Acupressure is a technique derived from Traditional Chinese Medicine (TCM) that involves applying pressure to specific body points using the fingers or thumbs. This non-invasive practice has gained popularity among expectant mothers seeking a non-pharmacological method to encourage the start of labor. This article explores the theoretical basis of acupressure and reviews the clinical evidence to determine its effectiveness for labor induction.
The Theoretical Basis of Acupressure for Labor
The belief that acupressure can influence the timing of labor is rooted in both traditional and modern physiological concepts. In TCM, acupressure points lie along energy pathways called meridians, through which the body’s vital energy, or Qi (pronounced “chee”), flows. Stimulating these points is thought to promote the smooth flow of Qi, encouraging energy downward to the uterus to facilitate contractions and cervical change.
From a contemporary perspective, the proposed mechanism centers on neurohormonal pathways. Applying firm pressure to specific points may stimulate nerve fibers, signaling the central nervous system. This is hypothesized to trigger the release of labor-related hormones, such as oxytocin, which stimulates uterine contractions. Acupressure may also promote the release of prostaglandins, compounds that help soften and ripen the cervix, making it more pliable for delivery.
Clinical Evidence on Induction Effectiveness
Scientific literature on the direct ability of acupressure to initiate labor is mixed. General consensus suggests it is more effective as a preparatory tool than a primary induction method. Multiple systematic reviews have investigated whether acupressure can trigger the onset of labor in women who are not already close to delivery. Acupressure does not appear to significantly increase the rate of spontaneous labor initiation or reduce the need for a medical cesarean section compared to sham treatments or standard care.
However, the evidence often points to a benefit in other areas of the labor process, particularly cervical ripening. Some studies indicate that acupressure may improve the readiness of the cervix for labor, which is measured using the Bishop score. This system assesses cervical dilation, effacement, consistency, position, and fetal station.
Research also suggests that acupressure can positively impact the duration of labor. Several meta-analyses found that women who received acupressure, particularly at points like Spleen 6 (SP-6) and Large Intestine 4 (LI-4), experienced a shorter overall labor time. This reduction is often more pronounced in the first stage of labor, which involves cervical dilation.
These findings suggest that while acupressure may not reliably force labor to begin, it serves as an effective complementary therapy. By improving cervical readiness and reducing the total time spent in labor, it supports the body’s natural progression toward delivery. Acupressure is also well-supported as a non-pharmacological method for reducing the perception of labor pain.
Essential Acupressure Points and Application
Several acupressure points are commonly cited for their potential to encourage labor progression, most notably Spleen 6 (SP-6) and Large Intestine 4 (LI-4).
The SP-6 point, known as Sanyinjiao, is located on the inner side of the lower leg, approximately four finger-widths above the prominent inner ankle bone, just behind the shin bone. To stimulate this area, firm, consistent pressure should be applied for one to two minutes at a time, using the thumb, and repeated multiple times a day on both legs.
The LI-4 point, or Hegu, is found on the hand in the fleshy webbing between the thumb and the index finger. To locate it, bring the thumb close to the index finger; the point is found at the highest point of the resulting muscle mound. Apply firm pressure to this point with the thumb of the opposite hand, massaging in a circular motion or applying steady pressure for a few minutes on each hand.
Another point often used is Bladder 32 (BL-32), located in the sacral region of the lower back, within the second sacral foramen. This point is found in the dimples just above the buttocks. Applying firm pressure with the knuckles or thumbs to this area, often with a downward motion, helps stimulate contractions and ease lower back pain during labor.
Important Safety Guidelines and Timing
Acupressure is considered a safe, low-risk practice, but its use for labor induction requires careful consideration and timing. Points used to encourage labor, such as LI-4 and SP-6, are traditionally contraindicated throughout most of pregnancy due to their potential to stimulate uterine activity. Therefore, stimulation of these points should only begin once a woman is at term, typically after 37 weeks of gestation.
Any attempt to use acupressure for labor induction or preparation should be done in consultation with a healthcare provider, such as a doctor or midwife. This ensures the mother and baby are healthy and that no underlying complications exist that would make the stimulation unsafe. Contraindications for using these points include high-risk pregnancies, conditions like placenta previa, or other complications where early uterine stimulation could be harmful.
While a birthing partner can be trained to apply pressure, seeking guidance from a licensed acupuncturist ensures accurate location and proper technique. Acupressure should be viewed as a method to support the body’s natural processes toward delivery, not as a replacement for medically necessary induction methods when maternal or fetal health is compromised.