My son was born after an 84 hour labor in which I dilated to only 5cm. I asked for a c-section. The anxiety from my pregnancy turned to despondency postpartum. I’m not sure if I reached a turning point because of this or if a turning point gave me the energy to ask the powerful question: what if I had been my own doctor?

My TCM training had left me confused throughout my pregnancy. When I looked at myself I saw patterns stacked on patterns and nothing fit quite right. I looked up my notes from my 6 week gynecology class in acupuncture school and found the single class on pregnancy. My notes read: “Do not treat pregnant women without specialty training. Do not use points SP 6, LI 4, UB 60, UB 67, back points, abdominal points, or GB 21.”

So I sought out specialty training. I studied with Sharon Weizenbaum and learned that none of my TCM patterns made sense because we were never even taught about the uterus. How the Ren Mai creates the Bao Mai under the influence of the Heart and Kidney, and the Bao Tai is the complex of the uterus and the fetus. That the fetal qi is hot, and that heat isn’t necessarily pathological. I became aware of a whole universe of women’s physiology that was glossed over in my 6 week course, that I never would have found unless I looked.

I started reading the classics. I read and committed to memory chapters 20 through 22 of the Jin Gui Yao Lue from the 2nd century, where already physicians were advised to give detailed diagnoses for women’s issues, with whole chapters dedicated to pregnancy and postpartum. I read Sun Simiao from the 7th century and marveled at the richness of diagnosis and treatment for menstruation and leukorrhea. I read Qi Zhongfu, translated by Sabine Wilms, from the 12th century, and noted the cultural veneration of the menstrual cycle at a time when in Europe it was considered a curse. I read Fu Qing Zhu from the 17th century and found my diagnosis.

Fu Qing Zhu described a pattern in pregnancy characterized by lateral costal pain, a wiry pulse, and the sense that the baby has moved up so high it is sitting under the ribs. It includes liver qi stagnation as a starting point, which prevents liver blood from assisting kidney water in nourishing the Bao Tai. It described the pain in my ribs, the anxiety, the sense that my baby was up way higher in my body than seemed possible, why it was so difficult to breathe. The treatment -- open the flow of liver qi, supplement dried liver blood -- would have shifted that sensation I was experiencing at 20 weeks. It also would have likely staved off the kidney infection that went untreated at the end of my pregnancy, which prevented me from having the uterine contractions needed to dilate and birth my baby. The formula was Jie Yu Tang.

All of my symptoms slipped through the cracks in obstetrics, midwifery, and TCM. They were common symptoms of pregnancy, something to endure. Fu Qing Zhu didn’t write them off in his Nu Ke. He explained them with clear logic, and described exactly where they would lead if left untreated. He was right. And his reasoning was clear enough that I could replicate it in my own patients.

When I read this section in Fu Qing Zhu’s Nu Ke, I felt like I had the key. If I had known about pregnancy physiology I could have easily interpreted the pattern. The liver qi stagnation, the spleen deficiency, the blood deficiency -- I could see it all before, but understanding how liver blood and kidney water needed to work together to nourish the fetus would have given me the tools to treat myself. It also would have stopped the progression of pathology to my kidneys, which were so taxed because they were entirely responsible for nourishing my, thankfully, very nourished son.

I should have been my own doctor way before the midwife told me not to be. I needed this knowledge, written by a physician from the 1600s, when I was 20 weeks pregnant. It was immediate -- I knew my practice needed to shift to focus on pregnancy and women’s health.

I would never let a woman with Suspended Fetus go untreated again. It is a pattern marked by what is so often dismissed as common pregnancy symptoms, not worth treating.

I started a new clinic inside a practice that specializes in services and education for pregnant women, Amazing Births and Beyond, run by Dr. Vivian Keeler, a doula, pregnancy chiropractor, and head of HypnoBirthing International. In no time, about a third of my patients were pregnant people who were having supported, comfortable pregnancies and wonderful births. I continue to canvas the classics of Chinese medicine gynecology and will continue to do so, because there are thousands of years of thoughtful ideas preserved in this lineage. Reading descriptions of different patterns often points me to the correct treatment for a current tricky patient. After years of listening to and experiencing positive birth stories, my husband and I found the courage to rewrite our birthing story too. My pregnancy with my daughter was easy compared to my first, and the birth was the most empowering experience of my life.

Insufficient milk supply is distressing in a way that is hard to overstate. So I went looking for what the current research actually says about acupuncture and lactation, and it turns out there is a lot of it.

