Impact of acupressure on onset of labour and labour duration: A systematic review.
BACKGROUND
There is worldwide concern with increasing rates of pharmacologically induced labour and operative birth. Many women would like to avoid medical or surgical interventions in childbirth; a desire that may contribute towards the popularity of complementary and alternative medicine/therapies.


METHODS
This systematic review examines the effects of acupressure on labour onset and duration of labour. We searched MEDLINE, CINAHL, AMED, Cochrane Collaboration, and Science Direct from 1999 to 2013 for published randomised controlled trials and controlled trials comparing acupressure with placebo and no treatment. Studies recruited primiparous and/or multiparous women with either spontaneous or induced onset of labour. The outcome measures were labour onset and duration of all stages of labour.


RESULTS
Seven trials with data reporting on 748 women using different acupressure points and methods of administration were included in the review. One study examined the initiation of labour and six studies examined labour duration and/or pain levels. The two most studied acupoints were Sanyinjiao/Spleen 6 and Hegu/Large Intestine 4. Results suggest acupressure may reduce the length of labour particularly in the first stage.


CONCLUSIONS
Further research is required on whether acupressure can shorten labour duration, augment prolonged labour or initiate onset of labour by stimulating uterine contractions. Clinical trials should report the basis for acupressure treatment described in the STRICTA (minus needling) and CONSORT non-pharmaceutical guidelines.
Faculty of Health, University of Technology Sydney, Broadway, Ultimo NSW 2007, Australia; Maternity Services, Central Coast Local Health District, Gosford NSW 2250, Australia. Electronic address: Lyndall.Mollart@health.nsw.gov.au.
Lyndall J
LJ
Mollart
Public Health, Faculty of Health, University of Technology Sydney, Broadway, Ultimo NSW 2007, Australia.
Jon
J
Adam
Midwifery, Faculty of Health, University of Technology Sydney, Broadway, Ultimo NSW 2007, Australia.
Maralyn
M
Foureur
D019050:Acupressure / Q000379:methods*; D015670:Acupuncture Therapy / Q000379:methods*; D000328:Adult; D016362:Analgesia, Obstetrical / Q000379:methods*; D036861:Delivery, Obstetric / Q000451:nursing; D005260:Female; D006801:Humans; D048949:Labor Pain / Q000628:therapy*; D007748:Labor Stage, Second / Q000502:physiology; D007743:Labor, Obstetric / Q000502:physiology; D011247:Pregnancy
Acupoints; Acupressure; Labour duration; Labour initiation; Labour onset; Labour pain; Systematic review