PREGNANCY AND ACUPUNCTURE
ACUPUNCTURE AND GYNAECOLOGY
In gynaecology, acupuncture is known to be an effective treatment for a wide range of problems, including: period pain, irregular periods, amenorrhea, PMT, endometriosis, fibroids, and infertility. Acupuncture is known to be effective during pregnancy, where it can be used to relieve morning sickness, boost energy, reduce fluid retention, and may assist with breech presentation and gently prepare the body for labour. Acupuncture is known to help increase energy levels, improve sleep, and enable the body to deal better with stress.
In Chinese medicine a dynamic balance between yin and yang and a smooth flow of qi is necessary for health. Chinese medicine recognises a strong link between the reproductive system and the mind and emotions, and it follows that anxiety and stress can contribute to menstrual problems and infertility.
EFFECTS OF ACUPUNCTURE
Acupuncture promotes the circulation of blood in the pelvic cavity, enhancing uterine blood flow and the quality of the uterine lining. Acupuncture is said to help regulate and balance hormone levels to improve the function of the ovaries, producing better quality eggs and greater numbers of follicles. At the same time acupuncture treatment is very relaxing and can reduce stress and anxiety and assists in lessening the side effects of some drugs used in IVF. Certain acupuncture points keep the uterus in a state of normal relaxation.
Beneficial results have been reported from combining acupuncture treatment with IVF and include increased number of follicles, thickened uterine lining and increased number of embryos, resulting in greater chances of pregnancy. Other gynaecological problems can also benefit from the enhanced pelvic blood flow, improved ovarian function and balanced hormone levels that can result from acupuncture treatment. An irregular menstrual cycle can become more regular, period pain reduced, and premenstrual disorders relieved.
Acupuncture in the months leading up to an IVF cycle can help to regulate the menstrual cycle and balance hormone levels. By treating the root causes of infertility, some patients may even fall pregnant during this preparation time and the chance of a successful IVF cycle can be increased.
Chinese medicine can be highly effective in caring for both mother and baby during pregnancy. Acupuncture can achieve excellent results for morning sickness, even where there are constant, countless episodes of vomiting. Closer to the due date, acupuncture can be used to prepare the perineum and enhance cervical ripening.
Chinese medicine can care for maternal health while avoiding antibiotics and other strong drugs, and by caring for maternal health and building the mother's strength, has been found to improve labour outcomes. The best outcomes occur when the mother's health and 'qi' are at optimum levels. Prolonged labour is often the result of deficient 'qi'.
Statistics suggest that some 75% of women suffer from morning sickness, ranging from mild occasional nausea to constant and severe vomiting. In some cases, the condition is so severe, the loss of fluids, electrolytes and nutrients leads to an urgent situation requiring hospitalisation. Acupuncture is not only highly effective, but has the advantage of not requiring the drinking of herbs, which may not stay down.
The optimal position of the baby for birth is where the buttocks are up, and the head is down; this means at birth the head is the presenting part. When the buttocks are the presenting part, it is called breech presentation. The baby frequently changes position during the earlier stages of pregnancy, and even if lying head upwards, will often spontaneously turn before 34 weeks' gestation. The Western medical intervention of physically trying to manoeuvre the baby by pressing and pushing on the abdomen has largely been discarded, due to its low rate of success, and the risks of pre-term labour, placental rupture, cord injury and uterine rupture.
Acupuncture and moxibustion are not always successful but have been shown in several studies to double the incidence of the baby turning when compared to spontaneous version. Breech presentation occurs in about 3-4% of women going into labour. Western obstetricians are not concerned until 36 weeks of pregnancy. In most cases, caesarean section will be recommended. However, the optimal time for using acupuncture and moxibustion to potentially help turn the baby is between 34 and 36 weeks, before the baby grows further and 'drops' lower in the abdomen - in other words, when there is still room to move.
Western obstetric practice manages overdue dates with the application of prostaglandins to the cervix, rupture of the membranes (breaking the waters) and the administration of Syntocinon (synthetic Oxytocin). The last option usually results in a more intense and uncomfortable labour, and is associated with hypertonicity of the uterus, raising the risk of uterine rupture. Acupuncture has been used by many women in this situation because it can assist in a smoother and more comfortable labour.
Acupuncture can be used to facilitate labour in many ways: it can be used at the time of delivery to promote the descent of the baby, to establish labour, to moderate (but not weaken) the contractions and to ease back pain. Best results are obtained when the mother has had treatment prior to the birth, where acupuncture can prepare the perineum and enhance cervical ripening. As described above, the best outcomes come for a mother in good health. Prolonged labour can be the result of deficient 'qi'. A Chinese medicine practitioner can determine if this is so quite early in the pregnancy and prescribe herbs to take during the pregnancy.
Chinese medicine can replenish the maternal energies depleted by the growth of the child, to whom Nature gives priority for the 38 weeks of pregnancy. By doing this, not only does the mother feel better, but breast milk can be augmented, Lochia can be reduced, and the chance of post-natal depression can be reduced. Acupuncture is also very effective in treating post-partum bleeding and in replenishing health where there has been a heavy loss of blood. Acupuncture, along with the aid of Chinese herbs, can also help with incontinence issues – it can help raise the sinking qi and lift the internal organs back into place reducing the weak bladder.
Age is not seen as a major issue unless the end of the normal child-bearing years has been reached. Chinese medicine views infertility from a different perspective, although parallels can be drawn with Western medical theory. A number of factors play a part in fertility - the quality of the man's sperm (number, shape and motility); the quality of the woman's ova (number, size, development, maturation and timely release); tubal health (mucus, tubal motility), health of the uterine lining or endometrium; viability and healthy development of the egg after conception; the process of implantation; the secretion of hormones which support the pregnancy for the first 12-13 weeks until the placenta is fully developed and functioning. Chinese medicine focuses on each of these factors. By enhancing and supporting the natural processes of conception and pregnancy, the aim of achieving a natural pregnancy can usually be achieved.
Although in women’s reproductive health there seem to be more factors which potentially could present a problem, modern statistics suggest that problems with sperm quality are more prevalent than previously thought. One of the reasons for this is that the “normal range” cited in sperm analysis tests is lower than the optimum level. In other words, the cited range is not quite good enough. Few are aware of how many sperm samples are rejected by sperm banks because they do not meet optimum standards. Modern research looking at men 40 and over has also shown the age of the father to be implicated in miscarriage. This is thought to be due to declining sperm quality associated with aging, even though 40 is far from ‘old’. Sperm quality can be improved with Chinese medicine.
And so, if both the prospective mother’s reproductive health and that of the prospective father are “not quite right”, even if there is no major problem, then the chance of conception and of carrying a baby to full term is significantly reduced. Except where the sperm being used is not that of the father, better results are obtained when both prospective parents attend the clinic for assessment and treatment.
IVF & ASSISTED CONCEPTION
Chinese medicine works well alongside Western fertilization techniques. In broad terms, IVF works by artificially controlling the hormonal environment. In this way, it increases the number of eggs developing in the ovary, ensures that ovulation takes place, and supports the early stage of conception until implantation is established. It does not address the status of tubal mucus or endometrial health, nor does it address the underlying health of the prospective mother. When Chinese medicine is used in combination with IVF treatment, optimum results are obtained if the Chinese medicine treatment is taken for 3 months prior to the start of IVF treatment. Statistics suggest that when IVF is used alone, the success rate is about 30% in women under 38 years of age. There are few statistics available for the success rate of Chinese medicine, however studies in Europe and Australia show that the success rate of IVF is increased when combined with Chinese medicine.