[Kate Levett]

Hi Danielle

Sorry this took a while to get around to replying.

With regard to acuneedling – firstly, midwives are Ahpra registered and have needling in their scope of practice already. They have insurance which covers needling within the hospital. For acuneedling they have extra insurance which covers dry needling. It is not called acupuncture because Ahpra and CMBA require that only registered acupuncturists can use the term. It is meant to be highlighing that this is different to what acupuncturists do. These course is endorsed by the ACM and has around 50 hours training and study, with ongoing supervision and mentoring and peer mentoring, which amounts to about 50 hours over the course of each year. There is no limit or end date on the mentoring and supervision that is provided by Heidi and me.

Their scope is specific to certain maternal health conditions and needs to be delivered within a midwifery consultation. This extends access to women who would not ordinarily be able to access acupuncture, due to cost, geographic location or awareness of acupuncture. The midwives often serve underserved communities.

This course is one that was introduced in Australia by Debra many years ago, and has been run by Heidi Williams since then. Heidi and I now run the courses once or twice a year. Since Covid, more of the information has gone online, and there is a requirement for attendees to undertake online study prior to attending, with modules and questions (much like MAMPS). This is about 20 hours.

The attendees then do a face-to-face over a weekend, where needling skills are introduced and we go through specific maternity protocols. Which is about 16 hours, and they need to have a certain level of skill attainment before they pass that component of the course.

They have assessments following the face to face course, and submit detailed case studies and short answer responses. They are required to video themselves and often have acupuncture mentors they work with. They have ongoing supervision, and access to video content.

We have a master class weekend that runs once a year for any past students to attend face to face to gain additional skills and practice any needling or protocols.

Midwives are usually either endorsed or independent midwives, and have had a great deal of experience with needling in their training and practice.

The website is being developed but is not active yet. Midwives have about 100 hours of training, study and practice in the year of the program, and access to ongoing mentoring. It is quite extensive and I think you would be impressed with their skill and practice level. We hope that they will be able to use their skills in the hospital, where we cannot, so that women will get the benefit of this wonderful medicine!

Hope that sheds some light

Thanks

Kate

[Kate Levett]

Hi Kristen

I’ve worked with a couple of cases of this and discussed at length with midwifery colleagues. The main risk here is if the cord has inserted low on the placenta and uterus, or is lying across the cervix or close to the Os. If the cord is high and clear, there should be no increased risk for prolapse or other complication. The main risk is for an IUGR baby due to the placentation restrictions letting fewer nutrients through. So moxa on St36 is my go-to for this.

If the cord has inserted low or is lying across the cervix, then a C/S will be necessary.

You can proceed with gentle cervical ripening treatments if the cord is clear

Hope that helps

Kate

[Kate Levett]

Hi Danielle

There is a 2020 update:

https://www.health.gov.au/resources/pregnancy-care-guidelines/part-i-common-conditions-during-pregnancy/pelvic-girdle-pain

It looks to say pretty much the same thing as the previous one. There is evidence for acupuncture being more effective that physiotherapy for PGP, based on Carolyn Ee’s 2008 paper. So the evidence is not super up to date

We are doing a review of the guidelines at the moment, and they never really do structured searches of the literature – it’s very broad brush strokes and not a good use of the evidence

Thnaks

Kate

[Kate Levett]

That sounds like a tricky and stubborn case. In the past I have used GB26 to release the diaphragm (reflux), TW5 (Left) to calm the system, and GB29 for the RSL – to good effect. With your other good points 🙂

Hope that gives you a bit of a hand

Kate

[Kate Levett]

Hi Danielle

So great to have all these Aussies on the program!! I am applying for a grant application to do some research in HG with Prof Leonie Calloway and her team at UQ and RBWH, and Greg Bantick a practitioner in Brissy.

She is an Obstetric physician, and is interested in seeing what can be done using Chinese medicine. We have some cost data and we’re doing a database study of ED admission in Sydney, but hoping to extend that to Qld too.

I’ll keep everyone in MAMPS in the loop as to progress 🙂

Thanks

Kate

[Kate Levett]

Hi Mel

I have produced a series of videos for acupressure for labour. Can discuss 🙂

Talk soon

Kate

[Kate Levett]

Hi Jamie

I know you asked Zena, but I thought I’d provide a response – Kiiko style acupuncture is my main style of practice.

The adrenal reflex points (Kiiko style), are at Ki16. If you press (gently) in toward the belly button at a 45 degree angle from Ki16, you may feel a hardness, or tightness, or the patient may feel discomfort. This may be indicative of some trauma stored in the body. This tightness is then released by Ki6 or Ki7 depending on the person. Ki7 will often be more useful for a trauma response or if the person has some bone issues (e.g.arthritis), but not always. Ki6 is usually what I will try first.

There are some other caveats (like checking Ki2 and other points), but I don’t want to confuse the issue.

