Effectiveness of acupuncture for the initiation of labour at term: a pilot randomized controlled trial. The Complementary Therapies for Labour and Birth Study making sense of labour and birth - Experiences of women, partners and midwives of a complementary medicine antenatal education course. Acupuncture to initiate labor (Acumoms 2): A randomized, sham-controlled clinical trial Acupuncture for the induction of labour: a double-blind randomised controlled study Acupuncture and/or sweeping of the fetal membranes before induction of labor: a prospective, randomized, controlled trial Influence of Acupuncture on Maternal Serum Levels of Interleukin‐8, Prostaglandin F2alpha, and Beta‐Endorphin: A Matched Pair Study Electroacupuncture for cervical ripening prior to labor induction: a randomized clinical trial Effect of Acupressure on Cervical Ripening Acupuncture for pain relief during induced labour in nulliparae: a randomised controlled study Complementary therapies for labour and birth study: a randomised controlled trial of antenatal integrative medicine for pain management in labour [Clinical observation of the impacts and safety of electroacupuncture at Sanyinjiao (SP 6) on labor]. Acupressure for inducing labour for nulliparous women with post-dates pregnancy. Laser acupuncture effect on fetal well-being during induction of labor Acupuncture to Induce Labor: A Randomized Controlled Trial A randomized controlled trial of acupuncture for initiation of labor in nulliparous women The effect of acupressure on the initiation of labor: A randomized controlled trial. A feasibility randomised controlled trial of acupressure to assist spontaneous labour for primigravid women experiencing a post-date pregnancy. Effects of acupuncture for initiation of labor: a double-blind randomized sham-controlled trial Introducing a placebo needle into acupuncture research Acupuncture for cervical ripening and induction of labor at term--a randomized controlled trial. Acupuncture in post-date pregnancy: a pilot study Acupuncture administered after spontaneous rupture of membranes at term significantly reduces the length of birth and use of oxytocin. A randomized controlled trial [Observation on therapeutic effect of scalp acupuncture analgesia on labor]. [Use of acupuncture for labour augmentation]. Evaluation effect of shiatsu technique on labor induction in post-term pregnancy. Transcutaneous electrical nerve stimulation at acupuncture points in the induction of uterine contractions.
OBJECTIVE This study was design ed to determine the effectiveness of acupuncture for the initiation of labour in women at term . METHODS A prospect i ve pilot r and omized control trial was undertaken , in which 16 pregnant women at term were r and omly assigned to receive acupuncture either at sites reported to cause onset of labour or at nearby sham sites . The primary outcome assessed was the interval from initial acupuncture treatment to delivery . RESULTS There was a difference in intervention to delivery interval of 62 hours in favour of the treatment group . Furthermore , women in this group had shorter labours by a mean of 2 hours and 20 minutes . CONCLUSION The interesting results of this pilot trial warrant further investigation into the use of acupuncture for the initiation of labour in women at term OBJECTIVE to gain insight into the experiences of women , partners and midwives who participated in the Complementary Therapies for Labour and Birth Study , an evidence based complementary medicine ( CM ) antenatal education course . DESIGN qualitative in-depth interviews and a focus group as part of the Complementary Therapies for Labour and Birth Study . SETTING AND PARTICIPANTS thirteen low risk primiparous women and seven partners who had participated in the study group of a r and omised controlled trial of the complementary therapies for labour and birth study , and 12 midwives caring for these women . The trial was conducted at two public hospitals , and through the Western Sydney University in Sydney , Australia . INTERVENTIONS the Complementary Therapies for Labour and Birth ( CTLB ) protocol , based on the She Births ® course and the Acupressure for labour and birth protocol , incorporated six evidence -based complementary medicine ( CM ) techniques ; acupressure , relaxation , visualisation , breathing , massage , yoga techniques and incorporated facilitated partner support . R and omisation to the trial occurred at 24 - 36 weeks ' gestation , and participants attended a two-day antenatal education programme , plus st and ard care , or st and ard care alone . FINDINGS the overarching theme identified in the qualitative data was making sense of labour and birth . Women used information about normal birth physiology from the course to make sense of labour , and to utilise the CM techniques to support normal birth and reduce interventions in labour . Women 's , partners ' and midwives ' experience of the course and its use during birth gave rise to supporting themes such as : working for normal ; having a toolkit ; and finding what works . KEY CONCLUSIONS the Complementary Therapies for Labour and Birth Study provided women and their partners with knowledge to underst and the physiology of normal labour and birth and enabled them to use evidence -based CM tools to support birth and reduce interventions . IMPLICATION S FOR PRACTICE the Complementary Therapies for Labour and Birth Study introduces concepts of what