Acupuncture and acupressure for pain management in labour: a systematic review

Introduction: Many women would like to avoid pharmacological or invasive methods of pain management in labour and this may contribute towards the popularity of complementary methods of pain management. The aim of the review is to examine the effects of acupuncture and acupressure for pain management in labour on maternal and perinatal morbidity. Methods: Design: Systematic review of published and unpublished randomised, controlled trials. Subjects: Women, whether primiparous or multiparous, and in spontaneous or induced labour, in the first and second stage of labour. Interventions: Acupuncture and acupuncture compared to placebo, no treatment or pharmacological forms of pain management in labour. Outcomes measured: Maternal satisfaction, use of pharmacological pain relief and maternal and neonatal outcomes. Results: Five trials were included in the review. Three trials involved acupuncture (n = 496 women) and two trials acupressure (n = 172 women). Women receiving acupressure reported less anxiety compared with women in the control group (WMD -1.40, 95% CI -2.51 to 0.29). A difference in labour pain was found in one acupressure trial in the active labour phase (WMD -2.12, 95% CI -3.65 to -0.59). The trials of acupuncture showed a decreased need for pain relief (RR 0.70, 95% CI 0.49 to 1.00). There was a benefit from acupuncture with a reduced need for augmentation in one trial (RR 0.40, 95% CI 0.23 to 0.69). Conclusions: Acupuncture may be beneficial for the management of pain during labour; however, the number of women studied has been small.