Acupressure during labour — a partner-led guide

Acupressure during labour offers a simple, drug-free tool for the birth partner to support a labouring mother. A handful of well-chosen points — pressed with the thumb, knuckle or elbow at the right moments — can reduce labour pain, regulate contractions, support cervical dilation, encourage descent and calm the mother when fear surges. The technique requires no anatomical training; clear feedback from the labouring woman guides where and how hard to press. This guide explains the most useful points, how to apply pressure, and how to combine them for the common situations that arise during labour. The approach has been popularised in modern midwifery by New Zealand acupuncturist Debra Betts, whose teaching to midwives has made this self-help technique widely accessible.

On this page

1. When and how to use acupressure in labour
2. Key acupressure points
3. When waters break before contractions
4. Before a planned medical induction
5. If the baby is in a posterior position
6. If labour stalls in the second stage
7. Cautions

1. When and how to use acupressure in labour

Acupressure can be used from the very first sign of labour through to delivery. Women who start using the points early — from the onset of regular contractions or even from prelabour symptoms — consistently report the greatest benefit. The technique is at its most effective when the support partner has practised locating the points beforehand and can respond rapidly to the mother’s feedback during contractions.

A few practical principles:

1. This is pressure, not massage. Massaging or rubbing the area can be irritating during labour. Use firm, sustained, focused pressure into a specific point.
2. Use body weight, not thumb joints. Lean in through the arm and shoulder; pushing from the thumb joint alone will exhaust the support partner’s hands quickly. Some couples use the rounded ends of wooden spoons or massage tools for sustained pressure.
3. Let the mother lead. The points are right when she says they feel right. If a point that worked in early labour stops feeling useful, move on to another. Different points suit different stages.
4. Pressure builds with contractions. Apply gentle continuous pressure between contractions, intensifying as a contraction starts and easing as it passes.
5. Acupressure is not a substitute for medical care. If pain relief is inadequate, conventional options (gas and air, pethidine, epidural) are available. If the mother, midwife or doctor decide medical intervention is needed, do not delay it for the sake of a “natural” birth.

2. Key acupressure points for labour

GB 21 (Jianjing) — Shoulder Well

Location. At the highest point of the trapezius muscle, halfway between the prominent bone at the base of the neck (C7) and the tip of the shoulder. You can feel a slightly tender depression at the muscle’s crest.

Technique. The partner stands behind the mother and presses firmly straight down with thumbs, knuckles or the soft pad of the fist, on both shoulders together. Pressure starts gently between contractions and intensifies as each contraction builds.

Use. GB 21 has a strongly descending action in classical Chinese medicine — it directs Qi downward. In labour this supports the natural downward movement of the baby and stimulates contractions. It is one of the most useful points throughout the first and second stages, and is particularly helpful when contractions need more strength.

BL 32 (Ciliao) — Second Bone Hole

Location. Over the second sacral foramen — the small bony depression on either side of the sacrum, roughly one finger’s width below the dimples of Venus visible at the lower back. Run a thumb over the sacrum and you can feel the foramen as a slight give in the bone.

Technique. The mother typically leans forwards over a bed, ball or partner. The support partner places knuckles or thumbs into both foramina and presses firmly. The mother can rock backwards into the pressure during contractions. As labour progresses and the baby descends, the partner moves the pressure progressively down the sacrum, following the mother’s instinctive direction.

Use. This is the single most frequently used acupressure point in active labour. Most women describe a marked anaesthetic effect on contraction pain, which wears off when pressure is released. It works in the bath, on a birth ball, kneeling or leaning — any position where the lower back is accessible.

GB 30 (Huantiao) — Jumping Circle

Location. On the buttock, about two-thirds of the way from the centre of the sacrum out to the tip of the hipbone (greater trochanter), on a horizontal line drawn from the top of the buttock crease.

Technique. With hands resting on the mother’s hips, the partner presses thumbs into the point as the mother rotates her hips during contractions.

Use. Particularly useful in transition, when contractions are at their most intense and the baby is moving deep into the pelvis. It can be used alone or combined with strong sweeping pressure outwards from BL 32 to GB 30 as labour progresses.

Baxie — the hand-crease points

Location. The four small depressions on the back of the hand where the fingers join the palm, between the knuckles of the metacarpal bones.

Technique. The mother holds a small comb in her palm, teeth pressing into the crease line, and grips during contractions. The grip strength is self-regulating — she increases pressure as the contraction peaks.

Use. Stimulating these points is thought to support the release of endorphins, the body’s natural painkillers. The handheld nature of this technique gives the mother direct control without needing the support partner’s involvement, which many find empowering.

KD 1 (Yongquan) — Gushing Spring

Location. In the depression that forms on the sole of the foot when the toes are curled downwards, approximately one-third of the way from the base of the toes to the heel.

Technique. The partner presses strongly into the depression with a knuckle, directing pressure upward toward the big toe. Easy to access when the mother is kneeling forwards.

Use. KD 1 has a powerfully calming effect — in classical TCM it descends rebellious Yang and grounds rising Qi. It is the point of choice when fear, panic or hyperventilation surge in labour, particularly common at transition or in mothers carrying difficult memories of a previous birth. It can also be stimulated walking around if a Sea-Band acupressure wristband is placed over the sole with the plastic stud over the point.

