Acupuncture During Pregnancy: Safety, Risks, and Benefits

While the pre-pregnant you might’ve popped a pill to manage, you no longer have the same luxury. Many medicines aren’t safe in pregnancy (especially in the first trimester). Or even if they are, you might still want to play it cautious. So, what options do you have to handle all these sucky side effects of pregnancy?

Acupuncture—a healing treatment based in Traditional Chinese Medicine—might be the answer to your most common prenatal complaints. But the practice does involve getting poked with needles…so, is it safe to get acupuncture during pregnancy?

Read on to learn about the risks (spoiler alert: there are very few) and benefits (a boatload) of this alternative medicine for pregnant people.

Is acupuncture safe during pregnancy?

“Studies consistently show that when correctly administered by a qualified, licensed practitioner, acupuncture is safe during pregnancy,” says Susan Wallmeyer, LAc, MSTOM, a licensed acupuncturist and master of Traditional Oriental Medicine with a focus in women’s health, pregnancy, and postpartum. It’s true. A 2022 systematic review and meta-analysis in BMJ Open—that included 10 studies and more than 1,000 pregnant people—concluded that acupuncture had no negative outcomes on newborns.

While side effects can happen, they’re “usually mild in nature” and don’t affect your baby, according to ob-gyn Staci Tanouye, MD. The most common complaints include pain, bleeding, bruising, or redness at the needling site. “There are also some reports of headache, nausea, and lightheadedness, but these are uncommon,” Dr. Tanouye says.

It’s even okay to get acupuncture in the early days of pregnancy. “Many people worry about getting acupuncture during the first trimester,” Wallmeyer says. We totally get it: The first 13 weeks are a delicate time. But as long as you’re healthy, your pregnancy is considered low risk, and you have the green light from your provider, acupuncture is considered generally safe for you and your baby. Wallmeyer points to a June 2002 study in Complementary Therapies in Medicine “that looked at nearly 600 pregnant people who had first-trimester acupuncture and found no increased risk of miscarriage.”

Of course, the decision is a personal one. You should only do what feels right for you and your little one after consulting with your ob-gyn or midwife.

And remember: Even though acupuncture can be helpful during pregnancy, it should only ever be a complementary therapy. Meaning: It should never replace treatments recommended by your doctor or care team for serious medical conditions.

Who should avoid acupuncture during pregnancy?

While the risks of acupuncture are low in most healthy pregnancies, it could be potentially harmful for certain groups of pregnant people. “Anyone who is having active pregnancy-related complications or who has been told they should be on ‘pelvic rest’ should avoid acupuncture,” says Dr. Tanouye.

Pregnancy complications can include preterm labor, cervical insufficiency, vaginal bleeding, placenta previa, or preterm premature rupture of membranes, among others, she says.

Are there “forbidden points?”

Perinatal acupuncturists generally avoid certain points in pregnant people. Why? Because certain points “are thought to either move the baby down lower in the pelvis or stimulate contractions of the uterus,” Wallmeyer says. These include a point on the outside of the little toe, a point on the inner upper ankle, and a point on the hand in between the thumb and forefinger, Dr. Tanouye says. While you may welcome a little help moving things along after 39 weeks (more on this later), you certainly don’t want to trigger labor before your baby is full-term.

That said, “there is no evidence to support any negative outcomes [including onset of preterm labor] from pressure on these or any other points on the external body,” Dr. Tanouye says.

Wallmeyer agrees: The current research shows that stimulating these points doesn’t result in an increase in premature labor. Still, she says more studies are needed to confirm this.

In the meantime, your acupuncturist may steer clear of these areas to be cautious. And don’t panic if they touch or massage around these points. “As acupuncturists, our concern is more about needling or focused, prolonged acupressure directly to the point,” Wallmeyer says.

