BY Samuel Mathis MD
Recently, my spouse and I welcomed our second child into the world. During this pregnancy, we followed all the recommended guidelines for healthy eating, physical activity, and preventative health. We also utilized some integrative therapies that were safe and proven to help improve the overall pregnancy experience. Physicians should have a base understanding of these therapies to engage with patients who are pregnant or hoping to become pregnant.
One of the first therapies that can be safely used in pregnancy is acupressure and acupuncture. Acupuncture is effective in almost all phases of pregnancy. Last year, a meta-analysis of 25 acupuncture trials (n=4757) showed that acupuncture improved outcomes when used in in vitro fertilization. It improved both clinical pregnancy rates and live birth rates in patients undergoing regular treatments (1). The pooled analysis of the studies showed that acupuncture improved clinical pregnancy rates by over 10% compared to controls (43.6% vs. 33.2, p<.00001). Not only does acupuncture help before pregnancy, but it is also commonly used for nausea and vomiting associated with pregnancy, pains, helping to flip breech presentations to vertex, improving labor pains, and even initiating labor in some studies. While many of the studies supporting these claims are small, further studies may continue to prove these effects. Please ensure patients receive acupuncture from a licensed physician or acupuncturist, as documented in historical acupuncture texts; some acupuncture points may induce labor or spontaneous abortions.
Another integrative therapy that can be safely used in pregnancy is body manipulation therapies, such as massage, chiropractic care, and osteopathic manipulation. It is important to note that these therapies should only be done by trained professionals in providing these services to pregnant patients. There is limited data on the safety of massage in early pregnancy, so many therapists will not provide massage until the second trimester. Massage should be performed on the patient’s side or in a special bed that does not put pressure on the abdomen. Chiropractic care has been recognized as a viable nonpharmacologic treatment modality for pain during pregnancy. Spinal manipulation is effective in reducing low back pain in pregnant patients (2). However, care should be given not to use high-velocity adjustments of the neck or overly aggressive manipulations late in pregnancy. Osteopathic manipulation is also another viable option for patients seeking manual manipulation for their pain. It is effective in treating low back pain compared to standard obstetric care (2).
The final integrative therapy used in pregnancy includes various supplements and herbs. These therapies have been anecdotally used for generations, and science has been showing their effectiveness as new studies emerge. The National Institutes of Health has a very detailed fact sheet regarding vitamins, supplements, and minerals that are needed and are effective at treating certain complaints during pregnancy (3). While there is not enough room to cover all supplements, we will review a few common ones. A general recommendation for all pregnant women is to take a daily multivitamin with iron to ensure they have adequate vitamins and minerals for the growing fetus. Ginger is a very effective supplement in helping first-trimester nausea, or morning sickness. My general recommendation is to use fresh ginger steeped in hot water for 3-5 minutes for its anti-nausea effect. It can be sweetened with honey or combined with other herbal teas to reduce the zing and peppery kick of the ginger. Red raspberry leaf and dates have been studied for helping to prime the cervix and induce labor, though the evidence is not strong (3). It is important to note that not all natural supplements are safe. Many concentrated herbal therapies could potentially cause harm to the pregnant patient or developing fetus (spice in food is considered acceptable). Supplements such as black cohosh, kava kava, St. John’s wort, feverfew, ginger, and sage are potentially harmful at high levels. Patients should discuss any possible supplement use with their physician or integrative health professional to ensure the supplement is safe for consumption.
For those wondering, baby and spouse are doing well without complications. This is all due to healthy habits, good prenatal care, and appropriate use of integrative therapies when needed. We are so thankful for the team of physicians, nursing staff, and technical staff that helped make this experience a cherished memory for us both. I hope these therapies can help other patients have a similar experience with healthy, happy newborns in the end.
References
- Xu, M., Zhu, M., & Zheng, C. (2024). Effects of acupuncture on pregnancy outcomes in women undergoing in vitro fertilization: an updated systematic review and meta-analysis. Archives of gynecology and obstetrics, 309(3), 775–788. https://doi.org/10.1007/s00404-023-07142-1
- Conner, S. N., Trudell, A. S., & Conner, C. A. (2021). Chiropractic Care for the Pregnant Body. Clinical obstetrics and gynecology, 64(3), 602–610. https://doi.org/10.1097/GRF.0000000000000621
- NIH Fact Sheet. https://ods.od.nih.gov/factsheets/Pregnancy-HealthProfessional/