Ask an expert - body - women's health - pregnancy

22 questions

q:

Hi. I have a.bmi of 46.and am.currently 22 weeks pregnant and have pgp. Does bmi.effect how acupuncture works?

 

a:

We can say categorically that someone's BMI has no impact at all on whether acupuncture works. From a Chinese medicine perspective the body is seen as a complex flow of energy, called 'qi', and putting a needle into a point will have an effect whether the person's BMI is 15 or 50. Generally speaking there are often energetic reasons why someone gains a great deal of weight, over and above lifestyle considerations and straightforward heredity, and these may have an impact on how much progress someone can make, but that will all be a part of the picture which the practitioner builds up and works with.

Indeed, there is some very good evidence that acupuncture can help with PGP. Studies such as this one published in the BMJ

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC555858/ seem to be very encouraging. In fact the same researcher went on to look at whether there was any potential for harm and concluded that while there may be some minor transient effects there was no serious risk

https://www.ncbi.nlm.nih.gov/pubmed/18582370

We are by nature a generalist healthcare modality, i.e. we treat the person, not the specific problems they have. In practice, of course, we are all able to go after specific symptoms as well as balancing up the whole system, but we believe that treating a symptom without regard to the whole is leaving things half finished. This means that we regard all of our members as capable of treating any patient who comes to them. However, we are close to reaching agreement on the treatment of pregnant women as an area of expert practice for which we have recognised postgraduate training. In the circumstances it would be highly advisable to go to someone who has had this kind of training and who has spent more time looking at the specific issues of pregnancy.

Unfortunately we haven't signed this work off yet, but we are pretty sure that if you type into google your place of residence, acupuncture and pregnancy it will generate a number of hits of our members who specialise in fertility and pregnancy issues. Failing that you could always call a local BAcC member and ask them to point you towards someone locally who has these skills. We are always very keen to see patients get the exact care they need.
 

 

 

 

 

Q: I am very interested in Acupuncture.

I am 32+ weeks pregnant and I was thinking to begin acupuncture in the 37+ week. I read it can relief a lot the pain in labour and helps deliver quicker. Could you please advice me? Because it seems that midwifes and GPS don't know much about it.

A: As you can see from our factsheet on obstetrics

https://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/1592-obstetrics.html

there has been a considerable amount of research into many areas of pregnancy, from early stage morning sickness through breech presentation and on to delivery itself. While the evidence is a long way from conclusive (it does tend to be, but this is more a reflection of the standards used in the West which may not be the most appropriate for evaluating acupuncture treatment), it does show a trend towards acupuncture treatment being worth a try for many of the problems/challenges associated with pregnancy/delivery.

Although we describe ourselves as generalists - we primarily treat people, not diseases or conditions - there are one or two areas where the training which we all have can be usefully supplemented by postgraduate training. In two of the most clear-cut cases, obstetrics and paediatrics, the training is now sophisticated enough to warrant a decision on recognising expert practice, i.e. someone can legitimately claim within our rules to be an expert at treating these specific patient groups. While we are not yet yet in a position to do this, ultimately it will mean that we can specify which training people have had and point to providers who all keep lists of their graduates and affiliates. In the absence of this, the best that we can say is that if you use google and search on 'acupuncture pregnancy' and your home area you will without doubt generate a number of hits, most of whom will be BAcC members.

There are a number of websites associated with the training providers which can be very helpful, often addressing many of the questions which people bring and have brought to their practitioners. The best advice we can offer, though, is that having located a person or people in your area who may be able to help you should arrange to see them for an informal chat to see how they can help you and also to see whether they are people you feel comfortable with. In most cases we would say that one practitioner is as good as any other, but childbirth  is a very intimate process and it would be especially good if you have confidence in and rapport with the practitioner. The earlier you establish this contact the better, even though you may not call on their services until near due date.

We are sorry that there is such a dearth of provision within the NHS. There have been a few hospitals like the Derriford in Plymouth which had a remarkable unit which incorporated acupuncture in all aspects of pregnancy, but that unit, like many others, has closed. The problem for NHS professionals is that most provision is evidence based, and as we said at the top, the evidence for the benefits of treatment is not quite good enough for NHS providers to bring acupuncture treatment within mainstream care. You may find some midwives with training in the basic skills, but these are few and far between.

We hope that you do manage to locate a good practitioner locally, and wish you every happiness with your baby's birth.

Q: I am seeking a bit of advice. I suffer from migraines and acupuncture has been extremely helpful to me which was suggested by my neurologist. I am now 16 weeks pregnant and I am having another episode where I am struggling to function the same as they were 12 months ago. The physiotherapist that treated me with acupuncture previously has refused to treat me this time due to the risks of miscarriage due to where the needles should be placed. Could you advise me if this is the case and that I should avoid for the foreseeable future?

A: The BAcC has been giving advice on its website for years which says:

How can acupuncture help during pregnancy?
Many conditions which routinely crop up during pregnancy would benefit from a natural solution. Acupuncture, when provided by a trained practitioner, can give relief for a range of pregnancy related conditions:

  • Morning sickness
  • High/low blood pressure
  • Anxiety
  • Tiredness
  • Constipation
  • Tender breasts
  • Migraine and other headaches
  • Back ache
  • Pelvic pain (Symphysis Pubis Dysfunction)
  • Varicose veins

This very much reflects what Debra Betts, one of the leading acupuncture experts in the field of obstetrics says on her own website

https://acupuncture.rhizome.net.nz/acupuncture/pregnancy-childbirth/acupuncture-use-pregnancy/

The problem usually arises when people use formula acupuncture, that is a kind of 'cookbook' approach where each condition with which someone presents has a specified group of points which a practitioner can use. There are, indeed, a number of points which we avoid during pregnancy because they have a strongly downward and expulsive effect, and it is highly likely that some of these are in the cookbook which the physiotherapist is using.

