Acupuncture in Pregnancy: Evidence, Safety and Points of Caution

Urgent signs come first

Acupuncture is not a way to deal with warning signs in pregnancy. The NHS (United Kingdom) says to call your midwife or maternity unit immediately if your baby is moving less than usual, or you cannot feel it move. [1] It also lists a severe headache that does not go away with simple painkillers, vision problems, pain below the ribs and sudden swelling of the face, hands or feet as possible signs of pre-eclampsia that need checking immediately. [2] In the United States, call your obstetric provider, or 911 in an emergency. Tell your maternity provider if you plan to try acupuncture at all.

The short answer

Acupuncture in pregnancy has been studied mainly for back and pelvic pain, and for labor and breech presentation (covered on their own pages). Studies that look for harms report few and mostly mild events, but the reporting is patchy. Evidence label: promising but limited for back and pelvic pain, insufficient evidence for most other uses. Background on how to read these trials is on what is acupuncture.

What the safety review found

A 2014 systematic review looked at needling and moxibustion (heat from a burning herb) in pregnant women. It included 105 studies, but detailed adverse events were reported in only 25 of them. [3] Events judged certainly, probably or possibly caused by acupuncture were all mild or moderate, and needling pain was the most common. [3] Severe events or deaths were few and all considered unlikely to have been caused by acupuncture. [3] The overall rate of adverse events was 1.9%, and 1.3% were judged related to acupuncture. [3] The authors concluded that acupuncture in pregnancy appears to have few adverse events when correctly applied. [3] That review left out studies of acupuncture for delivery, abortion, assisted reproduction and postpartum conditions. [3] Because most studies did not report details, absence of reported harm is not proof of safety.

Evidence by use

1. Low back and pelvic pain

   Promising but limited

   10 trials, 1,040 women: less pain and better function, but very different results between trials [4]

2. Starting labor

   Mixed to insufficient

   See labor, induction and breech

3. Nausea and vomiting

   See that page

   See postoperative nausea and morning sickness

4. Pain in labor

   Mixed

   See the same labor page and acupressure in labor

Back and pelvic pain in more detail

A 2022 meta-analysis pooled 10 trials with 1,040 women. [4] Acupuncture was linked with less pain, better function and better quality of life, but the results varied widely from trial to trial (I2 of 90% for pain, a sign of large inconsistency). [4] Two studies reported preterm contractions and two reported preterm birth during the study period, and all infants were in good health at birth. [4] The authors called for larger, better designed trials. [4] Many such trials cannot be blinded, so expectation may account for part of the benefit.

Points of caution

Some acupuncture points are traditionally avoided in pregnancy, and some practitioners will not needle certain areas. This site describes them on points commonly cautioned in pregnancy, Large Intestine 4 and Spleen 6. Those pages describe tradition and cautions; they are not instructions. Do not try to needle yourself or use at-home kits. Moxibustion has its own burn and smoke risks, covered in moxibustion and cupping risks and the TCM in pregnancy page.

Who should check first

The NHS says acupuncture may not be safe if you take blood-thinning medicine, are at increased risk of bleeding, or have a skin condition or skin infection. [5] Pregnancy that is high risk, has bleeding or a history of preterm labor needs your maternity provider's opinion first. For general guidance see therapies in pregnancy and who should avoid or take extra care.

Choosing a practitioner

Qualifications differ by country and US state. See how to choose an acupuncturist and tell the practitioner you are pregnant, including how many weeks. NCCIH warns that acupuncture that is not delivered properly can cause infections, punctured organs and injury to the central nervous system. [6]