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Reproductive Health Information - Pregnancy

Diet, health tips, information, treatment of specific conditions.

Pregnancy Research

Research on acupuncture and pregnancy

Acupuncture for pelvic and back pain in pregnancy: a systematic review. - Ee CC et al, . 2008 Am J Obstet Gynecol Mar;198(3):254-9. American Jnl Obstetrics and Gynecology


We conclude that limited evidence supports acupuncture use in treating pregnancy-related pelvic and back pain. Additional high-quality trials are needed to test the existing promising evidence for this relatively safe and popular complementary therapy.

The objective of our study was to review the effectiveness of needle acupuncture in treating the common and disabling problem of pelvic and back pain in pregnancy. Two small trials on mixed pelvic/back pain and 1 large high-quality trial on pelvic pain met the inclusion criteria. Acupuncture, as an adjunct to standard treatment, was superior to standard treatment alone and physiotherapy in relieving mixed pelvic/back pain. Women with well-defined pelvic pain had greater relief of pain with a combination of acupuncture and standard treatment, compared to standard treatment alone or stabilizing exercises and standard treatment. We used a narrative synthesis due to significant clinical heterogeneity between trials. Few and minor adverse events were reported.

Effects of acupuncture and stabilising exercises as adjunct to standard treatment in pregnant women with pelvic girdle pain: randomised single blind controlled trial. - Elden H et al 2005 Jul 30;331(7511):249-50. British Medical Journal


CONCLUSION: Acupuncture and stabilising exercises constitute efficient complements to standard treatment for the management of pelvic girdle pain during pregnancy. Acupuncture was superior to stabilising exercises in this study.

OBJECTIVES: To compare the efficacy of standard treatment, standard treatment plus acupuncture, and standard treatment plus stabilising exercises for pelvic girdle pain during pregnancy.

DESIGN: Randomised single blind controlled trial. Settings East Hospital, Gothenburg, and 27 maternity care centres in Sweden.

PARTICIPANTS: 386 pregnant women with pelvic girdle pain.

INTERVENTIONS: Treatment for six weeks with standard treatment (n = 130), standard treatment plus acupuncture (n = 125), or standard treatment plus stabilising exercises (n = 131).

MAIN OUTCOME MEASURES: Primary outcome measure was pain (visual analogue scale); secondary outcome measure was assessment of severity of pelvic girdle pain by an independent examiner before and after treatment.

RESULTS: After treatment the stabilising exercise group had less pain than the standard group in the morning (median difference = 9, 95% confidence interval 1.7 to 12.8; P = 0.0312) and in the evening (13, 2.7 to 17.5; P = 0.0245). The acupuncture group, in turn, had less pain in the evening than the stabilising exercise group (-14, -18.1 to -3.3; P = 0.0130). Furthermore, the acupuncture group had less pain than the standard treatment group in the morning (12, 5.9 to 17.3; P < 0.001) and in the evening (27, 13.3 to 29.5; P < 0.001). Attenuation of pelvic girdle pain as assessed by the independent examiner was greatest in the acupuncture group.

Acupuncture for Depression During Pregnancy: A Randomized Controlled Trial - Manber R et al, Obst and Gynec 2010, 115 (3) 511 - 520 Obstetrics and Gynecology


CONCLUSION: The short acupuncture protocol demonstrated symptom reduction and a response rate comparable to those observed in standard depression treatments of similar length and could be a viable treatment option for depression during pregnancy.

OBJECTIVE: To estimate the efficacy of acupuncture for depression during pregnancy in a randomized controlled trial.

METHODS: A total of 150 pregnant women who met Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) criteria for major depressive disorder were randomized to receive either acupuncture specific for depression or one of two active controls: control acupuncture or massage. Treatments lasted 8 weeks (12 sessions). Junior acupuncturists, who were not told about treatment assignment, needled participants at points prescribed by senior acupuncturists. All treatments were standardized. The primary outcome was the Hamilton Rating Scale for Depression, administered by masked raters at baseline and after 4 and 8 weeks of treatment. Continuous data were analyzed using mixed effects models and by intent to treat.

