Wholistic Approach to Pregnancy Complications and Miscarriage

Pregnant with twins!

Pregnancy complications and miscarriage

So you’ve decided you’re ready to start a family… all begins well, you fall pregnant easily but sadly you have a miscarriage. You prepare yourself and start again, understanding that sometimes maintaining a pregnancy can be difficult.

This is Simone’s* story. A 35-year old university lecturer, living a busy but healthy and active lifestyle.

Pregnant with twins

Simone and her partner had been trying to have a baby for 2 years. Following recurrent miscarriage her doctor ordered blood tests which diagnosed Anti-Phospholipid Syndrome (APS). Just days later, they were advised they were 7 weeks pregnant with twins.

Anti-Phospholipid Syndrome (APS) is an auto-immune disorder of the blood. It is sometimes called Hughes syndrome or sticky blood. 

In early pregnancy the anti-phospholipid antibodies (aPL) can cause early miscarriages because they prevent the pregnancy from embedding properly in the womb, and they inhibit the growth of fetal cells.

Simone was immediately concerned about the potential for miscarriage. Querying what she could do to take this pregnancy to full term, she began to search online… What natural pregnancy support is available? Can acupuncture provide pregnancy support?

A wholistic approach to health and pregnancy support – TEAM

Simone came in for an initial consultation seeking pregnancy support. We discussed her medical history, current condition and doctors’ approach and treatment to address APS and her pregnancies. Her doctor had prescribed administration of daily Clexane injections and aspirin medication to thin the blood and prevent her blood from clotting.

Further to this, we discussed eastern medicine – primarily the use of Japanese and Chinese acupuncture, moxibustion (moxa) and Chinese herbal medicine in pregnancy support. Traditional East Asian Medicine (TEAM) considers one’s outlook, the current state of day-to-day health, looking into clinical signs, symptoms and results to determine a diagnosis – using traditional Chinese medicine (TCM) or traditional Japanese medicine (TJM) paradigms. The TCM diagnosis guides the acupuncture and moxa treatment and any herbal medicines to work alongside and complement other medical treatment.

Thus, at each consultation we would work as part of a wholistic health and pregnancy support team: comprising of doctors, obstetricians, physiotherapists, specialists, midwives and her doula.  Information from medications, blood tests, urine tests, ultrasound scans, baby positions, baby weights, physical exercises and recommendations would determine the TCM diagnosis and adjust the acupuncture and moxa treatment to her changing needs as the pregnancies progressed.

Natural Pregnancy Support with Acupuncture

Diagnosis of her health from a eastern medicine perspective indicated that constitutionally she had a life-long blood deficiency. Her blood was always working hard, generating extreme heat especially with her love of bike riding and 5-10 km jogs.

Given Simone’s constitution, pregnancy, APS presentation and medications, I recommended the following TEAM plan including acupuncture treatment and some lifestyle changes to reduce the heat in her blood, generate blood and promote blood circulation. The acupuncture treatment involved weekly consultation until she reached 12 weeks, follow-ups every 3 weeks until approximately 32 weeks, then fortnightly to weekly after that depending on her needs. The lifestyle changes involved reducing and changing her sport activities and making some dietary changes.

I worked together with her through the duration of her pregnancy for constitutional, APS-related and common pregnancy symptoms until the birth.  She gave birth at almost 37 weeks by caesarean due to pre-eclampsia (high blood pressure) and the babies descending into the birth canal.

Following birth, one baby spent the first night in a humidicrib with both babies in the special care nursery monitoring for 2 weeks. Post nursery care they remained healthy and well and at 18 months reached the 50th percentile for weight. The babies have continued to be average weight for their age.

To read a summary of Simone’s pregnancy journey and TCM treatments, see details below.  Note: Blood work at 15 weeks showed there were no traces of anti-phospholipid antibodies (aPL), suggesting APS remission.

*Name has been changed

By Rebecca Bau – Acupuncture, Japanese Acupuncture, Chinese Herbal Medicine, Traditional East Asian Medicine (TEAM), Traditional Chinese Medicine (TCM), Traditional Japanese Medicine (TJM), Lohan Qigong. 

