The effect of midwives delivering perineal acupressure on the acupuncture point Conception Vessel 1 (CV1) for birthing women during the pushing phase of labour on birthing outcomes and the incidence of perineal tearing.

Conception Vessel 1 (CV1) is located at the midpoint of the perineum on the perineal body. The perineal body is an attachment point or conduit of interlaced and interdependent perineal muscle fibres, tendons and fascia (the pelvic floor). CV 1 is located by the Midwife with flat finger palpation along the length of the perineum until a nodule or “knot” is felt, or CV1 is visualized as a “dimple” in the centre of the perineal body once the fetal head is on view exerting force upon the pelvic floor. The perineal acupressure on Conception Vessel 1 (PACV) technique involves the Midwife who is trained in acupressure applying continual acupressure to CV1 using the middle or index finger of their dominant hand when the fetal head is visible and low on the perineum. Simultaneously, the Midwife places their non-dominant hand on the baby’s head to apply counter-pressure. PACV1 is a slow and controlled hands-on technique that is integrated into the current birth practice used by Midwives outlined in the Perineal Protection Bundle (Women's Healthcare Australasia 2019). The Midwife continues PACV1 until myofascial release of the transverse perineal muscles is observed resulting in progress with fetal descent, rotation and extension. The maximum duration of time for the application of PACV1 is 20 minutes or 8 contractions. PACV1 is applied by the Midwife with the woman supine, semi recumbent, lateral or in lithotomy position. Data was obtained from the electronic medical records of e-Maternity and Powerchart. Verbal informed consent was obtained from the birthing women in the study that received PACV1 and a waiver of consent was obtained for the data generated from a random sample of women who birthed without PACV1.