Unfortunately at this time there are no notable studies looking at the effect of acupuncture on anxiety disorders specifically either during or after pregnancy. This lack of studies (compared to the number of depression studies) mirrors the findings of a systematic review from 2017 about conventional treatments for mental disorders in pregnancy: “Most reviews and treatments for antepartum mental disorders (during pregnancy) focused on depression, while a broader range of mental disorders is prevalent during pregnancy and psychiatric symptoms may overlap” (14).

We do, however, have some studies to look at regarding acupuncture for anxiety in the general population. Although most of these studies investigate acupuncture for situational anxiety (such as before dental procedures), in my search I was able to identify one Systematic Review and Meta Analysis that focused solely on RCT’s for Generalized Anxiety Disorder (GAD) which seems it would be more applicable to anxiety during pregnancy (Yang et al. 2021) (13). Results of this SR and meta analysis suggest that acupuncture has a statistically significant benefit over control group treatments as well as that it is a safe and well-tolerated treatment. It is possible the results of these studies can be generalized to pregnant or postpartum patients with GAD; more studies are needed to confirm.

The review by Yang et al. looked at 20 RCT’s of 1823 patients. Two studies used electroacupuncture and 18 used manual acupuncture. Control groups were either medication (16 studies), ear seeds or acupressure (3 studies) or sham acupressure (1 study). All participants were diagnosed with GAD via DSM or CCMD-3 (Chinese Classification) criteria, and outcomes were based on a clinician-guided assessment (HAMA) in 15 studies and self- assessment (SAS or PHQ-7) in 5 studies. 

There was significant heterogeneity between studies, therefore the researchers performed subgroup analyses. 

In the first subgroup analysis, they looked at the differences between outcomes when participants were assessed by a clinician vs. self-assessment. Although both groups experienced greater benefit from acupuncture treatment (which was statistically significant), there was a larger benefit from those who rated improvement via self-assessment. The authors suggest that the effects for these participants may be overestimated and recommend that in future studies, clinician rated assessments should be used. 

In the second subgroup analysis, researchers compared those having acupuncture for more than 6 weeks or less than 6 weeks. Again, both groups of participants experienced a reduction in anxiety symptoms, but the group which had acupuncture for less than 6 weeks experienced greater benefit. The researchers suggested the possibility that since medications generally take at least 6 weeks to confer benefit, acupuncture may be used to improve symptoms more quickly and to “improve the first 6 weeks of the course of treatment”. After 6 weeks, there was no difference between acupuncture and medication groups. 

We must keep in mind that all studies from this SR took place in China, which may limit the generalizability of these results to other countries and cultures where acupuncture treatment is not as familiar. Any side effects of acupuncture treatment were mild and self-limiting, for example pain or bruising at the needling site, feeling faint or bleeding. For all studies, the dropout rate for the acupuncture group was less than 20%, similar to the control groups. Acupuncture was shown to be safe and a tolerable intervention method.