Risks with ECV

There are a number of risks with ECV. First, it may cause the membranes to rupture. Second, it may cause the placenta to separate. Third, it would not be carried out if the mother's blood group is Rhesus negative, because of the risk of her blood mixing with the baby's and the possibility of the baby's blood group being positive (see Ch. 4). Fourth, there may be problems if the mother has high blood pressure. Finally, if the mother has had a previous caesarean section, the weakness of the scar...

Chicken pox

Chicken pox in pregnancy is rare (one case in 2000 pregnancies). Most people in developed countries have had chicken pox at some time during childhood and have developed immunity. Where there is doubt or where there is concern about recent contact by a pregnant woman with someone infected by the virus, a blood test may be performed to check for past (immunoglobulin G level) or recent (immunoglobulin XI level) infection with the virus. Where immunity is in doubt, contact should be avoided. The...

Needle techniques

From personal experience, I believe the body adapts to whatever needle technique you use. Before my TCM training (at the College of Integrated Medicine), I studied Five Element acupuncture, so my techniques may be considered different from those of classically trained TCM practitioners. When I began training, I soon came to realise through observation that all practitioners develop their own personal needle technique. The following recommendations are therefore based on my own preferences. 1....

Hypertensive disorders of pregnancy Pregnancyinduced hypertension PIH

Hypertension, or high blood pressure, is defined as a level of 140 90 or more. It is considered potentially serious when measured at this level after the 20th week of pregnancy and on at least two separate occasions after that. It is usually accompanied by protein in the urine and by oedema. Although much research has been done on PIH, the causes remain uncertain. Certain women have more predisposing factors primigravidae or first-time mothers women with an obesity problem. I rarely treat...

Vitamin F essential fatty acids

There are many fatty acids but research has identified two important ones for the development and functioning of the brain arachidonic acid (AA) and DHA (Crawford 1992). During the third trimester, the brain of the fetus increases 4-5 times in weight, using two-thirds of the energy supplied by the mother. Large amounts of AA and DHA are needed during this 'brain growth spurt' that occurs in the baby just before and just after birth (Crawford & Doyle 1989). They are used as components of the...

Main pattern Stomach and Spleen deficiency

If the Stomach and Spleen are weak to begin with, Qi and Blood accumulate in the Chong and counterflow upwards, causing nausea. The Spleen generates and transforms the Blood after conception when there is an increased demand for Blood to nourish the fetus. When the Stomach and Spleen are weak they are unable to do this, causing a counterflow upwards. If there is an existing weakness prior to conception then poor diet, worry and fatigue will aggravate the condition in pregnancy. The clinical...

Foreword to the first edition

Like all branches of Chinese medicine, traditional gynaecology and obstetrics have a long history. The earliest records of gynaecological medical writings date from the Shang dynasty (1500-1000 bc) bones and tortoise shells have been found with inscriptions dealing with childbirth problems. The text 'Book of Mountains and Seas' from the Warring States period (476-221 bc) describes medicinal plants to treat infertility. The 'Yellow Emperor's Classic of Internal Medicine' (Huang Di Nei Jing Su...

Adrenaline

It is important that the acupuncturist understands the effect of fear on labour, and appreciates how simple measures can allay fear. When people are frightened and in pain, the body automatically increases catecholamine levels and releases the hormone adrenaline. This produces the 'fight or flight' syndrome, a pattern of behaviour intended to rescue them from danger (Fig. 11.4). The cardiac, respiratory, genitourinary, gastrointestinal and skeletal systems are all affected, resulting in an...

Postnatal period the fourth trimester

A mother is normally expected to make her recovery in the 6 weeks after the birth of her baby. In medical terms, this period (starting as soon as the placenta is expelled) is called the puerperium, meaning 'the period belonging to the child'. During this time the mother's reproductive organs return to their pre-pregnant state. Nevertheless, giving birth is a real shock to the new mother's system and the experience can affect every part of her life. A woman who has had a difficult or traumatic...

