Interview with Paul McCarthy on the Role of Acupuncture in Pregnancy

What is Acupuncture?

Acupuncture is a branch of Chinese Medicine that refers to the practice of inserting very fine metal needles into specific locations on the body in order to stimulate the body’s own natural healing processes. 

You mentioned that Acupuncture is branch of Chinese Medicine; can you briefly explain what is Chinese Medicine?

Chinese medicine is one of the oldest, most comprehensive and coherent and holistic medical and health care systems still in practice in the world.  It has sustained the health, wellbeing and longevity of the world’s longest ongoing civilization for over 5000 years, during which time its practitioners have carefully recorded the results of their meticulous research and clinical experience in classical medical archives that span more than 3000 years of written history. This research process, of course, continues today.

What is the intrinsic approach of your system of medicine?

More than a system of medicine in the Western sense of the term, the Chinese medicine approach to health care reflects the Daoist principles of the importance of promoting balance and harmony in body, mind and spirit.  These guiding principles have evolved from ancient medical Daoist texts such as Nei Jing, the Nan Jing, the Shan Han Lun and indeed other more world-renowned texts like the Tao Te Ching.

These guiding principles permeate all the healing modalities of Chinese Medicine, which include acupuncture, herbal medicine, nutrition, aromatherapy, massage, tuina, meditation, Tai Chi Chuan, Qi Gong and other holistic methods that restore the natural the natural balance of the human mind-body-spirit continuum.

If Chinese medicine has evolved from Daoist philosophy is it necessary therefore to believe in and/or practice Daoism in order to benefit from Chinese Medicine?

Chinese Medicine arouse out of the philosophy of Daoism, which quite simply observes the natural world and the balanced interrelationship of all its various components. Incidentally, as Chinese medicine evolved it has also been influenced by both Buddhism and Confucianism.  However, back to your question, it is no more necessary to practice Daoism to benefit from Chinese Medicine than it would be to practice the religions of ancient Greece or Rome to benefit from Western medicine.  

Daoism would probably argue however that the laws of nature that rule the actions of all things in the universe are in effect whether you “believe” in them or not. The pursuit of health and healing is nothing more than our active presence in the natural world as it is and by learning how to live in harmony with both our internal and external environment.  

Paul are you saying that the goal of Chinese medicine in treating diseases is to restore the balance of our internal and external environment?  What exactly does this mean?

Yes Ann, the goal of Chinese medicine is to restore and maintain balance. However it is important to keep in mind that Chinese medicine doesn’t treat disease. It treats individuals whose imbalances manifest in certain processes as the body attempts to regain balance. Disease is seen as an imbalance between internal factors such as diet, exercise, rest, emotions, thinking; and external factors such as climate, trauma, poisons, environment, bacteria and viruses. Health is not just the absence of disease; it is a state of being in balance in mind, body and spirit.

As I am mainly interested Women’s Health and Pregnancy and I would like to know if you use acupuncture during Pregnancy? Is acupuncture safe during pregnancy?

Yes acupuncture is safe during pregnancy; In fact acupuncture has been used prenatally for thousands of years to support a healthy and uncomplicated pregnancy. Many modern research studies have shown that acupuncture during pregnancy had no adverse effects and is completely safe when carried out by a properly trained acupuncturist. Quite a number of pregnant women are referred by consultant gynaecologists to my own practice for the treatment of various conditions and complaints. In fact, today, more and more women are seeking drug-free treatment for the conditions of pregnancy. Acupuncture has much to offer in this context as it can treat many conditions for which there is rarely another safe, effective or lasting remedy.

Would acupuncture benefit the baby also?

Yes, acupuncture during pregnancy benefits both the baby and the mother. As the baby grows in the womb certain organ systems develop at certain points in the pregnancy. Babies may be influenced by what are referred to maternal toxins, resulting in a childhood tendency for higher fevers when sick, more frequent childhood illness and indeed illnesses later in life and a tendency for skin problems such as psoriasis and eczema. Regular acupuncture harmonizing and balancing treatments throughout pregnancy enhance the health of the mother, prevent complications and influence the healthy development of the baby.

How often would you treat a woman who simply wanted what you termed balancing treatments?

