Pregnancy Problems

Comfort Strategies for Moms-to-Be

Trembling with anticipation, you head to the drugstore and buy an at-home pregnancy test. You race home. You read the instructions. You follow them to the letter. You wait the appointed time. You watch, hardly daring to breathe. And, finally, there it is before your eyes, the irrefutable proof that you are, indeed, pregnant. At long last, your body's wondrous design meets its greatest challenge.

As soon as that test turns color, your mind starts to wonder, wander and churn. And, if you're like most women, more than a few worries are likely to mingle with the wonderment and joy.

What changes will the next few months bring? What kind of prenatal care will you opt for? What will childbirth be like? How much will it hurt? What if something goes wrong? And, of course, will your baby be healthy?

Perhaps you've heard that high-tech medicine (ultrasonic fetal monitoring, for example) is great for high-risk pregnancies. But what about your pregnancy? Do you want the high-tech procedures for insurance, or do you want to trust the birth methods that were used long before the word sonic ever entered the human vocabulary?

Some advocates of natural childbirth are just plain opposed to the high-tech route. "I've been delivering babies in the mountains of western North Carolina for 21 years, and I worry about some of these high-tech birthing procedures," says Lisa Goldstein, R.N., a midwife practicing in Burnsville, North Carolina. "In some hospitals, for example, you're hooked up to a fetal monitor from the minute that you arrive in labor. You can't move around naturally. The beeping of the monitor is distracting and scares some women. Fear then causes adrenaline to surge through your system. This lessens the blood supply to the baby, slows labor and amplifies the perception of pain, which then increases fear. It's a cycle."

BUILDING BLOCKS OF A NATURAL PREGNANCY

Rest assured, though. If you're pregnant, high-tech delivery isn't your only option. Many alternative health practitioners offer more natural approaches to childbirth--safe, time-tested ways to help keep you comfortable and healthy. The process begins with competent prenatal care, sees you right through the birth and continues after your baby is born, explains Goldstein.

To relax and help condition your body and mind for delivery, you can choose from yoga, the Alexander Technique, exercise, visualization and meditation.

What Naturopathy Has to Offer a Mom-to-Be

Because naturopathic medicine draws on the medical wisdom of ancient cultures, it's been called the oldest medicine known to humankind. Yet a naturopath's medical education is similar to that of a conventional medical doctor's, and today's naturopaths blend the healing arts of the past with modern medical science.

During your pregnancy, a naturopath would work with you to optimize the way that your body functions.

"Naturopathic prenatal care starts, ideally, even before a woman becomes pregnant," says Lisa Alschuler, naturopathic physician and chairwoman of the Department of Botanical Medicine at Bastyr University of Naturopathic Medicine in Seattle.

Beyond the basic advice to avoid alcohol, cigarettes and refined sugar, a naturopath may recommend a detoxification program including herbs and nutrients to increase liver and gastrointestinal functioning before you conceive, says Dr. Alschuler. And as delivery time approaches, a natu-ropath may also prescribe certain herbal tonics depending upon your individual needs. "Exactly when and which herbs are used varies from woman to woman," she notes.

Some naturopaths are also midwives who'll take care of you from your first prenatal visit through delivery. In most states, however, a naturopath needs special midwifery training and a license in order to deliver babies.

Traditional Chinese Medicine: East Meets Mom

"There's no reason to choose between your obstetrician and practitioner of Traditional Chinese Medicine (TCM)--they complement each other," says Harriet Beinfield, licensed acupuncturist and co-author of Between Heaven and Earth: A Guide to Chinese Medicine.

"Each system has its advantages. For example, the morning sickness that can accompany pregnancy can be easily treated with Traditional Chinese Medicine instead of drugs, which can potentially damage the fetus. Acupressure, for example, has no side effects," says Christina Stemmler, M.D., a Houston physician who integrates TCM and acupuncture with Western medicine and who previously headed the American Academy of Medical Acupuncture.

