Moxa has been used to turn breech babies as part of traditional Chinese medicine for many years. The point we use (Bladder 67) is famous for this action, as well as similar functions such as hastening delivery. This is described in the Song of Points for Miscellaneous Diseases which was first recorded in Gao Wu’s Glorious Antholoy of Acupuncture and Moxibustion in 1529. Modern research has found the treatment to be effective too1.
So how does moxa turn breech babies?
Modern research suggests that moxa increases corticoadrenal secretion, affecting prostaglandin levels and thereby stimulating the uterine muscles2. This creates more movement in the uterus which will encourage the baby to turn head down. However, why burning a herb near your toe should have this effect is not well understood from a biomedical perspective. On the other hand, viewing the treatment from a Chinese medicine perspective, this makes perfect sense.
First, it’s useful to provide a bit of terminology and context. Traditional Chinese medicine views the body as a complex set of interrelated systems, the most important of which are named after the major organs of the body. These systems don’t refer to just the physical organ after which they are named, but a number of physiological functions, an associated sense organ and type of tissue as well as a system of pathways in the body (usually known as the acupuncture channels or meridians).
The system that has the greatest influence on reproduction is the Kidney system. During pregnancy, it is this system that is largely responsible for nourishing the foetus, helping it to grow. This function can be described as being yin in nature. That’s yin as in yin and yang – according to Daoist philosophy, all things can be described in terms of yin and yang.
This is the well-known taiji symbol. The black areas represent yin, while the white areas represent yang. Yin is dark, quiet, still, fluid and nourishing – it is like water. Yang is bright, active, hot, moving and transforming – it is like fire. However, yin transforms into yang and vice versa. It is when yang reaches its peak that yin begins.
The following video explains yin-yang in more detail.
Yin and Yang in Pregnancy
During pregnancy, the foetus grows and the mother along with it, gradually becoming more yin. Eventually, yin reaches its maximum and yang begins – this is where the baby begins to change position and move down into the pelvic cavity ready for the more intense yang of labour and birth. Sometimes this doesn’t happen, and the baby remains in breech position. In order to encourage this movement, we wish to increase yang, especially in the lower abdomen.
Moxibustion involves burning dried mugwort (artemisia vulgaris). This produces heat (yang) which is applied to the skin, and the herb itself is considered to be energetically moving (also yang).
Why Bladder 67?
Bladder 67 is the last point on the Bladder channel, situated at the corner of the nail on the little toe. Acupuncture points generally become stronger, more sensitive and more stimulating towards the extremities, and the nail points are particularly moving.
The Bladder channel runs from the corner of the eye, over the head, down the back twice and then down the legs to finish by the little toe. There is also a deep pathway that runs to the bladder itself. Stimulating Bladder 67 with moxa creates movement up the back and in the lower abdomen, which is exactly the area we wish to generate more movement in to turn breech babies.
The Bladder is also paired with the Kidney – the Kidney is the yin organ and the Bladder is the yang organ. Since it is the Kidney that is involved in the yin, nourishing stages of pregnancy, stimulating it’s paired yang organ will encourage yang movement. Finally, the point Bladder 67 is called ‘Reaching Yang’, which indicates its resonance with the stage in the yin-yang cycle where yin turns to yang.
What does the treatment involve?
Initially you will want to visit an acupuncturist. They should ask you some questions, look at your tongue and feel your pulses to determine if there is anything else they need to do as well as, or instead of the moxa treatment. If moxa is right for you, they will usually light one or two moxa sticks and hold them over your little toes for around 20 minutes. Moxa sticks look a bit like cigars and may be made from the dried herb, or may be a charcoal variety which doesn’t produce smoke.
The acupuncturist may teach you or your partner how to continue the treatment yourself, in which case they will show you how to use moxa safely and provide you with some moxa sticks.
The standard course of treatment is 20 minutes each day for 10 days. If, after 10 days, the baby hasn’t turned, you should take a break for 3-5 days before continuing treatment. At this point you might visit the acupuncturist for another session to determine if there are any other imbalances that need treating.
If the baby has obviously turned during the treatment, it is usually best to continue until the end of the 10 day course, but you can reduce the time to 10 minutes per day.
When is the best time to start the treatment?
It’s best to start from 34 weeks. There is less chance of success when starting treatment later, but it is still worth trying even up to week 38 or 39, as babies will sometimes still turn this late. Success at a later stage is more likely for women who have been pregnant at least once before.
What if the baby doesn’t turn?
Sometimes there are other imbalances going on that need treating, but sometimes the baby just won’t turn. There may a physical reason, like the umbilical cord being wrapped around the baby, though this isn’t always the case.
Is there anything else I can do?
Try to avoid sitting in low chairs that place the knees above the pelvis (sofas, car seats etc). Instead, try spending a few minutes on all fours, rocking the pelvis a few times a day.
For breech presentation, some women find positioning themselves with their head lower than their abdomen to be helpful. Perhaps the easiest method is to start on all fours, then gently lower the head and forearms to the ground, so the head rests on the forearms. Try holding this position for about 20 minutes, twice a day. Some women report that the baby becomes less active when using this position though, so try it and see if it works for you.
Considering the aim of moxibustion treatment is to increase yang, it would follow that reducing foods that are very yin (such as fruit, fruit juices, salads and many raw foods) while increasing foods that are more yang (such as cinnamon, ginger and garlic) may be helpful. Don’t completely change your diet though, a tilt in a new direction is enough and it’s easy to overdo changes like this.
If all else fails, External Cephalic Version may be recommended by your midwife or doctor, usually around 37 weeks and may be an option if you’re happy to try that.
I’d like to give it a try. What do I do now?
If you’re near Malvern, Worcestershire, contact us. Otherwise, search for a qualified traditional acupuncturist in your local area. In the UK, use the British Acupuncture Council website to find a practitioner.
- Cardini, F and Weixin, H. (1998) Moxibustion for correction of breech presentation. Journal of the American Medical Association. 280, 1580-1584.
- Cooperative Research Group of Moxibustion Version of Jangxi Province. Further studies on the clinical effects and mechanism of version by moxibustion. Abstracts of the Second National Symposium on Acupuncture, Moxibustion, and Acupuncture Anesthesia; 1984 Aug 7-10; Beijing, China. 1984:150-1.