constitutes normal birth and provides skills to support women , partners and midwives . It appears to be an effective form of antenatal education that supports normal birth , and maternity services need to consider how they can reform current antenatal education in line with this evidence Objective . To evaluate the efficacy of acupuncture for labor stimulation . Methods . Nulliparous women at 38 weeks or greater were r and omized to traditional Chinese medicine ( TCM ) acupuncture , sham acupuncture , or usual care only groups . Acupuncture points LI4 , SP6 , BL32 , and BL54 were needled bilaterally . The primary outcome was time from enrollment to delivery . Secondary outcomes included rates of spontaneous labor and cesarean delivery . Medical records were abstract ed for maternal demographic , medical , and delivery outcome data . ANOVA , Student 's t-test , Chi-square , and Kaplan – Meier statistics were used to compare groups . Results . Eighty-nine women were enrolled and r and omized . Maternal age , gestational age , prior acupuncture experience , tobacco , alcohol and drug use , gravida , and history of gynecological surgery were similar among the groups . There were no statistically significant differences among groups for time from enrollment to delivery ( p = 0.20 ) , rates of spontaneous labor ( p = 0.66 ) , or rates of cesarean delivery ( p = 0.37 ) . Rates of maternal and neonatal outcomes were not significantly different . Conclusion . TCM acupuncture was not effective in initiating spontaneous labor or reducing the rate of cesarean delivery compared with sham acupuncture or usual medical care Please cite this paper as : Modlock J , Nielsen B , Uldbjerg N. Acupuncture for the induction of labour :  a double‐blind r and omised controlled study . BJOG 2010;117:1255–1261 Abstract Aims : To evaluate the efficacy of acupuncture , and sweeping of the fetal membranes , as methods for induction of labor . Methods : Four hundred and seven pregnant women with normal singleton pregnancies and cephalic presentations were r and omized at three delivery wards in Denmark at day 290 of gestation into groups of acupuncture , sweeping , acupuncture and sweeping and controls . The primary objective was to compare the proportion of women going into labor before induction of labor at 294 days in the four groups . The secondary objective was to compare the combined groups : with and without acupuncture , and with and without sweeping of the fetal membranes . The midwives , completing the forms for the trial at labor or induction , were blinded to group assessment s. Results : Four hundred and seventeen women were r and omized . Ten were excluded after r and omization . One hundred and four women were r and omized to acupuncture , 103 to sweeping of the membranes , 100 to both acupuncture and sweeping , and 100 were r and omized to the control group . Comparison of the four groups demonstrated no significant difference in the number of women achieving spontaneous labor before planned induction . No difference was demonstrated by comparing the combined groups treated with acupuncture with the groups not treated with acupuncture ( P=0.76 ) . However , significantly more women went into labor before planned induction ( P=0.02 ) in the combined groups receiving sweeping , compared with the groups not treated with sweeping . Conclusions : Acupuncture at 41 + weeks of gestation did not reduce the need for induction . The study was of a sufficient size to demonstrate , in parallel , that sweeping of the fetal membranes significantly reduced the need of induction , sparing about 15 % for formal induction of labor Objective To measure the serum levels of interleukin (IL)-8 , prostagl and in ( PG ) F2α and β-endorphin in parturients with acupuncture treatment and in controls to clarify the effect of acupuncture and duration of labor on the serum levels of substances active in cervical ripening and dilatation . Methods A matched pair study was performed involving 80 women with and without prenatal acupuncture treatment , matched for age and parity . Serum levels of IL-8 , PGF2α , and β-endorphin were measured in serum sample s taken after delivery by use of enzyme-linked immunosorbent assay , enzyme immunoassay , and immunoradiometric assay , respectively . Results The mean difference in total duration of labor between matched pairs with and without acupuncture was-136.5 minutes ( 95 % confidence interval [ CI ] 191.1 minutes,-81.9 minutes ; paired t test , P < .001 ) . The mean difference of the duration of the first and second stages of labor between matched pairs with and without acupuncture was-138.8 minutes ( 95 % CI 188.6,-89.0 minutes ; paired t test , P < .001 ) and 2.3 minutes ( 95 % CI 15.5 , 20.1 minutes ; paired t test , P = 55 .8 ) , respectively . The geometric means of ratios of IL-8 , PGF2α , and β-endorphin between matched pairs in women with and without acupuncture showed no statistically significant differences . Serum levels of IL-8 , PGF2α , and β-endorphin were not significantly correlated with the duration of the first and second stages of labor . Conclusion Prenatal acupuncture treatment significantly reduces the duration of labor and may be a valuable tool in prenatal preparation . Serum levels of IL-8 , PGF2α and β-endorphin are not significantly influenced by acupuncture and are therefore not likely to mediate acupuncture-related effects during labor Purpose The present study was aim