Traditional Chinese Medicine can also help women who have certain types of infertility not caused by anatomical problems, says Dr. Stemmler. And she notes that "there are some women for whom acupuncture helped induce labor and provided pain relief with no need for a local or general anesthetic and no adverse affects on the fetus."

Diet for a Healthy Baby

Once you're pregnant, eating for two doesn't mean eating twice as much food--it means eating foods that are twice as healthy, says Andrew Weil, M.D., professor of herbalism, director of the Program of Integrative Medicine at the University of Arizona College of Medicine, near Tucson, and author of Spontaneous Healing.

Bag the junk food and go organic. Moms-to-be should eat a diet that includes a wide variety of organically grown vegetables, grains and cereals, according to Dr. Alschuler. Like many naturopaths, she says that pregnant women need to avoid the pesticides, preservatives and chemicals in processed, nonorganic foods.

Add a little fish to your diet. Essential fatty acids, also known as omega-3 fatty acids, are food substances essential for the normal growth and development of your baby. Omega-3's also improve the health of the placenta, which carries the nutrients that nourish a child in the womb. Studies show that these fatty acids are largely responsible for the health of your baby's nervous system and for her eyesight.

Fish and flaxseed, among other foods, are rich in omega-3 fatty acids. If you're planning to become pregnant, now's the time to start supplementing your diet with them. An adequate intake before conception sets the stage during pregnancy for the way that your body transfers fatty acids to your developing baby.

"To make sure that you get an adequate amount of omega-3 fatty acids, eat a four-ounce serving of salmon or sardines three times a week, or take a tablespoon of ground flaxseed daily," says Dr. Weil. Other good sources are nuts, seeds and whole grains.

VITAL VITAMINS FOR BABY'S HEALTH

Conventional doctors and alternative healers alike seem to unanimously agree that taking vitamins before and during your pregnancy is critical. Here are some guidelines.

Go the prescription route. If you're pregnant, it's better to take special prenatal vitamins prescribed by your doctor or midwife than to rely on over-the-counter vitamins, says Joyce Frye, D.O., an obstetrician/gynecologist and chairperson of the gynecology department at Presbyterian Medical Center and a clinical faculty member at Jefferson Medical College, both in Philadelphia.

This will ensure that you get protective amounts of folic acid, an essential B vitamin that helps prevent neural tube defects--severe problems that can affect the baby's spinal column and brain development.

Medical experts and alternative healers recommend that pregnant women get at least 400 micrograms of folic acid to prevent neural tube defects. If the woman has a family history of neural tube defects, her doctor may advise significantly larger amounts. Standard over-the-counter vitamins usually supply no more than 8 micrograms of folic acid, as compared with prescription prenatal vitamins, which contain one milligram of folic acid. One milligram, Dr. Frye says, is the appropriate amount for pregnant women as well as for women who are planning a pregnancy.

Vitamins prescribed by your doctor or midwife also contain other vitamins and minerals, including calcium, which is necessary for both mother and baby. In the prescription dose, you'll get more of the calcium and other minerals in the proportions that you need, says Dr. Frye. Ask your doctor if you might need additional calcium and other supplements, she adds.

Protect your pearly whites. "If your water isn't fluoridated, take a fluoride supplement during the last three months of pregnancy and continue taking it as long you're breastfeeding," advises Dr. Weil.

Dr. Fugh-Berman goes one step further, advising pregnant women to take fluoride right from the start. Fluoride helps prevent tooth decay. Since breast milk is low in fluoride, the American Academy of Pediatrics recommends that nursing moms take a daily 0.25-milligram fluoride supplement.

Exercise: It's Only Natural . . .

"One of the best gifts that you can give yourself during your pregnancy is the gift of fitness," says Lisa Stone, American Council on Exercise certified prenatal and postnatal fitness instructor and founder of Fit for 2, a prenatal and postnatal fitness program in Atlanta.

