Pacific College of Oriental Medicine Alumni

To have peace in one's soul is the greatest happiness. - Oriental Wisdom

Practice Building

Continuing Ed
Pacific Symposium
Additional CEU Events
CEU Tapes

Alumni events

Alumni Profiles

Oriental Medicine News

Update Your Info

Alumni Email List

Request Records

Download Graduate Exit Interview

Alumni Minutes

Classifieds
Jobs
Opportunities
Office Space
For Sale

Supportive Treatment During Pregnancy and Delivery

By Moshe Heiler, L.Ac.

My interest in treating infertility began years ago, and it so happened that many of my patients continued to see me after they became pregnant. It was not long before I found myself treating pregnant women and following them through the delivery process. The more I was exposed to this group of patients, I began to realize how much we as alternative healthcare providers have to offer in supporting pregnancy, especially for women who are concerned with taking Western pharmaceuticals. Western biomedicine does not always provide answers to the natural discomforts that accompany pregnancy, and therefore Oriental medicine practitioners can accommodate a great need in this area.

I frequently hear concerns from practitioners about treating pregnant women. I strongly believe that if we maintain the framework of our medicine we cannot harm or negatively interfere with pregnancy. If one understands the Chinese medical theory and the normal physiological processes that occur during this time, there is no place for concern. Supplementing or regulating qi blood yin and yang appropriately can at times be enough to avoid complications and support a smooth pregnancy and delivery. Furthermore, the use of acupuncture and herbs can enhance the natural processes and development of pregnancy.

Supportive care during pregnancy and delivery encompasses many treatment options that can be provided during this time.

Our guidance can start even before conception occurs. The health of the parents at the time of conception will influence the baby's constitution. Therefore, we want to educate parents about nutrition, lifestyle and exercise, which will strengthen their postnatal essence and enable a healthier baby. We can also discuss with parents the importance of the timing of conception and awareness of the space.

Once conception has been achieved, there are treatments that can support the development of the embryo. A special treatment called the "Pretty Baby Treatment" is performed at the end of the first and second trimesters. This treatment consists of only one point - Kidney9, which is needled with a golden needle and with supplementing technique. It is said to clear the jing/kidney essence from toxins or negative energy. This treatment is very popular among my pregnant patients and is an example of a simple way to support and enhance a healthy pregnancy.

In the chart below, we can see the development of the baby's organs according to the 10 lunar months of pregnancy. It is believed that if we want to influence any particular organ of the embryo we should do so during the specific month of pregnancy.

1st Month - liver
2nd Month - gall bladder
3rd Month - pericardium / triple warmer
4th Month - heart / small intestines
5th month - spleen
6th month - stomach
7th month - lung
8th month - large intestine
9th month - kidney
10th month - bladder

Pregnancy is divided in to trimesters; the first is weeks one through 12, the second weeks 13 through 28 and the third weeks 28 through 40, or delivery. Each trimester has its common complaints; below are some treatments addressing a few of them.

In the first trimester a common complaint is morning sickness, which, despite its name, can happen at any time of the day. In severe cases, women can experience constant nausea and may find it hard to keep food down. I have found that Chinese medicine treats this disorder quite effectively.

The etiology of this disorder includes:

Pooling of blood in the Chong, causing rebellious qi in the stomach
Liver qi constraint
Sp/St vacuity
Yin vacuity (less common)

Below is a chart with suggested treatments for each of these patterns.

In the second trimester the nausea usually subsides, and although there are other common complaints, this may be a good time for pregnant women. They may regain energy and the nausea may stop completely.

In the third trimester, women might start feeling heavy and tire more easily. A condition that appears at the end of this trimester is failure of the baby to turn around, called breech presentation. It is best to treat a breech presentation as early as week 32. The treatment may include:

The use of moxa on UB67
Needling Ren21-Xuan Ji / Jade Pivot. One of the translations of this point refers to the North Star and provides directionality to the qi.
Opening the Ren and the Du meridians provides for the proper ascending and descending of yin and yang.
Supplementation of liver blood and coursing liver qi may also allow for the relaxation of the uterus to enable the baby to turn freely, as we direct its qi in the correct direction.