Treatments are usually given once every three to four weeks until the last month, when weekly sessions help prepare the woman for labor. In this clinic a treatment session lasts approximately 45 minutes, and women usually only feel a mild sensation such as a feeling of slight heaviness at the site of needle insertion.

What actual conditions of pregnancy does acupuncture treat?

During the first trimester for example, acupuncture will focus on establishing the foundation for a healthy pregnancy. Many studies have demonstrated the efficacy of acupuncture during the first trimester in the treatment of morning sickness and hyperemesis gravidarum (severe vomiting during pregnancy). During the first trimester acupuncture can also relieve tiredness and fatigue, bleeding, headaches, migraines and sinusitis. During the second trimester acupuncture can be used, for example, in the treatment of heartburn, fatigue, stress, haemorrhoids, leg cramps, cystitis, and constipation. In the third trimester common complaints treated include back pain, sciatica, pubic and joint pain, carpel tunnel syndrome and indeed breech presentations.

How can acupuncture help with breech babies?

Chinese medicine has been treating breech presentation successfully for centuries. Very briefly, moxibustion, a facet of acupuncture, which involves placing long sticks of the herb moxa (artemisia vulgaris) to produce a gentle heat and smoke, close to an acupuncture point in the little toe (Zhiyin Bl-67). Research published in such reputable medical journals as the Journal of the American Medical Association has shown that this centuries old procedure significantly increases the number of head-first births in women with breech presentations. It is most successful if carried out at 32 to 36 weeks. The Zhiyin treatment is cheap, safe, effective, simple, painless and generally well tolerated. It can be self-administered, but preferably done by a partner or acupuncture practitioner. 

Can acupuncture help with labour?

Yes acupuncture is used during labor mainly to facilitate pain relief and improve vitality. It can also be used to stimulate contractions without the use of drugs. It does this by facilitating the mother to become more relaxed, by stimulating the mother’s body to release prostaglandins and oxytocin thereby increasing uterine contractions, helps the cervix to dilate, and relieves labor pain.

Several clinical trials have demonstrated that acupuncture significantly reduces labour pain according to the American Journal for Obstetrics and Gynecology. For example, in the 496 women who received acupuncture during labor, there was a 30% decrease in the need for pain-relieving interventions, including epidurals, than in women not receiving acupuncture. Among those who received acupuncture, 86% said that they would use acupuncture for the relief of labor pain again.

Have you personally given acupuncture during childbirth?

Yes I have used electro-acupuncture for the birth my own children. In our last pregnancy for example, I inserted the four needles prior to going to hospital and taped them down with waterproof plaster. I gave a 30min treatment just before setting off for the Maternity Hospital and another treatment after we arrived at the hospital at about 11am. To cut a long story short, everything went very well for mother and baby to such an extent that we were back home for tea time at 6pm the same day. 

How can acupuncture help after childbirth?

Traditionally in China women were prescribed bed rest for one month after childbirth. Female relatives would take care of both the new mother and the baby, allowing the new mother to restore her strength and energy. Specific herbal prescriptions were given to help shrink the uterus, stop bleeding, encourage lactation, and return vitality. In today’s fast moving world, few new mothers have the luxury of resting for a month after childbirth. The majority of mothers need to return to taking care of family or work before their bodies have had a chance to fully recover from the birth experience. This can lead to further health issues down the road. Acupuncture during this time can assist in returning the body to a state of balance and optimal health. It can also frequently redress years of relatively poor lifestyle and stress and can be used to rectify years of irregular menstruation, painful periods and prevent them from occurring. In addition acupuncture can used successfully to treat postpartum sadness, depression and the “baby blues” `decreased energy and vitality, mastitis, cystitis, abdominal and perineal pain, back pain, headaches, night sweats, insomnia/dream disturbed sleep, stress, fatigue and anxiety.

I read somewhere of an acupuncture point called the “beautiful baby point”, what is this?

This is a treatment that has been used for centuries to ensure a healthy, beautiful baby. It involves the stimulation of a single acupuncture point called Zhubbin (KI-9) with a very thin, golden needle. I’m not sure of it works or not as I have personally never used it. However, gold would be considered warm by nature and works well to strengthen the body and stimulate Qi. The beautiful baby point is located above the medial malleolus (inner ankle bone), right below the calf muscle. Even though the acupuncture point is located on the lower leg, it is a powerful point that is connected to meridians throughout the body and is used for many reasons.

