Moxibustion can have a significant effect in helping to turn breech babies. Ideally treatment is carried at 33-35 weeks, but can still be useful when used later in the pregnancy.
Moxibustion can also help babies that are not breech but are not in the optimal position prior to birth, such as those in a posterior position.
A landmark study published in the Journal of the American Medical Association in 1998 (1.) found that up to 75% of women with breech presentations before childbirth had fetuses that rotated to the normal position after receiving moxibustion at an acupuncture point (acupoint BL 67) on the Bladder meridian. The burning moxa’s heat touches the acupoint indirectly at a point above the skin. Since the moxa’s heat does not reach the skin directly, the threshold for discomfort is easily monitored. The acupoint given attention is located on the toes, so no actual heat approaches the uterus, making moxibustion safe for mother and baby.
What is moxibustion?
Indirect moxibustion is a popular form of increasing the body’s natural flow of energy at a certain point. One end of a moxa stick, roughly the shape and size of a cigar, is lit and is held or positioned close to the area being treated for several minutes. Administering Moxa opens up the uterus to make more room for the breech baby to turn. Combined with an acupuncture treatment, moxibustion helps to increase fetal movement, and the effect of gravity will encourage the heaviest part of the baby, the head, to enter the pelvis as it shifts its position.
Helena will give you instructions on how to administer Moxa at home after the initial treatment.
Research
Interventions on BL 67 for women with a breech foetus at 33 weeks gestation.
van den Berg I, Kaandorp G, Bosch J, Duvekot J, Arends L, Hununk M. Cost-effectiveness of breech version by acupuncture-type interventions on BL 67, including moxibustion, for women with a breech foetus at 33 weeks gestation: a modelling approach. Complementary Therapies in Medicine 2010;18, 67—77.
A modelling approach to evaluate the effectiveness and costs of using acupuncture-type interventions on BL67 (Zhiyin) compared to expectant management for women presenting with a baby in a breech position at 33 weeks gestation.
Summary
A modelling approach was used to predict the number of caesarean sections that could be prevented using moxibustion and or acupuncture on BL 67 at 33 gestational weeks. There were two strategies for women presenting with breech presentation at 33 weeks gestation:
- Expectant management – a wait and see approach with external cephalic version (ECV) offered if required
- Acupuncture-type interventions on BL67
Ten thousand women were accounted for in this model. Also included were the medical costs of two ultrasounds for every woman, ECV treatment if required and costs for pre- and postnatal care until eight days post delivery.
The acupuncture treatment included extra costings for two visits with an acupuncturist and the moxibustion sticks supplied for home treatment.
Both strategies of this modelling included an option for women to receive an ECV at 36 gestational weeks and for all births to occur in hospital. Women refusing the option of acupuncture-type interventions on BL67 or non compliance with using the moxa treatment at home were also accounted for.
Treatment Methods
The probability that women would accept treatment and that babies would remain in a persistent breech presentation were retrieved from a systematic review and meta-analysis of six randomized controlled trials (RCTs) reporting on the effectiveness of acupuncture-type interventions on BL 67 versus expectant management. These trials comprised of three RCT’s using moxibustion. The remaining three used acupuncture, electro- acupuncture and a mixture of moxibustion and acupuncture.
Conclusion
Two data analysis were preformed for the women receiving acupuncture type intervention: one with and one without ECV. Both resulted in a decreased breech presentation at term.
To prevent one caesarean section, seven women with breech presentation at 33 weeks gestation would need to be treated with acupuncture-type interventions on BL 67. Sensitivity analysis showed that if 16% or more of the women offered moxibustion treatment complied, it was more effective and less costly than expectant management. The cost difference per woman with a baby in breech position at 33 weeks gestation using the moxa around 33 weeks versus no additional treatment was € 451 (95% CI € 109, € 775; p = 0.005) eight days post delivery.
The authors concluded that offering acupuncture type interventions at BL 67 to women with a breech foetus at 33 weeks gestation reduced the number of breech presentations at term, the number of caesarean sections required, and was cost effective when compared to expectant management.
Clinical Perspective
The lead researcher of this study has published a previous systematic review on the safety and effectiveness of using acupuncture type interventions on BL 67 for women presenting with breech presentation. This recent research approach is timely, enabling acupuncturists to now engage in discussions with medical, midwifery and hospital clinic management staff about of the cost effectiveness of implementing acupuncture type interventions for breech presentation. Being able to enter into such discussions may well be an important factor for acupuncturists to facilitate the integration of acupuncture services within main stream medical care.
http://www.ncbi.nlm.nih.gov/pubmed/20430289
Betts, D. http://acupuncture.rhizome.net.nz/
Helena Barker ~ Acupuncture & Naturopathy 