Summary of *Simone’s pregnancy journey and TCM treatments:

  • 8wks – Background nausea, breathlessness, low energy, slight constipation
    • Acupuncture & moxa (heat therapy applied to the body)
    • Homework: diet and lifestyle therapy
  • 10wks – Severe nausea – lost 6kg, slight breathlessness
    • Acupuncture & moxa
  • 11wks – Low energy, sciatica
    • Acupuncture & moxa
  • 12wks – Bloating, slight heartburn, nocturia (night-time urination)
    • Acupuncture
    • Homework: diet therapy
  • 15wks – Headaches. Blood work: showed no traces of anti-phospholipid autoantibodies (aPL). Doctor advised that she could stop Clexane then or at 28 weeks.
    • Acupuncture & qigong breathing
  • 18wks – Low energy, constipation, pelvic pain, nocturia
    • Acupuncture
    • Physio exercises
  • 23wks – Headaches, head cold, carpal tunnel – RHS arm, sciatica, nocturia. Stopped Clexane.
    • Acupuncture & moxa
    • Homework: diet therapy
  • 25wks – Carpal tunnel – both arms, oedema (fluid retention) hands and feet, sore hips, severe constipation, anaemia, Baby A – breech position, nocturia, nausea, numb belly
    • Acupuncture, moxa, essential oil creams
    • Homework: diet and tea therapy
    • Physio exercises & supports
  • 28wks – Very slight carpal tunnel in both arms, oedema improved, slight constipation, Baby A & B – breech position, 1 baby reduced weight ie. Baby A – 0.9kg, Baby B – 1.3kg, anaemia, shortness of breath.
    • Acupuncture & moxa
    • Homework: moxa, diet therapy
  • 32wks – Very slight carpal tunnel – both arms, oedema feet and legs, Baby A – breech position, baby weight ie. Baby A – 1.2kg, Baby B – 1.4kg, shortness of breath, haemorrhoids
    • Acupuncture & moxa
    • Homework: moxa
  • 34wks – Carpal tunnel in both arms, oedema hands, feet and legs, Baby A – breech position, shortness of breath, haemorrhoids, sore lower back, constipation with black tar
    • Acupuncture, moxa, essential oil creams
    • Homework: moxa & qigong breathing & movement, foot bath
  • 36wks – Carpal tunnel – both arms, oedema hands, feet and legs, Baby A – breech position, Baby A & B – 2kg each, shortness of breath, pre-eclampsia
    • Acupuncture, moxa, gua sha (stone massage), essential oil creams
    • Homework: moxa, diet therapy

Ten Top Tips for Nausea During Pregnancy

Early pregnancy is an exciting time, however it can also be a challenging time, especially when there is daily nausea. Many women often experience some nausea and in some cases there can be vomiting as well. While this has been known as “morning sickness” most women will tell you that it is rarely restricted to feeling unwell in the morning. It often begins around the 4 to 8 week mark and typically tends to ease off around the 12th-14th week of pregnancy, except when carrying twins, although in some women it can last most of the pregnancy.

For some women, it can become difficult to be around even the smell of food, especially particular foods. For others, eating can ease the nausea, but it can be set off by moving around, or when they are hungry. Every woman’s experience of pregnancy is different, and often every pregnancy in the same woman is different.

What can help?
What might have worked for a friend may not work for you. Nausea during pregnancy is complex and there is usually no one solution that suits everyone. This means that you may need to try a few different things before you find something that provides some relief. Most options will not completely remove the nausea however, they can often make it less frequent, less severe and thus more manageable.

Tip 1:

Keep a nutritious snack next to your bed and eat this before sitting up in the morning. For example, some nuts and seeds, or a plain wholegrain cracker.

Tip 2:

Eat before you are hungry. Eat small amounts of food, particularly protein, more frequently (perhaps every 2-3 hours). This helps reduce fluctuations in your blood sugar levels which may tend to trigger nausea.

Tip 3:

Always keep a healthy snack in your bag, for example nuts and seeds, or wholemeal crackers, hommus and carrot sticks, or a protein bar. This helps you avoid any delays in eating when you are out and about.