The name ‘Zhubin’ has been translated as  ‘Guest Building’ or “Strong Dwelling Place” or “A Guest Serving Our Very Foundation”. A number of people question whether this ‘guest’ could refer to the growing foetus? This point is more commonly used to teat anxiety, fear, mania, nightmares and pain along the medial aspect of the leg.

What got you interested in Acupuncture?

I initially became interested in acupuncture and Chinese medicine in general when I was working as a nurse teacher. I was keen to explore what alternatives existed to the use of psychotropic drugs as the principle modality of treatment in psychiatric illness among other cultures and systems of healthcare and medicine. I was subsequently invited to a World Symposium on Traditional Medicine in New York sponsored by the Institute for Advanced Research in Asian Science and Medicine in March 1983. This symposium included 100 hours of training in acupuncture. My interest was purely academic at this stage. Some years later I enrolled on an acupuncture course with the Acupuncture Foundation of Ireland and was fortunate enough to have Giovanni Maciocia as my main teacher. Giovanni Maciocia is a world-renowned practitioner, teacher and author of many textbooks on Chinese medicine. His textbooks are used today in many colleges throughout the world. Post-graduate training included training with Prof. Shen on two occasions at Nanjing University of Chinese Medicine, China. I also trained in herbal medicine with Michael McIntyre, chairman of the European Herbal Practitioners Association. He has also written several herbal medicine books and was a co-founder and editor of the European Journal of Herbal Medicine. Since 2003 my teacher, colleague and friend in acupuncture and Chinese medicine has been Daoist Priest Jeffrey C. Yuen. Jeffrey is the 88^th generation Daoist Master of the Jade Purity School. Today he is recognized internationally as a master scholar, teacher and practitioner of Classical Chinese Medicine. Indeed, as a Daoist priest, Jeffrey is at the forefront of the restoration of the spiritual roots of Chinese Medicine. His teachings, which are rooted in the spiritual tradition of Daoist mysticism, bring a clarity, wisdom and depth to Chinese Medicine rarely found today.

In 2006 I established the Academy of Classical Chinese Medicine (www.accm.ie). The primary focus of ACCM is to be a centre of excellence in Ireland providing post-graduate educational seminars based on the teachings of Jeffrey Yuen. If you need to know more about my educational and work experiences they can be found on my website (www.paulmccarthy.ie).

Where do you work?

I am director and founder of the Summerhill Clinic, 1 Summerhill Parade, Sandycove, Co Dublin (just opposite the Dart station at Sandycove/Glasthule). In addition to Acupuncture and Chinese Medicine we also have homeopathy, physical therapy, massage therapy, chiropractic, aromatherapy, reflexology psychotherapy and counseling. 

If someone were interested in acupuncture, where would you advise him or her to look for more information?

Most people find an acupuncturist by personal recommendation. I would advise them to make sure that the practitioner was properly qualified and registered with a reputable body such as the Acupuncture Council of Ireland (http://www.tcmci.ie/acupuncturist.php). Of course if the acupuncture practitioner also has experience in western medicine, nursing or midwifery that would be an additional bonus from my point of view. 

What books would you recommend for pregnant women?

That is a difficult question to answer because there are so many books in this field. Off the top of my head, for an overview of acupuncture and chinese medicine, you could try Between Heaven and Earth by Harriet Beinfield and Efrem Korngold or The  Web that has no Weaver by Ted Kaptchuk and Healing with Whole Foods, by Paul Pitchford and/or the Essential Guide to Acupuncture in Pregnancy & Childbirth by Debra Betts. I’m not personally aware of any great books on acupuncture for the pregnant layperson.

Are there any oldwives tales or traditions regarding pregnancy in China that you are aware of?

