Borup 2009.

Methods	Randomised trial of acupuncture, TENS or traditional analgesics.
Participants	607 healthy, Danish‐speaking women in labour with a normal singleton pregnancy who were giving birth at term (37‐42 completed weeks) and with a fetus in cephalic presentation were eligible for the study. Women were recruited from a university hospital. Women were excluded if they had medical complications, or already received analgesics in labour.
Interventions	Acupuncture group: acupuncture was administered by midwives who had completed a 5‐day course in Western techniques of obstetric acupuncture, and received at least 6 months' clinical training using acupuncture during labour. Treatment was individualised, according to location of pain and woman’s mobility, needles used of 3 depths 0.20 mm x 15 mm, 0.30 mm x 30 mm, 0.35 mm x 50 mm. Duration of needling 30‐120 minutes and could be repeated. Needles removed if woman uncomfortable or if obstetric pathology. Supplementary analgesics provided on request as per control group. Acupuncture points included BL 23, 24, 25, 26, 31‐34, 36, 60, CV20 and sishongong, ear points uterus, shenmen, endocrine, EX‐HN3 yintang, LR3, SP6, SP9, ST36, GB34, HT7, PC6, LI10,11, LU7, LI 4. Control group: traditional analgesics: women randomised to the traditional group could choose among all analgesic methods available (sterile water papules, nitrous oxide, warm tub bath, pethidine, and epidural analgesia).
Outcomes	Need for pharmacological pain relief, pain intensity, overall experience and satisfaction, duration of labour, use of oxytocin, mode of birth, postpartum haemorrhage, Apgar score, umbilical cord pH.
Notes	Study duration: 1 March 2002 to 29 February 2004. Conflicts of interest: none stated. Employment declared in public health and research institutions. Funding: study sponsored by the Asse and Ejnar Danielsen's Foundation, Kgs, Lyngby, Dnemark; Knowledge and Research Cener for Alternative medicine, Aarhus, Denmark; Sophus Jacobsen Foundation, Capenhagen, Denmar; The Danish Midwifery Organisation, Copenhangen, Denmark; Lundbeck Foundation, Copenhagen, Denmark; Mads Clausens Foundation, Nordborg, Denmark; Hede Nielsen Foundation, Horsens, Denmark; The Research Fund at Aarhus University Hosptial, Aarhus, Denmark; Else and Mogens Wedell‐Wedellsborgs Foundation, Copenhagen, Denmark; and King Christian the 10th Foundation, Copenhagen, Denmark. Setting: maternity hospital. Country: Denmark.
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Computer‐generated sequence, with randomisation in a ratio of 2:1.
Allocation concealment (selection bias)	Low risk	Central randomisation voice response.
Blinding of participants and personnel (performance bias) All outcomes	High risk	Women, midwife acupuncturists were not blinded to their group allocation. Interventions were substantially different and obvious to an observer.
Blinding of outcome assessment (detection bias) All outcomes	High risk	It was unclear if the outcome assessor or analyst was blinded to group allocation. Outcomes would be recorded by staff providing care who would be aware of the intervention.
Incomplete outcome data (attrition bias) All outcomes	Low risk	Data were missing from 8%, with the reasons similar between groups: no project midwife available, did not want the allocated treatment, rapid progression of labour, other reasons.
Selective reporting (reporting bias)	Unclear risk	The study protocol is not available but the study reports the expected outcomes.
Other bias	Low risk	The study appears free of other biases.