Acupressure Points for Labour: A Practical Self-Help Guide

By Dr (TCM) Attilio D'Alberto | Traditional Chinese Medicine Practitioner, Wokingham

Acupressure — the application of firm manual pressure to specific acupuncture points — is one of the most practical tools available to women during labour. Unlike acupuncture needles, acupressure requires no equipment and no practitioner: a partner, birth companion, or the woman herself can apply it throughout labour to reduce pain, support contractions, encourage fetal descent, and ease specific discomforts as they arise. It is safe, non-invasive, completely compatible with other pain relief methods (including epidural, gas and air, and pethidine), and can be learned in a short time from this guide.

Traditional Chinese medicine has used specific points for labour support for thousands of years. Modern research has validated several of these points — particularly SP 6, LI 4, BL 32, and BL 67 — in randomised controlled trials demonstrating reduced labour pain, shorter labour duration, and improved maternal satisfaction. This guide provides clear, practical instructions for each key point.

On this page

1. How to apply acupressure
2. SP 6 — Three Yin Intersection
3. LI 4 — Union Valley
4. BL 32 — Second Crevice
5. BL 60 — Kunlun Mountain
6. KD 1 — Bubbling Spring
7. GB 21 — Shoulder Well
8. BL 67 — Reaching Yin
9. Ren 1 and the perineum
10. Using acupressure throughout labour
11. Cautions and contraindications
12. My Pregnancy Guide
13. References

1. How to apply acupressure

Acupressure is applied using the thumb pad (or two or three finger pads for larger areas), pressing firmly and perpendicularly into the skin over the acupuncture point. The pressure should be substantial — the woman should feel a strong sensation of pressure, dull aching, or warmth at the point. Too light a touch activates the skin's touch receptors without reaching the deeper mechanoreceptors that underlie the acupressure effect.

The standard approach during labour is:

• Apply sustained pressure for 60–90 seconds, then release for 30 seconds, then reapply — timed to coordinate with contractions
• During a contraction: apply firm pressure at the chosen point as the contraction builds, maintain through the peak, release as it subsides
• Between contractions: lighter maintenance pressure or rest
• Thumbs quickly tire — use a firm tennis ball or purpose-made acupressure tool for BL 32 (sacral) pressure
• Move between points as needed — no single point should be used exclusively throughout labour

Points on both sides of the body (paired points) can be stimulated simultaneously by two attendants, or alternated if only one helper is available. Communication between the woman and her partner is essential — she should guide the pressure intensity.

2. SP 6 — Three Yin Intersection (Sanyinjiao)

Location: Three finger-widths (cun) above the tip of the medial malleolus (inner ankle bone), on the posterior border of the tibia (shin bone). The point is just behind the bone — pressing on the bone itself does not activate it. Find the inner ankle, measure three finger-widths directly upward, then move slightly toward the back of the shin. Press firmly inward and slightly upward.

Actions in labour: Promotes and strengthens uterine contractions, reduces labour pain, encourages descent of the baby, calms the mind. One of the most powerful acupressure points in the TCM pharmacopoeia for reproductive and gynaecological conditions.

Evidence: Multiple randomised controlled trials have demonstrated that SP 6 acupressure significantly reduces self-reported labour pain scores and reduces the duration of the active phase of labour compared to controls.

How to use: Applied by a partner pressing with both thumbs on SP 6 bilaterally (both ankles simultaneously) during contractions. The seated or side-lying position gives the partner easy access. This point is often most effective in the active phase when contractions are established.

Caution: SP 6 is strongly labour-stimulating and must NOT be used before 37 weeks of pregnancy.

3. LI 4 — Union Valley (Hegu)

Location: In the webbing between the thumb and index finger of the hand. The highest point of the muscle when thumb and forefinger are pressed together — or the midpoint of the second metacarpal bone on the radial side. Press diagonally toward the index finger.

Actions in labour: Descends Qi (promotes downward movement), powerful analgesic effect (one of the most studied pain-relief points in acupuncture), stimulates oxytocin release, reduces anxiety and promotes calm.

Evidence: LI 4 is one of the most extensively researched acupressure and acupuncture points for pain relief, with mechanisms including stimulation of endogenous opioid release (endorphins and enkephalins) and activation of the descending inhibitory pain pathway. Labour studies show significant reduction in pain scores with LI 4 stimulation compared to controls.

How to use: A partner pinches the webbing between thumb and index finger firmly, angling the pressure diagonally toward the index finger. Can also be self-applied in positions where the hands are free. Apply during contractions; the analgesic effect builds with sustained stimulation.

Caution: LI 4 is strongly labour-stimulating and must NOT be used before 37 weeks of pregnancy. In early pregnancy, firm LI 4 stimulation should be avoided entirely.

4. BL 32 — Second Crevice (Ciliao)

Location: In the second sacral foramen — the small bony dimples palpable on either side of the lower sacrum (the flat triangular bone at the base of the spine). There are four pairs of sacral foramina; BL 32 is the second pair down, approximately 1.5 cun lateral to the midline and 1.5 cun below the posterior superior iliac spine (the bony protrusion at the back of the pelvis). Press firmly inward and slightly downward.

Actions in labour: Directly stimulates the sacral nerve roots that supply the uterus and cervix — the same nerves targeted by epidural anaesthesia. Reduces lower back pain and sacral pain (extremely common in labour, particularly with a posterior baby), promotes cervical dilation, and supports pelvic floor relaxation.

