This literally is magical when it works.
Generally, success occurs when gestation is around 34–36 weeks, often at the time of the last scan, where the mother will have been told that the baby is breech and offered an External Cephalic Version (ECV) (a fancy way of saying turning the baby while still in the womb.) Earlier treatment is more likely to be successful as the baby is smaller and has more room to turn; however, treatment should not be started too early as the baby can turn back again.
Treatment Method
There is no acupuncture involved. Burning moxa is applied over the little toe at Bladder 67 (BL67) while the mother is reclining at approximately a 45-degree angle. The moxa sticks are held over the little toes for approximately 15–20 minutes. This method requires professional guidance and should not be attempted at home without training. The treatment can be repeated up to 10 times over a 5-day period if the baby has not turned. We have a study below where they try and turn at 32 weeks, however, I find that to be too early as the baby can easily turn back.
Physiology and Mechanism
The physiology behind this treatment is that moxa increases the mother’s prostaglandins, which in turn send signals that slightly elevate the foetal heart rate. This increase in foetal activity may encourage movement sufficient for a full turn. Brici et al. report that stimulation of BL67 by moxibustion is associated with increased foetal movement and cephalic version in women treated between 32 and 35 weeks of gestation (Brici et al., 2019).
Evidence and Outcomes
In the observational study conducted by Brici et al., 62.4% of treated women achieved cephalic version and vaginal birth following moxibustion treatment (Brici et al., 2019). The treatment was accepted by 98.9% of women, and compliance with self-administered moxibustion was 91.4% (Brici et al., 2019). Previous studies reviewed by Brici et al. report success rates ranging between 55–70% for cephalic version following moxibustion at BL67 (Brici et al., 2019). Moxibustion is described as a safe procedure for both the pregnant mother and the foetus, with minimal reported side effects (Brici et al., 2019).
When Moxa Does Not Work
If moxa does not result in a turn, it may be due to mechanical or anatomical limitations.
Brici et al. 2019 note that persistence of breech presentation may be related to factors such as umbilical cord involvement, uterine or pelvic constraints, or other conditions limiting foetal movement (Brici et al., 2019). In these cases, the baby may not be able to turn safely.
Reference
Brici, P., Franconi, G., Scatassa, C., Fabbri, E., & Assirelli, P. (2019). Turning foetal breech presentation at 32–35 weeks of gestational age by acupuncture and moxibustion. Evidence-Based Complementary and Alternative Medicine, 2019, Article ID 8950924.