Theory

Acupuncture for Pregnancy, Childbirth and Postpartum Issues (1st and 2nd Trimester)



Acu Protocols

Below you will find common acupuncture diagnoses and treatment options for issues which may arise during the 1st and 2nd trimesters of pregnancy.

  • Morning Sickness (also described in more detail here)
  • Symptoms: nausea, vomiting, general lethargy, strong food cravings or aversions
  • TCM Theory: As the chong mai is heavily utilized for the distribution of blood within the body the descending effect it has on the body may be disrupted leading to the counterflow of Stomach Qi and poor digestion. Emotionally, the spleen is related to worry and overthinking so a preponderance of those emotions may also disrupt the functioning of the stomach/spleen system.
  • Differentiations:
    • Stomach and/or Spleen Qi Deficiency
    • Signs and Symptoms: slight morning sickness, if there is vomiting it may be small amounts and diluted, poor appetite, fatigue, feeling of cold, depression is also possible
    • Tongue: Pale
    • Pulse: Weak
    • Treatment Goals: Harmonize and strengthen the stomach and spleen
    • Acupuncture Points: SP 4 with PC 6 (regulate chong mai, stop nausea/vomiting), ST 36 (tonify st/sp qi), CV 12 (tonify st/sp qi), UB 20 (sp shu), UB 21 (st shu)
    • LV Qi Stagnation invading the Stomach
    • Signs and Symptoms: morning sickness with retching vomiting, sour taste in mouth, epigastric fullness, irritability
    • Tongue: Red Sides
    • Pulse: Wiry
    • Treatment Goals: Soothe the Liver, Relieve Stagnation, Descend Rebellious Qi
    • Acupuncture Points: PC 6 (stop nausea/vomiting), LV 14 (regulate liver qi), ST 36 (tonify st/sp qi), CV 12 (tonify st/sp qi), KD 21 (regulate chong mai), ST 34 (regulate stomach, stop vomiting)
    • Accumulation of Phlegm
    • Signs and Symptoms: profuse vomiting, signs of mucus/dampness, chest oppression, dizziness
    • Tongue: Swollen, Sticky Coat
    • Pulse: Slippery
    • Treatment Goals: Resolve Phlegm, Subdue Rebellious Qi
    • Acupuncture Points: ST 40 (resolve phlegm), SP 9 (resolve dampness), PC 6 (stop nausea), UB 20 (sp shu), CV 12 (tonify st/sp)
    • Heart Qi Deficiency
    • Signs and Symptoms: morning sickness with palpitations, anxiety
    • Tongue: Pale
    • Pulse: Empty Heart Position
    • Treatment Goals: Tonify Heart Qi, Calm the Mind, Regulate Stomach
    • Acupuncture Points: PC 6 (stop nausea/vomiting), ST 36 (tonify st/sp qi), CV 14 (tonify ht), HT 5 (calm mind), UB 15 (ht shu)

  • Anxiety (also described generally here)
  • Symptoms: anxiety, mental restlessness
  • TCM Theory: heat within the body aggravates the mind, this may arise from over work, excessive emotions, and dietary issues.
  • Differentiations:
    • Liver Fire
    • Signs and Symptoms: anxiety, mental restlessness, irritability, anger, dry mouth, thirst, red eyes, darker urine, constipation, dizziness, tinnitus, dream disturbed sleep
    • Tongue: Red w/Red Sides, Dry Yellow Coat
    • Pulse: Wiry, Rapid
    • Treatment Goals: Drain Liver Fire, Calm the Mind
    • Acupuncture Points: LV 2 (drain liver fire), LV 3 (regulate liver), UB 18 (liver shu), GV 18 (calm mind), HT 7 (calm mind), PC 7 (calm mind), GB 13 (calm mind)
    • Yin Deficiency (Empty Heat)
    • Signs and Symptoms: anxiety, mental restlessness, difficult relaxing (particularly in the evening), fidgety, palpitations, dry mouth, nightsweats
    • Tongue: Red w/o Coat
    • Pulse: Rapid
    • Treatment Goals: Tonify Yin, Clear Empty Heat, Calm the Mind
    • Acupuncture Points: KD 2 (clear empty heat), KD 3 (tonify yin), KD 6 (tonify yin), HT 6 (clear empty heat), HT 7 (calm mind), PC 7 (calm mind), CV 15 (heart shu)
    • Phlegm Fire Harrassing the Mind
    • Signs and Symptoms: strong agitation, phobias, irritability, chest oppression, nausea
    • Tongue: Red and Swollen, Sticky Coat
    • Pulse: Slippery, Rapid
    • Treatment Goals: Resolve Phlegm, Calm the Mind
    • Acupuncture Points: ST 40 (resolve phlegm), SP 9 (resolve dampness), LV 2 (drain fire), LI 11 (clear heat), ST 8 (clear the head), GB 17 (clear heat/head)