There are many old traditions, for example, Chinese women believe the month after childbirth is a critical time for both the mother and the baby. A Chinese woman is encouraged to zuo yue zi (lay-in) for one month after childbirth, during which time she is cared for by an older woman, usually her mother or mother-in-law, who takes on nearly all of the domestic tasks. This tradition is thousands of years old. In addition the new mother would not be let take a shower or wash her hair, and her diet was strictly monitored. For example, cold drinks and uncooked foods were forbidden, especially cold water and fruit. More warm cooked food was encouraged such as fish soup and pig-trotter soup. Visitors were not encouraged during this month except for immediate family members. Friends, cousins etc had to wait until after the month to visit the newborn baby. This was a pretty common tradition among Chinese women especially in rural areas. New mothers believed their bodies were very weak after childbirth, and they felt if they didn’t look after their health during the crucial four weeks they would suffer the consequences later in life, or get yue zi bing, which literally means “an illness caused by not resting sufficiently during the month after childbirth. In China looking after the mother’s health starts at conception. In some areas midwives and doctors advise the woman to sleep separately from their husbands because they feel intercourse may harm the baby. Generally speaking, during the first trimester and the last trimester, it’s forbidden to have sex, because it may induce miscarriage. Many women are not allowed to go out in cold windy weather, as this would damage their health.

What do you think of these traditional practices?

I sure in many areas they still continue today, as traditions such as these are very strong. You must remember that very often women did not receive sufficient nutrition and a pregnancy can be taxing on the body’s resources so it is very important that a woman take good care of her health during the month after childbirth. Women very often did not have the facilities to bathe at home in hot water and obviously they did not have central heating so they risked getting ill if they washed in such conditions while they were still weak. The tradition of not leaving the house during that month had important health benefits. In those days, during pregnancy and after childbirth, women lack calcium as there were minimal dairy products available and indeed many women were lactose intolerant. Osteoporosis later in life was not uncommon in these circumstances. Staying in the home and not going out in the wind and cold was protective therefore during this time of vulnerability. As you know during pregnancy, hormones change in a woman’s body, muscles and ligaments become loose to prepare for delivery, and so her joints are not well protected after childbirth. It is easy for her to get injured. Bed rest was seen as a sound method to ensure good heath. Of course today, Chinese women’s living conditions have improved substantially especially in the large cities and many women have healthy, nutritional diets, however this tradition of not washing or going out for a month remains in many provinces.

What do you think of the specific practice of maintaining celibacy during pregnancy?

This practice is based on the precept that a child will be much healthier if sex is avoided during pregnancy. This is not only a belief of Classical Chinese medicine but also a recommendation of Tibetan and Ayurvetic Medicine. These traditional medical systems of China, India and Tibet claim that their observations and research over many years show noticeable differences in the emotional integrity and awareness of children whose parents chose celibacy during pregnancy compared to the siblings who developed when the parents were not celibate during pregnancy.

From a Western scientific point of view it would be interesting to see what affect the physiological and hormonal changes that take place during sexual activity had on the developing foetus. 

Obviously this suggestion of celibacy during pregnancy would be unacceptable to many married people in the West. However, perhaps this prohibition and the old Aristotelian adage of “moderation in all things” would apply to sexual activity during pregnancy.

Can you give me 5 top tips for pregnancy and birth from a Chinese Medicine point of view?

I don’t like “top tips” type of questions however since you asked, there are a number of “top tips” to use your language, that I would recommend from a Chinese Medicine perspective.

1. Do not conceive if either partner is ill of weak or under the influence of alcohol or drugs.

2. During pregnancy do not dramatically alter your diet, as toxins releases in major detoxifying diets will affect the foetus. 

3. Avoid all intoxicants and stimulants including alcohol, coffee, cigarettes, marijuana, illegal drugs and unnecessary medications.

4. Eat a diet of whole, fresh food by using whole-grain breads instead of white breads, used fresh vegetables instead of canned and rice or barley malt, honey or black strap molasses instead of refined white sugar.

5. Eat plenty of greens vegetables that contain omega-3 fatty acids, folic acid, and magnesium such as wheat or barley grass, spinach, broccoli, kale, seaweeds, garden rocket, chard and lettuce.

6. Get regular moderate exercise preferable outdoors in fresh air and sunlight

7. Reduce stress and anxiety by engaging in such practices as quite contemplation, meditation, pregnancy yoga, tai ji chuan, Qigong, prayer, progressive muscle relaxation, pregnancy massage, reflexology, aromatherapy, acupuncture or just simply put your feet up and enjoy some nice relaxing music.

So Anne now you have seven instead of five.

Anne: Thank you for taking the time to answer my questions

You’re most welcome. Take Care