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Chinese Medicine in the News
On pins and needles
The News & Observer (Sept. 2, 2004)
Eager expectant mothers join study to find out if acupuncture can bring on labor.
Shawn Jeter, due to give birth soon, rests as she undergoes acupuncture. She is part of a study to see if the treatment can induce labor.
By VICKI CHENG, Staff Writer
CHAPEL HILL—Shawn Jeter hasn’t exactly hated pregnancy. Morning sickness was never a problem. Recently, she played tennis. But by Friday—three days before her due date—Jeter had just about had enough. “I’m ready to get this over with,” said the Durham resident, who complained of the back pain that comes with carrying about 40 extra pounds in the summer. “Now, I’m to the point where, the fun part’s over.”
So Jeter lay on her side on a bed at the UNC Family Practice Center in Chapel Hill. She stared at the back of her hand, where a hair-thin acupuncture needle protruded from the fleshy part between her thumb and forefinger. She didn’t flinch as Dr. Wunian Chen prodded spots on her lower back with his fingers, then quickly tapped in four more needles. To these, he connected small clamps and wires—they looked like miniature jumper cables—and hooked up Jeter to nine volts of electricity. The last needles went in above her ankles.
Jeter is a participant in one of two Triangle studies on whether acupuncture can help induce labor in women close to their due dates. Two physicians—Dr. Terry Harper of UNC and Dr. Michael Paglia of Duke—hope that their research will lay the groundwork for larger studies on whether acupuncture can help prevent the C-sections and stillbirths that are sometimes the result of pregnancies that last too long. The studies might validate a treatment that’s been standard in Chinese medicine for ages, according to Chen, a medical doctor and acupuncturist working with Harper at UNC.
Paglia said his research has raised eyebrows among the medical establishment. “Some of my colleagues think, ‘Michael, why are you doing this? This is ridiculous,’ including my wife, who’s a physician,” he said. “But acupuncture has been practiced for thousands of years. If it didn’t work, it wouldn’t be around. This is sort of a niche in the world of [obstetrics] that hasn’t been explored.” Harper said some of her colleagues doubted enough people would volunteer for anything involving needles. But most of the women she’s approached—18 have enrolled so far—haven’t been that concerned, she said. Jeter had no qualms.
“I was kind of like, I’ll try anything,” Jeter said.
What works
When a woman approaches her due date, it seems as though everyone has advice on how to jump-start the labor process. The “old people” told Jeter to take castor oil and to go for long walks, she said. Other methods, including herbal supplements, hot baths, enemas, sexual intercourse and nipple stimulation haven’t been shown to be effective, according to a 2003 review in the journal American Family Physician. Past studies involving acupuncture haven’t been well designed, the review concluded.
Although every practice is different, doctors generally use drugs such as Pitocin when there is a need to induce labor, such as when a baby is two weeks late, Harper said. That’s because women are twice as likely to end up with C-sections in the 42nd week of pregnancy, compared to the 40th week. Beyond the 42nd week, babies are twice as likely to die.
“Women will say Pitocin labor is much worse,” Harper said. “To me, the biggest issue is time, how long people can be in labor.” Harper, whose specialty is high-risk obstetrics, said some Pitocin-induced labors can last as long as 72 hours, she said. And when a woman receives Pitocin, she’s confined to a hospital bed. In comparison, acupuncture doesn’t require a hospital stay and is relatively cheap, about $200 for three treatments.
In Harper’s study, which began in July, 60 first-time expectant mothers in their 40th week of pregnancy will be randomly assigned to have either acupuncture or no acupuncture. Those designated for acupuncture will get three treatments of 20 minutes each, using methods outlined in the Shanghai College of Traditional Medicine textbook. Harper will compare the average number of days to delivery from the first treatment in the acupuncture group versus the control group. She can’t discuss preliminary results, but one woman’s water broke the same day she received an acupuncture treatment.
She hopes this and subsequent studies will show that acupuncture triggers something in the body to start the labor process naturally. “How that works is a mystery to all of us,” she said.
Method Used
Acupuncturists believe the needles affect qi (pronounced “chee”), said to regulate spiritual, emotional, mental and physical balance in the body. Experts at the National Center for Complementary and Alternative Medicine, a branch of the National Institutes of Health, theorize that acupuncture points conduct electromagnetic signals or alter brain chemistry.
Dagmar Ehling, an acupuncturist with Oriental Health Solutions in Durham, is working with Paglia on the Duke acupuncture study, which will enroll 70 Duke patients. For years, she and other acupuncturists in the Triangle have been using the needles on women who want to start labor without drugs. She usually starts the treatments when a woman is 36 weeks pregnant, and the results have been good, although she has no statistics, she said. “In Germany, they have birthing centers that employ acupuncturists, and they do that routinely,” said Ehling, who is German.
Paglia said that there’s nothing to stop a woman from using acupuncture to try to induce labor, even though the results of the studies won’t be known for months. But he recommended that expectant moms check out their practitioners carefully.
“There are definitely spots that can be dangerous in acupuncture,” he said. “Query [the acupuncturists] about how often they deal with pregnant women.” Jeter said that not knowing when her baby will arrive is driving her crazy. “I’m one of those beaver-type personalities that lives by my Palm Pilot,” she said. But she wants to avoid a C-section if possible.
On Saturday, she received her final acupuncture treatment. The needles weren’t painful, but the experience was odd, she said—she felt a tiny prick when they went in, and a pulse of something like static electricity in her back. By Sunday, she was having painful but irregular contractions. On Monday, Jeter said she wasn’t sure whether she was in labor. Whatever it was, it wasn’t pleasant. Tuesday morning, her doctor simply told her to wait. And that’s what she was still doing Wednesday morning, at press time.
“I’ve done everything I can do,” Jeter said. “I guess nature’s got to take its course. ... She’s going to be like me. I guess I’m kind of stubborn.”
Staff writer Vicki Cheng can be reached at 919-829-4816 or .(JavaScript must be enabled to view this email address).
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