Pregnancy and Postpartum

Context

Pregnancy is a time of unusually close medical attention, yet many of its day-to-day symptoms are simply expected to be endured. Nausea, exhaustion, back and pelvic pain, heartburn, headaches, and persistent sleep disruption may be common, but common does not mean insignificant — or that there is nothing we can do to make pregnancy more comfortable.

Acupuncture offers a non-pharmacological approach to many common pregnancy-related symptoms and can be used alongside routine prenatal care. We regularly work with patients throughout pregnancy, including patients referred by obstetricians, midwives, physical therapists, and other maternity-care providers.

Pregnancy and postpartum care have been part of our practice from the beginning. Adele completed postgraduate clinical training in hospital gynecology in Beijing and has treated women during pregnancy and postpartum since 1999. Adele and Tammy routinely treat patients throughout pregnancy and have substantial experience with prenatal care.

The first trimester

Nausea and vomiting

Nausea is one of the most common reasons patients come to us during early pregnancy. Acupuncture and acupressure are frequently used to help manage pregnancy-related nausea, and treatment can be adapted according to the severity and timing of symptoms.

During the most symptomatic weeks, treatment may be weekly or even twice weekly for severe nausea. We may also show you acupressure points that can be used between visits.

Severe or persistent vomiting is different. If you are unable to keep down fluids, are losing weight, or have been diagnosed with hyperemesis gravidarum, acupuncture may be used as supportive care, but close obstetric management is important.

Fatigue, sleep, and other early-pregnancy symptoms

The fatigue of early pregnancy can be profound. We also commonly see patients for headaches, constipation, reflux, sleep disturbance, and the combination of symptoms that can make the first trimester particularly difficult.

Treatment is individualized rather than based simply on the week of pregnancy.

Anxiety and pregnancy after loss

Pregnancy can bring considerable anxiety, particularly after miscarriage, fertility treatment, or a difficult previous pregnancy.

Acupuncture cannot remove the uncertainty that accompanies pregnancy, but treatment can provide support for sleep, physical tension, and the heightened state of anxiety that some patients experience during this time. When anxiety becomes severe or persistent, we also encourage appropriate mental-health and medical support.

The second and third trimesters

As the pregnancy progresses, the reasons patients come for treatment often change.

Back, hip, and pelvic pain

Low back pain, sacroiliac pain, pelvic girdle pain, pubic symphysis pain, hip pain, and sciatica are common reasons for treatment later in pregnancy.

Acupuncture may be combined with manual therapy when appropriate. Treatment positioning is adapted as the pregnancy progresses, using side-lying and other supported positions for comfort and safety.

Other common symptoms

We also treat:

• Carpal tunnel and hand discomfort
• Swelling of the hands, feet, and legs
• Sleep disturbance
• Headaches
• Heartburn and reflux
• Muscular tension and discomfort associated with the changing demands on the body

Significant or sudden swelling, particularly when accompanied by headache, visual changes, or other concerning symptoms, needs obstetric evaluation rather than treatment here first.

Breech presentation

When a baby remains breech in the early third trimester, acupuncture and moxibustion may be considered as part of care.

We generally recommend beginning around 32 to 34 weeks, rather than waiting until the final weeks of pregnancy. Moxibustion is commonly used at home between visits, and we teach patients how to do it safely.

If an external cephalic version (ECV) is planned, we also recommend treatment beforehand when scheduling allows. Acupuncture and moxibustion do not replace obstetric monitoring or procedures, and your obstetric provider or midwife should continue to follow fetal position and advise you about your options.

Preparing for birth

Beginning around 36 weeks, some patients choose to come weekly for birth preparation.

These treatments are not intended to force labor to begin before the body and baby are ready. We use acupuncture to support the final weeks of pregnancy, address pain and tension, encourage relaxation, and prepare for the physical demands of labor and birth.

Treatment remains individualized. Someone with significant pelvic or low-back discomfort may need a different approach from someone who is comfortable and simply wants support through the final weeks.

When to contact your maternity-care provider

Some symptoms during pregnancy need prompt medical assessment. Contact your obstetric provider, midwife, or labor and delivery according to the instructions you have been given if you experience symptoms such as:

• Vaginal bleeding or leaking fluid
• Reduced or absent fetal movement
• Severe or persistent headache, visual changes, sudden swelling of the face or hands, or significant pain beneath the right ribs
• Regular contractions before 37 weeks
• Fever or severe abdominal pain
• Shortness of breath, chest pain, fainting, or other sudden or severe symptoms

When in doubt about an acute pregnancy symptom, contact your maternity-care team first.