  • Threat of Miscarriage
  • TCM Theory: TCM looks at 3 "types" or "indicators" of miscarriage - one is vaginal bleeding, another is called "restless fetus", and another is "falling fetus". In general there is a weakness of the CV and Chong Meridians to gather Blood and nourish the fetus. A deficiency in the Kidney is most often behind these issues although, blood deficiency and/or spleen deficiency can also plan a role. Problems may arise from overwork, strong emotions, trauma, and excessive sexual activity within the first 3 months.
  • Differentiations:
    • Kidney Deficiency (vaginal bleeding issues)
    • Signs and Symptoms: scanty vaginal bleeding, lumbar soreness, dizziness, fatigue, frequent urination
    • Tongue: Pale (KD Yang), or Red w/o Coating (KD Yin)
    • Pulse: Deep, Weak (KD Yang), or Floating, Empty (KD Yin)
    • Treatment Goals: Tonify Kidney, Strengthen the GV, CV, and Chong Meridians, Calm the Fetus
    • Acupuncture Points: UB 20 (spleen shu), UB 23 (kidney shu), KD 3 (tonify kidneys), GV 20 (raise energy, lift fetus), SP 1 (stop uterine bleeding), ST 36 (tonify qi)
    • Qi and Blood Deficiency (vaginal bleeding issues)
    • Signs and Symptoms: vaginal bleeding (more at end of 1st trimester), scanty pale and dilute blood, weakness, fatigue, pale complexion, palpitations
    • Tongue: Pale
    • Pulse: Fine, weak, empty
    • Treatment Goals: Tonify Qi and Build Blood
    • Acupuncture Points: ST 36 (tonify qi), UB 20 (spleen shu), UB 23 (kidney shu), UB 17 with UB 19 ("four flowers", build blood), LV 8 (tonify blood), SP 1 (stop uterine bleeding)
    • Blood Heat (vaginal bleeding issues)
    • Signs and Symptoms: scanty vaginal bleeding, bright red blood, sensations of heat, thrist, constipation, anxiety, insomnia, dark urine
    • Tongue: Red w/Yellow Coating
    • Pulse: Rapid, Full
    • Treatment Goals: Clear Heat, Cool Blood, Calm the Fetus
    • Acupuncture Points: LV 2 (clear heat), LI 11 (clear heat), SP 10 (clear blood heat), KD 2 (clear heat), LV 3 (regulate liver), SP 1 (stop uterine bleeding)

  • Heartburn
  • TCM Theory: Heartburn in pregnancy is related to both the physical changes of the abdominal area and stomach meridian issues, usually heat. Recommendations include eating smaller meals more often, avoiding coffee and chocolate, limit fluid intake when eating, avoiding spicy, fried and fatty foods and possibly being propped up when sleeping.
  • Differentiations:
    • Possible variations include: Stomach Heat, Retention of Food in the Stomach, Deficient Stomach Qi - treatment is similar for all patterns
    • Signs and Symptoms: scanty vaginal bleeding, lumbar soreness, dizziness, fatigue, frequent urination
    • Treatment Goals: Tonify stomach and spleen, relieve stagnation of the middle burner, clear heat
    • Acupuncture Points: CV 12 (stomach mu), CV 14 (descend energy), ST 44 (clear stomach heat), ST 45 (clear stomach heat), LI 11 (clear heat), ST 36 (tonify qi)

  • Constipation (also described in more detail here)
  • TCM Theory: Blood or Qi deficiency can lead to drying of the intestines and result with constipation. Qi stagnation is also possible during the first trimester as the fetus is growing and the abdomen is changing.
  • Differentiations:
    • Blood Deficiency
    • Signs and Symptoms: difficult, dry stools, pale complexion, blurred vision, tired, possibly depressed
    • Tongue: Pale, thin
    • Pulse: Choppy
    • Treatment Goals: Nourish blood, moisten intestines, tonify liver
    • Acupuncture Points: ST 36 (tonify qi and blood), UB 17 (hui meeting of the blood), LV 8 (tonify liver/blood)
    • Kidney Yang Deficiency
    • Signs and Symptoms: difficult bowel movements with tiredness afterwards, sore back, sensations of cold, frequent, pale urine
    • Tongue: Pale, wet
    • Pulse: Deep, weak
    • Treatment Goals: Tonify Kidney Yang, Warm Lower Burner, Moisten Instestines
    • Acupuncture Points: ST 36 (w/moxa tonify qi), UB 23 (kd shu), UB 25 (li shu), KD 7 (tonify kd yang)
    • Kidney Yin Deficiency
    • Signs and Symptoms: dry stools, thirst with little desire to drink, dry mouth usually worse in evenings, sore back and/or knees, tinnitus, night sweats
    • Tongue: Red w/no coat
    • Pulse: Floating, empty
    • Treatment Goals: Tonify Yin, Moisten Intestines
    • Acupuncture Points: ST 36 (tonify qi), KD 3 (tonify kd yin), KD 6 (tonify kd yin), UB 23 (kd shu), UB 25 (li shu)
    • Qi Stagnation
    • Signs and Symptoms: pebbly stools, more belching, irritability, abdominal distention
    • Tongue: N/A
    • Pulse: Wiry
    • Treatment Goals: Regulate Liver, Move Stagnation
    • Acupuncture Points: LV 3 (regulate lv), CV 10 (aid stomach - 1st 3 months only), GB 34 (regulate lv, move stagnation)

  • Hemorrhoids
  • TCM Theory: Hemorrhoids may arise from the changes in vasculature due to pregnancy, qi deficiencies can bring about weakness (prolapses), constipation as described above can lead to hemorrhoids and prolonged labor may also be a cause.
  • Differentiations:
    • Possible variations include: Blood Deficiency, Heat in the Blood, Blood Stasis, Qi Stagnation and Damp Heat - treatment is similar for all patterns
    • Treatment Goals: Clear hemorrhoids and pathogenic factors
    • Acupuncture Points: Empirical points for hemorrhoids are ( UB 57, GV 20, & erbai ), then add additional points to move stagnation, clear blood heat, etc. as appropriate





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