Possible benefits of acupuncture during pregnancy

1. May help reduce nausea and vomiting

At one point or another in pregnancy, you’ll likely puke your guts up (or at least feel the urge to). For some, morning (or more aptly, all-day) sickness is enough to put a major damper on their day-to-day. But you don’t have to grin and bear it when you’re green.

“Acupuncture can help to reduce the intensity of nausea and its impact on your day-to-day functioning,” Wallmeyer says. Following East Asian medical theory, “we use acupuncture points that regulate the stomach’s qi (movement),” she says. The idea is to encourage things to move downward instead of upward.

Through the lens of Traditional Chinese Medicine, your nausea and tummy troubles may also be related to excessive heat or cold in the digestive organs, Wallmeyer says. “For example, a burning feeling in the throat would be a symptom of heat rising upwards.” Once again, your acupuncturist would choose points to help rebalance your system.

Many people see some improvement—less nausea and vomiting—in just a few sessions, Wallmeyer says. Plus, you may also be able to eat a wider variety of foods (buh bye, saltine crackers).

The science is starting to support the benefits of acupuncture for nausea in pregnancy too. A June 2023 study in the Annals of Internal Medicine concluded that acupuncture is an effective and safe treatment for moderate to severe nausea and vomiting in pregnancy. The researchers also noted that a combo of acupuncture and doxylamine-pyridoxine (an antihistamine with vitamin B6) might have an even bigger positive effect.

Still, everyone is different, so levels of relief can vary (depending on the severity of your symptoms). And nothing —including acupuncture—is a panacea for all your pregnancy digestive discomfort (bummer, we know). All this to say, it’s a good idea to adjust your expectations about what acupuncture treatment can and can’t do.

“Although it might not be possible to completely eliminate nausea or vomiting, for most pregnant people, acupuncture seems to help ‘take the edge off,’” Wallmeyer says. And let’s face it: Sometimes even a little break from hugging the porcelain throne can make a big difference.

2. May help ease insomnia

No one knows the struggle of sleep deprivation quite like a pregnant person. Between an array of aches and pains, a growing belly that makes finding a comfy position nearly impossible, and middle-of-the-night bathroom trips, quality sleep is a thing of the (pre-pregnancy) past.

Another common thing that can trigger insomnia during pregnancy is anxiety, Wallmeyer says. Seriously, we get it: There’s so much to consider (and worry about) before the baby comes. And when you lie down, and everything is quiet, there’s no distraction from those racing thoughts at night. This is where acupuncture can be particularly helpful. “According to East Asian Medicine, the heart and liver are commonly found to be out of balance in cases of insomnia due to anxiety, so we would choose points along these meridians,” Wallmayer says.

The research supports acupuncture’s benefits for sleep during pregnancy. A small May 2020 study in Nature and Science of Sleep concluded that acupuncture significantly improved sleep quality in pregnant people. Though it’s still not fully understood how it works, the researchers hypothesize that acupuncture may promote a release of melatonin, a hormone that helps you relax and makes you sleepy.

Anecdotally, Wallmeyer’s patients often report that acupuncture helps them “feel a deeper connection between their mind and body.”

In addition to needling, your acupuncturist has other tools in their bag to help you hit the hay. Techniques such as cupping therapy (which uses suction to pull on your skin and increase blood flow by placing cups on your body) or acupressure (which involves pressing and/or rubbing trigger points with a finger or noninvasive tool) can target symptoms of insomnia too, Wallmeyer says. “Your acupuncturist might also give you ‘homework’ (such as self-acupressure) or discuss your bedtime and sleep routine with you,” she adds.

3. Could help with anxiety and depression

Pregnancy can be hard. With all the physical, emotional, and hormonal changes, your mental health can take a hit. While certain anti-anxiety and antidepressant medications are safe to take when you’re expecting, some people prefer to avoid taking drugs during pregnancy. Whether you choose to manage your anxiety or depression with or without medication, acupuncture can be an additional coping strategy.

As we already know, acupuncture can address anxiety, and research also shows that it may be an effective treatment for depression during pregnancy too, according to the MGH Center for Women’s Mental Health.