After the birth

Chinese medicine has traditionally regarded the postpartum period as a distinct stage of recovery deserving particular care and attention.

Pregnancy and birth require an enormous physiological effort. Recovery occurs while sleep is fragmented, feeding and caring for a newborn place new demands on the body, and hormonal changes continue for months.

In Chinese medicine, this is another important transitional period — like menarche and menopause — in which rest, nourishment, treatment, and attention to recovery are considered especially important. These periods of profound change are also viewed as opportunities: with appropriate care, we can not only support immediate recovery, but strengthen the constitution and lay a better foundation for health in the years that follow.

Postpartum treatment

Patients come to us postpartum for:

• Fatigue and a prolonged sense of depletion
• Low back, neck, shoulder, and upper-back pain associated with feeding and caring for a baby
• Pelvic and perineal discomfort
• Cesarean recovery and scar treatment
• Night sweats and other postpartum temperature changes
• Headaches and sleep disturbance
• Lactation concerns, alongside appropriate lactation support
• Urinary symptoms and pelvic-floor complaints, often alongside pelvic-floor physical therapy
• Postpartum anxiety and mood changes

Treatment is adapted to how recently you gave birth, the type of delivery, blood loss, sleep, feeding, physical recovery, and any complications of pregnancy or birth.

Postpartum mood

Emotional changes after birth deserve particular attention.

Acupuncture can be used as supportive care for stress, sleep disruption, anxiety, and the physical effects of prolonged nervous-system activation. But postpartum depression and significant postpartum anxiety are medical conditions and may require treatment beyond acupuncture.

If you are experiencing persistent depression or anxiety, frightening or intrusive thoughts, severe agitation, inability to sleep even when you have the opportunity, or thoughts of harming yourself or your baby, seek medical help promptly.

Cesarean and scar recovery

Once the incision has healed sufficiently, we can incorporate treatment of a cesarean scar into postpartum care.

Scar treatment may include acupuncture, manual techniques, and microcurrent treatment depending on the stage of healing and the individual presentation. We also look beyond the scar itself at abdominal-wall tension, sensitivity, numbness, restriction, low-back or pelvic discomfort, and the way the surrounding tissues are recovering after surgery.

Safety during pregnancy

Acupuncture during pregnancy requires appropriate training and an understanding of how treatment changes through the different stages of pregnancy.

Point selection, stimulation, positioning, and treatment goals are adapted throughout pregnancy. Chinese herbal medicine requires particular care as well: herbs that may be used routinely outside pregnancy may be inappropriate during pregnancy.

At every visit, tell us how many weeks pregnant you are, about any complications your maternity-care team is monitoring, and what medications and supplements you are taking.

Common questions

Is acupuncture safe during pregnancy?

Acupuncture can be used during pregnancy when treatment is provided by a practitioner experienced in prenatal care. Treatment and positioning are adapted according to gestational stage, symptoms, and medical circumstances.

When should I start treatment for breech presentation?

We generally recommend starting around 32 to 34 weeks. There is more time to work with fetal positioning at that stage than if treatment begins very late in pregnancy. If an ECV is planned, treatment beforehand may also be useful.

What happens during birth-preparation treatments?

Beginning around 36 weeks, treatment may focus on relaxation, pelvic and low-back tension, sleep, comfort, and preparation for labor. We are not trying to force labor to begin before the body is ready.

How often should I come during pregnancy?

It depends on why you are coming. Acute symptoms such as significant nausea or pain may be treated weekly, or sometimes more frequently, for a period of time. Patients coming primarily for general support may space visits farther apart. From around 36 weeks, some patients choose to come weekly for birth preparation.

Can I take Chinese herbs while pregnant?

Chinese herbs can sometimes be used during pregnancy, but prescribing requires specific knowledge of pregnancy and the individual situation. Do not continue a formula prescribed before pregnancy without having it reviewed.

How soon can I come after giving birth?

There is no standard waiting period before receiving postpartum acupuncture. You can come when you feel physically ready. Many patients wait several weeks simply because the first weeks with a newborn are so demanding, while others benefit from treatment earlier. After a complicated delivery or cesarean birth, treatment is adapted to your stage of recovery and any recommendations from your obstetric team.

Can I bring my baby?

Yes.

Do you work alongside my obstetrician or midwife?

Yes. Acupuncture is intended to complement prenatal and postpartum medical care, and we are happy to work alongside the other practitioners involved in your care.