Intrapartum Acupuncture Provision in the UK: A Survey of Independent Acupuncture Practitioners

Background/Objectives: Acupuncture is effective for labor pain yet rarely used in the UK. Midwife-delivered acupuncture (commonplace in Europe) is cost-effective but typically demands a protocol-based approach. Randomized controlled trial (RCT) protocols have varied greatly in terms of acupuncture rationale/style, needle number/location and retention time. The aim of this study was to determine the intrapartum acupuncture experience of professional UK acupuncturists specializing in pregnancy/childbirth and compare their treatment recommendations with research evidence regarding acupuncture "dose" during labor. Methods: Fifty self-identified obstetric acupuncturists (various styles) with 10 [4, 6] years of experience (median [interquartile range]) were surveyed about their personal intrapartum acupuncture experience and recommendations regarding traditional acupuncture point selection and overall treatment approach. Results: Of 50 respondents, 36% (n = 18) had never attended a labor. For those with experience, the median number of labors attended was 0.4/year [interquartile range 0.1-0.3]. Only 12% (n = 6) had attended ≥10 labors. Recommendations included using between 2 [1, 2] and 8 ± 4 (mean ± standard deviation) needles left in situ for 5 [1, 10] to 30 [30, 30] min. Only 32% (n = 16) advised retention throughout labor, of which 25% (n = 4) would tape needles down. The remainder advised interval treatments, typically 1-2 hourly. Most practitioners highlighted the need to vary the treatment according to individual needs/sensitivity. Regarding points, only SP6 and LI4 were ubiquitous, although 41/51 RCT points were mentioned, which were most often segmental and/or so-called major points for central effects (SP6/LI4/BL32/BL60/LR3/BL67/PC6/BL31/ST36/Shenmen). Regarding needle stimulation, 18% (n = 9) recommended none, 20% (n = 10) elicitation of de qi only, and 54% (n = 27) repetitive manual manipulation (every 5-15 min). Only 8% endorsed electroacupuncture use. Conclusions: UK experience with intrapartum acupuncture appears limited. Most practitioners recommended short periods of needling using relatively few needles, i.e., low-dose acupuncture.