RESULTS: Fifty-two women were randomized to acupuncture specific for depression, 49 to control acupuncture, and 49 to massage. Women who received acupuncture specific for depression experienced a greater rate of decrease in symptom severity (P<.05) compared with the combined controls (Cohen's d=0.39, 95% confidence interval [CI] 0.01–0.77) or control acupuncture alone (P<.05; Cohen's d=0.46, 95% CI 0.01–0.92). They also had significantly greater response rate (63.0%) than the combined controls (44.3%; P<.05; number needed to treat, 5.3; 95% CI 2.8–75.0) and control acupuncture alone (37.5%; P<.05: number needed to treat, 3.9; 95% CI 2.2–19.8). Symptom reduction and response rates did not differ significantly between controls (control acupuncture, 37.5%; massage, 50.0%).

Acupuncture For Prebirth Treatment:
An Observational Study Of Its Use In Midwifery Practice - Betts D and Lennox S, Medical Acupuncture 2006, 17, (3) 16 - 19 Medical Acupuncture


Conclusions: Prebirth acupuncture appeared to provide some promising therapeutic benefits in assisting women to have a normal vaginal birth. A further randomized controlled study is warranted.

Background Midwives in Wellington, New Zealand, observed that women receiving prebirth acupuncture consistently experienced efficient labors, reporting a reduction in the length of labor and medical intervention, specifically the use of epidurals, medical inductions, and cesarean deliveries.

Objective To undertake a naturalistic observational study of women receiving acupuncture as part of their antenatal care.


Design, Setting, and Patients Practices of 14 midwives recorded their prebirth acupuncture treatments over a 4-month period in 2004 in 169 New Zealand women who received prebirth acupuncture. 


Main Outcome Measures Gestation at onset of labor, incidence of medical induction, length of labor, use of analgesia, and type of delivery. 


Results When compared with the local population rates, there was an overall 35% reduction in the number of inductions (for primigravida women, this was a 43% reduction); 31% reduction in the epidural rate; 32% reduction in emergency cesarean delivery; and a 9% increase in normal vaginal birth.

Pregnancy Treatment

Prevention of miscarriage, treatment of nausea, depression and stress, headaches, restless legs, back pain, breech presentation, preparation for labour, and post-partum breastfeeding and emotional issues.

Does acupuncture effectively treat conditions associated with pregnancy?



Yes.

In my experience, acupuncture is good for treating many conditions and uncomfortable issues associated with being pregnant.

Prevent miscarriage. Treatments 1-2 times per week help prevent miscarriage or early pregnancy loss by reducing the activity of the sympathetic nervous system, reducing stress, and encouraging blood flow to the developing embryo.

Spotting (sub-chorionic hematoma). Acupuncture employed with a technique called moxabustion can help reduce or eliminate bleeding from the uterus (depending on the cause).

Nausea or morning sickness. Depending on the severity of the nausea, 1-5 acupuncture treatments per week may be necessary to restore quality of life and the ability to eat. Often acupuncture is very effective for this condition, especially if combined with the knowledge and practice of keeping blood sugar levels consistent throughout the day.

Headaches. From my experience, many women experience headaches toward the end of their first trimester. Acupuncture is known better for the relief of pain than for any other ailment. If you are experiencing headaches that are not just obviously associated with dehydration or fatigue, then try acupuncture.

Depression. The balancing of many emotional conditions is a primary principle of treatment when pregnant women come to my practice. Acupuncture combined with singing lessons administered by singing teacher proficient in proper breathing techniques is quite effective for pregnancy or post-partum related depression. Sing the blues away.

Stress. Hormones secreted by the adrenal glands cause anxiety and stress. During pregnancy, this can affect the amount of life giving blood flow feeding the embryo. Therefore reducing stress or using techniques such as acupuncture to alleviate stress is important.

