Erasmus MC Press Release Rotterdam, 16 December 2010
Acupuncture helps turn breech baby
Timely treatment could save health care as much as EUR10 million
If during labor a babies bottom or feet are in the down position rather than the head this results in risks to the mother’s and baby’s health.  A certain treatment on a specific acupuncture point can result in the baby turning ‘spontaneously’ before childbirth. This therapy can be successfully performed in consultation with a midwife and under the supervision of an acupuncturist. This is the conclusion made by Ineke van den Berg, researcher at Erasmus MC, in her thesis for which she recently received a PhD.
Based on an ultrasound taken at a gestational age of thirty weeks, it can be predicted whether the baby will be in a correct position during labor or in a bottom down position, called breech. Until not so long ago the standard treatment was to wait and see if the baby would turn by itself. If this did not happen then a gynaecologist or midwife could try to turn the baby at approximately 36 weeks gestation by putting pressure on the mother’s stomach. It appears that if a certain acupuncture point is stimulated at 33 weeks gestation, it leads to substantially more head down positions (66%) during childbirth than if one just waits (33%). This is Van den Berg’s conclusion based on a large-scale analysis of research figures from Japan, Hungary, Italy and China. A similar study is currently being carried out in Spain.

The therapy concerned is called Moxibustion and does not make use of needles but of a glowing moxa stick. This is a roll of compressed mugwort herbs that is burnt just above a specific acupuncture point on the small toe. The radiant heat from the roll stimulates the acupuncture point. After an introduction and instructions by the acupuncturist, the treatment can be taught to the pregnant woman’s partner. The Moxibustion is then repeated in the next two weeks at home by the partner.

Van den Berg recommends that this therapy is only performed after consultation with the attending physician or midwife and after instructions by a qualified acupuncturist. Van den Berg: “Unfortunately, Moxibustion is also readily available on the internet but if it is used incorrectly the therapy can also have negative effects, for example, the baby can move even further into the mother’s pelvis with its bottom. I would, therefore, advise pregnant women only to perform this therapy upon consultation with their midwife as she is well aware of the health of mother and child. Based on this information, a qualified acupuncturist can determine whether Moxibustion can be safely carried out.”

In addition to significant health benefits, the therapy also appears to lead to substantial savings in health care costs. In 80% of the childbirths of singletons in breech a cesarean is ultimately necessary. Besides the health risks for mother and child, the surgery is also expensive. With the help of a computer model Van den Berg calculated that using Moxibustion at around the 33rd week of pregnancy in combination with external turning in the 36th week of pregnancy appears to result in a substantial decrease in the percentage of cesareans among singleton pregnancies. There is a 54% decrease in the number of caesarean sections compared to the wait and see manner. Van den Berg: “In order to give an overall estimate of the cost savings, I have related them to the birth figures for 2002, giving the most unbiased comparison as Moxibustion was hardly carried out at the time. In that year,    7,135 babies were born breech position which comes to a saving of approximately EUR10 million.”

The positive effects of acupuncture and Moxibustion are rooted in the traditional Chinese medicine. This type of therapy is increasingly used in combination with conventional medicine. This is why Van den Berg  wanted to scientifically substantiate in her thesis the effects of acupuncture, embedded in the Dutch health care and not independently.

Finally, Van den Berg calls for high quality care and safety and high degree of transparency for patients of acupuncturists, similar to that of the conventional Dutch health care. “A patient should be confident that his/her acupuncturist practises according to the latest developments and takes proper hygienic precautions. The acupuncturist should have an approved degree and his/her skills should be maintained by continued training. You know this is the case for members of certified professional organisations”, according to Van den Berg.  
Erasmus MC is the largest University Medical Center in the Netherlands. Our primary goal is a healthy population. Nearly 13,000 employees devote themselves every day to providing outstanding care, facilitating world-class education and conducting pioneering research. These professionals are instrumental in developing expertise on health and illness. They link the latest scientific insights to practical treatments and prevention measures to provide maximum benefit to patients and to enable healthy people to stay healthy longer. Being visibly better and leading the way in the areas of complex, innovative and acute care by collaborating with others: these are key ambitions at Erasmus MC.