One study shows that women who continue to exercise during pregnancy are better able to control excessive weight gain during pregnancy. If you haven't been exercising regularly before your pregnancy, check with your doctor before you begin, recommends Stone. Ask your doctor about joining a prenatal exercise class. She's likely to be familiar with good ones in your area.

But whether or not you take a class, here are some guidelines to follow once you have your doctor's okay.

Take your body and your baby for a walk. If you already exercise, you're ahead of the game. If not, says Dr. Alschuler, consider walking: It's easy and convenient, even when your body gains girth.

Take baby steps. Start your exercise program slowly with a moderately brisk walk of 15 to 20 minutes about every other day, says Adriane Fugh-Berman, M.D., former head of field investigations for the Office of Alternative Medicine at the National Institutes of Health in Bethesda, Maryland. Standard advice says to walk at a rate at which you can carry on a conversation. If you're out of breath, slow down.

Make exercise routine. Consistent exercise is most effective. Aim to walk daily or at least three times a week, says Dr. Fugh-Berman.

Get off your back. After the first three months of pregnancy, avoid exercises that are done while lying on your back, such as sit-ups.

Take water breaks. Drink water before, during and after your workout. That helps to regulate your body temperature and also your baby's.

If you hurt, stop. When you exercise, listen to your body, says Dr. Fugh-Berman. If you feel dizzy, get light-headed or feel any kind of cramp or pain, stop immediately.

MORNING SICKNESS:
BANE OF THOSE EARLY MONTHS

Morning sickness, the infamous hallmark of early pregnancy, is experienced by about half of all pregnant women. Happily, it generally disappears by the end of the first trimester.

Morning sickness can be as mild as a faintly nauseated feeling when you wake up or as severe as nausea and vomiting that lead to dehydration and weight loss. Despite its name, morning sickness can occur any time of day.

What causes morning sickness? "When you're pregnant, increased hormonal activity slows down your digestion, and that can cause nausea above and constipation below," says Dr. Fugh-Berman.

Fortunately, natural medicine offers safe remedies for your queasy feelings. Here are some of the best.

Acupressure Eases Morning Sickness

"Acupressure can lessen both the nausea and the vomiting of morning sickness," says Dr. Fugh-Berman. Studies show that pregnant women who applied acupressure to the point just above their wrists for ten minutes, four times a day, significantly reduced their nausea, she adds. (To locate the P6 point, see the diagram in the acupressure chapter on page 14.)

Herbal Medicine: Ancient Medicine
for Modern Morning Sickness

Herbal medicine offers safe remedies for morning sickness, according to Susun S. Weed, an herbalist and teacher from Woodstock, New York, and author of the Wise Woman herbal series.

But you should use only herbs deemed safe and effective for use during pregnancy. Herbs normally used during cooking are fine, but pregnant women should not consider using more potent medicinal herbs without advice from an expert herbalist, says Dr. Fugh-Berman. The following mild herbs are fine, according to herbalists. (But be sure to examine packages carefully--some ginger tea, for example, may contain licorice root, which can raise blood pressure if consumed daily in large doses.)

Try ginger candy. Crystallized gingerroot candy, available in health food stores, can ease morning sickness, says Rosemary Gladstar, herbalist and author of Herbal Healing for Women. Keep it on your nightstand for first-thing-in-the-morning use.

Sip raspberry-leaf tea. Try some raspberry tea as soon as you get out of bed. Weed says that the tea--or sucking on ice cubes made from the tea--helps relieve early-morning digestive distress.

Try some morning mint tea. Peppermint or spearmint infusions, sipped first thing in the morning, are effective against nausea, says Weed. To make an infusion, pour one quart boiling water over one ounce dried mint leaves in a quart glass jar. Cover tightly and allow the mint leaves to steep overnight, or for at least four hours. Refrigerate. If kept refrigerated, the tea will last for up to a week. If you wish, you can strain the leaves out or reheat the tea before drinking it. Many women keep the infusion by their bedside at room temperature and sip it as needed.