ed to compare the effects of the use of electroacupuncture and misoprostol in inducing labor in patients with Bishop score < 7 and to observe the characteristics of labor in both methods . Methods As much as 67 pregnant women with Bishop score < 7 , single cephalic presentation with gestational age confirmed by first-trimester ultrasound , reactive cardiotocography , and amniotic fluid volume and estimated fetal weight within the respective normal ranges for gestational age were selected . They were r and omized into 2 groups : electroacupuncture ( AC ) or misoprostol ( M ) . Results There were no significant differences regarding age , gestational age , fetal weight , parity , Bishop score , or indication for induction . Labor was the main outcome , which was obtained in both groups without significant difference regarding frequency ( p = 0.07 ) and time of induction ( p = 0.29 ) . Absence of obstetric complication , higher duration of labor ( p = 0.036 ) , and tendency to a higher satisfaction of the patients ( p = 0.046 ) were observed among patients of group AC . Higher frequency of cesarean sections ( p = 0.014 ) and obstetric complications ( 9.3 % ) were observed among patients of group M. Conclusions Our results showed that electroacupuncture can be used to obtain cervical ripening , with similar results as compared with misoprostol , with a significantly higher frequency of vaginal deliveries and without occurrence of obstetric complications Background : Cervical ripening is one of the main stages of initiation labor . Acupressure in Chinese medicine is considered as an invasive technique , which through reliving oxytocin ripens the cervix . Acupoint Sanyinjiao ( SP6 ) was selected in this study because it is the acupoint selected in gynecology and it is easy for women to locate and apply pressure without medical assistance . Objectives : The aim of this study was to determine the effect of acupressure on cervical ripening . Patients and Methods : In this r and omized clinical trial , 150 primigravida with term pregnancy who had referred to Deziani hospital in Gorgan were chosen and divided to three groups : in the first group acupressure was done by the research er while in the second groups this was performed by the mother her self , and the third group served as a control and only received routine care . For both intervention groups the pressure was applied on Sp6 for about 20 minutes during one to five days . Elements were checked from cervical ripening at 48 and 96 hours after intervention and at the time of hospitalization . The tools for gathering information included demographic characteristics and midwifery history question naire , daily records and follow up forms . Content validity was used for validity of tools . Reliability of the observation check-list and physical examination was confirmed by inter-rater scores ( inter observer ) , and daily records by test-re-test . Data was analyzed by analysis of variance ( ANOVA ) , Kruskal-Wallis and Chi-squared tests ( P ≤ 0.05 ) . Results : There was a significant difference between mothers ’ educations in the three groups . Most of the mothers ( 59.5 % ) in the research er-performed acupressure group had secondary education . Cervical ripening was significantly different between the three groups after 48 hours ( P ≤ 0.05 ) , yet there was no significant difference after 96 hours and at the time of admission . Mean Bishop score was enhanced after 48 hours in the research er-performed acupressure group ( P ≤ 0.021 ) and the self-performed acupressure group ( P ≤ 0.007 ) in comparison to the control group . Conclusions : The results showed that acupressure is a safe technique and leads to cervical ripening . Thus , regarding the desired results that were achieved when mothers applied acupressure themselves , it could be suggested that it is beneficial for mothers to be trained to apply this method at home Please cite this paper as : MacKenzie I , Xu J , Cusick C , Midwinter‐Morten H , Meacher H , Mollison J , Brock M. Acupuncture for pain relief during induced labour in nulliparae : a r and omised controlled study . BJOG 2011;118:440–447 Objective To evaluate the effect of an antenatal integrative medicine education programme in addition to usual care for nulliparous women on intrapartum epidural use . Design Open-label , assessor blind , r and omised controlled trial . Setting 2 public hospitals in Sydney , Australia . Population 176 nulliparous women with low-risk pregnancies , attending hospital-based antenatal clinics . Methods and intervention The Complementary Therapies for Labour and Birth protocol , based on the She Births and acupressure for labour and birth courses , incorporated 6 evidence -based complementary medicine techniques : acupressure , visualisation and relaxation , breathing , massage , yoga techniques , and facilitated partner support . R and omisation occurred at 24–36 weeks ’ gestation , and participants attended a 2-day antenatal education programme plus st and ard care , or st and ard care alone . Main outcome measures Rate of analgesic epidural use . Secondary : onset of labour , augmentation , mode of birth , newborn outcomes . Results There was a significant difference in epidural use between the 2 groups : study group ( 23.9 % ) st and ard care ( 68.7 % ; risk ratio ( RR ) 0.37 ( 95 % CI 0.25 to 0.55 ) , p≤0.001 ) . The study group participants reported a reduced rate of augmentation ( RR=0.54 ( 95 % CI 0.38 to 0.77 ) , p<0.0001 ) ; caesarean section ( RR=0.52 ( 95 % CI 0.31 to 0.87 ) , p=0.017 ) ; length of second stage ( mean difference=−0.32 ( 95 % CI −0.64 to 0.002 ) , p=0.05 ) ; any perineal trauma ( 0.88 ( 95 % CI 0.78 to 0.98 ) , p=0.02 ) and resuscitation of the newborn ( RR=0.47 ( 95 % CI 0.25 to 0.87 ) , p≤0.015 ) . There were no statistically significant differences found in spontaneous onset of labour , pethidine use , rate of postpartum haemorrhage , major perineal trauma ( third and fourth degree tears/episiotomy ) , or admission to special care nursery/neonatal intensive care unit ( p=0.25 ) . Conclusions The Complementary Therapies for Labour and Birth study protocol significantly reduced epidural use and caesarean section . This study provides evidence for integrative medicine as an effective adjunct to antenatal education , and contributes to the body of best practice evidence . Trial registration number ACTRN12611001126909 OBJECTIVE To observe the impacts of electroacupuncture ( EA ) at Sanyinjiao ( SP 6 ) on labor and assess its safety . METHODS The r and om and single-blind method was adopted to divide 111 cases of the puerperas of natural delivery into an  EA group ( 38 cases ) , a  sham-acupuncture group ( 37 cases ) and a  blank control group ( 36 cases ) . In EA group , Sanyinjiao ( SP 6 ) was selected and stimulated with Han 's acupoint nerve stimulator ( HANS ) . In the sham-acupuncture group , the puerperas were stimulated only with the needle tube , needle removed in advance and they felt subjectively to be needled . Afterward , the filiform needle was attached to Sanyinjiao ( SP 6 ) with the needle tip wrapped with the adhesive plaster in advance , then HANS which one conducting wire was cut off in was connected . In the blank control group , no any treatment was applied , but the same indices were recorded at corresponding time points . The blood pressure and the heart rate of the puerperas as well as the heart rate of fetus were measured in 20 min of EA and 30 min after needle removal in three groups separately . The bleeding 24 h after labor and 1 min Apger score of the newborns were observed . RESULTS In EA group , the active phase of the 1st labor stage ( ( 4.38 + /- 1.76)h ) was shorter than that ( ( 5.28 + /- 2.41)h ) in the blank control group and that ( ( 5.38 + /- 2.36)h ) in the sham-acupuncture group , presenting statistically significant differences ( all P < 0.05 ) . In the latent phase of the 1st labor stage and the 2nd and 3rd stages , in the comparison of the blood pressure and the heart rate of the puerperas as well as the heart rate of fetus after EA , the bleeding 24 h after labor and 1 min Apger score of the newborns among three groups , there were no statistically significant differences ( all P > 0.05 ) . CONCLUSION EA at Sanyinjiao ( SP 6 ) can shorten the duration of the active phase of the 1st labor stage . It is safe for either the puerpera or the fetus and can assist the parturition quality in clinic OBJECTIVE To compare the efficacy of acupressure for induction of labour for nulliparous women with a post- date s pregnancy . DESIGN A single-blind r and omised trial . SETTING Antenatal and labour ward of a UK district general hospital . PARTICIPANTS One hundred and thirty two women requiring induction of labour with a post- date s pregnancy ( > 41 weeks gestation ) with no significant medical , obstetric or fetal condition . METHOD Acupressure : 20 intermittent presses to stimulate each pair of acupressure points ; ( Large Intestine 4 , followed by Spleen 6 ) or ' Sham " treatment : 20 intermittent presses to the patella and then to the olecranon . MAIN OUTCOME MEASURES Treatment-to-commencement of labour interval . SECONDARY OUTCOME MEASURES Requirements for oxytocin , mode of delivery , duration of labour , requirement for pre-labour Caesarean section , presence of meconium , neonatal intensive care admission , 5 min Apgar scores , and evaluation of maternal satisfaction . RESULTS There were no significant differences between the two groups in treatment-to-commencement of labour interval , requirements for oxytocin or mode of delivery . Fewer inductions of labour were required in the sham treatment group ( p = 0.004 CI 1 - 35 ) . The incidence of meconium-stained liquor , and neonatal outcomes were similar for both groups . CONCLUSIONS Acupressure performed at 41 weeks gestation in nulliparous women does not appear to be effective for inducing labour for post- date s pregnancy Labor induction with traditional drugs is sometimes associated with fetal complications as fetal distress or death . The aim of this study was to evaluate the effect of labor induction by laser acupuncture on fetal well-being in post-term pregnancy . Nulliparous women at 40 weeks or greater were r and omized to sham laser  group versus laser acupuncture group . Each session consisted of laser application on bilateral points LI 4 , SP 6 , BL 31 , and BL 32 . The study was conducted in Cairo University , National Institute of Laser Enhanced Sciences . Sixty nulliparous women were r and omized into laser acupuncture group n = 30 and control group n = 30 . Women were treated in both groups in three consecutive days in post- date pregnancy . Results ( 66.6 % ) showed a significant difference in rate of normal vaginal delivery ( NVD ) between acupuncture group ( 50 % ) and control group ( 50 % ) ( p = 0.002 ) . There was no significant difference of enrollment delivery time between laser acupuncture and sham groups ( p > 0.05 ) . There were six cases of cesarean section ( CS ) due to no fetal movement with normal cardiotocography ( CTG ) . Laser acupuncture has no effect on fetus , and its effect on fetal movement needs more investigations . Laser can induce labor if the cervical length is less than 1 cm and dilation ( 0 ) OBJECTIVE : To estimate the clinical effectiveness of acupuncture to induce labor . METHODS : This study was a r and omized controlled trial of acupuncture compared with sham acupuncture .  