Please cite this article in press as: Levett KM, et al. Acupuncture and acupressure for pain management in labour and birth: A critical narrative review of current systematic review evidence. Complement Ther Med (2014), http://dx.doi.org/10.1016/j.ctim.2014.03.011 ARTICLE IN PRESS +Model YCTIM-1329; No. of Pages 18 Complementary Therapies in Medicine (2014) xxx, xxx—xxx Available online at www.sciencedirect.com ScienceDirect jo ur nal home p ag e: www.elsevierhealth.com/journals/ctim Acupuncture and acupressure for pain management in labour and birth: A critical narrative review of current systematic review evidence  K.M. Levett a,* , C.A. Smith a , H.G. Dahlen b , A. Bensoussan a a National Institute for Complementary Medicine, University of Western Sydney, Penrith, New South Wales, Australia b School of Nursing and Midwifery, University of Western Sydney, Penrith, New South Wales, Australia KEYWORDS Acupuncture; Acupressure; CAM; Pregnancy and childbirth; Labour and birth; CAM for labour and birth; Systematic reviews; Pragmatic trials; Intervention cascade Summary Background: Reviews of maternity services highlight the need for a reduction of medical inter- ventions for women with low risk pregnancies and births to prevent the potential cascade of interventions and their associated risks. Complementary medicines (CM) such as acupuncture and acupressure have claimed to be effective in reducing interventions in labour; however, systematic reviews of evidence to date are conflicting. Aims: To examine current evidence from systematic reviews on the topic of acupuncture and acupressure for pain management in labour and birth, and to evaluate the methodological and treatment frameworks applied to this evidence. Methods: A search limited to systematic reviews of the MEDLINE, CINAHL, PUBMED, EMBASE and Cochrane databases was performed in December 2013 using the keywords ‘CAM’, ‘alternative medicine’, ‘complementary medicine’, ‘complementary therapies’, ‘traditional medicine’, ‘Chinese Medicine’, ‘Traditional Chinese Medicine’, ‘acupuncture’, ‘acupressure’, cross-referenced with ‘childbirth’, ‘birth’, labo*r’, and ‘delivery’. The quality of the evidence is also evaluated in the context of study design. Results: The RCTs included in these systematic reviews differed in terms of study designs, research questions, treatment protocols and outcome measures, and yielded some conflicting results. It may be inappropriate to include these together in a systematic review, or pooled analysis, of acupuncture for labour with an expectation of an overall conclusion for efficacy. Trials of acupuncture and acupressure in labour show promise, but further studies are required.  Sources of support: Kate Levett is a PhD student supported by an Australian Post-Graduate Award. ∗ Corresponding author at: National Institute for Complementary Medicine, CA: 5.LG.04, University of Western Sydney, Locked Bag 1797, Penrith, New South Wales 2751, Australia. Tel.: +61 2 44620 3284; fax: +61 2 46203291. E-mail addresses: K.Levett@uws.edu.au (K.M. Levett), Caroline.Smith@uws.edu.au (C.A. Smith), H.Dahlen@uws.edu.au (H.G. Dahlen), A.Bensoussan@uws.edu.au (A. Bensoussan). http://dx.doi.org/10.1016/j.ctim.2014.03.011 0965-2299/© 2014 Elsevier Ltd. All rights reserved.