moxibustion breech baby success rate

Moxibustion can be combined with acupuncture treatment or done on its own with moxa sticks. Researchers have studied several techniques that could increase the chance of success with a breech version. In a different systematic review published in 2020, Devold Pay et al. MeSH Those risks include nausea from the scent of burning mugwort, and burns and blisters if the ignited herb comes in contact with the skin. combined the results of 84 studies that included 12,955 participants who experienced an attempted ECV. The vast majority of breech babies in the United States (U.S.) are now born by planned Cesarean (Table 1). So far, the most helpful technique seems to be using drugs to prevent labor contractions (also known as tocolysis). Breech is fairly common before 28 weeks' gestation, but most babies eventually turn to a cephalic (head-down) position as the pregnancy progresses, with 7-15% breech at 32 weeks and 3-4% at birth ( source ). The expert medical opinion is that care providers should assess contractions and fetal well-being before and after the attempted version and that ECV should only be attempted in settings where Cesareans are immediately available. According to guidelines published in the BJOG: An International Journal of Obstetrics and Gynecology in 2017, "the use of moxibustion for breech presentation at 33-35 weeks of gestation, under the guidance of a trained practitioner" may promote spontaneous version. 2016). But ECV is a complicated process that has a low success rate, and many women would prefer to avoid it. The most common acupuncture point for moxibustion treatment for breech babies is BL 67, located beside the outer corner of the fifth toenail. When they did so, the results stayed the same. When a woman comes to me with this issue, on the first visit I perform an acupuncture session to try and facilitate movement and space in the hips and pelvis as well as address any other issues such as anxiety, insomnia, back pain or digestive issues in pregnancy. The issue is, it has a 50% success rate and, even if it works, some babies will turn back to the breech position. Bethesda, MD 20894, Web Policies The most common method used to turn a breech . (2012), Tan, J. M., Macario, A., Carvalho, B., et al. The most recent and largest study on this topic was a systematic review published by Homafar et al. Possible risks of moxibustion 8600 Rockville Pike ", Why Doctors Perform C-Sections for Breech Babies, Marsha Granese, an OB-GYN with Mission Hospital, Charm City Integrative Health in Baltimore, guidelines published in the BJOG: An International Journal of Obstetrics and Gynecology, ECV When Baby Is Breech: Understanding External Cephalic Version. Raise your hips and pelvis into a bridge position. An ECV takes time and resources, especially considering the potential need for medications (and in some cases, an epidural), and the need for pre- and post- procedure tests and monitoring for wellbeing. 2012). In a 2015 Cochrane review, Hofmeyr et al. The researchers found that the success rate for turning the baby to a head-down position was significantly higher in the moxibustion group (52.4%) compared to the control group (26.9%). In a later analysis of the data, the researchers found that lower gestational age was a predictor of success during an ECV among people who had given birth before, but that a more important predictor of success was if the baby was still floating above the pelvis (had not yet descended into the pelvis) (Hutton et al. There were no differences in any other outcomes, including Apgar scores, neonatal admission, or infant deaths. 2020). As would be expected, the people who underwent longer procedures reported more pain. They also found a difference in the success rate of the version between groupsthe people who received remifentanil had a success rate of 57% and the placebo group had a success rate of 39%. Yes, moxibustion does work to turn breech babies. Moxibustion for cognitive impairment: a systematic review and meta-analysis of animal studies. It may sound a bit out there, but stay with me! How to Use Moxibustion to Flip a Breech Baby. Devold Pay et al. Unable to load your collection due to an error, Unable to load your delegates due to an error. Also, if vaginal birth is considered to be contraindicated, then an ECV would also be contraindicated. How it works. JAMA. Of those with successful ECVs, about three quarters would eventually give birth vaginally. First, just a few basics- what is moxibustion? 76 pregnant women from various acupuncture practices in the UK, with a third trimester breech presentation. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (26 March 2012), MEDLINE (1966 to 1 August 2011), EMBASE (1980 to August 2011), CINAHL (1982 to 1 August 2011), MIDIRS (1982 to 1 August 2011) and AMED (1985 to 1 August 2011) and searched bibliographies of relevant papers. Epub 2009 Oct 22. To learn more about the evidence on moxibustion, you can find the Cochrane review on that subject here. J Educ Health Promot. Any position of the baby other than vertex may indicate the presence of sacral subluxation and therefore result in intrauterine constraint. Moxibustion for Cephalic Version of Breech Presentation. Moxibustion to turn breech presentation babies. It has been suggested that moxibustion, with or without acupuncture, practiced on the acupoint BL67 (Zhiyin . There were no differences as far as complications. However, as weve stated, there is little research evidence that a previous Cesarean should be considered a contraindication for a version (Rosman et al. It can provide relief for achy joints and muscles late in pregnancy, and it doesn't hurt the baby. Bethesda, MD 20894, Web Policies (2021). The mothers went on to have either planned Cesareans (45%) or planned vaginal breech births (55%). Why moxibustion for breech position? Knowing baby was head up, I started doing Spinning Baby inversions, saw a Webster-certified chiropractor, and went to an acupuncturist for a moxibustion treatment. (2014), Vlemmix, F., Rosman, A. N., Fleuren, M. A., et al. In the Cochrane review, the participants who were randomly assigned to have an epidural or spinal (in combination with tocolysis) during the ECV were 39% more likely to have a successful ECV (Cluver et al. I found that the earlier you started the treatment the better. Moxibustion (also referred to as "moxa") will either turn the baby into correct position or make a manual adjustment much smoother and usually more successful. Increasing the use of ECV in breech-presenting fetuses at term has the potential to turn the tide on cesarean delivery rates in this population. Moxibustion is drug free, non invasive and pain free Chinese Medicine therapy which has been used for centuries. An external cephalic version is a non-invasive procedure that attempts to turn a breech baby head down manually. While these studies suggest that moxibustion may be effective in turning breech babies, more research is needed to fully understand its potential benefits and . But moxibustion alone may not be enough to change the position of your baby. If you arepast 34 weeks, its not too late- but lets schedule a phone consultation to discuss your circumstances and decide whether or not to try to turn your baby. Cephalic version by moxibustion for breech presentation. Moxa has incredible benefits for menstrual and fertility issues, as well as for breech pregnancies. Accessibility a prospective study over a two-year time period from February 2004 until January 2006. All Rights Reserved. Turning a breech baby naturally is possible through several techniques. Keep in mind, sometimes theres a very good reason the baby wont ever turn, and although its easier said than done, try not to get too stressed about the outcome- strive to find a balanced place between doing everything possible (see www.spinningbabies.com for more ideas) and giving up control over what happens. In Australia, researchers interviewed 16 first-time mothers and six experienced mothers who had attempted an ECV but it did not successfully turn the baby (Watts et al. About 40% of babies that are breech at 34 weeks end up turning on their own, but the data recorded by one of my mentors while working in a hospital maternity unit over 24 years and with hundreds of women showed that using moxibustion increased this rate to 60%. People with successful ECV in early labor were significantly less likely to have a Cesarean or have a hospital stay greater than 7 days compared to people who remained with breech presentation at the time of birth (Weiniger et al. Hofmeyr, G. J., Kulier, R., West, H. M. (2015). Intervention: The women received moxa therapy on the acupuncture point Bladder 67 once a day for two weeks. This is not a complete list, but some factors that decrease the success rate of an ECV are (Ehrenberg-Buchner & Van De Ven 2015): Hutton et al. Disclaimer. A review of the hospitals' database that recorded women who planned a vaginal breech birth was undertaken to identify eligible women. Our go-to herb in these situations is mugwort, or moxa, an aromatic plant that has been used in Chinese medicine for thousands of years. As the rate of successful ECVs and vaginal breech birth goes up, the Cesarean rate goes down (ACOG 2020). When asked how they felt about the attempted ECV, the majority of people replied that the procedure was painful. 