While we’re still not totally sure why it has this positive effect, there are some theories. For example, “acupuncture is thought to help with anxiety via releasing endorphins,” i.e, the feel-good hormones that are your body’s natural pain-relievers, Wallmeyer says. This rush of endorphins modulates the body’s stress response and influences heart rate variability, she says.

This might explain why people who had acupuncture also report reduced stress levels, per a May 2022 study in The Journal of School of Nursing – University of São Paulo.

“Above all, if you’re pregnant and think you might be depressed and/or suffering from anxiety, your OB or midwife needs to know,” Wallmeyer says. “Acupuncture can be a part of your treatment plan, but it is not a replacement for care with a mental health specialist.”

Resources like Postpartum Support International and The Motherhood Center can also support you to get the help you need if your mental health is struggling during pregnancy.

4. May ease back, hip, and pelvic pain

With the extra weight of the baby and the shift of your center of gravity (read: your belly pulling you forward), your back, hips, and pelvis can really feel it. Not to mention your ligaments soften and stretch (to prep you for labor), and this can seriously strain the joints of your lower back and pelvis, according to the National Health Service (NHS). Sadly, aches and pains are par for the pregnancy course. But that doesn’t mean you have to suffer through without any relief.

“Lower back and pelvic pain tend to respond quite well to acupuncture, and studies back this up,” Wallmeyer says. Case in point: The 2022 systematic review and meta-analysis in BMJ Open we mentioned earlier found that acupuncture significantly improved pain and quality of life in pregnant people with lower back and/or pelvic pain.

And it can help with achy hips as well. “Oftentimes, cupping is used in combination with acupuncture to help with blood flow and release stagnation in the tissues,” Wallmeyer says.

As your belly grows, lying face down will be difficult, so your acupuncturist will position you in other ways to reach areas like your back. “It’s normally easiest to have a pregnant person lie on their side for an acupuncture treatment,” Wallmeyer says. “Using points on the legs, feet, or even ears can be wonderful for pain relief as well,” she adds.

5. Could help with headaches

Okay, nausea and back pain are one thing, but headaches too? Yep, pregnancy headaches are a thing. Though it’s still unclear why pregnant people are more prone to headaches, fluctuating hormones, increased blood volume, nasal congestion (more on this later), and dehydration (from puking a lot) can all play a part, especially in the first trimester, according to Stanford Medicine. And headaches can be pretty debilitating, especially if you’re trying to avoid taking medicine like OTC pain-relievers.

Enter, acupuncture. “In my experience, acupuncture can help quite a bit [with headaches],” says Wallmeyer. It deactivates pain centers in the brain, causing the release of the body’s own opioids, and activates other pain-reducing substances in our bodies, she says.

Wallmeyer admits the data is still limited, but a few studies show promise. A December 2012 study in the European Journal of Integrative Medicine concluded that acupuncture can ease tension-type headaches during pregnancy, and newer research shows that it appears safe for pregnant people with migraine, per a September 2022 retrospective study in Neurological Sciences.

There’s also a June 2016 Cochrane Review, which found that acupuncture can help prevent episodic migraines. But the researchers only looked at studies involving nonpregnant people. Again, more studies are needed, but if you suffer with pounding pregnancy headaches, it doesn’t hurt to try.

However, if you’re only starting to get headaches later on in your pregnancy, something more serious might be going on. “We first need to rule out preeclampsia or other conditions,” Wallmeyer says. Preeclampsia is a potentially dangerous complication characterized by high blood pressure, and one of the telltale signs is severe headaches. For this reason, it’s always important to let your doctor or midwife know if you’re having headaches, Wallmeyer says.

6. May help lower high blood pressure

In the United States, high blood pressure occurs in 1 in every 12 to 17 pregnancies among people ages 20 to 44, according to the Centers for Disease Control and Prevention (CDC). In other words, it’s incredibly common. But it’s also potentially dangerous for the birthing person and their baby.

