When a woman is pregnant, she needs to be taken extra care: for example about what medicines to take which might be different from when she is not pregnant. How about using complementary and alternative therapies? There was a report by Stewart et al about healthcdare professional views and experiences of complementary and alternative medicine (CAM) therapies in obstetric practice in North East Scotland. They conducted a survey about the use of CAM therapies by UK healthcare professionals for pregnant women. The participants include midwives, obstetricians, and anaesthetists. 32.5% of the respondents had recommended (prescribed, referred or advised) the use of CAMs to pregnant women. The most frequently recommended CAM therapies were vitamins and minerals (excluding folic acid) 55%; massage 53%; homeopathy 50%; acupuncture 32%; yoga 32%; reflexology 26%; aromatherapy 24% and herbal medicine 21%. Midwives who had been in post for over 5 years, had received training in CAMs, were interested in CAMs and were themselves users of CAMs were more likely to recommend CAMs. Those who recommended CAMs were 8 times more likely using CAMs themselves.
Some NHS hospital hospitals provide maternity acupuncture service for paitents. Their survey of patient attitude to the maternity acupuncture service showed that 90% of patients were satisfied greatly about the maternity acupuncture service; 69% of women said that they were benefited from acupuncture and 65% said their wellbeing had significantly improved with acupuncture service; 88% said that presence of this service at the Whttington would ensure that they would preferentially re book at the Whitttington Hospital in future pregnancies rather than any other local hospital.
Effect of acupuncture on nausea and vomiting in pregnancy
Up to 90% of pregnant women experience nausea and vomiting. Hyperemesis gravidarum is an extreme end of hyperemesis or morning sickness which is prolonged and severe nausea and vomiting in pregnancy. One of the main dangers of this condition is dehydration. Women with hyperemesis gradidarum could be constantly nausea and vomiting many times a day and it is difficult to keep fluids within the body. It could cause lot of weight loss, electrolyte imbalance and blood volume depletion. This condition is caused by hormone in pregnancy and is improved when the hormone levels go down as pregnancy turns to 13 weeks. Sometimes it could continue throughout of pregnancy. This condition is not likely to cause any harm to the baby. But there is a risk of the baby being born with a low birth weight if there is a significant weight loss during the pregnancy. Intravenous fluids and medication are used to control the vomiting and nausea.
Foods in rich carbohydrates and low fat and acid are recommended. Recommended foods include Light snacks, nuts, dairy products, beans and dry and salty biscuits. Electrolyte-replacement drinks and taking nutritional supplements are beneficial for maintenance of electrolyte balance and sufficient calories. Intake of food rich in protein is recommended. Use of ginger and vitamin B6 are effective though there is limited evidence.
Acupuncture was used in China to treat morning sickness. Carisson CP et al from University Hospital, Lund Sweden conducted a randomized placebo controlled trial to study the effect of acupuncture in treating morning sickness. Acupuncture treatments were given three times daily on treatment days. Each treatment lasted for 30 minutes. Acupuncture point PC6 was selected. Women in the acupuncture group had significantly quicker decrease in the amount of nausea they experienced compared with the placebo control group. There was also a significant difference in the amount of vomiting between the acupuncture and placebo groups. In acupuncture group there were fewer patients vomiting. There was no significant difference of food intake between the two groups. There were no side effects observed. The possible mechanisms for the acupuncture inhibiting nausea and vomiting include that acupuncture inhibits nociceptive transmission and autonomic reflexes; acupuncture decreases pain in the system; acupuncture has effect on gastric intestine tract; the effect of acupuncture is through somatovisceral reflexes.
Carisson et al J Pain Symptom Manage (2000) 20:273-9