Women who were scheduled for a postterm induction with a singleton pregnancy and cephalic presentation were eligible for the study . Women received two acupuncture or sham acupuncture sessions over a 2-day period before the planned medical/pharmacological induction . The principal primary outcomes related to the need for induction methods and time from the administration of the intervention to delivery . RESULTS : Three hundred sixty-four women were r and omly assigned to the trial ( treatment n=181 and control n=183 ) . Women did not differ in their need for induction methods between groups : prostagl and in induction : relative risk ( RR ) 1.20 , 95 % confidence interval ( CI ) 0.96–1.51 , P=.11 ; artificial rupture of membranes only : RR 0.93 , 95 % CI 0.72–1.20 , P=.57 ; oxytocin only : RR 0.89 , 95 % CI 0.60–1.32 , P=.55 ; artificial rupture of membranes plus oxytocin : RR 0.87 , 95 % CI 0.57–1.33 , P=.52 ; prostagl and ins , artificial rupture of membranes , and oxytocin :  RR 0.84 , 95 % CI 0.37–1.91 , P=.68 . The median time from acupuncture to delivery was 68.6 hours ( interquartile range 53.9–79.5 ) compared with 65 hours ( interquartile range 49.3–76.3 ) for women in the control group . CONCLUSION : Two sessions of manual acupuncture , using local and distal acupuncture points , administered 2 days before a scheduled induction of labor did not reduce the need for induction methods or the duration of labor for women with a postterm pregnancy . CLINICAL TRIAL REGISTRATION : Australian New Zeal and Clinical Trials Registry , www.anzctr.org.au , ACTRN12606000494538 LEVEL OF EVIDENCE : Objective . To evaluate the utility of outpatient acupuncture for labor stimulation . Methods . Nulliparous women at 39 4/7 weeks or greater with a singleton gestation and Bishop score of less than 7 were r and omized to usual medical care ( control group ) versus usual care and three outpatient acupuncture treatments ( acupuncture group ) . Each treatment consisted of eight needles applied to bilateral points LI4 , SP6 , UB31 , and UB32 . The primary outcome was time elapsed from the time of r and omization to delivery . Secondary outcomes included rates of cesarean section and induction of labor . Medical records were abstract ed for maternal demographic , medical , and delivery outcome data . A priori sample size calculation revealed that 56 women were required to detect a 72-hour difference in delivery time with a power of 83 % and an alpha of 0.05 . Student 's t-test , Chi-square , and Kaplan – Meier statistics were used to compare groups . Results . Fifty-six women were r and omized and completed the study procedures . Race , age , gestational age , and cervical Bishop score were similar in both groups . Mean time to delivery occurred 21 hours sooner in the acupuncture group , but this difference did not reach statistical significance ( p = 0.36 ) . Compared to controls , women in the acupuncture group tended to be more likely to labor spontaneously ( 70 % vs. 50 % , p = 0.12 ) and less likely to deliver by cesarean section ( 39 % vs. 17 % , p = 0.07 ) . Of women who were not induced , those in the acupuncture group were more likely to be delivered than the controls at any point after enrollment ( p = 0.05 ) . Conclusion . Acupuncture is well tolerated among term nulliparous women and holds promise in reducing interventions that occur in post-term pregnancies BACKGROUND Induction of labor is a common obstetric procedure . Acupressure is a natural method that is used for inducing uterine contractions . Nevertheless , few studies have examined the impact of acupressure on the induction of labor . AIM The aim of this study was to evaluate the effect of acupressure on the initiation of labor . MATERIAL AND METHODS In this r and omized clinical trial , 162 nulliparous pregnant women were admitted to the hospital . They were categorized into 3 groups ; acupressure , sham acupressure and control . Acupressure points SP6 , BL 60 and BL 32 were pressured bilaterally . The intervention was done by the research er every other day between 9 am and 11 am . The intervention was carried out on women in the afternoon and the following day . Subjects were examined to determine the initiation of labor symptoms48 and 96h after the start of intervention and at the time of hospitalization . Data were analyzed using the ANOVA , Kruskal-Wallis and Chi-square tests ( p<0.05 ) . RESULTS There was no significant difference among the groups for spontaneous initiation of labor within 48h ( P=0.464 ) , and 49 - 96h after beginning the intervention ( P=0.111 ) and 97h after beginning the intervention to the time of hospitalization for the spontaneous initiation of labor ( P=0.897 ) . There were no significant differences in the secondary outcomes between the groups . CONCLUSION According to the finding of this study , it seems that acupressure treatment was not effective in