LI 4 (Hegu) — Joining Valley

Location. On the back of the hand, in the muscular web between the thumb and index finger. When the thumb is brought to rest against the base of the middle finger, the point lies at the highest point of the muscle bulge.

Technique. Press firmly with the thumb of the opposite hand — the point produces a clear, dull, achy sensation when located correctly. Several minutes of strong pressure, repeated as needed. An ice cube wrapped in a thin cloth held over the point is an effective alternative.

Use. LI 4 is the master point for pain relief in the body. In labour it regulates and strengthens contractions when they are irregular or weakening, and in the second stage it supports the mother’s pushing efforts when she is becoming tired.

BL 60 (Kunlun) — Kunlun Mountains

Location. In the depression behind the outer ankle bone, between the outer ankle and the Achilles tendon.

Technique. The partner grips the ankle with one hand and presses firmly into the point with the thumb.

Use. Like GB 21, BL 60 has a descending action. It supports the descent of the baby through the birth canal and is widely used in the first stage to maintain forward progress.

SP 6 (Sanyinjiao) — Three Yin Intersection

Location. On the inside of the lower leg, four of the mother’s own finger widths above the inner ankle bone, just behind the back edge of the shin bone.

Technique. Firm pressure with the thumb or index finger for approximately one minute on one leg, then switching to the other leg after 20–30 minutes.

Use. SP 6 supports cervical dilation. It is particularly useful in early labour for women in their first labour or those with a history of slow dilation. Many women report feeling their cervix stretching and contractions strengthening shortly after pressure is applied. Discontinue once labour has clearly established.

3. When waters break before contractions

If the membranes have ruptured but contractions have not begun, acupressure can support the natural onset of labour and reduce the chance of needing medical induction. Combine LI 4 with SP 6 — firm pressure on each for several minutes, at hourly or two-hourly intervals. Use LI 4 on one hand together with SP 6 on the opposite leg, then alternate sides at the next round. Add downward sweeping pressure from BL 32 to the buttocks for five minutes once or twice a day.

Always notify your midwife or doctor immediately if amniotic fluid is brownish or greenish — this needs urgent assessment.

4. Before a planned medical induction

If a medical induction is scheduled, beginning the LI 4 + SP 6 + BL 32 combination three days before the induction can ripen the cervix and increase the chance of a smoother induction with less intervention. Even if labour does not start spontaneously, midwives consistently report that women who have prepared the cervix in advance progress more easily through the induction itself.

5. If the baby is in a posterior position

A posterior baby (back of the baby’s head against the mother’s spine) typically produces severe back pain in labour and slower progress. The points below can encourage the baby to rotate into the more favourable anterior position. If the points are going to work, you will usually see a noticeable improvement in contraction strength and a reduction in back pain within ten minutes.

BL 60 + SP 6

Press BL 60 for up to two minutes, then SP 6 for up to two minutes, ideally on both legs so that all four points are used in sequence.

BL 67 (Zhiyin) — Reaching Yin

This is the small point at the outer corner of the little toenail. It is best stimulated with press-tack needles or a small ear-seed plaster that an acupuncturist can supply in advance of labour. If using finger pressure or the blunt end of a ballpoint pen, sustained pressure for up to five minutes is the typical protocol. BL 67 has long been the principal point in both moxibustion for breech presentation in late pregnancy and in stimulating fetal repositioning in labour.

6. If labour stalls in the second stage

If the cervix is fully dilated but the mother is struggling to push the baby down through the birth canal, firm acupressure to GB 21 and LI 4 for 5–10 minutes often restores effective pushing. Both points have a strongly descending action that supports the second-stage effort.

If the baby is in an anterior position but labour is not progressing efficiently in active first stage, SP 6 combined with LI 4 (one on each side, alternating) encourages stronger, more coordinated contractions and continued cervical dilation.

7. Cautions

The points described above — particularly LI 4, SP 6, BL 60 and BL 32 — have a downward-moving, channel-opening effect. They should not be used with strong sustained pressure during pregnancy before labour has begun (with the specific exception of the planned-induction protocol described above, and only on direct recommendation of a midwife or doctor). During established labour they are entirely appropriate.

Acupressure is a tool to support a natural labour, not a substitute for skilled clinical care. If pain relief is inadequate, conventional options are available and should not be refused for the sake of a particular birth ideal. Equally, not all labours unfold as planned — medical intervention plays an important role in a meaningful proportion of births, and the wise birth partner is one who can use acupressure when it is helpful and step aside cleanly when conventional care is needed.

About this guide

I am Dr (TCM) Attilio D’Alberto, a member of the British Acupuncture Council and the Register of Chinese Herbal Medicine, with over 25 years of clinical experience. I treat fertility, pregnancy and labour-related conditions at my clinic in Wokingham, Berkshire. See acupuncture for labour induction and prebirth acupuncture for the clinical equivalent of the acupressure work described here. The labour acupressure protocols outlined above draw on the modern teaching tradition established by Debra Betts, whose work has brought these techniques into widespread midwifery use.