acupressure: promoting a natural labour and partner involvement, 22 p. Betts D (2006) Acupressure for non-professionals. Interview by Tervonen V, 50 min.

Betts D (2006) The essential guide to acupuncture in pregnancy & childbirth. Edited by Peter Deadman & Inga Heese. Journal of Chinese Medicine Publications, Hove, 320 p.

Cardini F & Weixin H (1998) Moxibustion for correction of breech presentation. JAMA 280: 1580-1584. Chung U et al. (2003) Effects of LI4 and BL67 acupressure on labor pain and uterine contractions in the first stage of labor. J Nurs Res 11: 251-260. Ingram J et al. (2005) The effects of shiatsu on post-term pregnancy. Complement Ther Med 13: 11-15. Lee M et al. (2004) Effects of SP6 acupressure on labor pain and length of delivery time in women during labor. J Altern Complement Med 10: 959-965. Maslow A & Sweeny A (2000) Elective induction of labor as a risk factor for Cesarean delivery among low-risk women at term. Obstet Gynecol 95: 917 - 922. Rabl M et al. (2001) Acupuncture for cervical ripening and induction of labour at term – a randomised controlled trial. Wien Klin Wochenschr 113: 942-946. Seyb S et al. (1999) Risk of Cesarean delivery with elective induction of labor at term in nulliparous women. Obstetrics & Gynecology 94: 600-607. Tempfer C et al. (1998) Influence of acupuncture on duration of labour. Gynecol Obstet Invest 46:22-25. Tsuei J et al. (1974) Induction of labor by acupuncture and electrical stimulation. Obstetrics and Gynecology 43: 337-342. Waters B & Raisler J (2003) Ice massage for the reduction of labor pain. J Midwifery Womens Health 48: 317-321. Yates S. (2006) Shiatsu - an ancient art. Pract Midwife 9: 30. Zeisler H et al. (1998) Influence of acupuncture on duration of labor. Gynecologic and Obstetric Investigation 46: 22-25.



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easier shorter safer birth

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