*3.2.1 How does acupuncture work?*

Acupuncture involves the insertion of fine needles into various parts of the body. The technique is aimed to treat illnesses and alleviate pain by stimulating acupuncture points. Acupuncture points used to relief labor pain are located on the hands, feet, and ears. Acupuncture stimulates nervous system, spinal cord by locking touch fibers and then block pain impulses at the pain gates, and finally help the body to release endorphins [47]. Randomized controlled trials employed found that women randomized to acupuncture had slightly reduced pain scores and decreased use of the pharmacological methods than the control groups [46]. Another randomized controlled trial was conducted on 303 nulliparous women with normal pregnancies revealed that the mean VAS scores were 66.4 in the MA

**Figure 1.** *A TENS unit in use [50].*

group, 68.5 in the EA group, and 69.0 in the SC group. The study also showed that 2 months after birth recollection of labor pain, no significant differences were found among the groups and women's feeling in the EA group reported acupuncture as being effective for labor pain than MA, MA, spent less time in labor, and had less blood loss. Finally, the study revealed that no serious impacts of acupuncture treatment were reported [40].