initiating labor as compared with the sham acupressure and the routine care groups OBJECTIVE this Australian feasibility study aim ed to determine ; the willingness of women experiencing a post- date pregnancy to participate in a r and omised controlled trial ( RCT ) of acupressure and compliance with the study protocol . The study also aim ed to determine the effect size of the primary outcome in order to calculate a sample size for a future appropriately powered RCT . DESIGN a two-arm r and omised controlled trial . Staff providing clinical care were blinded to group allocation unless the participant disclosed study participation . SETTING maternity services at two outer metropolitan public hospitals in New South Wales , Australia PARTICIPANTS sixty seven healthy primigravid women experiencing a singleton cephalic pregnancy at 40 weeks±2 days gestation were assessed as eligible to participate and were provided with study information . INTERVENTION both groups received st and ard clinical care , with the intervention group also receiving verbal and written instructions on the self-administration of three acupoints ( Spleen 6 , Large Intestine 4 , and Gall Bladder 21 ) to be used until spontaneous or induced labour began . MEASUREMENTS assessment of feasibility included determining recruitment rate and acceptability of an RCT for a CAM modality , and acupressure treatment compliance , via participant surveys . The primary clinical outcome was spontaneous onset of labour . FINDINGS from the 67 women eligible during the timeframe for the study , 44 women ( 65.6 % ) agreed to participate and were r and omised . There was no statistically significant difference in rate of spontaneous onset of labour ( 50 % acupressure vs 41 % control ) . Twenty nine participant surveys were returned ( 65.9 % ) . In the intervention group there was a high compliance with the acupressure protocol ( 83 % ) and the use of the three acupoints ( 94 % ) . CONCLUSIONS AND IMPLICATION S FOR PRACTICE this feasibility study revealed that pregnant women are interested in the use of CAM , and acupressure in particular , for the initiation of labour . Most women found it acceptable to be r and omised to receive the intervention . While the 9 % difference in the primary outcome was not statistically significant it is the best estimate of the treatment effect for calculating a sample size of 994 for a future RCT with 80 % power , alpha 0.05 . TRIAL REGISTRATION Australia and New Zeal and Clinical Trials Register ( ANZCTR ) : ANZCTR:12613000145707 Purpose This double-blind r and omized controlled trial was conducted to evaluate whether use of acupuncture could initiate labor at term and thus reduce post-term induction . Methods Between 2010 and 2011 , a total of 80 women at 38 weeks of gestation or greater were r and omized to acupuncture and sham acupuncture groups .  Acupuncture points LI4 , SP6 and BL67 were needled bilaterally . The primary outcome was initiation of labor . The time from acupuncture to delivery , mode of delivery , fetal and maternal outcome and Apgar scores were recorded . The trial is registered at i rct .ir , number I RCT 201111218151N1 . Results Eighty women were r and omized and 75 women completed the study procedure . Age , BMI , parity and gestational age were similar in both groups .  Spontaneous labor was initiated in 94.7 % of acupuncture group and 89.2 % of sham acupuncture group ( p = 0.430 ) . There were no statistically significant difference between groups for time from enrollment to delivery ( p = 0.06 ) . Conclusion According to this study , it seems that acupuncture was not effective in labor initiation compared to sham acupuncture BACKGROUND A problem acupuncture research has to face is the concept of a control group . If , in control groups , non-acupoint needling is done , physiological acupuncture effects are implied . Therefore the effects shown in this group are often close to those shown in the acupuncture group . In other trials , control groups have received obviously different treatments , such as transcutaneous electrical nervous stimulation or TENS-laser treatment ; it is not clear if the effects of acupuncture are due only to the psychological effects of the treatment . METHODS We developed a placebo acupuncture needle , with which it should be possible to simulate an acupuncture procedure without penetrating the skin . In a cross-over experiment with 60 volunteers we tested whether needling with the placebo needle feels any different from real acupuncture . FINDINGS Of 60 volunteers , 54 felt a penetration with acupuncture  ( mean visual analogue scale [ VAS ] 13.4 ; SD 10.58 ) and 47 felt it with placebo ( VAS 8.86 ; SD 10.55 ) , 34 felt a dull pain sensation ( DEQI ) with acupuncture and 13 with placebo . None of the volunteers suspected that the needle may not have penetrated the skin . INTERPRETATION The placebo needle is sufficiently credible to be used in investigations of the effects of acupuncture OBJECTIVE The aim of this study was to evaluate whether acupuncture at term can influence cervical ripening , induce labor and thus reduce the need for post date s induction . METHODS On the estimated date of confinement ( EDC ) women were prospect ively r and omized to an acupuncture group ( AG ) or a control group ( CG ) . Data of 45 women were evaluated ( AG , n = 25 ; CG , n = 20 ) . Inclusion criteria were as follows : confirmed EDC , uncomplicated course of pregnancy , singleton pregnancy in cephalic presentation . Exclusion criteria were as follows : cervical dilation > 3 cm , active labor , premature rupture of membranes , previous cesarean section , pathologies in mother or fetus . Women were examined at 2-day intervals . The cervical length was measured with vaginal ultrasonography , cervical mucus was obtained for a fetal Fibronectin test and the cervical status was assessed according to the Bishop score . In the AG , the points Hegu ( Large Intestine 4 ) and Sanyinjiao ( Spleen 6 ) were pierced on both sides every second day . If women were not delivered 10 days after EDC , labor was induced by administering vaginal prostagl and in tablets . RESULTS The cervical length in the AG was shorter than that in the CG on day 6 and day 8 after EDC ( P = 0.04 for both ) . In the AG the time period from the first positive Fibronectin test to delivery was 2.3 days , while that in the CG was 4.2 days ( P = 0.08 ) . The time period from EDC to delivery was on average 5.0 days in the AG and 7.9 days in the CG ( P = 0.03 ) . Labor was induced in 20 % of women in the AG ( n = 5 ) and in 35 % in the CG ( n = 7 ) ( P = 0.3 ) . Overall duration of labor , and first and second stage of labor were not different in the two groups . In 56 % of women who underwent acupuncture ( n = 14 ) and in 65 % of controls ( n = 13 ) ,  Oxytocin  was used to augment labor . ( P = 0.54 ) . CONCLUSION Acupuncture at points LI4 and SP 6 supports cervical ripening at term and can shorten the time interval between the EDC and the actual time of delivery Abstract Aim : Pharmacological labor induction is obtained through intracervical/vaginal prostagl and ins and /or oxytocin infusion ; however , the use of these agents produces fetal and maternal side effects . Traditional Chinese medicine advocates the use of acupuncture to soften the cervix and induce uterine contractions . The aim of the present study is to investigate the effect of acupuncture to induce labor .  Acupuncture was applied in post- date pregnancies one week before a planned induction ; the primary outcome was the rate of women su bmi tted to labor induction for prolonged pregnancy at week 41 + 5 . Methods : After informed consent , 221 undelivered women ranging between 40 + 2/40 + 6 gestational age were considered eligible for the study and 202 were r and omized to receive acupuncture or observation . Sessions of acupuncture were planned every odd day from the r and omization till 41a week plus 4 days . At 41 + 5 week a pharmacological induction of labor was planned . Results : The total rate of labor induction did not significantly differ between observation and acupuncture group ( 20 % versus 17 % ) . Moreover no differences were found as far as the indications to induce labor , in particular “ prolonged pregnancy ” was similar between groups ( 8/96 versus 5/99 ) . To investigate between-group differences in time elapsed between inclusion and delivery , survival analysis was performed excluding women requiring labor induction : women receiving acupuncture showed a trend to deliver earlier than women in the observation group ( p < 0.09 ) . Conclusion : The present study demonstrated that acupuncture applied every odd day for one week seems ineffective in reducing the rate of labor induction performed for prolonged pregnancy at 41 + 5 weeks . Previous reports reached similar conclusions , independently of the different timing , duration and mode of stimuli application Background . The objective was to investigate whether acupuncture could be a reasonable option for augmentation in labor after spontaneous rupture of membranes at term and to look for possible effects on the progress of labor . Methods . In a r and omized controlled trial 100 healthy parturients , with spontaneous rupture of membranes at term , were assigned to receive either acupuncture or no acupuncture . The main response variables were the duration of active labor , the amount of oxytocin given , and number of inductions . Results . Duration of labor was significantly reduced ( mean difference 1.7 h , p = 0.03 ) and there was significant reduction in the need for  oxytocin infusion to augment labor in the study group compared to the control group ( odds ratio 2.0 , p = 0.018 ) . We also discovered that the participants in the acupuncture group who needed labor induction had a significantly shorter duration of active phase than the ones induced in the control group ( mean difference 3.6 h , p = 0.002 ) . These findings remained significant also when multiple regression was performed , controlling for potentially confounding factors like parity , epidural analgesia , and birth weight . Conclusion . Acupuncture may be a good alternative or complement to pharmacological methods in the effort to facilitate birth and provide normal delivery for women with prelabor rupture of membranes OBJECTIVE To observe analgesic effect of scalp acupuncture on  labor .  METHODS Seventy primiparae with term pregnancy and monocyesis were r and omly divided into scalp acupuncture group treated by acupuncture at the Shengzhi area of scalp , and control group by no treatment .  