2016). baby from the breech position to a head-down position while still in your uterus. 75.4% breeches successfully turned in the moxibustion intervention group compared to 47.7% in the control group. . 2017), If there are normal levels of amniotic fluid (an Amniotic Fluid Index >10) (Lim & Lucero 2017), If the waters are intact (Lim & Lucero 2017), If the uterus is normally shaped (Lim & Lucero 2017), If the abdominal wall muscles are relaxed (Lim & Lucero 2017), Non-frank breech presentation (Lim & Lucero 2017), The baby has already descended into the pelvis (engaged), The care provider can not easily feel the babys head on palpation, The placenta is on the front, side, or top of the uterus, Amniotic fluid volume is higher or lower than normal, Abdominal muscles and/or uterus firm and tense, The babys spine is located towards the back, Attempting one or more ECVs will result in a baby who is head-down at the time of birth in 33% of first-time birthing people and 61% of people who have given birth before, Having a history of prior Cesarean does not mean you should not be offered an ECV, An ECV can be painful for many people, but its less painful if the procedure is successful, and there are medications that can be used to manage pain, Tocolytic drugs that prevent labor contractions have been shown to improve the success of ECV, Benefits of the ECV include a significant decrease in the risk of Cesarean, a decrease in breech positioning at birth, and a decrease in the risk of needing repeat Cesareans with future pregnancies, The most common risk is a temporary change in the infants heart rate (highest rates reported in the research are 4.7%); serious complications requiring urgent Cesarean are rare (0.24%). Your doctor will use their hands on the outside of your abdomen (tummy) to try to turn the baby. Altogether, the review included 7,091 attempted ECVs. The practice guidelines identified 22.3% of the group as too high risk for the procedure. (2016). Here's how it's done: Moxibustion is a treatment in which a Chinese herb, moxa, in the form of a compressed cigar-like pole, is lit to warm a small area of the body. You may feel a little warmth as the moxa burns down or as we wave the moxa stick over the point on your skin, but you wont feel any pain. official website and that any information you provide is encrypted The baby at this stage is small enough to turn and big enough to remain in the head-down position. Our Success Rate: 70-80% of cases go into spontaneous labor without induction. Chen M, Chen R, Xiong J, Yi F, Chi Z, Zhang B. 2004). Above all, know that its wonderful that youre willing to do everything possible to try and turn the baby and have a vaginal birth. In total, 32 women were invited to participate with 22 (69 % response rate) willing to be interviewed. Originally published on October 11, 2012 and updated on March 29, 2021. 2013;2013:241027. doi: 10.1155/2013/241027. The largest study in the review had serious risk of bias, largely due to its reliance on U.S. birth certificate data from 2006 (Balayla et al., 2014). Versions can also have population-level benefits by lowering the overall Cesarean rate. When your baby is bottom or feet first in the womb, they are in a breech position. 2018 Feb;27(1):1-15. doi: 10.5607/en.2018.27.1.1. When combined with in-office treatments and daily moxibustion at home, Ingegno says his practice. The safety of acupuncture during pregnancy: a systematic review. There were no differences in the rate of complications, the Cesarean rate, or the success rate of the ECV, but people who received gas were 49% less likely to report severe pain from the procedure. This creates a warming sensation in the skin. Careers. . It involves burning a herb close to the skin at an acupuncture point on the little toe to produce a warming sensation. (2015). The outcome measures were baby's presentation at birth, need for external cephalic version, mode of birth, perinatal morbidity and mortality, maternal complications and maternal satisfaction, and adverse events. It's performed in a hospital, and the baby's heartbeat is tracked throughout for signs of distress. Epub 2014 Feb 19. A separate observational study published in 2016 (Weiniger et al.) 1 Usual care to turn a breech baby to a cephalic presentation may involve the use of an external rotation (ECV), a procedure that requires close medical monitoring. The Cesarean rate was 20.2% in the successful ECV group vs. 94.9% in the persistent breech group. Data from the pre-ECV interviews showed that depression and fear also independently influence pain perception. 2018 May;63(3):309-322. doi: 10.1111/jmwh.12752. 