By Sarah Thompson Dpl.OM, L.Ac., Doula
Breech. As an expectant mother, this one word can strike fear and anxiety into the most beautiful of pregnancies. Why? In today’s medical birth society, this often means one thing: cesarean delivery. Aside from External Cephalic Version (ECV), there is not much option offered by Western Medicine to prevent a cesarean delivery.
An article in the Journal of the American Medical Association (JAMA) has spurred interest in an ancient modality used in Traditional Chinese Medicine called Moxibustion. The conclusion of the study noted that “Among primigravidas with breech presentation during the 33rd week of gestation, moxibustion for 1 to 2 weeks increased fetal activity during the treatment period and cephalic presentation after the treatment period and at delivery.” The Moxibustion group had a 75% success rate in fetal rotation.
What is Moxibustion and how is it used?
Moxibustion is the burning of an herb call Mugwort, or Moxa. For breech presentation, moxa is burned close to, but not touching, the pinkie toe at a point called UB 67. The moxa is held to the point for approximately 15 minutes, or as long as it takes to create a reddening of the area. Treatments are then repeated twice daily for 5 days, unless there is significant fetal movement. Then treatments should stop and the patient should have the position of the baby checked. If after 5 days of treatments there is no change, there should be a break in treatments for 3 days, and the mother should have the fetal position double checked. Then treatments can begin again for up to another 5 days.
The first treatment is often done in the office or at the patient’s home to demonstrate proper technique, while subsequent treatments are done in the home with the help of a partner. If after 10 days of treatments there is no position change, it is time to consider other options. Life in the womb can be a mystery, and often there are unforeseen circumstances than inhibit a baby from moving into the correct position, and these include a short umbilical cord, uterine structure, or just a good old stubborn child. (It won’t be the last time they test you.)
The most optimal time to administer Moxibustion is between 32-36 weeks, with the most recognized success being between 34-36 weeks, but there can still be success before 38 weeks.
How does Moxibustion Work?
In Traditional Chinese Medicine, the technique warms, tonifies and invigorates the uterus and the fetus creating fetal movement and a descending effect.
In Western Medicine, the application of moxa works in two ways. By warming UB 67, there is adrenocortical stimulation which causes changes in the levels of prostaglandin and placental estrogens. The prostaglandins in turn increase myometrial contractility and the estrogens increase myometrial sensitivity, and together this increases fetal heart rates and activity causing baby to move excessively and turn in the womb.
Moxa is a vasodilator, which means in dilates the blood vessels, and increases maternal heart rate. This increases blood flow and oxygen to the uterus and fetus.
Is Moxibustion safe?
The success rate of moxibustion and ECV is about the same (75%). The difference is the risks involved. The ECV is a physical and forceful procedure that unnaturally moves the baby, increasing the risk of issues like cord entanglement and knotting.
The moxibustion treatment is not forceful. We are not making the baby turn, we are encouraging movement that allows the baby to make the turn as it naturally would. Although this technique is safe, and does not carry any additional risks of complications, there is always a natural risk when a baby moves in the womb. The use of Moxibustion does not increase the likelihood of these occurring.
Talk to a licensed Acupuncturist who specializes in Obstetrics and Gynecology to see if this is an option for you.