Acupuncture treatment after the birth Mother roasting

'Mother roasting' is a general term to describe practices of warming the mother to aid recovery, which take different forms in various cultures. In Malaysia, the mother is given a massage a week or so after giving birth, with a special stone that is heated on the fire, wrapped in a cloth and placed on the abdomen. In South East Asia, new mothers are encouraged to sit next to the open fire. In Thailand, newly delivered women are sometimes placed in a special bed above a fire. Using moxa...

Chlamydia

Chlamydia trachomatis is now the most common sexually transmitted disease organism. It is particularly common amongst teenage girls. Treatment consists of antibiotic therapy. However, most people experience no symptoms, which makes it particularly insidious. Stage 1 of the infection occurs between 1 and 3 weeks after sexual intercourse with an infected person, when an abnormal discharge and a burning sensation on passing urine may be experienced. Stage 2 can occur several weeks or months after...

Ovarian hyperstimulation syndrome

During an IVF cycle some women may be more sensitive to the drugs used to stimulate follicle production, and produce a large amount of follicles. This can cause the ovaries to increase in size and raise blood oestrogen levels. As a result it can lead to leakage of fluid into the abdominal cavity and lungs causing breathlessness, reduced urine production and blood clotting problems. This is known as ovarian hyperstimulation syndrome (OHSS). The most common time for this to occur would be near to...

Inhalation analgesia

Inhalation analgesia gives partial relief of pain but no anaesthesia. Entonox is a mixture of equal parts of nitrous oxide and oxygen (the oxygen helps fetal oxygenation). It is administered from a premixed cylinder by the mother herself, by means of a face mask or mouthpiece. Entonox is effective only while it is being breathed in, plus about 15 seconds. Deep breathing is required to activate the machine, which makes a gurgling noise. The mother is instructed to start using the mask as soon as...

Use moxa on SP1 and encourage the patient to continue use at home

Celia had had three pregnancies, all the result of IVF, but all had ended in miscarriage. In one pregnancy she sadly lost the baby at 24 weeks. She came to me for acupuncture in desperate hope, prior to her fourth IVF attempt. Her main weakness was a Kidney deficiency, which was exacerbated by all the IVF drugs. She became pregnant but at 5 weeks she started to bleed. The treatment I gave her concentrated on SP-1, which I heated with moxa cones. I also gave her sufficient cones to take away, so...

References

Mothers' and babies' health in later life. Churchill Livingstone, New York Barker DJP 1998 Mothers' and babies' health in later life. Churchill Livingstone, New York Bryce-Smith D 1986 The zinc solution. Century Arrow, London, pp 53-57 Crawford MA 1992 The role of dietary fatty acids in biology their place in the evolution of the human brain. Nutritional Reviews 50 3-11 Crawford M, Doyle A 1989 Fatty acids during early human development. Journal of Internal...

Copper

Copper is absorbed from water pipes, saucepans, jewellery, coins, the contraceptive pill and the copper intrauterine device (IUD). Copper levels rise naturally during pregnancy and immediately after birth, so it is easy for a woman to reach toxic overload levels. This may be one of the causes of many premature births or miscarriages. Raised levels of copper can also lead to postnatal depression and they are usually accompanied by low levels of zinc and manganese, both of which deficiencies are...

Ear acupuncture

Ear Acupuncture Endocrine

I have increasingly found ear points to be effective in pregnancy and in labour. Ear points are particularly good for the first stage Fig. 12.9 , as follows. Uterus to stimulate uterine contractions. Shenmen for general analgesia. Endocrine to stimulate uterine contractions. The use of ear points in labour can, in my opinion, help with the 'spaced-out' state that often ensues as labour progresses. The most effective ear points to use here are Uterus and Shenmen. You can also add Endocrine to...

Embryo transfer

This will take place between 2 and 5 days following fertilisation. A 5-day embryo is called a blastocyst in natural conception this is the stage at which the embryo will implant in the uterus. However, in IVF embryos may stop developing at any stage and although longer culture can allow the embryologist to choose the best-quality one, it could also leave the couple with no embryos to transfer back. The transfer is a simple procedure the embryos are put into a thin catheter, which is inserted...

