EBB 414 - Evidence on Natural Labor Induction: Acupuncture, Acupressure, and Breast Stimulation

Rebecca Dekker (0:00)

Hi, everyone. On today's podcast, we're going to talk about the natural labor induction methods of acupuncture, acupressure, shiatsu, and breast or nipple stimulation.

Welcome to the Evidence Based Birth podcast. My name is Rebecca Dekker, and I'm a nurse with my PhD and the founder of Evidence Based Birth. Join me each week as we work together to get evidence-based information into the hands of families and professionals around the world.

As a reminder, this information is not medical advice. See ebbirth.com/disclaimer for more details.

Hi, everyone. I'm so excited to talk with you about the evidence on several natural labor induction methods. This episode is part of a series and we're working our way alphabetically through various natural labor induction methods. Today, we'll be talking about the evidence on acupuncture and acupressure as well as its close relative, Shiatsu, and we'll discuss the evidence on breast stimulation or nipple stimulation for labor induction. The last time I talked about this topic was episode 125 of the Evidence Based Birth podcast from the year 2020

Today, we are giving you an update with the latest research. We will also be updating our other natural labor induction methods in the coming months. Keep your eyes out for episodes on castor oil, evening primrose oil, pineapple, and much more.

By the end of this particular episode, you'll be able to discuss the evidence behind acupuncture, acupressure, shiatsu, and breast stimulation for cervical ripening and induction, as well as some of the limitations on the evidence for these methods. We'll also talk about some sample protocols for each of these methods. We don't know exactly how many people around the world try to start their labor with natural methods. However, we do know that probably for about as long as there have been pregnancies, people have been trying to get labor started for whatever reason. On the latest Listening to Mothers 4 survey published in 2026, 27% of US participants reported trying to start labor on their own. Let's start at the beginning of the alphabet. We'll talk about acupuncture, acupressure, and shiatsu. I'm going to start by giving you a little background on these three concepts in general. Acupuncture has been used for more than 2,000 years in China and Japan. The earliest evidence on the use of acupuncture dates back to the Stone Age around 3,000 BCE. In traditional Chinese medicine, also known as TCM, qi, which is spelled q-i in English, is the energy that flows through the body's 14 meridians. The meridians are like pathways or rivers or branches through the body. With acupuncture, very fine acupuncture needles are asserted into specific acupuncture points along the meridians to stimulate the circulation of qi and blood in order to restore balance between yin and yang and improve health. There are 361 acupuncture points located along the 14 meridians throughout the body. The most common type of acupuncture needles are called filiform needles. These are tiny needles made of stainless steel and they're extremely thin. Some people describe them as about the diameter of a strand of hair.

The needles come in varying lengths and diameters depending on the area that's being treated and the depth required. Acupuncture needles can just be left alone for a while, or they could be stimulated with electricity, which we call electroacupuncture. With electroacupuncture, electrodes are attached to the acupuncture needles, and then a mild electric current is applied to the acu points. Both regular philiform needles and electroacupuncture needles are used in the research that we have on acupuncture for labor induction. Acupuncture can be administered only by a licensed acupuncturist. In contrast, we have something called acupressure, which is when you use your thumb or finger to put pressure on or to massage an acupuncture point. Acupressure can be performed on yourself by yourself, or it can be performed by another person, and it does not require a licensed practitioner. The places where an acupuncturist might place the needle are called acupoints, and they can be broken down into local or distant categories. The two categories help determine how close you are to the point you want to use and which effect you want to happen. Local acupoints are the ones really close to the area you're trying to treat. These work by increasing blood flow to the area where you want to be and calming down nerve activity right in that zone. Distant acupoints, on the other hand, are further away from the target area entirely. These distant points work more through effects on the central nervous system, and practitioners often start treatment with distant points because they're less painful and it helps patients ease into acupuncture, feel more comfortable, and build a little trust before moving on to the more sensitive local points.