Evidence: BL 32 is widely used in hospital midwifery acupuncture protocols specifically for back labour and is considered the most important point for sacral pain relief during contractions.

How to use: A partner presses firmly with both thumbs (or a tennis ball held against the sacrum) directly into the foramina during contractions. The woman can guide her partner to exactly the right spot — when the correct point is found, there is often an immediate sensation of pressure-relief and relaxation in the lower back. Counter-pressure applied simultaneously to the lower back (the iliac crests) enhances the effect.

5. BL 60 — Kunlun Mountain (Kunlun)

Location: In the depression between the lateral malleolus (outer ankle bone) and the Achilles tendon. Press firmly inward.

Actions in labour: Descends Qi and encourages fetal descent into the pelvis; reduces pain and swelling in the lower limbs; supports the downward-moving energy needed in the final stages of labour. Particularly useful when labour stalls or when fetal descent is slow.

Caution: BL 60 is contraindicated in pregnancy before 37 weeks and should be used with care in women with heavy bleeding.

6. KD 1 — Bubbling Spring (Yongquan)

Location: On the sole of the foot, in the depression formed when the toes are plantar-flexed (curled downward), approximately at the junction of the anterior third and posterior two-thirds of the foot, between the 2nd and 3rd toes.

Actions in labour: Grounds energy, calms the mind, reduces anxiety and panic. In TCM terms, KD 1 draws excess energy downward (away from the anxious, overthinking mind) and roots the spirit. Very useful during transition (the most intense phase of labour) when anxiety, disorientation, or a feeling of loss of control is most acute.

How to use: Firm pressure with a thumb or fingers, or the woman can press her own soles against a hard surface. Also effective for headaches and hypertension during labour.

7. GB 21 — Shoulder Well (Jianjing)

Location: On the top of the shoulder, at the midpoint of the line connecting the base of the neck (C7 spinous process) to the tip of the acromion (the bony point of the shoulder). Press firmly downward.

Actions in labour: Descends Qi strongly — promotes the downward energy of labour and fetal descent. Also relieves shoulder and neck tension (very common in labour as women brace and tense). Used to encourage contractions when they have stalled or weakened.

Caution: GB 21 is strongly descending in action and is contraindicated in all trimesters of pregnancy before 37 weeks. At term and in labour it is appropriate.

8. BL 67 — Reaching Yin (Zhiyin)

Location: On the lateral corner of the little toenail of each foot.

Actions in labour: The classical moxibustion point for turning a breech baby when used antenatally. In labour, it promotes fetal activity and engagement and supports the overall movement of the baby through the birth canal. Stimulation with a thumbnail on BL 67 can be applied during contractions when descent is slow.

9. Ren 1 and the perineum

Location: Ren 1 (Huiyin) is located on the perineum, in the midpoint between the anus and the vaginal opening.

Actions: Perineal massage — applying warm oil (sweet almond oil or coconut oil) and gently stretching the perineal tissues from 34–35 weeks — reduces the risk of perineal tearing and the need for episiotomy. This is not strictly an acupressure technique but is related to the TCM concept of preparing the soft tissues of the lower body for birth. Perineal massage for five minutes daily from 34 weeks has good evidence for reducing perineal trauma, particularly in women who have not given birth vaginally before.

10. Using acupressure throughout labour

A practical guide to using acupressure across the phases of labour:

Early labour (latent phase — contractions irregular, cervix dilating to 4 cm): Light preparation work — LI 4 and SP 6 to support the onset and establishment of contractions. Encourage movement, upright positions, warm bath or shower.

Active labour (contractions regular, 3–4 minutes apart, cervix dilating 4–10 cm): BL 32 for sacral pain, SP 6 and LI 4 during contractions for pain relief and contraction support. Change points regularly as sensitivity varies. KD 1 if anxiety is high.

Transition (approaching full dilation — most intense contractions): All pain relief points — BL 32, LI 4, SP 6. KD 1 for grounding and calming. Short, intense contractions need immediate acupressure response at onset.

Second stage (pushing): Pressure on sacrum (BL 32) with counter-pressure on iliac crests. Encourage the woman to focus downward and forward. BL 60 supports descent.

Third stage (placenta delivery): SP 6 and LI 4 may continue to support uterine contractions for placental expulsion and reduction of postpartum haemorrhage.

11. Cautions and contraindications

• All points described as labour-stimulating (SP 6, LI 4, BL 32, BL 60, GB 21) must NOT be used before 37 weeks of pregnancy
• In the case of placenta praevia, unexplained vaginal bleeding, or other obstetric complications, consult your midwife or obstetrician before using any self-help techniques
• Acupressure is complementary to midwifery and medical care — it does not replace monitoring of maternal and fetal wellbeing
• If the woman's labour becomes complicated or deviates from normal progress, focus should shift to working with the medical team rather than continuing acupressure independently

12. My Pregnancy Guide

13. References

• Lee MK, et al. Effects of SP6 acupressure on labour pain and delivery time in women in active labour. J Altern Complement Med. 2004;10(6):959–965.
• Hjelmstedt A, et al. Acupressure to reduce labour pain: a randomised controlled trial. Acta Obstet Gynecol Scand. 2010;89(11):1453–1459.
• Tournaire M, Theau-Yonneau A. Complementary and alternative approaches to pain relief during labor. Evid Based Complement Alternat Med. 2007;4(4):409–417.
• Beckmann MM, Stock OM. Antenatal perineal massage for reducing perineal trauma. Cochrane Database Syst Rev. 2013;(4):CD005123.