Acupressure in the Third Trimester

The third trimester brings lower back pain, swollen ankles, disrupted sleep, and the slow approach of labour. Certain acupressure points are genuinely helpful for these complaints — and a small number of points should be avoided entirely during pregnancy. This guide covers both.

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By 28 weeks, most pregnant people are carrying an additional 8–12 kg, with the weight concentrated at the front of the body. This shifts the centre of gravity forward, increases lumbar lordosis, and puts sustained load on the sacroiliac joints and lower back. Simultaneously, the hormone relaxin — which loosens ligaments to prepare the pelvis for delivery — creates joint instability throughout the body, including the ankles and wrists. The result is a predictable cluster of complaints: lower back and hip pain, ankle and hand swelling, wrist pain (pregnancy-associated carpal tunnel syndrome affects roughly 50% of pregnant people), fatigue, and difficulty sleeping.

Acupressure cannot change the biomechanics of late pregnancy, but it can reduce the pain and discomfort associated with them. The evidence base is strongest for PC6 (nausea, though this is less common in the third trimester) and BL67 (labour induction/preparation). Evidence for the other points below is largely traditional and practitioner-consensus, but carries a good safety profile when correctly applied.

In Canada, registered midwives and some registered acupuncturists (RAc) specialize in pregnancy acupressure and acupuncture. Several provinces — including British Columbia, Ontario, and Alberta — have regulated acupuncture professions, which means practitioners must meet training standards and hold liability insurance. If you're uncertain about self-applying any points, a single session with a registered practitioner can show you exactly what and how to apply.

Points to Avoid During Pregnancy

This is the most important section on the page. Several acupressure points are traditionally contraindicated during pregnancy because they have strong descending, uterine-stimulating, or emmenagogue (menstruation-promoting) effects. The evidence that self-applied acupressure at these points actually causes preterm labour is limited, but the precautionary principle applies — there is no reason to stimulate these points in normal third-trimester use, and every reason not to.

Avoid or use only under practitioner guidance near term (before 37–38 weeks):

The points recommended below are well-established as safe in the third trimester. Work gently — your body is already doing a great deal, and you don't need aggressive stimulation.

Safe Points for Third-Trimester Complaints

BL23 / Shenshu — Kidney Shu

Location: On the lower back, 1.5 finger-widths either side of the spine, at the level of the space between the 2nd and 3rd lumbar vertebrae — roughly level with your navel when you trace a horizontal line around to your back.

What it does: BL23 is the primary back-strengthening point and the most commonly used point for lumbar pain in pregnancy. It tonifies the Kidney meridian, which in traditional Chinese medicine governs the low back and supports the growing fetus. Practically, applying moderate sustained pressure here — or using a rolled towel or tennis ball against the wall at this height — relieves lumbar muscle tension and reduces the dull aching that characterises late-pregnancy lower back pain. Press or lean for 60–90 seconds per side. Can be done multiple times daily.

BL40 / Weizhong — Supporting Middle

Location: In the centre of the back of the knee, in the popliteal crease.

What it does: BL40 is the command point for the lower back on the Bladder meridian, which runs down the back of the legs. For sciatic-type pain that radiates from the lower back into the buttocks and down the leg — which becomes very common in the third trimester as the baby's head descends and presses on the sciatic nerve — BL40 provides distal relief without any uterine-stimulating effects. Firm pressure for 45–60 seconds. Use when standing or sitting becomes painful due to leg radiating pain. See also the sciatica guide for additional points.

KD1 / Yongquan — Gushing Spring

Location: On the sole of the foot, in the depression formed when the toes curl, approximately one-third of the way from the base of the toes to the heel.

What it does: KD1 is primarily used for its grounding and calming effects, and for reducing the sensation of heat and heaviness in the lower extremities. For third-trimester ankle and foot swelling, stimulating KD1 along with elevating the feet improves local circulation. It also has a mild sedative effect useful for the sleep disruption of late pregnancy. Use gentle-to-moderate pressure for 60 seconds per foot. Can be applied through a tennis ball on the floor — stand and gently roll the sole over it.

SP9 / Yinlingquan — Yin Mound Spring

Location: On the inner side of the lower leg, just below and behind the head of the tibia (the prominent bone on the inner side of the knee). Find the bone, then slide your thumb just below and behind it into a natural depression.

What it does: SP9 is the primary damp-resolving point — in TCM terms, it drains excess fluid accumulation. For the ankle and lower leg oedema that affects most people in the third trimester, SP9 promotes lymphatic drainage and reduces fluid retention. This is one level above the contraindicated SP6, so ensure you locate it accurately — SP9 is at the knee level, well above the ankle. Moderate pressure, 60 seconds per side. Pair with foot elevation for best results.

