Your hands…

Originally uploaded by pepenut

One Sunday afternoon, almost 6 years ago I got a call at home from the husband of a client. Always cool, and collected, he said, “R. would like you to come over now.” His tone didn’t waver when, in the middle of this neatly delivered request, I could hear R. in the background screaming and cursing. Clearly, she was in labor. I packed my own breast pump and my needles, and left my 5 month old with his nearly 3 year old sister (and my husband, of course).

As I approached the front door of the salt box house I could hear deep moaning from within. It seemed as if the whole house was reverberating. Once inside I met 2 local midwives for the first time, Sarah Ackerly and Holly Arends. They stood in the kitchen, making tea and washing a few dishes. Off to our right there was a loud thumping noise, followed by a shuffle-thump. Thump, shuffle, thump. Pause. Thump, shuffle, thump…

Alarmed, I looked to the right, and then back at the midwives, who were calm and cheery and I wondered who these women were, to be so nonchalant in the face of such dire sounds coming from the next room. Harrumpff! After being at many more home births with these two wonderful, extraordinary midwives, and with other midwives and doctors as well, I learned to appreciate that nonchalance for what it was (and not for what it seemed at first). Now I believe that their nonchalance came from a deep respect for the process of labor, the knowledge that each woman will labor in her own way, and the understanding that there is nothing wrong when a laboring woman sounds like a wounded elephant dragging herself up a flight of stairs.

I must have had a questioning look on my face. Holly said, “we suggested that R. climb the stairs to try to get things moving a little more. ” “Tea?” She added. I said no, thanks, hoping there was some politeness and not too much urgency in my voice, and I rounded the corner to the stairs, where I saw S. leaning against the stairway wall, about half way up. Again he demonstrated his unflappable cool. He smiled down at me, and waved. Ahead of him, one step up, was his wife, R. Her back was to me. She wore a thin blue-gray bathrobe and every muscle in her back screamed fatigue.

“Hey, R,” I said. “If you’d like to come down now we can try some acupuncture instead of this–”

S. interjected too quickly (a momentary insight into the stress beneath the calm) “Yes!”

R. said nothing. But she slowly made her way down the stairs.

It was pretty clear that she was having severe back labor. I put some needles in her ears first: shenmen, uterus, sympathetic, endocrine. And did a little electrical stimulation between uterus and endocrine. Later I briefly did some electrical stim in the Liao points (UB 32 and 34). Afterwards she was ready to walk the stairs again, briefly, before getting into the birthing tub, which was set up in the living room.

My kids had both been born in the water. This was the first time I got to witness it from outside the tub. What a blessing. A few days later, R. said to me, “We got some pictures back that were taken right after the birth–were you crying?”

“Of course I was, R. Tears of joy my friend, tears of joy.”

Since then I’ve been to water births, home births, hospital vaginal births and C-sections. I’ve done acupuncture, acupressure, held a cool cloth to women’s foreheads, and stopped at least one Dad from fainting with some swift acupressure and reassuring words. Being a support person for birthing families gives me a lot of joy.

If you’re an acupuncturist wondering what you can do to help labor progress, just remember all of the those contra-indicated points during pregnancy. Those are the ones that will get labor going.

Here are 7 things every Acupuncturist should remember:

1. Respect the process of labor. Don’t try to distract women during contractions. Contractions are necessary and require a woman’s full attention. Instead, hold a space of focused “yang within yin” energy.

2. In between contractions get consent. This should not be a long conversation. The long conversation about the types of support you can offer should have happened well before labor begins, as you met with the couple and discussed your role. Instead this should be a simple request, such as, can I place a few needles (or press balls) in your ears now? Or, we might be able to lessen the back labor if you get on all fours and I put some needles in your back. Is that OK? These are scenarios you hopefully discussed fully beforehand. Don’t expect more than a grunt or a nod, but make sure you get some form of expressed consent. Stop insertions immediately during a contraction, and be prepared to whip out the back needles if the woman needs to change position during a contraction, because…

3. Women often want and need to change positions during labor and your treatments should always allow for that. Ear needles are great as they don’t inhibit movement. But points on the body will–that means you may be taking the needles out before you otherwise would. Never leave the room. Be alert. Be flexible. Move quickly. Laboring women can be extremely non-verbal.  If you’re using body points, ask her to let you know if she needs to move.  But she may not—If you see her moving, get cracking!

4. The birthing woman is the QUEEN, and can make and change rules at any time. You have to be willing and able to get out of the way at a moment’s notice. That being said, most birthing moms need help remembering to drink water between contractions. If no one else is remembering to help with this, you can help by bringing a cup forward (with a straw) after every contraction. Water is nature’s lubricant.

5. Women who become deeply focused and engaged in labor do not need acupuncture. At this point, you may be able to offer some support to the woman’s partner, or to other members of the birthing team. Be humble. If you’re at a home birth, be willing to wash the dishes or cook food, or otherwise attend to tasks outside your job description.

6. After the need for acupuncture has passed, offer to leave, or (if it’s possible for you) to stay. Every birthing woman I have assisted has asked me to stay and be present for the birth, although that won’t necessarily always be true. In the conversations you had with the couple before labor began you should make it absolutely clear to them that the choice is always theirs, and there will be no hard feelings if they prefer that you bow out gracefully.

7. If you are in a hospital you need to have permission to do needles, but you don’t need permission to do acupressure.

One final note to acupuncturists:  Returning Current, Kidney 7, which is the metal (and hence mother) point of the yin water meridian is said in Chinese folk medicine to be the “happy baby” point.  As a mom, and out of respect for folk culture, I cannot turn my head from such lore.  I always needle the “happy baby” point!