Restless legs. Acupuncture has shown some promise in relieving the sometimes agonising frustration associated with restless legs. If you have it you understand what I am talking about. You may also need more calcium in your diet.

Back pain. Again, acupuncture is fundamentally one of the best choices humans have for relieving pain of any kind. Cupping and moxabustion may also be administered when back pain is effecting a woman that is pregnant.

Breech presentation. Studies have shown that moxabustion can be effective at turning a baby that is presenting breech. Is is most effective if done daily for 10-14 days between the weeks of 34-36.

Labour preparation or cervical ripening. Between the weeks of 37-40, acupuncture given once per week helps prepare a woman for labour by boosting vital energy and ensuring smooth flow of emotions and blood during the process. Induction is most often not needed when women commit to the cervical ripening acupuncture protocol.

Induction of Labour. I have personally seen many women move swiftly into active labour after just one acupuncture induction treatment. Sometimes 2-3 are required within 1 week post due date.

Mastitis. Blocked milk duct. Acupuncture given quickly enough, along with somewhat aggressive self-massage and herbal compresses, can help hasten the recovery from a mastitis infection. This infection can progress quickly so do not hesitate to get treatment and do everything you can at home as well.

Lack of breast milk. Acupuncture and Chinese herbs, when given alongside a Guiness beer per day has shown moderate to good results with increasing the amount of milk production.

Pregnancy General

General information on pregnancy & acupuncture in Vancouver

First Trimester Screening at PCRM

This is a 5 part diagnostic toward the end of the first trimester of pregnancy;

1. Nuchal Translucency
This is an ultrasound measurement of fluid between the spine and the skin of the fetal neck, done best at 11-14 weeks.
2. Nasal Bone
This is the ultrasound determination of calcium in the nasal cartilage.
3. Ductus Venosus
This is an ultrasound measurement of blood flow through a small vessel in the fetal liver.
4. hCG
A blood test that measures a protein made by the placenta which can go up or down in genetic syndromes and other conditions.
5. PAPP-A
A blood test that measures another protein made by the placenta and the fetus

Should I hire a doula? ?


Yes. If you do not have a woman in your life, that lives close by, that you trust deeply, and that can be there for you whenever she gets the call, a doula is something to strongly consider when approaching labour and delivery. A doula is someone who is there for you every step of the way through your labour and delivery. They are knowledgeable about most everything you are going through, and are great support for both you and your husband or partner. In the old village, there would have been wise women around that would have been there for the labouring women. In today's reality, birth has been largely hospitalized, therefore the first birth a woman attends is her own. This can give rise to many fears that can slow and hault labour.

Click here for links to Vancouver pregnancy resources & doulas

What pregnancy books should I read?


This question is best first answered by what you should NOT read; 'What to expect when you are expecting'. This book tends to strike fear into the hearts of those that read its pages.

Here is a list of recommended reading;

1. Pregnancy, Childbirth, and the Newborn - Simkin, Whalley, Keppler
2. The Complete Book of Pregnancy and Childbirth - Kitzinger
3. Conception, Pregnancy, and Birth - Dr. Stoppard
4. The Mother of All Pregnancy Books - Ann Douglas

I am pregnant, now what?

prenatal multi
folic acid 1mg
DHA 1000mg/day (fish oils nordic naturals)
Vitamin D 1000 iu/day (sisu)

*take with food, and spread out with meals.
*eat like a rabbit. Always be munching. Try to eat more protein rich foods. Avoid high/simple sugar content foods.
*book recommendation: the mother of all pregnancy books (banyen books, 4th & alma). Do not read 'what to expect when you are expecting'.
*walking is enough for exercise for the 1st trimester.
*listen to your body, if you are tired, rest. If you feel sleepy, go to bed. If you are hungry, eat.
*try to ground some of your negative energy in the trees. They are great for this.
*work is not your priority anymore. delegate where you can.
*alleviate stress: acupuncture, walks, girl time. regularly schedule these things.

Accept all the above as your most important job now. These are your priorities.

Brenda C's miscarriage story...

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