Tip 4:

Ginger is an age-old nausea remedy and is perfectly safe for the pregnant woman and the developing foetus. Make ginger tea by grating half a teaspoon (or more) of fresh ginger into a mug of boiled water and infuse for 5-10 minutes. Drink this throughout the day. Some women find chai tea to be very settling, as it has ginger as one of the ingredients. You could add a little lemon juice or honey occasionally for a change. You could snack on pickled ginger when you feel nausea rising. Use ginger in your meal preparation when you can. Alternatively ask your Naturopath for ginger liquid extract or tablets.

Tip 5:

Other herbal teas such as Chamomile may be helpful. Speak to your Naturopath about whether there should be a limit to the number of cups in a day. Stimulating herbal teas such as peppermint should be avoided. Make sure you source a good quality organic herbal tea for the best therapeutic action. If you use tea bags, make sure they are unbleached.

Tip 6:

Try acupuncture. Many women use acupuncture to relieve or reduce nausea during pregnancy. In early pregnancy the body undergoes many changes energetically and hormonally. The usual flow of energy and blood during the menstrual cycle stops as your baby begins developing. One of the body’s meridians (called the Chong meridian in Chinese medicine) is strongly involved with blood supply to the uterus runs alongside the stomach meridian. In early pregnancy the changes in energy flow temporarily create an imbalance in the Chong meridian causing the energy to rise upwards, affecting the energy in the stomach channel which lies alongside it and causing nausea. Acupuncture is used to regulate the energy in the Chong and Stomach meridians and helps redirect the stomach energy downwards to settle the nausea.

Tip 7:

If you need even more support, try wearing travel sickness prevention bands from your chemist. They are positioned over acupuncture points on the wrists that reduce nausea. There are also other acupuncture points on the body that can help. Your acupuncturist can show you how to locate these points are and how to use pressure (acupressure) on them.

Tip 8:

Talk to your Naturopath about a vitamin B6 supplement. Research supports the use of vitamin B6 during pregnancy to help reduce nausea.

Tip 9:

Avoid dehydration. It can be easy to become dehydrated especially if you are vomiting.  Some women find even plain water makes them feel nauseous. While it may not appear that drinking relieves nausea, becoming even slightly dehydrated will make any nausea more intense. Dry lips, feeling thirsty and a reduced urinary output are signs you are dehydrated. Make sure you are having small regular sips of water, herbal teas, mineral water or even hydrolyte if you have been vomiting to replenish your electrolytes as well as fluids.

Tip 10:

Rest: Make sure you are getting enough rest as being tired can accentuate any nausea you might be experiencing. According to Chinese medicine your body is using a lot of very deep constitutional energy in the early stages of pregnancy and many women feel a lot more tired than usual. This is a message that your body is needing more rest even though you may be tempted to push through with your usual workload.

Keep in mind
If vomiting occurs more than 3 times a day, and this is not relieved or reduced by self-help or natural remedies, then it could be that you have hyperemesis gravidarum. You should alert your GP or obstetrician. Prolonged vomiting can lead to dehydration, electrolyte imbalance, weight loss and threaten the health of the mother and baby.

If you have gone off, or are unable to stomach, a lot of different foods it may be worthwhile to consult your Naturopath for a dietary assessment to ensure you are covering all of your nutritional requirements. Naturopaths are often able to suggest alternative dietary options to improve your nutritional intake and support a healthy pregnancy.

by Kathy Harris (Naturopath, Nutritionist) & Tanya Newton (Acupuncture, Chinese Herbal Medicine)

Massage to the rescue when shoulder pain gets in the way

 Men, women, and teens can experience restricted movement due to shoulder pain

Shoulder pain can impact on your day. It can disrupt your sleep and make the simplest actions like brushing your hair or reaching for items on the top shelf of the pantry unbearable.

What can be done to break the cycle of shoulder pain?

Jane* was seeking help for her persistent right shoulder pain that was aggravated when she raised her arm above her shoulder. This pain had been ongoing for three months and had been limiting her ability to exercise and move freely. Remedial massage had been recommended to improve movement and reduce pain.

I approached the consultation as I always do with a thorough history and background of Jane’s condition. I conducted a thorough assessment of both shoulders, comparing movement, symmetry and strength in each arm and closely observing posture that can affect how the shoulders are positioned.

