So now what? You got pregnant, you’re very excited…except that now your “PMS” won’t go away, your breasts hurt all the time, and you are tired, and you are constipated, and you have nausea unless you eat every two hours. Welcome to being pregnant.

Now of course not all women feel this way in their first trimester, but unfortunately many do have some degree of uncomfortable side effects.

The pulse changes during each phase of the menstrual cycle and it changes during the first trimester. When taking the pulse, I look for certain qualities to ascertain the potential for miscarriage. Certain pulse patterns would be considered pathological if a woman was not pregnant. Of course, this is not an exact science. I can’t always tell who is going to miscarry or who is going to become nauseated. However, it is easier for me to diagnose and treat women during the first trimester if I’ve treated them during their menstrual cycle because I know their baseline.

Included in the rigorous American Board of Oriental Reproductive Medicine (ABORM) exam (of which I am a fellow) are first trimester issues such as: strengthening the pregnancy (trying to prevent miscarriage), fatigue, morning sickness, constipation, bleeding during pregnancy, etc. These are not reproductive medicine issues per say, however when women seek treatment to become pregnant, they often continue through the duration of their pregnancy, or at least the first trimester. Oriental medicine is rich with acupuncture and herbal formulas for first trimester woes.

The second trimester is usually the “golden period”. Women tend to feel good, they have their energy back, nausea subsides and they breath a sigh of relief as they pass week 12. Sometimes I see women regularly during this phase, especially if they have a preexisting back problem, as low back pain can flare during pregnancy. There are certain structural treatments I do during this time and through the third trimester to help the body support the weight of the baby and take the pressure off the low back, shoulders and neck. Gestational diabetes is another common issue that women seek treatment for during this period of pregnancy.

A common issue at the end of pregnancy is breech presentation. Basically, by week 33 the baby should be head down in the pelvis. If it isn’t, we have to work on turning the fetus. Otherwise, a woman may have to choose between manual turning called

external cephalic version (which can cause spontaneous labor) and a planned C-section. Acupuncture and moxabustion can be very effective in encouraging the fetus to turn. A very compelling study, Factors affecting the success of moxibustion in the management of a breech presentation as a preliminary treatment ot external cephalic version (ECV), found that it was both less invasive and cost effective to offer women moxibustion treatment as an alternative to ECV. ECV was used when moxibustion treatment was unsuccessful. Moxibustion started to creep into the mainstream OB usage for breech babies after a study published in a very prestigious medical journal, The Journal of the American Medical Association (JAMA), found moxibustion to be an effective tool in correcting breech presentation.

Sometimes women skate right through their pregnancy with no problems, no issues what so ever. I don’t see these women again until week 36 where I start their “Pre-birth Acupuncture Series”. This protocol came from Germany. It consists of acupuncture one time per week for the last four weeks of pregnancy. Researchers found women who received these treatments on average had  a faster labor with less medical intervention.

Occasionally, qi and blood stagnation causes women to pass their due date. For existing patients, I offer to treat them with the intention of moving qi and blood. This may cause labor to begin, or contractions to become more rhythmic and productive. I make the call on a case by case basis and if I don’t feel acupuncture treatment is appropriate, I will refer women to the germane medical professional.

After giving birth mom and baby are quite tired. They have gone through an ordeal! If needed, I help new moms with milk production, mastitis issues, low back pain and getting their energy back (or as much as they can with very little sleep!). There is a Chinese medical tradition called “Mother Roasting” in which we heat the new mother up with blankets, nourishing soups and lots and lots of moxabustion. This is another step in her recovery, as mothers loose a lot of qi and blood during the birthing process, not to mention the next several weeks after the baby is born. I use herbal formulas specifically tailored to the postpartum period to increase breast milk, energy, balance hormones and moods.

Fertility, pregnancy, labor and the postpartum period is quite a journey that I have been honored to assist many patients with. It is so wonderful to meet the baby that I have been watching grow for the last nine months. I often feel like I’ve known them when they were just a sparkle in their mother’s eyes.