However the great strength of traditional acupuncture is its self-contained and completely systematic understanding of the system which means that there are many alternative ways of addressing the imbalances in the system which are causing the migraines. This may mean that you have to seek treatment with another acupuncture practitioner, but we have always taken the view that in the hands of a properly qualified and trained practitioner there should be no risks at all in treating migraines and many other conditions during pregnancy.

There are an increasing number of BAcC members who now take specialist postgraduate training in obstetrics, and in the foreseeable future we expert to recognise them as 'expert practitioners.' When this happens we will be able to offer a list of possibilities, but for now you will find that using google and searching under 'acupuncture and pregnancy' alongside your area will generate a number of hits of our members with specialist training. These may be the best bet, because they will probably have a more in depth understanding of the energetics of pregnancy.

We mean no disrespect to the physio, by the way, but because the majority of their work is western medical acupuncture and within their scope of practice it is not surprising that they are cautious when taking on more specialist areas of practice, and for that your practitioner should be commended.

We wish you a peaceful and stress-free pregnancy, and hope that treatment brings you the relief you need. We also hope that if you do see a BAcC member with specialist training they can perhaps help you with some of the later stages of the pregnancy.

Q: I had an embryo transfer today and had acupuncture after the lady used a heat lamp on my abdomen after reading up I am worried as it says don't heat stomach.

A:

We are sorry to hear that you are concerned about this on a day when you are probably incredibly concerned about what is happening anyway.

You have probably found websites about heat lamps which say something like:

We recommend that the lamp is not used in cases of fever, diabetes, peripheral vascular conditions, or serious arteriosclerosis. All of these conditions are contraindicated where the application of heat treatment is concerned. In the cases of diabetes (I & II) and peripheral vascular conditions, the specific reason is that the individual may experience lack of sensitivity and/or numbness in certain areas which could in turn lead to possible burning of the skin should the lamp be placed too close to the body. Not suitable for pregnant women. Patients with hypertension must avoid treatment of the head. Patients who wear a pacemaker should avoid treatment of the chest. If using the lamps around the head or face, ensure that the eyes are protected.

and this indeed is the information which we tend to use with members asking about safety. One of our members, Zita West, who writes extensively about this aspect of fertility treatment sets out some very straightforward guidelines here:

http://www.zitawest.com/do-i-need-to-rest-after-an-embryo-transfer/

However, if your practitioner is properly trained and qualified, and we assume that she is, then we suspect that there are probably energetic reasons for applying heat to the lower abdomen to maximise the chance of a successful implantation. Many cases of problem fertility have a root, in part at least, in coldness in the lower abdomen, and if the practitioner believes that this is the case it would not be surprising if this were to be added to the treatment.. This would be more a matter of enhancing the chances of implantation after transfer rather than interfering with an existing pregnancy.

The simplest solution in cases like this, though, is always to ask the practitioner herself why she used the lamp, and whether it is safe. A responsible and trained practitioner will invariably be more than happy to explain what they do and explain too the safety of nearly all acupuncture procedures. A part of our work is to be available to patients before, during and after treatment to set their minds at rest about what we do. We use acupuncture every day, so it is not an exceptional thing for us, and we have to remember all the time how unusual and a little weird it is still perceived to be by many people.

If the answer you get is unsatisfactory, or even if it is and you still don't feel comfortable with heat being used, then simply ask that this is not done again. We doubt that what you have had done already could have done any harm, and it may be quite the reverse.  However, it is very important at this time that you feel as relaxed and confident as possible, so if this is likely to be a source of concern, then ask the practitioner not to do it again.

We wish you well, and hope that the transfer has been successful.

Q:  I m trying to be  convinced , but my period stopped from three months.  My doctor says I m passing through the premonopouse.  I am 37 years old.  Should I get pregnant ? What should I do to get  my period back?

A:  We are sorry to hear of your problems. Early menopause can be a terrible blow when someone decides to have a child at what should be a perfectly normal age to conceive.

As our factsheets show

http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/female-fertility.html

http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/menopausal-symptoms.html

the treatment of fertility and menopausal problems has been an area of great focus within the last decade, and a significant proportion of BAcC members undertake postgraduate training in treating fertility issues. We are actually on the verge of agreeing standards which allow someone properly qualified to claim to be an expert provider. Speaking to someone with this kind of training background who may be based near to you would be an extremely useful thing to do. We cannot tell, for example, whether your doctor's view that you are peri-menopausal or menopausal is based on blood tests of hormone levels or just an assumption based on the fact that your periods have stopped and you are in the right age group. There may also be family history which would give some insight into what is happening. If there is a history of early menopause in your family that could make a significant difference to what you could expect from treatment.

Once someone is armed with this background information it is possible to offer a much better idea of what may be possible. As this rather dense and heavy study shows

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3962314/

there have been interesting and often successful studies of almost all aspects of women's reproductive health, so there is every reason to believe that if you have not fully entered the menopause treatment may be able to enhance the remaining functions of your body.

Our advice, as always, is to visit a BAcC member local to you who can tailor the advice to your specific circumstances. The one thing they will need to know is whether your doctor has checked your hormone levels and if they show that you are truly in the menopause. This will have a huge impact on the advice they can offer you.

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