Acupuncture for breech babies

I had an enquiry from a new patient who was referred me for acupuncture because her baby was in breech position (bottom/legs first). I haven’t done any acupuncture to attempt to “turn” babies in the third trimester, and I thought I would look into it first. It’s one of those traditional techniques that is mainstream practice in China. In fact, women are instructed to perform self-acupuncture at home! A quick search revealed two systematic reviews, one on acupuncture and one on moxibustion. Moxibustion is an interesting Chinese medical procedure where a herb, mugwort, is burnt (causing a very distinctive, but not unpleasant odor) and the warmth from the burning herb is used to warm the acupuncture point. The herb might be attached directly to the needle (hence the needle is warmed) or a herbal stick is burnt and held close to the acupuncture point. There is only one point that is traditionally used, and this is on the side of the little toe. Noone has been able to explain, from a physiological point of view, why this point in particular is effective. However, some researchers theorise that acupuncture might work by increasing fetal movement, hence encouraging the baby to turn itself. Clever! Both reviews conclude that the evidence so far (a handful of trials, but none of them placebo-controlled) is encouraging, but more research is needed, including research on the safety of acupuncture and moxibustion in late pregnancy. However, given that we know that acupuncture is generally very safe, and the alternative might be a Caesarian section, it is probably worth a try.