SP4 and PC6

Stomach or Spleen deficiency can cause sinking of Qi and consequent failure to hold the fetus. There may also be a Kidney deficiency, a constitutional weakness or a Heat pattern. Emotional factors, such as worry, fear, anger or grief, can all contribute. The eventual result will be to affect the Liver Qi, which will turn to Liver Fire and Blood Heat. If a woman has had any previous miscarriages, it is vital to mitigate the risks with good preconceptual care....

Immune system

In recent years there has been much research into the role of the immune system and the body's inflammatory response during pregnancy. However, many of the new theories remain controversial. For a pregnancy to survive to term, the woman's immune system must recognise what is going on and not reject the fetus. It is thought that recurrent miscarriage may be due to a failure in the immune mechanisms, from either an autoimmune reaction or the inability of the mother's immune system to respond...

Emotions

Emotions strongly affect morning sickness because of their links to particular organs. Anger. Anger causes Liver Qi stagnation. When the cause of anger is repressed frustration and resentment, it leads to Liver Qi stagnation which affects the Spleen, causing diarrhoea. The Stomach is also affected, as Stomach Qi is prevented from descending, causing obstruction, epigastric pain, belching and nausea. The influence of the Liver on the Stomach is frequently seen in patterns of disharmony of the...

Natural killer NK cells

These cells are part of the immune system's first line of defence against life-threatening diseases such as cancer. In pregnancy there is an abundance of NK cells in the uterine lining, which work with the fetal trophoblast to help develop the placenta Hanna et al 2006 . However, recent research from around the world has shown that an overabundance of NK cells can be toxic to the trophoblast cells and lead to cell death and early abortion Quenby amp Farquharson 2006 . Further studies on the...

Detecting abnormalities of the fetus

Baby Vagina

The growth of various parts of the baby takes place at different rates Fig. 4.8 hence harmful substances may affect a variety of organs, depending on the stage of pregnancy. There are now a whole range of tests available for pregnant women, to assess the risks of the baby having an abnormality. While certain abnormalities can be diagnosed, there is always a margin of error. No test is 100 accurate. Nor does diagnosis in any way mean that a condition can be rectified. Often there is nothing a...

Antenatal care explained

The first 'booking-in' visit 54 Detecting abnormalities of the fetus 58 AFP alpha-fetoprotein test 60 Chorionic villus sampling CVS 62 Getting off the conveyor belt 64 Antenatal maternal infections 64 The aims of antenatal care are, first and foremost, to look after the health and safety of the mother and to ensure delivery of a healthy baby. Monitoring the health of mother and baby throughout the pregnancy allows for the early detection and treatment of any problems. A vital element in good...

Palpation and position of the baby

As pregnancy advances, more information than just the fundal height will be needed and the midwife will carry out an abdominal examination at every visit. After emptying her bladder, the woman should lie flat, supported by pillows if necessary, with only her abdomen exposed. She should be as relaxed and at ease as possible. There are three stages to the examination. 1 Inspection - to note the size and shape of the uterus. The size should correspond with the estimated dates and period of...

Parvovirus

In childhood, human parvovirus causes erythema infectiosum or fifth disease, which is sometimes mistaken for rubella or German measles. It may also be called 'slapped face syndrome' because of the reddened appearance of a child's face. Infection is commonly asymptomatic. In pregnancy, if the fetus is infected this causes anaemia and fluid retention or hydrops. In approximately half of all cases of fetal infection, miscarriage or still birth occurs but in the remainder the anaemia and hydrops...

The Eastern philosophy of childbirth

The Yellow Emperor 1963 said 'After the person's connection, the Jing is first composed. Then the Jing composes the brain and the bone marrow. The bones become the Stem, the vessels become the Ying, the muscles become firm. The flesh becomes a wall, the Jing is hard and then the hair and body grow'. The chapter on preconception discusses the importance of getting healthy, regulating periods and correcting imbalances before becoming pregnant. In my experience, a woman's physical and emotional...

