Acupuncture on pregnant women

By Dr. Li Shi-zhen

I got a question from another doctor who asked me why I can use acupuncture point He Gu and San Yin Jiao for the treatment of irritable fetus condition, since it has been indicated in old TCM books that these two acupuncture points should not be used during pregnancy, otherwise, it may cause baby abortion.

I answered him that it is true that there has been record in old TCM book with a clinic case report. That is a record in Song dynasty in China. A women had a died fetus in uterus. A doctor use acupuncture on the point of San Yin Jiao and Tai Chong to stimulate the deliver of the died fetus. There are another case also indicating that acupuncture on He Gu and Zu San Li caused delivery of a normal fetus. So, it has been indicated from later medical books that acupuncture on He Gu (with supplying technique) may cause deliver of fetus.

I believe that we should learn and regard the clinic experience of previous doctors with much careful consideration and caution. It does not mean that what the previous clinic is a general rule that applicable to every clinic condition. We should think about the condition of the pregnancy, the body constitution of the pregnant woman, and the function of the acupuncture point He Gu and Zu San Li, to decide if the two acupuncture points should be used or not and how to use them during pregnancy.

We should know that during pregnancy, the body of woman is relatively less with Blood that has to be used to nourish the fetus, so relatively more in Qi. Supplying technique on the point He Gu will furthermore supply more Qi in the body so makes the imbalance of Blood and Qi worse. This might be the main reason for abortion.

In the clinic report of mine, the pregnant woman has had three normal pregnancy before. This time it is her fourth pregnancy. She usually felt dizziness and chronic fatigue. Three days ago before she came to me, she had been working very hard and felt much tired. The night she came, she felt very weakness and ache in the lower back, bloating in the lower stomach with little bleeding from vagina. On consulting, I saw her pale in face with low ambition and emotion reaction. She talk very low in voice, and complain pain in the lower stomach again and again. Her tongue is pale, pulse feels thin, fast and smooth as bear moving. So my diagnosis for her is Qi and Blood deficiency, weak condition for fetus. For this reason, I used acupuncture point of He Gu (with supplying technique), Sa Yin Jiao and Shen Shu to stabilize the fetus condition. For twice treatment, the clinic condition of the women was stabilized.

In this case, the women is in a condition of Qi deficiency. So acupuncture on He Gu (with supplying technique) supplies more Qi to her to re-balance the Qi and Blood in her body. For this, the acupuncture does cause abortion at all. 

There has been another clinic report from a Japanese doctor indicating that acupuncture on He Gu with supplying technique is useful to treat numbness of hands in pregnancy women, suggesting that it is not always forbidden to use this point during pregnancy. There has also been another case report for a pregnancy woman who has discontinuous urine. Acupuncture on the point of He Gu with supplying technique did not cause abortion but solved her urine problem. So, it should be pointed out that knowledge on book is not “alive”. Doctor has to really adapt the information in a book with further more consideration and testing. It has been said in folk that if you believe everything in a book, it is better no any book! I believe this is true and right way in clinic.

Comment from Dr. Martin:

Due to warning from the TCM textbook, acupuncture (and TCM) graduates are very nervous to use acupuncture on pregnant woman, especially on some acupuncture points, such as He Gu, Zu San Li, Quan Yuan, Qu Gu, Tai Xi and some others. This is also true that they are warn not to use some herbs that work to improve blood circulation and to remove blood stagnation for pregnant women.

In clinic, there could be two major goals for pregnant women: either to stabilize the fetus, or to cause abortion. If it is so easy to cause abortion in a pregnant women, is it similar easy to cause abortion for a women who want the abortion? No, not all. It appears that when we want to stabilize the fetus, the abortion may happen and on the other side, when we want to have abortion, such as for many girls who has pregnancy without marriage, it is so difficult to induce abortion for them!

To me, I totally agree with Dr. Li Shi-zhen that stabilization or abortion of a fetus really depends on the body condition of the pregnant women AND the fetus too. So many times, a woman is in a very Qi deficiency, such as a woman in poor family, but the fetus still develops into full mature. On the other side, some women may have abortion even with very mild slipper on ground.

Similar thing happens with the Chinese herbal therapy. Doctors are also nervous to some level to use herbs that works to remove blood stagnation in the body, or when use many herbal formula introduced in book <<Shang Han Lun>>.

I agree with the suggestion that whether an acupuncture point or a herbal formula should be used or not in a pregnant women really depends on the health condition of the women. If the clinic condition is severe or if a clinic diagnosis is pretty clear suggesting a disorder in the body (no matter what it is), whatever the acupuncture points or herbs that we will normally used in non-pregnant woman should be used in the pregnant woman too. Correction of any disorder in the body of a pregnant women should be helpful for the development of a full mature fetus.