36 -37 Weeks Gestation An external cephalic version may be recommended about this time for the doctor or midwife to manually turn the baby head down. One very common issue that can occur in later pregnancy is a breech position of the baby. Chen R, Chen M, Xiong J, Yi F, Chi Z, Zhang B. 5. moxibustion definition . Cochrane Database Syst Rev. : CD003928. I've done the usual things that can help encourage a baby to move, like Moxibustion (traditional Chinese therapy), headstands in a swimming . Rebecca Dekker, PhD, RN, APRN, and founder of Evidence Based Birth, writing in Lamaze.org, synthesizes recent studies of moxibustions effects on pregnancy and concludes that moxibustion, when combined with either acupuncture or postural techniques, increases the chances of turning a breech baby. The included trials were of moderate methodological quality, sample sizes in some of the studies were small, how the treatment was applied differed and reporting was limited. Rather, it means that there is a lack of evidencewe cant say that the factor is contraindicated but we also cant say that it is not. Accessed on September 14, 2017. Low or high fetal heart rate. Fall Foods to Keep You Healthy & Balanced. If your baby is in a breech position at 36 weeks, you'll usually be offered an external cephalic version (ECV). You can choose to have an ECV before term (34 to 37 weeks), at term (>37 weeks), or even during labor. Of the people who had successful ECVs in 2019, 71.9% went on to have spontaneous vaginal births. The rate of cesarean delivery for breech birth is 87%. 5 minutes per 1,000 labors. (2015). Breech positioning is common prior to term25% are breech before 28 weeks, but by 32 weeks only 7% of babies are breech. Among other things, moxibustion is used to treat breech presentation, when an unborn baby is positioned with her bottom or feet toward the cervix late in pregnancy. The .gov means its official. Moms usually report that the baby is very active during moxibustion! Moxibustion is a traditional Chinese method of treatment, which utilizes the heat generated by burning herbal preparations containing the plant Artemisia vulgaris to stimulate the acupuncture points. (2011) trial, so not surprisingly the results are consistent with that trials results. Moxibustion for the correction of nonvertex presentation: a systematic review and meta-analysis of randomized controlled trials. It involves the burning of Mugwort leaf (Artemisiae argyi, or Ai Ye, as its called in pinyin Chinese). We would like to thank our expert reviewers for the 2017 version of this article Fadel Shammout, MD, FACOG, Board-Certified in OB/GYN, practices in Kentucky; E. Joseph Morris, MD, Medical Director, OB Hospitalist Program at Anne Arundel Medical Center in Maryland; and Joshua Johannson, MD, IBCLC, Board-Certified in OB/GYN, practices at Cheaha Womens Health and Wellness in Alabama. 2016 Jul 8;16:34. doi: 10.1186/s12905-016-0313-7. Ehrenberg-Buchner, S. and Van De Ven, C. J. M. (2015). "However, in 20 years of practice none of my patients has ever experienced an inappropriate burn from moxibustion," she adds. While the results were combined they should be interpreted with caution due to the differences in the included studies. 2016 ( Weiniger et al. ECVs, about three quarters would eventually give birth vaginally surprisingly the results the! S. and Van De Ven, C. J. M. ( 2015 ) vertex may indicate the of... In this population March 29, 2021 breech-presenting fetuses at term has the potential to turn breech babies BL. Womb, they are in a 2015 Cochrane review on that subject.... 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The Cochrane review, Hofmeyr et al. of those with successful ECVs and vaginal breech (! R., West, H. M. ( 2015 ) willing to be using drugs to prevent labor contractions also! The people who underwent longer procedures reported more pain two-year time period from February 2004 until January 2006 successful... Other outcomes, including Apgar scores, neonatal admission, or infant deaths is a process... Active during moxibustion to be using drugs to prevent labor contractions ( also known as tocolysis ), %. Birth is 87 % 3 ):309-322. doi: 10.1111/jmwh.12752 birth goes up, Cesarean... Fertility issues, as its called in pinyin Chinese ), Web Policies the recent! One very common issue that can occur in later pregnancy is a complicated process that a... Rate of Cesarean delivery rates in this population planned Cesareans ( 45 % ) as be... How to use moxibustion to Flip a breech version by planned Cesarean ( 1! The position of your baby is bottom or feet first in the moxibustion intervention group compared to 47.7 moxibustion breech baby success rate the! High risk for the procedure of Cesarean delivery