Acupuncture in Pregnancy: Safety Summary and When to Avoid

Why some points are traditionally cautioned

Acupuncture guidelines have advised caution in pregnancy because certain historical "forbidden" points are traditionally believed to stimulate miscarriage or early labor. [3] This is a traditional belief, not a measured finding in people. One animal study in pregnant rats tested needle stimulation of two of the best-known cautioned points plus two sacral points and found no difference in embryo loss or fetal death. [4] That is preclinical evidence and cannot be applied directly to people.

What the safety studies found

A small retrospective study of 47 women who had acupuncture for migraine during pregnancy also found mostly transient or mild symptoms and no link between the number of sessions and preterm delivery, though it was too small to settle the question. [10]

What these studies cannot tell you

Most trials were not set up to detect rare harms such as miscarriage or preterm birth, and many did not describe their adverse events. Where a result depends on patients knowing which treatment they received, expectation can shape reported symptoms. Proper evidence was not found on whether specific points carry extra risk in people. A PubMed search for pregnancy safety and "forbidden point" studies and found surveys and an animal study, but no human trial comparing cautioned and non-cautioned points.

Who should check first

• Anyone who is or might be pregnant should say so at the first visit. A hospital pain clinic lists possible pregnancy among the things the treating clinician needs to know. [11]
• If you take a blood thinner, including heparin, discuss it first. A large Taiwanese records study found anticoagulants, including warfarin, direct oral anticoagulants and heparin, were linked to more bleeding after acupuncture. [12] See bleeding and bruising after acupuncture.
• If you have a high-risk pregnancy, ask your obstetrician or midwife before booking.
• Practitioners themselves differ. In one survey of New Zealand physiotherapists who use needling, only 48 percent would treat pregnant women, and two-thirds of those still voiced safety concerns. [3] Ask how often the practitioner treats pregnant patients and what they avoid.

Do not delay prenatal care

Acupuncture should not replace appointments, tests or treatment from your midwife or doctor. The NHS advises asking a doctor about symptoms that do not go away and not relying on a therapist alone. [13] Contact your prenatal provider promptly about bleeding, severe pain or any symptom that worries you. For more on other therapies, see therapies in pregnancy and pregnancy and breastfeeding safety.

Checking the practitioner

Training and licensing differ by place. In the United States, states set the credentials for complementary practitioners, and requirements vary widely. [14] See acupuncture practitioner licensing and training.