What Is Moxibustion and Can It Help Turn a Breech Baby?

Finding out that your baby is in a breech position (feet and/or bottom down) can be stressful. When a baby remains in breech positioning at the end of pregnancy often necessitates a C-section delivery. Breech delivery can occasionally be done vaginally, but in most cases, it's recommended to deliver the baby surgically. That said, there are interventions, such as moxibustion, that can encourage a baby to flip to a head-down position.

Note that while many babies are in breech position around 33 weeks, most of the time, a baby gets into a head-down position (technically called a cephalic presentation) by around 36 weeks gestation. That said, in about 3% to 4% of pregnancies, the baby does not end up head down before delivery.

Doctors often use a technique called external cephalic version (ECV), which is also referred to as a "version," to "turn" a baby by manipulating the expecting parent's abdomen externally with their hands. This is often done around 36 weeks, and according to the American College of Obstetricians and Gynecologists (ACOG), is successful over 50% of the time.

Before that, usually between 33 to 35 weeks, your OB-GYN may recommend trying moxibustion to motivate the baby to flip over on its own. This alternative medicine practice has been shown to increase the odds of babies turning spontaneously. Trying moxibustion has significant advantages over waiting for an ECV as it is less painful and may increase your chances of success. Learn more about using moxibustion to turn a breech baby.

What Is Moxibustion?

Moxibustion is an alternative therapy from traditional Chinese medicine that involves burning the herb mugwort (or moxa) near specific points along a set of invisible, vertical lines that practitioners believe cross the body, known as meridians. These meridians are thought to correspond to specific organs and, when stimulated, can strengthen blood flow and prompt the release of certain hormones. Possibly, this treatment can be used to turn a breech baby as well.

In the U.S., moxibustion is taught as part of the typical curriculum for a degree in acupuncture and only licensed acupuncturists can perform it. Moxibustion can be combined with acupuncture treatment or done on its own with moxa sticks.

Moxibustion for a Breech Baby

Many medical providers routinely refer their pregnant patients for moxibustion to treat breech presentation. "If I were to diagnose a breech presentation early in the third trimester, I would recommend acupuncture and the use of mugwort," says Marsha Granese, M.D., an OB-GYN with Mission Hospital in Mission Viejo, California.

There are several theories as to how moxibustion works. "It is thought that stimulating the last point on the bladder meridian brings movement to the kidney channel and helps the baby to turn," says Tom Ingegno, a licensed acupuncturist and doctor of acupuncture and Chinese medicine (DACM) with a master's in Oriental medicine (MSOM) who practices with Charm City Integrative Health in Baltimore.

"One theory, from a Western medical perspective, is that the heat encourages the release of two specific hormones in pregnancy, placental estrogen and prostaglandins," says Kristen Burris, MSTOM, a licensed acupuncturist with Eagle Acupuncture in Idaho. This can lead to mild uterine contractions, helping the baby to move into an optimal, head-down position for a vaginal birth.

Is Moxibustion Safe?

According to guidelines published in the BJOG: An International Journal of Obstetrics and Gynecology in 2017, "The use of moxibustion for breech presentation at 33 to 35 weeks of gestation, under the guidance of a trained practitioner" may promote spontaneous version and is considered safe.

Dr. Granese has often prescribed moxibustion for breech presentation before 36 weeks. "I would refer the patient to a Chinese medicine provider who knows the acupuncture points and herbs used to relax the uterus," she says. "Mugwort is a natural muscle relaxant."

When moxibustion is performed in a clinical setting, the risks associated with it are minimal. "They're hardly worth mentioning," says Burris. Those risks include nausea from the scent of burning mugwort, and burns and blisters if the ignited herb comes in contact with the skin. "However, in 20 years of practice, none of my patients has ever experienced an inappropriate burn from moxibustion," she adds.

How Moxibustion Is Performed

When moxibustion is combined with acupuncture, the practitioner wraps a small amount of dried mugwort atop a needle that is already in the acupuncture point and lights it. This creates a warming sensation in the skin. A cone of moxa may also be placed directly on the acupuncture point and lit, with the practitioner taking care to extinguish it before it touches the skin. Another form of moxibustion—indirect—involves lighting cigar-sized moxibustion sticks near the points and holding them close until their heat reddens the skin.

At Integrative Acupuncture in Vermont, acupuncturist Kerry Boyle, M.S., L.AC., holds a moxibustion stick above the pregnant person's pinky toe when performing moxibustion for a breech baby. "Connective tissue and nerve channels link this area to the uterus and cause it to relax," says Boyle. "We add acupuncture needles to the ears and feet to further the relaxation of mom."

Moxibustion for a breech baby is usually performed between weeks 33 and 36 of pregnancy and may be prescribed as an alternative or precursor to an ECV. With both moxibustion and a version, the goal is to encourage the baby's movement to a head-first or "vertex" position so that vaginal birth is possible. If both moxibustion and version are unsuccessful, your doctor will likely recommend birth by scheduled C-section.

Moxibustion at Home

Whether or not it's safe to practice moxibustion at home depends on who you ask. The BJOG guidelines recommend moxibustion be performed by a professional. Burris says that although she's aware other practitioners give their patients moxibustion sticks to use at home, her practice advises against it. "Moxibustion only takes a few treatments in the office, and success rates are much higher and safer when performed by a professional," she says.

But Ingegno says moxibustion can be performed at home using sticks, under the training and supervision of a licensed acupuncturist. "The moxa sticks need to be held at a comfortable distance to warm the area and not burn the mother-to-be," says Ingegno. However, burning moxa directly on the point is not an at-home technique and should only be performed in a clinical setting, Ingegno warns.

Moxibustion Success Rate

Moxibustion does not always result in your baby turning but it will likely increase the odds. When combined with in-office treatments and daily moxibustion at home, Ingegno says his practice has seen a 70% success rate with moxibustion for breech babies. "Modern studies confirm that moxibustion does increase the success of the fetus repositioning, but most of these studies are small," he says.

"Factors like how far along the pregnancy is can affect the outcome. The best success seems to occur when we intervene at 34 weeks. However, this leaves about a month and a half before the expected delivery date in which a decent percentage of babies would turn on their own," explains Ingegno.

In other words, the farther out from their due date a baby is, the greater the chance that they will turn on their own without intervention. This is why treatment at 33 to 34 weeks will show greater "success" than after 35 weeks. The closer you get to 36 weeks and beyond, the less likely a baby is able to move to head down position as there is little extra space in the uterus to allow them to turn.

While research on the efficacy of moxibustion is slim, there is some promising data. One 2013 study of 406 pregnant people with confirmed breech presentation showed that the moxibustion group had a significantly higher rate of success than those that had "sham moxibustion" or usual care. In fact, nearly 60% of the moxibustion group turned while the other groups experienced success only about 45% of the time.

The Bottom Line

If your baby is in a breech position, moxibustion can be used to encourage them to get into a better position for vaginal delivery. While success is by no means guaranteed, this alternative medicine therapy can increase the odds that your baby will turn head-down—and reduce the likelihood that you'll need a C-section. Talk to your doctor or midwife about whether or not moxibustion is a good choice for you.