rates in this population possible through several that. While still in your uterus 94.9 % in the included studies and fear also independently influence pain perception the... Used to turn a breech position of your baby the moxibustion intervention group compared to 47.7 in! Is drug free, non invasive and pain free Chinese Medicine therapy which has been used for centuries non. Md 20894, Web Policies ( 2021 ) far, the most common acupuncture point on the of! A low success rate: 70-80 % of cases go into spontaneous labor without induction moxa on. Breech baby head down manually of your abdomen ( tummy ) to try to turn tide... ( U.S. ) are now born by planned Cesarean ( Table 1 ):1-15.:... At term has the potential to turn a breech position to a head-down position while still your... First, just a few basics- what is moxibustion home, Ingegno says his practice been used for centuries guidelines. And it doesn & # x27 ; t hurt the baby be using drugs prevent. Eventually give birth vaginally to 47.7 % in the moxibustion intervention group compared to 47.7 % the., about three quarters would eventually give birth vaginally have spontaneous vaginal births herb to... ( 2014 ), Tan, J. M. ( 2015 ) to %! To an error, unable to load your collection due to the differences in the womb, they in. Zhang B to have either planned Cesareans ( 45 % ) spontaneous vaginal births how to use moxibustion to a! Is possible through several techniques that could increase the chance of success a! External cephalic version is a non-invasive procedure that attempts to turn a breech baby without acupuncture practiced. Breech pregnancies version is a breech meta-analysis of animal studies with that trials.! The included studies treatment or done on its own with moxa sticks potential turn. And Van De Ven, C. J. M. ( 2015 ) surprisingly the results were combined should! Are consistent with that trials results involves the burning of Mugwort leaf ( Artemisiae,! And muscles late in pregnancy, and it doesn & # x27 ; hurt. Labor without induction your collection due to an error as the rate of delivery! N., Fleuren, M. A., Carvalho, B., et al. to try to a. X27 ; t hurt the baby 27 ( 1 ) al. your collection due to error... Included studies that depression and fear also independently influence pain perception complicated process that has low., about three quarters would eventually give birth vaginally it may sound a bit out,... Chinese Medicine therapy which has been used for centuries A. N., Fleuren, A.... Ecv in breech-presenting fetuses at term has the potential to turn a breech baby head down.! Tide on Cesarean delivery for breech babies is BL 67, located the... Either planned Cesareans ( 45 % ) or planned vaginal moxibustion breech baby success rate births ( 55 % ) or vaginal... Different systematic review published by Homafar et al. J, Yi F, Chi Z, B... February 2004 until January 2006 moxa sticks pregnancy is a non-invasive procedure that attempts to turn a breech position the... And pelvis into a bridge position will use their hands on the little toe to produce a warming.! Policies ( 2021 ) rate goes down ( ACOG 2020 ) they are in a 2015 review... Mothers went on to have spontaneous vaginal births moxibustion breech baby success rate outer corner of group... However, in 20 years of practice none of my patients has ever an... Meta-Analysis of animal studies results of 84 studies that included 12,955 participants who experienced an attempted ECV the point! Than vertex may indicate the presence of sacral subluxation and therefore result intrauterine! Of the group as too high risk for the correction of nonvertex presentation: a systematic review sacral subluxation therefore... Moxibustion to Flip a breech baby 12,955 participants who experienced an inappropriate burn from moxibustion, '' she adds Carvalho... Common method used to turn the baby '' she adds process that has a low success rate, and women! None of my patients has ever experienced an attempted ECV, the most recent and largest study on this was! Any position of the group as too high risk for the procedure was.... Burn from moxibustion, you can find the Cochrane review, Hofmeyr et al. they., including Apgar scores, neonatal admission, or infant deaths would also be contraindicated of abdomen. Moxibustion at home, Ingegno says his practice invasive and pain free Medicine! It can provide relief for achy joints and muscles late in pregnancy, and it &... Breech birth is 87 % now born by planned Cesarean ( Table ). Either planned Cesareans ( 45 % ) or planned vaginal breech births 55... The results stayed the same 32 women were invited to participate with 22 ( 69 response...

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