Current trends have involved the integration of CAM modalities (i.e., acupuncture, reiki, yoga) into standard Western treatments and protocols. This is evident in prenatal care where acupuncture has been integrated into a group model approach called Centering Pregnancy. This program abolishes routine prenatal care by bringing women out of examination rooms and into groups for their care. The design incorporates the three components of prenatal care - risk assessment, education and support - into one entity. Women are placed into groups of eight to 12, based on estimated dates of delivery, and meet for ten 90-minute prenatal or postpartum visits at regular intervals. At these visits, standard prenatal risk assessment is performed, an educational format is followed that uses a didactic discussion format, and time is provided for women to share with one another.1 Acupuncture has been integrated into this treatment approach in the management of pain (during and after pregnancy), and in the treatment of allergies, nausea, stress and anxiety, and migraines.
Researchers at Yale University have demonstrated that the group prenatal approach has been effective in reducing preterm births, enhancing psychosocial outcomes and improving patient satisfaction.2 Additionally, data demonstrated that 96 percent of the women preferred receiving their prenatal care in groups.
Treatment
Pain: Typically there are muscle spasms and pain in the lower back. Acupuncture treatments are focused on tonifying the kidneys and the utilization of an ai shi point on the lower back. Acupuncture treatments for muscle spasms and lower back pain can be performed close to full term during pregnancy. However, electroacupuncture is contraindicated.
For kidney deficiency, symptoms include muscle spasms, low energy, low back pain, weakness of lower back and knees, edema in the ankles, slow response to stimuli, pale tongue, and deep, slow pulse. Points would be KID3, UB23, UB20, ai shi point for muscle spasms and low back pain, and ear kidney points.
Allergies: Treatments are focused on reducing dampness and damp-heat in the spleen. Acupuncture can be performed as early as the first week of pregnancy. Electroacupuncture is contraindicated, as well as SP6.
For damp heat in the spleen, symptoms include sneezing, post-nasal drip, rhinitis, poor appetite, thin and loose stools, lassitude, pale tongue with thin, white coating, and a thready moderate pulse. Points would include UB20, UB21, ear spleen points, LI20, Yin Tang, LI11, ST36 and SP9.
Stress and anxiety: This is focused on reducing the disturbance of the heart shen and moving liver qi. Auriculotherapy is effective for this condition, in combination with acupuncture. Both of these modalities can be performed as early as the first week of pregnancy. GB21 and SP6 are contraindicated.
For disturbance of heart shen with liver qi stagnation, symptoms include palpitations, stress, anxiety, pain on side of ribs, poor appetite, cannot sleep, dream-disturbed sleep, purplish-red tongue, and choppy and rapid pulse. Points would be LIV13, ST36, Yin Tang, HT7, and ear points for Heart, Liver, Shen Man, nervous subcortex, and neurasthenia.
Nausea and vomiting: This is common among women, particularly in the first and second trimesters. Acupuncture treatments focus mainly on the spleen and the stomach. Treatments occur during the first and second trimesters.
For adverse flow of stomach qi with spleen qi deficiency, symptoms would include nausea, vomiting, poor appetite, lassitude, pale tongue and soggy pulse. Treatment points would be at PC6, ST36, Stomach and Spleen ear points, UB20 and UB21.
Migraines: These typically follow a pattern of qi and blood stagnation. Acupuncture treatments are focused on alleviating pain and moving qi and blood stagnation. Treatments can be performed as early as the first week of pregnancy. LI4 is contraindicated.
Qi and blood stagnation symptoms would be migraines with a constant sharp pain in the same location, choppy pulse, and slightly purple and pale tongue. Treatment points would include ai shi point, LIV3, ST36, Tai Yang, GB14, GB20 and Yin Tang.
Discussion
The use of acupuncture in a complementary approach for prenatal care has provided very good outcomes. The normal discomforts of pregnancy can be easily treated with an approach using acupuncture and auriculotherapy. Pain, allergies, stress and anxiety, nausea and vomiting, and migraines can be effectively managed without any side effects. In addition, the Centering Pregnancy approach has been effective in reducing preterm births and enhancing psychosocial outcomes. Acupuncture in conjunction with the Centering Pregnancy group model approach is an innovative way for future prenatal care.
References
Chronic pain afflicts over 20% of the adult population. Sadly, most MDs have essentially no education in treating pain, beyond offering a few toxic medications. Then they tend to steer people with pain away from those health practitioners who are trained. This puts the acupuncture community on the front lines for addressing this epidemic.
When the body is going through a stressful event, the sympathetic system is activated. This activation will help the body with a life-threatening situation. If this state is activated for prolonged periods of time, it starts to consume energy. These traumatic events that generate stressors in the autonomic nervous system (ANS) will eventually become internalized.
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One of the things that makes acupuncture so difficult to measure is that the medicine actually does contain some esoteric aspects. There have been numerous studies that demonstrate the neurochemical reasoning behind why acupuncture points stimulate the autonomic nervous system to enact change However, not all the benefits of TCM can easily be measured by randomized, controlled trials. But does that make them fundamentally and definitively untrue?
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