Preparation for Labor

It is very important to prepare for the labor process. Good breathing techniques could help greatly with pain management. Practicing these techniques during pregnancy is of paramount importance and can determine how well the delivery progresses. I have found that women, especially in the first pregnancy, do not realize the importance of this technique. If the mother feels that she is in control and managing the delivery, the whole process is easier, but if the woman is overcome by pain, it can interfere with the progression of the delivery.

Labor is defined as the progressive effacement and dilation of the cervix due to rhythmic contractions of the uterus; it is also divided into three stages:

Onset of contractions until full dilation is achieved
Complete dilation of the cervix until delivery
Delivery of the placenta

In the first phase of delivery, acupuncture plays an important role. It can be used for pain management, increasing dilation and improving contractions. It could also be used for induction, when needed. When inducing labor the following points may be used:

LI4, SP6, BL31, BL32, GB21, Liv. 3
Ear points can be added - Shen Men, Uterus, Endocrine, Liver or Kidney
Huo Bao - an extra point located on the plantar surface of the foot, in the center of the proximal phalangeal joint of the second toe.

I have found it helpful to divide patients into three groups:

Vacuity - Patient is very tired, contraction not strong enough.
Repletion (qi constraint) - Patient is very emotional, may have strong painful contractions, but there is no dilation, and a wiry pulse.
Damp - Patient may have edema, thick tongue coat, labor progresses very slowly.

Generally speaking, in cases of vacuity I would use St36 to help strengthen the contractions. In the case of repletion, Liv3 can help with the pain and GB41 would help with dilation. When damp is present, stimulating Sp9 would be very helpful to progress the delivery faster.

During the second phase, once the woman is starting to push, retention of needles is difficult. At this phase we can help the patient by using intradermal needles as well as massage techniques and acupressure.

After the delivery of the placenta, it is advised to supplement qi and blood. Treatment should include blood-building points such as the six flowers - BL17, BL18, BL20 and HT7 to calm the shen.

In conclusion, this case study represents the supportive care we can provide:

S. came to see me because she was having difficulty getting pregnant. She was 34 and had been trying to conceive for the past two years. I diagnosed her as having kidney essence vacuity, liver blood vacuity and damp in the lower jiao. It took about nine months of treatments, recording basal body temperature, dietary recommendations and taking different formulas until she finally conceived. Once she was pregnant, treatment continued once a week to address different issues. During the first three months, it was constant nausea. During the second trimester, she suffered from insomnia and in the third, lower back pain. I performed the pretty baby treatment at the end of the first and second trimesters and usually addressed the kidney vacuity and liver blood vacuity in almost every treatment. When her contractions started on week 41, she had a lot of discomfort. The contractions lasted 24 hours with not much dilation achieve d. I used points such as UB 31 and 32, Sp6 and LI4 to enhance the process and GB41 to improve the dilation. I joined her at the delivery room once she was admitted with an opening of 4cm. At that point she was exhausted, and wanted an epidural to relieve the pains from the contractions. After she received the epidural, her contractions decreased, a common side effect of the epidural. I used UB 31 and 32, Sp6 and LI4 again to increase the contractions. She responded well, her contractions strengthened, and she was soon ready to push. Two hours later she delivered a healthy, beautiful (remember the beautiful baby point?) male baby.

Moshe Heller,L.Ac.is currently Chair of the Department of Oriental Medicine at Pacific College, New York. Moshe came to Pacific College from Israel; where he has taught Chinese medicine at Hebrew University, Medicine College, and the Israeli College of Complementary Medicine. He is a graduate of Pacific College of Oriental Medicine and has studied at the Israeli School of Oriental Medicine and Tel-Aviv University. Moshe has also done postgraduate work at the Guan An Men Hospital in Beijing,China,where he focused on internal medicine and TCM gynecology. Bibliography * Acupuncture in Pregnancy and Childbirth/ Zita West.