Deficiencies

A number of crucial minerals are involved in the prevention of birth abnormalities, including the following. In tests, mothers who gave birth to babies with congenital malformations were found to have very low levels of manganese, as did their babies Saner et al 1985 . The best food sources are nuts, green leafy vegetables, peas, beets, egg yolks and wholegrains. Zinc deficiency is linked to low birthweight, still births and male infertility, and to difficult births and poor weight gain in...

Zinc

In addition to its role in preventing defects and low birthweight in the newborn see Ch. 1 , zinc is needed for cell division and growth, for maintaining hormone levels and to keep the immune system healthy. Zinc deficiency inhibits metabolism of vitamin A and may also be one of the causes of morning sickness Pfeiffer 1978 see Ch. 5 . The best dietary sources are meat and poultry, so vegetarians are likely to be zinc deficient. Good food sources. These include meat and poultry, fish, shellfish...

AFP alphafetoprotein test

Alpha Fetoprotein Test

This is one of several blood tests routinely offered in pregnancy. Concentration of AFP in the blood can be assessed most accurately between weeks 16 and 18, and it is usually given in conjunction with an ultrasound scan MacLachlan 1992 . A high level of AFP in the blood might indicate that the pregnancy is more advanced than realised, a multiple pregnancy, a spinal tube defect such as spina bifida, Turner's syndrome very rare or death of the baby. A low level of AFP might indicate that the...

Allergies

Food allergies are remarkably common, though in some people the obvious symptoms may be slight or masked. Allergies are linked to a range of conditions, including asthma, eczema, hayfever, migraine, hyperactivity and depression, any of which may require drug treatment. For prospective parents there is particular reason to investigate and clear up any allergy. Many food allergies are the result of nutritional imbalance, and in particular of zinc deficiency. Any allergy is an impairment to good...

Toxic chemicals metals and minerals

Every year, each one of us eats approximately 5 kilos of preservatives and additives, inhales 1 gram of heavy metals and has 4 litres of pesticides and herbicides sprayed on our fruit and vegetables. Pollution is more widespread than ever before. The adverse effects of ingestion and inhalation of even low levels of toxic chemicals, metals and minerals can lead to a huge range of conditions, including cardiovascular disease, renal and metabolic disease, immune dysfunction, lethargy, depression,...

Negative influences on prenatal health Stress

The medical world remains divided on the effect of stress on fertility although studies have shown it can affect both the man's and woman's ability to conceive Berga et al 2003, Bethea et al 2005, Brkovich amp Fisher 1998, Campagne 2006, Marcus et al 2001 . For women there is a link with the endocrine system and the hormones produced during stressful times. A recent pilot study from the USA showed that 85 women started to ovulate again following a 20-week course of cognitive behaviour therapy...

Other pointers on protecting yourself from pollution

As well as good nutrition and supplementation, there are some general measures that can help minimise exposure to pollution. Wash all fruit and vegetables and remove the outer leaves of vegetables buy organic whenever possible. Avoid copper or aluminium cookware and do not wrap food in aluminium foil. Avoid canned food, particularly from unlined tins. Use a water filter or drink bottled spring water and never drink hot tap water. Avoid heavy traffic as far as possible and close car windows in...

The Chinese viewpoint on preconceptual care

Ren Mai Woman

Eastern thinking has always maintained that a woman should take special care of herself during her periods and after childbirth. She should avoid heavy physical work and overexposure to cold and damp. This care extends not just to physical considerations but to her diet and emotional state as well worry will inhibit Qi from flowing anger gives rise to Liver Qi stagnation see Imbalance of the Liver in the next section fear will cause Qi to sink, which may result in miscarriage joy may lead to...

The menstrual cycle

During each cycle, approximately 100 millilitres of blood are lost. The blood flow will vary according to age, constitution, lifestyle, mental state and any drugs being taken. Each menstrual cycle usually lasts 3 5 days, though in some women it may last 7 days. Menstrual blood is usually light red at the beginning of a cycle, deep red in the middle and pinkish towards the end. A normal blood flow does not contain clots. Questions about a woman's cycle are vitally important to establish where...