August 05, 2016
I am often asked by friends, family, and my own patients about the apparent tension between “traditional, western” obstetrics and other more alternative or integrative systems surrounding prenatal care (i.e. homeopathic therapies, as opposed to prescription medications, strict hospital protocols for laboring and delivering, etc). I welcome these questions because I believe that there can and should be room for many such ideas in our contemporary approach to prenatal care. Here are some of the most common areas in which I think alternative/complementary therapies can benefit women during their pregnancies.
There are homeopathic remedies for nearly every symptom of pregnancy, but one area where the evidence really supports their use is actually one of the most important from my perspective. Nausea and vomiting (morning sickness) is a common and occasionally debilitating aspect of pregnancy for many women. While we do have a number of safe medications to treat nausea, we have actually found that some natural agents can be just as effective. If watching the size and schedule of your meals isn’t helping with nausea, supplementing with ginger and some vitamins (specifically B6) has also proven effective and is commonly regarded as a first-line treatment for pregnancy-related nausea.
I have had innumerable patients seek treatment from acupuncturists during pregnancy for a variety of complaints – often with very positive results. Women often use this approach to improve nausea, aid with relaxation, and also to address common aches and pains of a progressing pregnancy – specifically lower back and pelvic pain. Acupuncture can also be helpful for depression and anxiety, if either seems to be worsening during pregnancy. Safety is always our chief concern, but in the hands of a licensed professional, acupuncture has not been shown to lead to an increased incidence of infections or pregnancy-related issues.
Like acupuncture, yoga is great because it addresses both the mental and the physical. Not only does it help with relaxation and cardiovascular fitness, but the stretching and strengthening involved also helps to reduce back and pelvic pain and can support the pelvic floor during childbirth. Furthermore, I am personally a firm believer that good sleep is foundational to good health (inside or out of pregnancy) and yoga can help many women mentally and physically unwind in such a way that promotes restorative rest at night.
Labor and Delivery
The other area where traditional OB and alternative medicine seem to collide is on the labor and delivery floor. As is true earlier in pregnancy, there is no reason that we can’t draw from both schools of thought to arrive at the care plan that is right for each individual patient.
I am a major advocate for doulas. Large studies have shown time and time again that women who have more (and more consistent) emotional and physical support during their labor tend to require less pain medication and they tend to have better outcomes and birth experiences.
Alternatives for Analgesia
This can be a difficult area for many mothers-to-be, for a variety of reasons. I always encourage patients to remember that, in the end, this choice is always a personal one – but that the good news is there are no wrong answers! If moms are interested in trying to avoid traditional medications and/or an epidural, there are definitely some other ways to help ease the pain of labor in a more natural way.
Staying active and mobile during the course of your labor can be a great way to cope with (and even improve) labor pain. Standing, squatting, walking, sitting on a birthing ball – each of these can help with pain and may even help women progress in labor. Another great option is to labor in the tub or shower. Submersion in warm water can have a myriad of beneficial effects on laboring women – from improved mental and physical relaxation, to better pain control.
The relationship between these various schools of thought is complex and steeped in history. In my own practice, I try to provide a model of prenatal care that involves as many of these complementary therapies as possible – while always keeping the safety of mother and baby as my first priority. Ultimately, everyone involved in the conversation wants the same thing at the end of the day: the happiest, safest birth experience possible for you and your baby.
Dr. Jeremiah McNamara is an OB/GYN provider at the OB/GYN Center, where he provides obstetric care to women with both high and low risk pregnancies. An avid cyclist and yogi, Dr. McNamara grew up in the Midwest, but now feels most at home in the mountains.