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MindBody Research: Acupressure on LI4 Provides Comfort and Decreases Time of Active Labor

Originally posted March 5, 2014.

In 2012, Ahmad Khosravi, Msc, and his colleagues at the Shahroud University of Medical Sciences in Iran conducted a research study to see

if using Large Intestine 4 in labor actually helped provide comfort and shortened the duration of labor time. Using acupressure to relieve pain is inexpensive and has no side effects and may be a way to help women in areas that are underserved by modern hospital care.

In Traditional Chinese Medicine (TCM), acupressure is known to balance the human body’s qi, or energy, or vital force by applying pressure on the 12 meridians (12 energy lines) of the body. Each meridian influences emotional and physical aspects associated with it. Individual acupressure points are located along the 12 meridians.

Large Intestine 4 (LI4) is an acupressure point located bilaterally on the back of the hand, in the webbing between the thumb and forefinger, pressing up under the bone towards the index finger. LI4 is also known as Hoku, or Joining of the Valley.

Activating LI4 is said to promote descending qi. It’s used to relieve pain, to help promote let down when nursing, to promote childbirth by stimulating the uterus.

The study used a small sample size of 100 women, 50 in the acupressure group and 50 in the control group. The inclusion criteria was 1) first to third pregnancy; 2) no addiction to drugs; 3) reading and writing literacy; 4) greater than or equal to 37 weeks’ gestation; 5) natural pregnancy with a single fetus in the vertex presentation and anterior position; 6) spontaneous onset of labor pain and cervical dilatation of 3 to 5 cm; 7) age 20 to 40 years; 8) not having the experience of acupressure; 9) no damage, bruises, sensitivity, or irritation at the LI4 acupressure point; and 10) not having a prior cesarean birth. In this study, potential confounding factors were controlled for via randomizing techniques.

The pattern of acupressure was as follows: bilateral pressure on LI4 during each contraction for a duration of 10 seconds with 2 seconds of rest over a 20 minute period. Pain intensity was measured before and after the intervention, 20 and 60 minutes, every 60 minutes until the onset of the second stage of labor, and then once after the second stage of labor commenced and also 24 hours after birth. The people doing the acupressure had been trained in an introductory course in acupressure.

Perception of pain was significantly different for the acupressure group than the control group. As dilation increased, so did the intensity of pain for both groups, but the pain levels were less intense in the acupressure group than in the control group and the effects lasted about 120 minutes after the acupressure intervention. .

The duration of the active phase of labor was significantly shorter in the acupressure group than the control group (2.44 hours versus 3.90 hours) as was the duration of the second stage of labor (21% of the acupressure group had second stage labor over 30 minutes whereas 45% of the control group had second stage labor over 30 minutes).

Women also expressed greater satisfaction with their childbirth experience.

This study showed, for this small sample size, that using LI4 reduced pain, decreased duration of labor and increased satisfaction for women in childbirth.

Want a simple guide to relaxation and family bonding in pregnancy and increased comfort in childbirth using shiatsu and acupressure in the childbearing year?

I’ve written an easy-to-read guide to a simple shiatsu routine for comfort in pregnancy & labor and a simple acupressure routine to induce birthing.



Hamidzadeh, A., Shahpourian, F., Orak, R.J., Montazeri, A.S., Khosravi, A. (2012). Effects of LI4 acupressure on labor pain in the first stage of labor. Journal of Midwifery & Women’s Health, 57(2), 133-138.


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