Rising caesarean section associated morbidity is of international concern. In NSW, nulliparous women having an induced labour, once past their expected due date, experience higher caesarean (32.7%) compared to nulliparas with spontaneous labour onset (18.5%) [Patterson et al.2011]. This population may benefit from acupressure’s known influence on enhancing uterine activity [Ingram et al 2005]. We assessed the feasibility of conducting a randomised controlled trial of ‘usual care’ compared with ‘usual care plus acupressure’ to stimulate uterine contractions and spontaneous labour. We examined the views of women and health care providers towards implementing a trial within an Australian context.

Method: Following ethical approval, the study was undertaken in Gosford Hospital (ANZCTR:12613000145707). Nulliparous women at gestation 40+5 days, accessing midwifery models of care, were randomised to ‘usual care plus acupressure’ or ‘usual care’ alone. After receiving instruction, acupressure was self-administered by women until onset of spontaneous labour or medically induced labour (7-8 days). Clinical outcomes included onset of labour, and mode of birth. Feasibility assessment included recruitment rate, acceptability, compliance and effect size for a future study.

Results: 62% of women approached agreed to participate. There was no statistically significant difference between women receiving acupressure/usual care and women receiving usual care, in rates of spontaneous onset of labour or vaginal birth. Thirty surveys were returned (68%) with high compliance with the acupressure protocol (89.5%). 

Conclusion: A major limitation was the small sample size (N=63). Acceptability of randomisation to usual care was low. An appropriately powered RCT is planned contingent upon funding.