Pain grade s before and after scalp acupuncture were evaluated with the pain 4- grade rating criteria stipulated by WHO , and the active stage and the second birth process , the Apgar scores of new-born and postpartum hemorrage amount were compared between the two groups . RESULTS The labor pain with 1 to approximately 2 grade s was found in 33 cases in the scalp acupuncture group , and 2 cases in the control group with very significant difference between the two groups ( P < 0.01 ) ; the active stage was ( 130.70 + /- 74.16 ) min and the second birth process was ( 40.70 + /- 21.65 ) min in the scalp acupuncture group , and ( 166.15 + /- 62.65 ) min and ( 53.30 + /- 26.93 ) min in the control group , respectively , with significant differences between the two groups ( all P < 0.05 ) ; and there were no significant differences in Apgar score of new-born and postpartum hemorrhage amount . CONCLUSION Scalp acupuncture has a better analgesic effect in vaginal delivery with no adverse effect on the mother and infant INTRODUCTION In Denmark , 45 % of all primiparas and 12 % of multiparas with uneventful pregnancies are augmented in order to treat dystocia . Augmentation using oxytocin is associated with uterine hyperstimulation , uterine rupture and foetal death . Currently , no studies show that acupuncture is effective for augmentation . MATERIAL AND METHODS A single-blinded r and omized controlled trial with women diagnosed with dystocia . In the acupuncture group , the women had acupuncture in SP6 , KI3 , KI6 , BL60 , LI4 and acupressure on BL67 . The control group received no treatment . The primary outcome was progression in cervical dilatation within two hours . The secondary outcomes were length of labour , length of second stage , use of augmentation , use of analgesia , caesarean section rate and number of instrumental deliveries . RESULTS A total of 84 women were r and omised . There was no significant difference between the groups with regard to dilatation from r and omization to effect assessment ( p = 0.54 ) . In the acupuncture group , the mean difference was 1.3 cm ( 0.69 - 1.91 ) . In the control group , the mean difference was 1.56 ( 0.6 - 2.52 ) . 27 % of the women with dystocia delivered spontaneously without augmentation . No major side effects of acupuncture treatment were reported . CONCLUSION This study showed no effect of acupuncture treatment for primary or secondary inertia OBJECTIVES Labor induction in post-term pregnancy is considered as a conventional process of mothers ' care . Shiatsu technique is one of the complementary methods which use for post-term pregnancy induction . Therefore , the research ers decided to examine the effect of Shiatsu technique on the induction of post-term pregnancy . MATERIAL S & METHODS This is a r and omized control trials which conducted on 288 women with post-term pregnancy who referred to consulting clinic at Ali- Ibn- Abi -Talib Hospital , in Zahedan-Iran in 2010 - 2011 . Participants were selected based on r and om table . The participants divided into two groups : the first was shiatsu technique and the second group was control group ( routine procedure ) . Shiatsu technique was conducted on the participants of intervention group for 30s on three points by an experienced midwife . The gathered data analyzed by SPSS version 15.00 and comparing tests were t-students tests , chi-square . RESULTS Mothers ages range were between 16 to 42 years ( mean 26.5 - 5.7 ) in shiatsu and 17 to 43 years ( mean 24.5 - 5.1 ) in control group . Regarding spontaneous initiation of labor , 82 women ( 56.9 % ) in Shiatsu group had spontaneous initiation of labor , whereas the number of women was only 12 ( 8.3 % ) in control group . Women who have used Shiatsu technique were significantly more likely to have spontaneous labour than those women who did not . CONCLUSIONS Results of the study showed that shiatsu technique can be used as one of safe complementary methods for post-term pregnancy induction The effectiveness of transcutaneous electrical stimulation at acupuncture points for increasing uterine contractions in 20 post- date s pregnant women was assessed in a controlled study . Subjects were r and omly assigned to either a treatment condition , consisting of the application via surface electrodes of a 30-Hz current to the points " spleen 6 " ( lower leg ) and " liver 3 " ( foot ) , or a placebo condition , in which the equipment was attached but not activated . The frequency and strength of uterine contractions were monitored for 1 hour prior to stimulation and then for the final 2 hours of a 4-hour test period . A significant increase in frequency and strength of uterine contractions was found in the electrically stimulated women compared with the placebo-group women . The possible physiologic mechanisms underlying this effect , and its implication for labor induction , are discussed
BACKGROUND This is one of a series of review s of methods of cervical ripening and labour induction .
The use of complementary therapies is increasing .
Women may look to complementary therapies during pregnancy and childbirth to be used alongside conventional medical practice .
Acupuncture involves the insertion of very fine needles into specific points of the body .
Acupressure is using the thumbs or fingers to apply pressure to specific points .
The limited observational studies to date suggest acupuncture for induction of labour has no known adverse effects to the fetus , and may be effective .
However , the evidence regarding the clinical effectiveness of this technique is limited .
OBJECTIVES To determine , from the best available evidence , the effectiveness and safety of acupuncture and acupressure for third trimester cervical ripening or induction of labour .