If you have hypertension while pregnant, you “must be closely monitored by your doctor and midwife” at all times, Walmeyer says. “But as long as they feel comfortable that things are stable, and you would like to try something additional to help, acupuncture is an option.”

In nonpregnant folks, studies have shown that acupuncture can reduce blood pressure through its effect on oxidative stress, the neuroendocrine system, the inner cellular lining of arteries, veins, and capillaries, and other bodily systems, according to a February 2021 paper in Medical Acupuncture.

However, “at this point the research [in pregnant people] is extremely limited, so we can’t draw conclusions on how much it may help or for how long,” Wallmeyer says. But one December 2019 case study in Medical Acupuncture shows a lot of potential. It involved “a pregnant woman admitted [to the hospital] with high blood pressure due to preeclampsia and HELLP syndrome (a serious medical complication) who received usual medical care alongside daily acupuncture,” she says. The study’s authors concluded that acupuncture helped reduce the patient’s blood pressure, increased her uterine blood flow, and had a protective effect on her kidneys and liver.

“Although a single case study is not enough to guide clinical recommendations, the result was encouraging and shows the need for more research,” Wallmeyer says.

7. Could help with heartburn

At one point or another, most pregnant people feel the burn. Heartburn that is. While the burning sensation happens in your chest, this common pregnancy complaint has little to do with your heart. Heartburn happens when acid and gastric juices from your stomach flow up into your esophagus. Thanks to hormones and a growing baby putting upward pressure on your stomach, it’s more likely to occur during pregnancy.

Though certain OTC heartburn meds (like Tums) are generally safe to take in pregnancy, you might also find temporary relief with acupuncture. “Although the research is extremely limited on acupuncture for heartburn during pregnancy, clinically I find that it can be helpful,” Wallmeyer says. From the perspective of Traditional Chinese Medicine, heartburn is generally “due to heat in the stomach organ, and the stomach energy moving up instead of down,” Wallmeyer says. “Therefore, we utilize points with the goal of clearing heat and down-bearing the stomach’s qi (movement).”

But acupuncture treatment for heartburn isn’t a one-size-fits-all. “There can be other patterns of disharmony present, so we make an individualized diagnosis in each case,” she says.

In addition to acupuncture sessions, making certain lifestyle modifications (like avoiding spicy foods, eating smaller meals, and elevating your head at night) and doing self-acupressure at home can also offer relief in mild to moderate cases of heartburn, Wallmeyer says.

8. May ease rhinitis

Congestion, sneezing, postnasal drip, and runny nose. Just a few more symptoms to add to the list of weird things that happen to your body during pregnancy. Rhinitis (when mucous membranes in the nose become inflamed and swollen) affects almost one-fifth of pregnant people in the second and third trimesters, according to UT Southwestern Medical Center. Once again, those pesky hormones are to blame. So is the increase in blood volume and fluids your body makes while pregnant. These can make the blood vessels in your nasal passages swell.

If you’re looking for a nonmedicated way to manage the stuffiness (which can be a huge pain when you’re trying to sleep and can’t breathe well), acupuncture may help. It can reduce fluid accumulation and inflammation and harmonize the body systems that are causing the issue, Wallmeyer says.

“I’ve had patients with fairly intense sinus congestion and pressure during pregnancy that decreased quite a bit after just one session,” she says. The downside? The relief is usually short-lived. Rhinitis symptoms “tend to return after one to two weeks, so it’s something that usually requires regular sessions to get consistent relief,” Wallmeyer says.

9. Could help with postpartum issues, too

Like pregnancy, postpartum isn’t a walk in the park for many people. Even after your little one has arrived, you might still need, well, a little needling.