What the research says

A comprehensive NIH review summarized 42 studies on acupuncture and related therapies, including electroacupuncture, tui na, massage, and auricular acupuncture, for lactation support. The findings are striking: acupuncture consistently improved milk volume, serum prolactin levels, infant weight gain, and duration of exclusive breastfeeding. In head-to-head comparisons with drugs used to increase milk supply, such as metoclopramide and domperidone, acupuncture often performed as well or better, without the side effect of medication passing into the milk and causing gas in the infant.

The research also confirmed something classical Chinese medicine has known for centuries: SI-1, a point on the tip of the pinky finger, significantly increases milk volume. This always fascinated me, because the small intestine channel does not run through the chest, yet SI-1 outperformed LI-1, the analogous point on the index finger, in head-to-head trials. Traditional knowledge and modern research aligning is always satisfying to see. Points on the sternum, particularly CV-17, also have strong evidence for stimulating milk production when needled or used for acupressure. I have made a short video demonstrating these acupressure points if you would like to try them at home. [link your video here]

For painful breastfeeding, including engorgement, mastitis, breast abscess, fever, and tender nipples, acupuncture also shows real benefit. A meta-analysis found that women with engorgement who received 2–3 acupuncture points to improve milk flow were less likely to develop an abscess, had less severe symptoms, and had lower rates of fever than the standard care group. Auricular therapy can also raise the pain threshold, making engorgement significantly more bearable.

A Chinese medicine perspective on postpartum and lactation

Chapter 21 of the Jin Gui Yao Lue, Zhang Zhongjing’s classical postpartum chapter, opens by establishing the foundational reality of the postpartum body: qi, blood, essence, yin, and yang are all depleted. This is not a single deficiency pattern to be addressed with a single formula. It is a state of global exhaustion from which everything in the postpartum period must be understood. Growing a child consumes essence. Labor expends qi and spills blood. What remains is a body that must simultaneously recover, produce milk, and regulate an enormous hormonal transition, often on two hours of sleep at a stretch.

Breast milk, in classical thought, is not a separate substance the body manufactures independently. After birth, the Chong vessel, the sea of blood, undergoes a profound redirection. Rather than nourishing the uterus and supporting the fetus, it redirects upward through the breast. Stomach qi, traveling along the channel that runs directly through the breast tissue, provides the transforming force. Milk is essentially blood and qi, redirected and transformed. This is why breastfeeding can feel so depleting, because it is, and why supporting the postpartum body with food, rest, herbs, and acupuncture is not optional self-care but physiological necessity.

My diagnostic approach follows from this framework. Insufficient milk supply can stem from several root causes: severe blood deficiency leaving nothing to transform, heat or dryness in the Stomach disrupting the transforming function, or blood stasis from incomplete clearing of the lochia blocking the flow. Without identifying which pattern is operating, through tongue, pulse, and symptom presentation, treatment is guesswork. The right formula for one woman may be entirely wrong for another presenting with the same chief complaint. Evidence supports a short, concentrated course of treatment: 2–7 sessions over two weeks. First-time mothers tend to respond faster and need fewer treatments overall.

A patient story: when more is not more

A new mother came to see me around two to three weeks postpartum. Her baby seemed constantly hungry, so she had been drinking a lactation support tea containing goat’s rue, blessed thistle, and fenugreek, by the pitcher, daily, because she assumed more was better. Her breasts were engorged, hard, and trending toward mastitis.

What was actually happening: constant feeding at that age is not a supply problem. It is simply what two-to-four-week-old babies do. The herbs were driving her supply far beyond what her baby could consume, and the milk had nowhere to go.

The point selection in this case reflects a different clinical goal than increasing supply. SI-11, on the scapula, is a local point directly indicated for breast distension and pain, and its job here was to move stagnation and relieve pressure in the tissue itself. The Stomach points address the channel: descending Stomach qi draws milk downward and away from the breast, relieving the upward accumulation driving the engorgement. ST-36 has the added value of being especially appropriate for new mothers, who are almost universally contending with the multiple simultaneous deficiencies Zhang Zhongjing describes. LV-4, the jing-river point of the Liver channel, courses and frees the channels, and the Liver channel runs directly through the breast, making it essential any time there is stagnation or obstruction in that region.

By the end of the session her breasts had visibly softened. She stopped the herbs, continued feeding on demand, and nursed her baby for the next year without further issues.

