Difficult delivery

Also delivery stagnation. Difficulty in giving birth; failure to give birth despite labor pains and aching lumbus and sagging sensation in the smaller abdomen, and despite the breaking of the bag of waters. Distinction is made between qì-blood vacuity on the one hand and qì stagnation and blood stasis on the other.

Biomedical correspondence: Western medicine explains difficult delivery as being due to narrowness of the birth canal, malposition of the fetus, oversized fetus, or premature rupture of the amniotic sac (bag of waters).

See also malposition of the fetus.

Patterns

Dual vacuity of qì and blood (气血两虚 qì xuè liǎng xū) patterns may be attributable to a normally weak constitution and insufficiency of right qì; damage to qì by straining too early in delivery; or lack of fluid and exhaustion of blood due to early breaking of the bag of waters. Signs include somber-white facial complexion, fatigue, limp limbs, heart palpitation, shortness of breath, pale tongue with thin fur, large vacuous or sunken fine weak pulse.

Medicinal therapy: Qì-blood vacuity patterns are treated with Cai Song-Ding’s Difficult Delivery Formula (蔡松汀难产方 cài sōng dīng nán chǎn fāng) or Agreeable Birth-Hastening Powder (催生如意散 cuī shēng rú yì sǎn).

Qì stagnation and blood stasis (气滞血瘀 qì zhì xuè yū) may arise from nervousness and fear of childbirth or idleness during pregnancy, either of which can prevent the normal movement of qì and hamper the flow of blood; it may also result from contraction of cold evil, which causes the blood to congeal and inhibits qì dynamic. Signs include a dark purplish facial complexion, nervousness, distension and oppression in the chest and stomach duct, nausea and vomiting, dark red tongue, normal or thin slimy tongue fur, large stringlike pulse with irregular beats.

Medicinal therapy: Qì stagnation and blood stasis patterns are treated with Birth-Hastening Beverage (催生饮 cuī shēng yǐn).

Acumoxatherapy: Base treatment mainly on SP and LI. Main points: LI-4 (Union Valley, 合谷 hé gǔ), SP-6 (Three Yīn Intersection, 三阴交 sān yīn jiāo), BL-67 (Reaching Yīn, 至阴 zhì yīn), and Solitary Yīn (独阴 dú yīn). These are combined with other points according to vacuity and repletion. For qì-blood vacuity, add ST-36 (Leg Three Lǐ, 足三里 zú sān lǐ) and KI-7 (Recover Flow, 复溜 fù liū), needling with supplementation. For qì stagnation and blood stasis repletion patterns, add LR-3 (Supreme Surge, 太冲 tài chōng) and GB-21 (Shoulder Well, 肩井 jiān jǐng), needling with drainage.