“Acupuncture can be used for a variety of reasons during the postpartum period,” Wallmeyer says. Here are just a few:

• Postpartum anxiety and/or depression
• Lactation concerns
• Cesarean scar healing
• Aches and pains
• General fatigue

Again, acupuncture should never be a substitute for proper medical or psychiatric care. Think of it instead as an additional wellness tool you can use “in conjunction with care from your primary medical provider,” Wallmeyer says.

Can acupuncture be used to induce labor?

Currently, “there is no evidence to support that acupuncture can induce contractions or labor,” Dr. Tanouye says. While it may not start labor, some research shows that it can increase cervical changes and prepare your body for the big day, Wallmeyer says. Acupuncture can also make you feel more relaxed, comfortable, and well-rested. All important things going into labor. You may even end up with a more satisfying birth experience when your mind and body are balanced, she says.

That’s why Dr. Tanouye says acupuncture is worth a shot if you haven’t gone into spontaneous labor after 39 weeks and want to avoid a medical induction. At 39 weeks or more, your acupuncturist will “first try to look for any underlying reasons why labor might not be starting spontaneously and address those [disharmonies in the body],” Wallmayer says. “If there are no complications with the pregnancy, the baby is in a great position, and mom is healthy and ready, it could be helpful to do points to try and stimulate contractions.”

Still, every birthing person is unique, so acupuncture may not get your labor going even if it successfully stimulates contractions. “If someone’s body is not quite ready…those contractions may just fizzle out or simply be unproductive,” Walmeyer says.

You also don’t need to wait until 39 weeks for labor preparation acupuncture. Wallmeyer recommends starting around week 36 or 37. “It’s a much more relaxed approach, and I feel it’s more conducive to gradually getting your body ready for labor (which involves a lot more than just starting contractions),” she says.

Getting acupuncture before 39 weeks may also help prep you for labor in situations where your baby is breech (i.e., when they are feet- or bottom-down instead of head-down in your uterus). If your baby doesn’t turn before labor, they might have difficulty coming out the birth canal. “Acupuncture and moxibustion (a method of warming and stimulating acupuncture points using an herb called Ai Ye or mugwort) can be used between weeks 33 and 35 to help a breech or transverse baby turn to head-down (cephalic) position,” Wallmeyer says. Meaning, you could have the option of a vaginal birth. This is exactly what a May 2023 Cochrane Review found: Starting moxibustion before 37 weeks may reduce the chance of a baby being breech at birth.

Where to find an acupuncturist with specialized training in pregnant people

“The first step is to find someone who is licensed in your state,” Wallmeyer says. “Most states have a website where you can verify that a particular acupuncturist has a current license.” (Like this license verification site for New York State.)

Once you’ve confirmed an acupuncturist has a legit license, interview them: Find out “what kind of training they’ve done in pregnancy acupuncture and how often they work with pregnant people,” Wallmeyer says. Keep in mind: General acupuncturists aren’t typically trained to work with pregnant folks, which requires additional education.

So where can you find perinatal practitioners? “There are a few perinatal acupuncture organizations that either provide training in pregnancy acupuncture or require passing an exam in order to be a member,” Wallmeyer says. The Obstetrical Acupuncture Association and MAMPS (Maternity Acupuncture Mentorship and Peer Support) are great places to look for qualified and experienced perinatal acupuncturists.

You can also ask you ob-gyn or midwife if they have any referrals, Wallmeyer adds.

The bottom line

While research is still evolving, all signs point to acupuncture being safe and helpful for a variety of issues common in pregnancy. As long as your provider is on board, and you’ve found a qualified perinatal acupuncturist, feel free to give it a go.

Just take a few, simple precautions if you do. Firstly, don’t lie on your back when you’re receiving acupuncture treatment, Dr. Tanouye says. Being on your back for too long in the second and third trimesters can compress a major blood vessel, which may reduce blood flow to your uterus. It’s safer to lie on your left side, she says.

Secondly, and most importantly, “pay attention to fetal movements and your body,” Dr. Tanouye says. “If there is any worrisome pain, decreased fetal movement, or other symptoms,” stop doing acupuncture.