Banish Morning Sickness with Homeopathy

"I have had excellent results using homeopathy for morning sickness, even when no other type of remedy has worked," says Goldstein.

Homeopathic remedies are available in different potencies (concentrations), expressed by a number and commonly followed by the letter "c". Goldstein and other homeopaths suggest that beginners start by choosing remedies labeled 6c. Take these every two to eight hours as needed. If the remedy hasn't helped ease discomfort after the third dose, it's probably the wrong remedy. Here are a few of the many effective remedies for morning sickness.

Pulsatilla. If nausea hits later in the day or evening, accompanied by intolerance to heat and perhaps a dry mouth (but not thirst), and you also feel teary or crave sympathy, Goldstein and other homeopaths suggest pulsatilla. This is a homeopathic remedy derived from the windflower, a plant native to Europe.

Ipecac. If nausea and vomiting are constant or persistent and you're salivating excessively, feeling a noticeable lack of thirst, and your tongue feels clean rather than coated, homeopaths recommend a homeopathic version of ipecac, derived from the dried root of a South American plant. Signs of mucus in your vomit also calls for ipecac, says Goldstein.

Practitioners emphasize that in addition to pulsatilla and ipecac, there are several other homeopathic treatments for morning sickness worth trying. Ask your practitioner for additional recommendations, suggests Dr. Alschuler.

PRENATAL ACHES AND PAINS: PAMPER YOUR BODY

As your baby grows, so will your girth, and your posture will change to accommodate your altered center of gravity. Your new swaybacked stance is likely to cause pain in your lower back. In addition, you may feel discomfort in your pelvic area as your hip joints loosen a bit in preparation for birth.

Here are some safe, natural remedies to ease pregnancy-induced aches.

Alexander Technique: Taking a Stand against Pain

The Alexander Technique is a form of movement therapy which stresses improved coordination and enhanced mind-body functioning. According to proponents of this technique, women who learn it early in their pregnancies can avoid backaches, varicose veins and other problems. (For details on learning the Alexander Technique, see page 40.)

Get Thee to a Masseuse

"Massage therapy can ease cramps, lower-back pain, chronic tension and hip pain," says Carole Osborne-Sheets, a licensed massage therapist with expertise in prenatal massage.

"One of the benefits of massage therapy during pregnancy is that it reduces stress and activates the parasympathetic branch of the nervous system, which lowers blood pressure, deepens breathing and facilitates blood flow to internal organs," says Dr. Fugh-Berman.

Many women have back pain during their pregnancies, notes Osborne-Sheets. One-third to one-half of all pregnant women will have back pain in late pregnancy, and of those, one-third will have pain that's debilitating enough to keep them from working or performing everyday chores, she adds.

Massage is also useful for discomfort related to fluid retention throughout the body during pregnancy. "Massage can reduce the swelling and discomfort that some pregnant women experience," says Dr. Fugh-Berman. But certain areas, like the ankles, shouldn't be massaged during pregnancy.

Find a certified massage therapist who has received special training in pregnancy massage, recommends Robert A. Edwards, licensed massage therapist and director of the Somerset School of Massage in Somerset, New Jersey.

BREAST CHANGES: PREPARING FOR BABY

One of the earliest signs of pregnancy is breast tenderness. Because your breasts increase in size early in pregnancy and continue to grow and change throughout your pregnancy in preparation for breastfeeding, feelings of heaviness or discomfort are common.

Your breasts will look different, too: The nipples and surrounding skin may darken and the veins may become more prominent. Toward the end of your pregnancy, your nipples may leak a yellow, watery fluid. This is colostrum, a rich first food that protects your baby against infections.

To minimize breast tenderness that you may encounter during pregnancy, try these tactics.

Shop for a supportive bra. Sports bras provide the extra support that pregnant women need, says Stone. Look for a bra with extra-wide straps. You may even be able to find sports bras with nursing features for use after delivery, she says.

