Cervical Ripening


Almost every day in Baby Steps fertility clinic we will have at least one client visit for an acupuncture treatment to encourage cervical ripening. You will be happy to hear that it is one treatment that requires the minimum amount of very fine needles and is quite a relaxing session where you may even fall asleep. During the acupuncture session the emphasis is on regulating qi and blood prior to delivery, once qi is correct and blood is circulating properly, labour should be harmonious and so it is ideaI to help women prepare themselves to have the most efficient labour possible.
Acupuncture treatments for cervical ripening are requested more than ever before. I believe this is simply because people have become more aware of the value that the treatments can bring as it seems to be mostly referrals by word of mouth that contact us. People see how it can help avoid the discomfort caused by Western medically induced pregnancies. This is a drug free option which for obvious reasons people prefer to opt for. Western medicine uses prostaglandins and oxytocin to dilate and ripen the cervix, this can cause painful contractions whereby there is a high probability you will also need an epidural.
Prebirth acupuncture should start at 37-38 weeks and continue once a week thereafter until delivery. Today I’m going to talk specifically about acupuncture to assist cervical ripening although prebirth acupuncture also has the effect of possibly minimising the hours of labour, reducing chances of needing an induction and it harmonises the body to encourage a smooth childbirth.
Certain acupuncture points in the lower leg area of the body result in softening and promoting dilation of your cervix. We stimulate these points to prepare the body, in particular the cervix and pelvis for labour. This is not just about the cervix opening up. Sometimes women have a hard cervix. It is important that the effacement of the cervix thins out and thins down. When it’s thin, it softens and it opens up. If the cervix is 3-4 cm dilated before going into labour, the mother’s body is better prepared, relaxed, open and ready to give birth naturally. You should note that this is preparing the body for labour, only at around week 40 do we do the acupuncture treatment to induce labour.


There was a randomised controlled trial into the effects of acupuncture on cervical ripening published by Rabl in 2001.
Here is the Summary and conclusion
‘The objective of this study was to evaluate whether acupuncture at term can influence cervical ripening and thus reduce the need for postdates induction.
On their due dates 45 women were randomised into either an acupuncture group (25) or a control group (20).
The acupuncture group received acupuncture every two days.
The women in both groups were examined every other day for cervical length (measured by vaginal trasonography, cervical mucus and cervical stasis according to Bishop’s score).
If women had not delivered after 10 days labour was induced by administering vaginal prostaglandin tablets.
The time from the woman’s due date to delivery was an average of 5 days in the acupuncture group compared to 7.9 days in the control group, and labour was medically induced in 20% of women in the acupuncture group compared to 35% in the control group.
There were no differences between overall duration of labour or of the first and second stages of labour.
The authors concluded that acupuncture at the points Hegu L.I.-4 and Sanyinjiao SP-6 supports cervical ripening and can shorten the time interval between the woman’s expected date of delivery and the actual time of delivery.’
I would like to add that during a treatment session at this stage of the pregnancy I would also be advising you to regulate exercise to invigorate but not to exhaust the body. Some examples of good exercise at this time would be Pregnancy Yoga or Pilates, swimming, walking, Qi Gong or Tai Chi. It is important that you remember to be gentle with yourself and try to allow yourself some ‘down time’ to rest or nap every day.
I would also offer dietary advice for example the infamous raspberry tea is always worth a try. During the last 3 months sip 2 cups a day to strengthen the tissue of the uterus in preparation for labour. I would also teach you some techniques to maintain a calm emotional state, like a mindfulness breathing technique I can show you, visualization, meditation, acupressure points.
I love this area of acupuncture because I get so many phone messages and emails with pictures of babies and happy stories which really make my job so rewarding and a one to be grateful for.

Whatever stage you are at in life, if you enjoy reading, I recommend my favourite book, Traditional Chinese Medicine for Women by Xiaolan Zhao. Xiaolin is an internationally renowned practitioner of Traditional Chinese Medicine and the book is her story about how women in China look after themselves while moving through life from their first menses to child birth to menopause. She talks about diet, exercise and traditions. Here is an extract that is appropriate for this subject of cervical ripening and childbirth.
‘Childbirth is a milestone in the feminine life cycle that she (Xiaolin’s mother) was able to move through as it naturally unfolded. She did not spend a lot of time worrying about what was going to happen. She had not been conditioned to view childbirth with foreboding and fear. My mother was confident in her ability and strength to work through the pain and process of giving birth. Women throughout time have given birth to healthy infants who have grown to have children of their own. And yet childbirth is still viewed with anxiety, fear and apprehension. Is this a result of our concern around the health of our babies or fear around pain? Is it nervousness that we’ll do something wrong or that something will go wrong? Is it our fear over the loss of our ability to control what is happening with our minds? Or is it the result of a general lack of confidence in natural processes and a distrust in our innate wisdom? I often wonder to what degree medicated technological deliveries have separated us from what should be a natural birthing experience. Could focusing on what could go wrong contribute to our distrust of our body’s intelligence of this event? I do not deny the value and benefits of modern medicine but I think it’s important that we reconnect with the inner wisdom of the female body. This is the same intelligence that our body accesses when it ‘knows’ how to heal a cut. Trusting in this wisdom will help reduce our anxiety around the uncertainties of childbirth and may ease our labour. Though we can neither predict what will happen nor control it, we can learn to be with our uncertainty in a new way. In order for something new to be born into our lives, we must experience something unfamiliar. I must develop a relationship with my body and feelings and learn to nurture what is best for me. In doing so, I honour and respect the deeply intuitive voice that is our collective wisdom, the wisdom that knows of the birthing process, we lessen the anxiety and fear around the uncertainties of childbirth. This natural event has a miraculous design that is already being enacted, if only we can give ourselves over to it.’

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