So, summary – check the adrenal points for tenderness or tightness, if present, try to release with Ki6 or Ki7

Hope that helps 🙂

Kate

[Kate Levett]

Hi Emma

A fellow Sydney-sider! I’m in Crows Nest, so not far from you!

So glad you’re able to join us 🙂

Looking forward to a dive into pre-eclampsia during the course

Best wishes

Kate

[Kate Levett]

Hi Jennifer

Along with what Sarah has said, I focus quite a bit on the woman’s hips and making sure they are soft and aligned, so that baby has room. If there is tenderness in the ASIS, I find Ki9 really good for softening that, then GB points (26, 29), josen, outer BL points, etc for loosening the PSIS.

I use acupuncture and moxa at BL67, while others don’t as it is a cervical ripening point. But I have never had any issues with this. Personal preference 🙂

[Kate Levett]

<div>Hi Sarah</div>

This is what I could find for acup for prolapse – seems like it’s a neglected area. But one of the studies is a protocol for a planned RCT, so there is some evidence on the way!

Let me know if you can’t access via these links

Thanks

Kate

1. A study of efficacy of traditional Chinese
medicine combined with biofeedback electrical
stimulation on postpartum pelvic organ prolapse

https://e-century.us/files/ijcem/13/12/ijcem0120199.pdf

2. Effect of electroacupuncture on symptoms of female pelvic organ prolapse (stage II–III) (EAPOP study): protocol of a randomised controlled trialEffect of electroacupuncture on
symptoms of female pelvic organ
prolapse (stage II–III) (EAPOP study):
protocol of a randomised controlled trial

https://bmjopen.bmj.com/content/bmjopen/12/6/e051249.full.pdf

3. Evaluation of acupuncture treatments of postpartum female pelvic floor dysfunction by four-dimensional transperineal pelvic floor ultrasoundEvaluation of acupuncture treatments of postpartum female pelvic floor dysfunction by four-dimensional transperineal pelvic floor ultrasound

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8542121/

4. The use of acupuncture for managing gynaecologic conditions: An overview of systematic reviewsThe use of acupuncture for managing gynaecologic conditions: An overview of systematic reviews

*but no research on prolapse found

https://www.sciencedirect.com/science/article/pii/S0378512211000363?casa_token=qy3xPODVG24AAAAA:3rZzlGvIsYx2C2asGf5I-STRLiRM3f3nvyzW4NROS5gs-34_XomWFY2xmoDK91PaJYkMwaOdKB4

5. Cupping: An Alternative Surgical Procedure Used by Hippocratic PhysiciansCupping: An Alternative Surgical Procedure
Used by Hippocratic Physicians

*a weird little interest piece 🙂

https://www.liebertpub.com/doi/pdf/10.1089/acm.2008.0238?casa_token=AfX5l7cTBcQAAAAA:3Adczd8CawV3PMUuau5vjWJnf9YnJQ_Qjq80cWBArP8c3JYRV5DzxxyegeAq8BMcvt1Jyt9QhYGA

[Kate Levett]

Hi Jennifer

Does your client have a factor V deficiency or factor V leiden disease? I’m assuming it’s deficiency??

What’s her presentation? Is she Sp Qi xu, or Lv stasis? Or pulses etc.?

Just to understand what the underlying pattern is

Thanks

Kate

[Kate Levett]

Hi Ciara

After I posted about using GV22 for excessive saliva, I had a client come in who had this in early pregnancy! (funny how that works).

Her symptoms were not anywhere near as severe as your client reported, but I tried out GV22, and it worked almost instantly! She was able to feel the difference with the saliva and a shift in sensation in the salivary glands.

I found the location that was tender with my finger, and then directed the pressure both forward (toward the nose) and back (toward the back of the head) to see which worked better. She was very clear that it was forward.

I added Ki6+27 and Sp5+9 (for nausea), then GB15-17 area also assisted with the saliva along with TW5 (L) for calming the vagal system. I added GB41 which didn’t make any difference for the saliva (as a shao yang Rx with TW5), but assisted with some lower back pain. St36 for the St channel, and Pc6 also for nausea, and partner for Sp Rx.

Hope that helps

Thanks

Kate

[Kate Levett]

Hi Ciara

How is this person going? I was just reading some information from Kiiko and found a section on excessive saliva – and thought of this case.

The diagnosis was parasympathetic dominance. The symptoms were excessive saliva, low blood pressure, sometimes reflux and sensitive abdomen on palpation. The rationale is around the vagus nerve being stimulated excessively.

The treatment is Du22 angled toward the face. It should reduce symptoms of sensitivity around Ren 10-12 and saliva should start to reduce immediately.

Love to know if it is helpful 🙂

[Kate Levett]

Hi Ciara

I have also found that using Shao Yang treatment helps this. Either [TW4 or 5 or 9], plus either [GB41 or 40]. Check the points against the symptom and the pattern she is presenting with though.

Let us know how you go.

Kate 🙂

[Kate Levett]

These infographics might be useful 🙂