As pregnancy nears its end, most babies spontaneously turn head-down into a cephalic presentation. In about 3–4% of pregnant women, however, the baby remains positioned with their bottom or feet down – this is called a breech presentation.

In many countries (UK, Australia, USA, China), more than 80% of breech babies are born via C-section, which indicates a high level of interest in alternatives if a vaginal birth is not possible or desired.

Although this sometimes doesn’t pose a problem and vaginal breech births are possible, many pregnant women want the baby to turn on its own before delivery. Among the natural and complementary approaches that can help with this, acupuncture and moxibustion are among the best-researched and most frequently used.

Scientific research (Liao et al., 2021; Lee et al., 2012; Schlaeger et al., 2018) shows that a combination of acupuncture and moxibustion can help turn the fetus from a breech to a cephalic presentation. Both methods work by stimulating specific acupuncture points, thereby influencing uterine function, hormonal balance, and fetal movement.

What are acupuncture and moxibustion

Moxibustion and acupuncture are two of the key techniques of Traditional Chinese Medicine (TCM), which have been used for thousands of years to promote energy flow, regulate internal balance, and support natural processes in the body. In recent years, more and more research has also focused on their role in turning a fetus from breech to cephalic presentation, which can affect the course of pregnancy and birth.

Acupuncture is a method of Traditional Chinese Medicine (TCM) in which tiny needles are used to stimulate specific energy points (acupuncture points) on the body. The goal is to balance the flow of Qi energy, release tension, improve circulation, and support balance in the body.

Moxibustion is a related technique that uses heated dried mugwort (moxa) to warm specific points or areas of the body. The heat from the moxa stimulates blood circulation, strengthens yang energy, and deepens the effect of the acupuncture points.

Both methods are often performed simultaneously or complement each other. Acupuncture balances the energy flow, while moxa supports and activates it with heat.

Moxibustion for turning a baby from a breech presentation

Moxibustion is one of the techniques within Traditional Chinese Medicine (TCM) that uses heated mugwort (moxa) to warm specific points or parts of the body. It is a gentle but effective method that stimulates the flow of energy (Qi), circulation, and the body’s natural self-healing processes.

Moxa is usually used:

• indirectly, where the smoldering mugwort stick is not in direct contact with the skin,
• on an acupuncture needle, where the heat travels through the needle,
• or in the form of a “moxa cigar”, where a roll of mugwort is lit and used to warm a specific spot on the body with heat.

The name moxibustion comes from the Japanese word mogusa (herb) and the Latin bustion (burning). This technique originates from the northern parts of China and Mongolia, where long, cold winters encouraged the development of ways to warm the body and maintain a balance between heat and cold in the organism.

How moxibustion works

In Traditional Chinese Medicine, heat plays a key role in strengthening yang energy, promoting the movement of Qi and blood through the meridians, and warming the internal organs. The plant Artemisia vulgaris is most commonly used, as it has distinct warming properties and is also known for its mild antibacterial effects.

The heat from the moxa relaxes muscles, stimulates circulation, and helps the body with its natural self-healing processes. It is often used for:

• pain (especially pain that worsens with cold or humidity),
• digestive issues,
• a weakened immune system,
• menstrual problems and hormonal imbalances,
• and for specific conditions, such as fetal breech presentation during pregnancy.

Key acupuncture point: BL 67

The point BL 67 (Zhi Yin) is located on the outer edge of the pinky toenail.

It is an important point between yin and yang energies, which affects the uterus and promotes the correct position of the fetus. Thermal stimulation of this point with moxibustion increases the release of estrogen and progesterone, which improves uterine tone, stimulates fetal movement, and increases the likelihood of a spontaneous turn to a cephalic presentation.

How moxibustion for turning the fetus is performed

For breech presentation, indirect moxibustion with a moxa stick is most commonly used. The therapy usually proceeds as follows:

• it starts between the 33rd and 36th week of pregnancy,
• it is performed once a day for about 30 minutes,
• recommended for at least 7–10 consecutive days,
• the moxa stick is held 1–2 cm away from point BL 67 on both feet.

Women can perform moxibustion themselves at home (after consulting with an experienced TCM therapist), as the glowing stick does not touch the skin. It is important that the heat remains pleasant – when it gets too hot, move the stick away, then bring it closer again.

Moxibustion for Breech in Pregnancy – YouTube video

Moxibustion For Turning A Breech Baby | Stoke-on-Trent, Staffordshire | Amanda Redford

Effectiveness and safety

Research reports a high success rate for fetal version. In some studies, as many as 80–90% of fetuses turned with moxibustion. Moxibustion and acupuncture are not associated with an increased risk of premature birth or rupture of membranes, but like external version, they have certain contraindications:

• uterine or placental anomalies,
• multiple pregnancy,
• vaginal bleeding,
• ruptured membranes or a short umbilical cord,
• umbilical cord wrapped around the body,
• hypertensive disorders in pregnancy.

Despite everything, more research is needed in this area. At the same time, always contact a qualified professional. In Slovenia, acupuncture can be performed by

Acupuncture as a complementary approach

Acupuncture stimulates biochemical changes in the body that affect the hypothalamus, nerve pathways, and hormonal responses. It increases adrenal cortex activity and prostaglandin balance, which improves uterine tone and stimulates fetal movement.

In addition to point BL 67, the following points are also important for the turn:

• LI 4,
• ST 36,
• SP 6 — together they help tonify Qi and blood, which are often weakened in breech presentation.

Acupuncture can be performed by qualified doctors, acupuncturists, or licensed physiotherapists, with various approaches available (Japanese, Korean, Traditional Chinese, Western).

Sources:

• Dr‑Flis.si – information on moxibustion and traditional Chinese medicine.
• Center TKM – moxibustion and traditional Chinese medicine therapies.
• DAO Traditional Chinese Medicine – description of methods and use of moxibustion.
• Moxibustion: An alternative option for breech presentation, British Journal of Midwifery.
• Methods of external cephalic version for breech presentation. RUL
• Correction of Breech Presentation with Moxibustion and Acupuncture: A Systematic Review and Meta-Analysis, MDPI.
• Effectiveness of Moxibustion for Breech Presentation: A Prospective Study, PubMed.
• Cephalic version by moxibustion for breech presentation, Cochrane Review, PubMed.
• Moxibustion for breech version: a randomized controlled trial, PubMed.
• Combined Complementary and Alternative Therapies for the Management of a Breech Fetus: A Feasibility Study, PubMed.
• EBB 296 – Evidence on Breech Birth with Dr. Rebecca Dekker and Sara Ailshire, MA, Evidence Based Birth®.
• Moxibustion for turning a baby in breech position, Cochrane