During the last birth I attended, my client decided to get an epidural, but when the anesthesiologist discovered the acupuncture marks on her back from the treatment she had received the day before, he immediately backed off.
“I can’t give you an epidural,” he said. “We have no way of knowing whether the acupuncturist used sterile technique or not, and we could push bacteria into your spine, causing meningitis!”
Uh, what?! How many women have received acupuncture treatments to induce labor and then received epidurals after labor started? I assumed since acupuncture was not an uncommon practice that it would not be a problem (or we would have heard about it), but this doctor seemed to think it was since he had “never seen this before”. Now what?
After a couple phone calls to the acupuncturist’s office, and conversations with hospital staff, my client felt confident that an epidural was safe in this regard and chose to have one despite the anesthesiologist’s warning. She suffered no infection, and does not regret her decision, but I still wondered – is there an additional risk of infection with epidurals following acupunture?
I did a little research, and could only find two studies which might offer insight.
- A journal called Medical Acupuncture, in volume 17 #3, May 2006, reported a study called “Acupuncture for Prebirth Treatment” in which the benefits of acupuncture on pregnant women were considered. Among the results, epidurals were used 31% less frequently compared to women without acupuncture treatments. This tells me that 69% of the women who would have chosen an epidural still had one after recently receiving acupuncture. Meaning, women do get epidurals after acupuncture treatments.
- The American Society of Anesthesiologists, in their journal, Anesthesiology 2001; 95: 349-56, reported a study called, “Preoperative Intradermal Acupuncture Reduces Postoperative Pain, Nausea, and Vomiting, Analgesic Requirement, and Sympathoadrenal Rsponses.” In this study, patients were given acupuncture treatment along the spine the day before planned abdominal surgeries with epidural anesthesia. Not only did they not mention safety issues, but the authors said, “intradermal acupuncture is easy to use and requires no special training.”
It seems to me that receiving acupuncture treatments to jumpstart labor is not a problem for women who may want, or need, an epidural during birth, but it isn’t a bad idea to consider a few safety tips just in case.
- Interview the acupuncturist before treatment to ensure sterile technique is used and no infections have resulted from his/her treatments.
- After treatment, get a written note with contact information from the acupuncturist stating their practice methods, safety precautions, and experience. Include this note in your hospital bag to show to your anesthesiologist if needed.
- Bathe well before and after acupuncture treatment and birth to help minimize introduction of bacteria under your skin. Not necessary, but may help.
- Understand the signs and symptoms of infection, including meningitis, so you can receive treatment as quickly as possible should it occur.
Have you received an acupuncture treatment shortly before epidural anesthesia? Tell us about your experience!