PC6 / Neiguan — Inner Gate

Location: Three finger-widths up from the inner wrist crease, between the two central tendons.

What it does: PC6 remains useful in the third trimester for nausea (which returns for some people late in pregnancy as the uterus presses on the stomach) and for the wrist pain associated with pregnancy-related carpal tunnel syndrome. It also has a calming effect on anxiety and palpitations. This is the best-evidenced acupressure point in pregnancy — the Sea-Band wristbands used for morning sickness work by applying sustained pressure to PC6. Safe throughout pregnancy. See the general pregnancy acupressure guide for more on PC6.

HT7 / Shenmen — Spirit Gate

Location: On the inner wrist crease, on the pinky side — at the radial side of the flexor carpi ulnaris tendon.

What it does: HT7 is the primary calming point for anxiety, insomnia, and heart palpitations. Third-trimester sleep disruption is nearly universal, with discomfort, fetal movement, and anxiety about the approaching birth all contributing. HT7 before bed — 60 seconds per side with firm thumb pressure — can reduce the hyperarousal that makes it hard to fall asleep despite exhaustion. Combine with left lateral (side) positioning and a pillow between the knees.

Labour Preparation Points (37+ Weeks Only)

The following points are traditionally used for labour preparation and cervical ripening. They should only be used at or after 37 weeks of pregnancy, and ideally with guidance from your midwife or a registered acupuncturist experienced in obstetric care.

SP6 / Sanyinjiao — Three Yin Intersection

Location: Four finger-widths above the inner ankle bone (medial malleolus), just behind the tibia.

What it does: SP6 is the meeting point of the three leg yin meridians and has a powerful effect on the uterus and cervix. In labour induction protocols, it is applied with sustained firm pressure to stimulate uterine activity and promote cervical softening. After 38 weeks in an uncomplicated pregnancy, SP6 can be used for 2–3 minutes per side. Many midwives in Canada teach this point to patients approaching their due date. If your pregnancy has any complications — placenta previa, high blood pressure, breech presentation — discuss with your care provider before use.

BL67 / Zhiyin — Reaching Yin

Location: On the outer corner of the little toenail.

What it does: BL67 has the strongest evidence for obstetric use of any acupuncture or acupressure point. Multiple trials have demonstrated its effectiveness for correcting breech presentation (typically with moxibustion — a warming technique using burning herbs — rather than pressure alone). It is also used in labour preparation. Pressure at this point is mild in effect; the traditional method uses a moxa stick held close to the point for warmth, performed by a trained practitioner. Worth discussing with your midwife if your baby has not turned by 34–36 weeks.

How to Apply Third-Trimester Acupressure Safely

Positioning: In the third trimester, lying flat on your back for extended periods compresses the inferior vena cava and reduces blood return to the heart. Apply acupressure in a semi-reclined position (45 degrees), on your left side, or seated. If you feel lightheaded at any point, change position immediately.

Pressure: Work at 60–70% of the pressure you'd apply outside pregnancy. Your tissues are softer due to relaxin, and the goal is sustained gentle stimulation rather than deep penetration. If a point is sharply painful, ease off.

Duration: 45–90 seconds per point is sufficient. A full lower-back and swelling session (BL23, BL40, SP9, KD1) takes 10–12 minutes.

Frequency: Once or twice daily for comfort management. More than twice daily is not more effective and is unnecessary.

When to Call Your Midwife or Doctor

Acupressure does not replace obstetric monitoring. Call your care provider immediately if you experience: sudden severe headache, visual changes, or upper right abdominal pain (possible preeclampsia); vaginal bleeding; fluid leaking from the vagina; reduced fetal movement; regular painful contractions before 37 weeks; or any symptom that feels sudden, severe, or different from your baseline. These are not acupressure situations — they are medical situations.

For lower back pain in pregnancy that is significantly limiting your mobility or not responding to conservative measures, physiotherapy (covered by most Canadian extended health plans) and massage therapy are also worth pursuing. Many registered massage therapists in Canada have prenatal training and can apply safe targeted treatment.

Medical disclaimer: This page is for informational purposes only and does not constitute medical advice. Point recommendations are based on traditional use and available evidence. The contraindicated points list reflects traditional practice; individual risk may vary. Always inform your midwife, obstetrician, or GP about any complementary therapies you are using during pregnancy.

See also: General pregnancy acupressure guide · Morning sickness (PC6 guide) · Lower back pain points · Postpartum recovery