By Rebecca Dekker, PhD, RN, APRN
Occasional Science & Sensibility contributor Rebecca Dekker of www.EvidenceBasedBirth.com examines the practice of Moxibustion to help turn breech babies head down. Rebecca looks at what the current research shows on this ancient treatment for turning babies and shares the results with Science & Sensibility readers in an article that can be easily shared with students, clients and patients. - Sharon Muza, Science & Sensibility Community Manager.
About 3-4% of pregnant women end up with a baby who is in breech (bottom first) position at term. The vast majority of these babies (90%) are born by planned cesarean section. In order to avoid a cesarean section, many women try various ways to turn their babies into a head-down position. I have written in the past about using external cephalic version (ECV), also called the hands-to-belly procedure, for turning breech babies. However, although ECV is safe and frequently effective, it can be uncomfortable and women may want to try different options for turning a breech baby. One potential option is moxibustion.
What is moxibustion?
Moxibustion is a type of Chinese medicine where you burn an herb (Artemesia vulgaria) close to the skin of the fifth toes of both feet. The fifth toe is a traditional acupuncture point called Bladder 67.
How do you use moxibustion?
There is no one recommended way to use moxibustion, but many women burn the moxa sticks close to their toes for about 15-20 minutes, from anywhere to 1-10 times per day, for up to two weeks. This treatment is usually started between 28 and 37 weeks of pregnancy.
How could moxibustion work?
The burning of the moxa stick stimulates heat receptors on the skin of the toe. It is thought that the heat encourages the release of two pregnancy hormones - placental estrogen and prostaglandins - which lead to uterine contractions. These contractions can then stimulate the baby to move (Cardini & Weixin, 1998).
So, does moxibustion work?
In 2012, researchers combined results from eight studies where 1,346 women with breech babies were randomly assigned to moxibustion, no treatment, or an alternative treatment (like acupuncture). The women in these studies lived in Italy, China, and Switzerland (Coyle et al., 2012).
For the women who were assigned to receive moxibustion, some used moxibustion alone, some had moxibustion plus acupuncture, and some used moxibustion plus posture techniques.
When moxibustion alone was compared to no treatment (3 studies, 594 women) there was:
- No difference in the percentage of babies who were breech at birth
- No difference in the need for external cephalic version
- No difference in cesarean section rates
- No difference in the risk of water breaking before labor began
- No difference in Apgar scores at birth
- A 72% decrease in the risk of using oxytocin for women in the moxibustion group who ended up with a vaginal birth
Side effects of the moxibustion included smelling an unpleasant odor, nausea, and abdominal pain from contractions.
When moxibustion alone was compared to acupuncture alone, fewer women in the moxibustion group had breech babies at birth compared to the acupuncture group. However, there were only 25 women in the single study that compared moxibustion alone to acupuncture alone, so this doesn't really tell us that much.
When moxibustion plus acupuncture was compared to no treatment (1 study, 226 women), women who had moxibustion plus acupuncture had a:
- 27% decrease in the risk of having a breech baby at birth
- 21% decrease in the risk of having a cesarean section
When moxibustion plus acupuncture was compared to acupuncture alone, one study with only 24 women found no difference in the number of women who had breech babies at birth. Because this study was so small, it doesn't really give us much meaningful information.
When moxibustion plus postural techniques was compared to postural techniques alone (3 studies, 470 women), women in the moxibustion plus postural group had:
- a 74% decrease in the risk of having a breech baby at birth
