It is a well-established concept that stimulating the skin activates the large diameter "touch" fibers. The "touch" message travels faster to the brain than the competitive and smaller pain fibers in labor. Because the human brain is only capable of a certain amount of cutaneous stimuli, the gate to the brain is closed during touch stimulation and the amount of pain sensation felt is inhibited. This Gate Control Theory is valuable in learning how acupressure works.

Massage and acupressure may be also be linked to decreasing pain sensations through endorphin production. Endorphins are opiate-like substances that occur naturally and influence the transmission of impulses. The presence of endorphins at the junction of nerve cells may result in a decrease in pain sensation. Women have varying amounts of endorphin production during labor, however women with an epidural may have decreased amounts of endorphins. Thus, if the epidural ceases to function, the woman may not have her natural ability to raise her pain tolerance. She may be stagnate at her pain threshold.

While no official evidence exists regarding acupressure and inducing/stimulating labor, many perinatal specialists (midwives, physicians, childbirth educators and doulas) confirm the relationship between acupressure points and increased uterine contractions - an alternative to pharmacologic induction or augmentation with pitocin. When applying finger acupressure, instruct the client to press against the desired point on the skin. Massage in a small circular motion. Continue for 1-5 minutes.

Three points are commonly used to stimulate labor and the first two are also linked to relief of migraine headaches.

	Hoku (Large intestine 6): located deep in the webbing between either hand's thumb and forefinger; in between the 1st and 2nd metacarpal bones. Stimulation of this point has been know to begin labor, enhance contractions during labor and in non-pregnant females, bring on menstruation several days early. Also may relieve pain from migraine.
	Chih-yin (Bladder 67): located approximately 1/10" behind the lateral corner of the smallest toe's nail of either foot. Stimulation of this point has been known to relieve labor pains and migraine discomfort.
	San-yin-chiao (Spleen 6): placing your left hand on your right leg with your pinkie finger just above the interior ankle bone, the lateral tibia is located just under where your index finger lies. You may utilize both points simultaneously by placing a thumb on each point as shown.

Just as care providers need to share information regarding the administration of medication to either eliminate pain in labor or to induce or augment contractions during labor, so should the client inform the care provider when she decides to use certain acupressure to induce or augment labor.

References:

1. Bobak, I., Jensen, M. Maternity & Gynecologic Care: The Nurse and the Family. (1989) St. Louis: Mosby Publishers.
2. Nichols, F., Humenick, S. Childbirth Education: Practice, Research & Theory (2000) Saunders & Co.
3. Whitely, N. A Manual of Clinical Obstetrics (1985) Philadelphia: J.B. Lippincott Company.
4. Reeder, S., Martin, L., and Koniak-Griffin, D. Maternity Nursing: Family, Newborn, and Women's Health Care. (1997) Philadelphia: J.B. Lippincott Company.