Wear two for comfort. "The women in my exercise classes taught me another trick for easing breast tenderness, especially while you're exercising: Wear two sports bras, one atop the other, for extra support," says Stone.

Warm up a compress. As with breast tenderness associated with premenstrual changes, some women whose breasts grow tender during pregnancy find that warm compresses help, says Dr. Weil. Hold a comfortably hot towel or hot-water bottle against your breasts for 10 to 15 minutes.

SLEEPING PROBLEMS:
WHEN YOU JUST CAN'T GET COMFY

When you're pregnant, sleeping isn't what it used to be. Many women find that sleeping is a cinch early in pregnancy: Anytime, any place, you can catch a nap just like that. But when your belly gets bigger and your baby starts moving, you may find that getting a good night's sleep is hard work.

Relaxation techniques, including visualization, breathing exercises and meditation are just a few safe exercises that aid sleep.

Breathe yourself to sleep. Deep-breathing exercises are often all that you need to nod off, suggests Jeff Migdow, M.D., a holistic medical doctor, director of yoga teacher-training at the Kripalu Center for Yoga and Health in Lenox, Massachusetts, and co-author of Take a Deep Breath. Here's how.

Lie on your back and breathe rhythmically--four counts in, eight counts out. As you breathe, picture a light wind moving in and out of your body and enveloping your entire body. As you become sleepy, you may wish to shift to your favorite sleeping position and continue breathing to the rhythm that you've established.

Wide-awake at 3:00 a.m.? Meditate. "Meditation has definitely been found to be effective in helping pregnant women get a good night's sleep," says Mark Epstein, M.D., psychiatrist in New York City and author of Thoughts without a Thinker: Psychotherapy from a Buddhist Perspective.

Meditation can help you get to sleep by letting you focus on, and then release, what's keeping you awake, no matter whether it's emotional or physical discomfort, suggests Dr. Epstein.

And you don't need meditation experience to meditate yourself back to sleep. Just follow Dr. Epstein's suggestions whenever you have insomnia.

Rouse yourself to full awareness, then sit up in a comfortable position and use your breathing (or an object) as a focus point. Fully experience all that's keeping you awake, whether it's disturbing thoughts or discomfort. Focus on your disturbance or discomfort and then release your disturbance or discomfort. Lie back and go to sleep.

Water Births: No More Wailing Imagine a delivery so calm, so peaceful, that your precious little one arrives blissfully asleep. Going through labor, even delivery, in water can achieve an unusual level of relaxation for mother and baby, say proponents of water birth. "Seeing a baby born asleep is an incredible experience, and it takes a while before you realize that a baby born this way isn't in trouble--she's just sound asleep," says Barbara Harper, R.N., author of Gentle Birth Choices and president of the Global Maternal/Child Health Association, a nonprofit corporation that promotes water births and midwifery. In a water birth, the woman sits in a tub of warm water at various stages of labor, including delivery. The baby is born completely submerged and begins breathing when lifted into the mother's arms, seconds later. In the United States, water birth is catching on slowly but steadily: About 1,000 water births are reported each year and about 60 hospitals and birthing centers have installed special tubs for the purpose. Water birth is more popular in England, where more than 200 hospitals have birthing tubs. Only a small percentage of women offered water birth choose it as an option. "But so far, the women who choose it are very pleased," says Elizabeth K. Dickson, a certified nurse-midwife and founder and director of the Carolina Birth Center in High Point, North Carolina. The advantages of laboring in water include complete relaxation for mother and baby and non-narcotic, all-natural pain relief, says Harper. The water also softens the perineum so that it can stretch, minimizing the need for episiotomy. "In a fluid environment, a woman can remain in control of her labor and follow her instincts much better. Women seem to melt into the warmth of the water and actually enter almost an altered state of consciousness," she says. Water births should be attempted under proper supervision only, not on your own. For more information about water births, contact the Global Maternal/Child H