This is the pattern I see more often than insufficient supply: an oversupply driven by well-intentioned supplementation, colliding with a baby whose hunger cues are being misread. The lactation supplement industry has a financial interest in making every new mother feel her supply is inadequate. It often is not. Sometimes the most important intervention is stopping something, and understanding what the body is actually doing.

Acupuncture works alongside lactation support, not instead of it

There is no amount of acupuncture that will establish milk supply without suction and proper latch. Breastfeeding education and hands-on support from a lactation consultant are essential, especially in the early weeks when milk flow is being established. Timing of feeds, pump schedules, positioning, these matter enormously and are not things acupuncture addresses.

If you are in the Miami area and need same-day lactation support, Amazing Births and Beyond (786-955-6560) has lactation consultants available. My office is located inside theirs in North Miami Beach, and the two approaches work beautifully together.

What a postpartum visit looks like at The Spot

I see postpartum patients with a few specific things in mind. Every treatment includes space for an extra caregiver, and the ability to feed your baby during or after the session if needed. I know that what many postpartum women most need is 45 minutes of genuine quiet and stillness, and that is built into every treatment alongside the clinical work. I am currently seeing clients three days a week while I am in my own postpartum recovery. Space is limited. If you have questions about acupuncture for breastfeeding support, low milk supply, engorgement, or mastitis in the Miami area, reach out directly: cocojonquil@gmail.com or text 786-660-3389.

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I remember her leaning in close to speak conspiratorially though there was nobody else in the room. She said “I have pain during sex. It feels like glass shards in my vagina whenever my husband is inside me. It has ruined my life.” Genevive had a history of fibroids that ultimately was resolved with a total hysterectomy. The removal of the uterus and the ovaries induced menopause, which was accompanied by many menopausal symptoms, such as hot flushes, insomnia, urinary incontinence, weight gain, vaginal dryness and terrible pain during sex. Her hormone replacement therapy reduced most of the symptoms to manageable, but the pain during sex made sex so painful that she could no longer have sex with her husband. After seeing doctors, sex therapists, and a pelvic floor specialist, she and her husband decided that they wouldn’t be having sex anymore, and they ended up getting a divorce. Happily, they remarried- and committed to a companionate and spiritual love.

Dyspareunia is the medical term for pain during intercourse, and it can be caused by many different conditions. It often occurs during menopause and is associated with vulvovaginal atrophy or vaginal dryness. It can also occur after pelvic infections, fibroid, endometriosis, physical trauma from surgeries (hysterectomy or c-section) or vaginal birth, and psychological trauma from sexual abuse. In Genevive’s case, she had a history of fibroids, hysterectomy and surgically induced menopause. People often don’t discuss sexual disorders with their doctors (and doctors don’t ask) because they assume it is “a normal part of getting older” or “it is embarrassing”, which is a shame because losing sex can be devastating. Depending on the etiology and the severity there are many treatment options, including hormonal and non-hormonal treatments, pelvic floor therapy, laser therapy (potentially promising treatment, but can result in further scarring and can exacerbate the issue), cognitive behavioral therapy, and acupuncture and herbal medicine.

Looking at her tongue, I could see a deep purple color on the back of the tongue, indicating there was a lot of “blood stagnation”. I took her pulses as well, and the character was choppy, giving further support to my blood stagnation pattern theory. It indicated to me that there was a lot of scar tissue and adhesions left after the surgery, which could interfere with the functioning of the pelvic floor and the muscles and nerves in the vagina. While I assumed some vaginal atrophy due to menopause and the lack of sexual stimulation over the past few years (which in Chinese Medicine often is a kidney yin/yang deficiency), the majority of my treatment was to work on this apparent blood stagnation pattern.

We did a session a day for the remaining 6 days of the cruise. I used acupoints on Liver, kidney, ren and chong meridians, which traverse the genitals and are often used for moving blood stagnation and enriching yin fluids. I used electroacupuncture on points on her low abdomen and inner thighs and a heat lamp on her lower abdomen. After the first session, she reported that a feeling of warmth replaced a cold sensation that she didn’t know had existed in her lower abdomen and vagina. After the 3rd session, she and her husband had sex with lubrication and there was none of the “stabbing glass like” pain she had previously experienced. After the 5th session, she reported that she and her husband felt “like teenagers” and that she was achieving orgasms! She was sore after sex, but there was no stabbing pain. She also reported that she wasn’t waking to urinate at night and that she was experiencing better sleep and fewer menopausal symptoms in general. After many months, Genevive found me online to report that there was no recurrence and her sex life was better than ever.

This is a story I have thought about for years- how a simple round of acupuncture, following a clear pattern, can change lives.