What I noticed first was that the affected shoulder was brought forward and held higher compared to the unaffected shoulder indicating that those muscle groups of the chest and top of the shoulder were creating the problem by raising the shoulder and scapula up and forward and limiting movement of the right shoulder. This was confirmed with palpation of the muscle groups to the chest, upper shoulders and those muscles surrounding the scapula.

The initial treatment targeted those affected muscle groups to the chest, shoulders and upper back, improving blood flow and softening those affected muscle tissues. After the first treatment Jane could raise her arm above her shoulder and her pain had been reduced considerably. She was happy with this initial result.

Jane returned for a further three weekly massage treatments and her pain had resolved after the fourth treatment. Jane was able to return to regular exercising and was even able to help her sister move house at our last consultation.

* Name has been changed

By Kyla Mayer – Pregnancy and Remedial Massage, Lactation Consultant, Acupuncture and Traditional Chinese Medicine

Acupuncture and TCM when unable to do IVF

   TCM and Acupuncture may support the journey to have a baby

Unable to undergo IVF

Sue and John* who are in their mid-thirties, came to see me at Red Tent, seeking support for fertility. They are both in corporate jobs with high responsibility, long hours and lots of overseas work trips. They had been trying for a baby for over two years and had investigated IVF. Because Sue’s thyroid levels were fluctuating too much she was unable to undergo IVF.

The couple sought my assistance in re-balancing her body so that she could go ahead with IVF. My first step, as always, was to take a full health history.

Wholistic approach

Sue had a history of gut issues which had worsened when she ate contaminated food in a developing country. She also came down with dengue fever (see below). Her bowel movements were irregular, sometimes harder, sometimes softer, sometimes with lots of pain. She had pains on and off in her legs and joints. She was highly stressed and found it difficult to wind down after work and sleep well.

Her thyroid levels would fluctuate quite markedly. This would give her a whole other cascade of symptoms depending on whether her thyroid was running too fast or too slow.

I recommended that she see an Integrative GP to check for parasites as well as anything else that could be adversely affecting her that needed to be dealt with. She also continued to be under the guidance of her IVF specialist.

In Traditional Chinese Medicine (TCM) we look at the body as a whole. So I wanted to know every symptom she was feeling at each appointment, where she felt it in her body and I would translate this into a Chinese Medicine diagnosis that would fluctuate depending on what was going on for her. I then gave her acupuncture, Chinese Herbal Medicine, dietary changes and lifestyle changes. All of these aspects look to balance the body, mind and spirit so that her body can work towards healing itself.

The Integrative GP confirmed that there were no parasites or harmful bacteria that may have required treatment. She was on medication for her thyroid and those levels were being monitored by her GP and Endocrinologist.

Finding the balance

We worked on re-balancing Sue’s body for a period of 18 months. It took time as there were deep entrenched patterns of disharmony but slowly, slowly, she cut back on over-working, decreased the amount of overseas travel, increased time for herself, took up meditation. During that time she took Chinese herbs, had regular acupuncture, which she said helped a lot to decrease her stress levels, and looked into old mental patterns that weren’t working for her anymore. As well she continued to consult with her specialists about her thyroid medication levels.

John continued to see me also to ensure his stress levels were managed well and that his body was working to optimal capacity.

Then around that 18-month mark, Sue’s thyroid had been stable enough for a number of months to try for her first complete IVF cycle. She had an embryo transfer that was successful. After so many months of not even being able to have a transfer, it was a wonderful result. She is now pregnant and over the moon.

Dengue fever is a virus transmitted by mosquitoes. Symptoms include:

  • fever (mild to incapacitating)
  • headache
  • pain behind the eyes
  • muscle and joint pain
  • nausea and vomiting
  • swollen glands
  • rash

These symptoms may be mild or severe. They usually appear between 3 and 14 days after the mosquito bite, and usually last for between 2 and 7 days.

* Names have been changed

By Rebecca Mar Young – Acupuncture, Japanese Acupuncture, Chinese Medicine, Paediatric Acupuncture. 

Red Tent Surry Hills is now located within the Wholistic Medical Centre