Editor’s Note: The following article comes as a response to several pregnancy Research Corner questions. It comes from Jan’s fantastic book "The Natural Way to Better Pregnancy". There are certain references throughout the article to other chapters of the book. We have left these in for those of you who own or want to buy the book. For ordering details, visit Jan’s web site on her author page.
Thus far in the series, we have explored holistic treatment and remedies for conditions of the digestive, urinary, cardiovascular, musculoskeletal, nervous and respiratory systems. This month’s article explores alternative remedies for conditions of the skin, endocrine, immune and reproductive systems during pregnancy.
Stretch marks may be prevented by ensuring that you supplement adequately with zinc and vitamin C with the bioflavonoids. Zinc is an essential nutrient in the formation of collagen which is a component of all connective tissue. If you're zinc deficient, you'll not only suffer from stretch marks as the size of your belly and breasts increases, but you'll be more likely to need an episiotomy since your perineum will be less likely to stretch adequately as your baby is born. Cracked nipples are something else you can expect if you're zinc deficient. (See Chapters 3 and 4 for more on zinc.)
Other important nutrients for skin integrity are the essential fatty acids. Deep-sea fish, Evening Primrose and Flaxseed oils are the richest sources, and should be taken throughout pregnancy at the recommended dosages (see Chapter 4). Vitamin E and silica are also nutrients which have a positive effect on skin condition.
Unless your skin is nourished from the inside, ointments and creams may not have much effect, but--as an adjunct to nutritional therapy--you can try rubbing your breasts and tummy with oils such as olive, vitamin E, wheatgerm, jojoba, avocado, sweet almond or sesame, with lanolin, or with Comfrey, St John's Wort and Calendula ointments.
Aromatherapy oils can also be used. Try Lavender, Mandarin, Frankincense or Rosewood.
Perineal and Nipple Preparation
To prevent perineal tearing at birth, and sore, cracked nipples afterwards, the best treatment is prevention. For helpful nutrients, and for ointments and oils that can also be used on these areas of your body, see 'Stretch marks' earlier in this section. Gentle doses of sunlight and fresh air on nipples can also help prepare them for breastfeeding. Just don't overdo the exposure to sunlight, and be aware of high ultra-violet levels at midday.
Skin Pigmentation (the 'mask of pregnancy')
This condition, known as chloasma, is due to increased levels of hormones and their effect on certain nutrients such as folic acid and PABA. This is why it also affects women who take the oral contraceptive pill. Adrenal stress is also thought to be a contributing factor. Luckily (unlike the effects of the pill) the marks will disappear after pregnancy is over. The marks usually appear on the face as dark brown patches (for white skin) or white patches (for black skin). Other marks may appear, such as a dark line from the navel to the pubic area, and your nipples may darken. These changes may stay with you for ever.
Sunlight aggravates the condition, and if you have this problem, you should restrict exposure, using hats and PABA sunscreens. St John's Wort can protect against sensitivity to sunlight, either taken internally (in small doses and only for a limited period), or rubbed on as an ointment. Cosmetics can aggravate the condition, and should be avoided.
Homoeopathic remedies include Calc Sulph, Silica and Sepia, and essential oils to try are Lavender and Sandalwood.
Some women experience a general itchiness during pregnancy. This can be due to stretching of the skin, and the remedies given for stretch marks earlier in this section should help. Itchiness can also be a symptom of liver stress. Yellow Dock tea is specifically recommended for itchy conditions (use with caution, and in small amounts only), and bathing in water to which you have added Rosemary, Comfrey, Dandelion or Lavender (herbs or oils) can also help.
CONDITIONS OF THE ENDOCRINE SYSTEM
We've already talked about the tendency to hypoglycaemia (low blood sugar) during pregnancy; now it's time to look at the other side of the coin.
Mums-to-be who already suffer from diabetes need specialised medical care, but as long as they are extremely careful about their diet there is a very high probability of a successful pregnancy.
Similar precautions can give a high level of protection against the development of gestational diabetes (that is, diabetes which develops during pregnancy), which is increasing in incidence. Women at greatest risk are older mothers, those who have a family history of diabetes, have a personal history of blood sugar disturbance, have had, or were, low weight babies, or have a history of pregnancy complications.
- Vitamins C, E, B5 and B6 are preventative.
- Chromium stabilises blood sugar levels; magnesium, manganese, zinc and potassium are also important nutrient minerals.
- Essential fatty acids, from Evening Primrose and Deep-sea fish oils are helpful, as are digestive enzymes, such as papain (from papaya).
- Eliminate sugar from your diet and reduce fruit to two or three pieces daily (including those in your juice).
- Keep the liver healthy. Bitter salad vegetables and Dandelion tea or coffee will do the trick.
- Keep complex carbohydrate levels high in your diet, and balanced with protein as we've described in Chapter 3.
- Drink Nettle tea (and avoid coffee).
- Eat lots of onion and garlic.
- Eat little and often, and chew your food carefully.
- Keep your weight gain under control.
- Keep your stress levels under control.
- Get adequate exercise.
If, despite your best attempts, you are one of the 1-10 per cent of women who do develop the condition (making it the most common serious complication of pregnancy), it is still possible to use natural medicine to control the disease, though there should always be medical supervision. Take care if combining natural and orthodox medicine, as the dual approach can be over-successful, and you may develop a hypo (low) glycaemic (blood sugar) episode. Control can be achieved with the use of a glucometer. If on the meter your glucose level is 7, then you are okay; if it's greater than 9, commence natural treatment; if it's greater than 11, start medical treatment.
The first sign of diabetes is sugar in your urine, though this can also be normal in pregnancy, and is not necessarily a cause for concern. Your urine may be tested at the start of pregnancy (or before, if you practice preconception health care), though the more significant time for testing is in weeks 24-28, unless you are in a high risk category. If the test is positive, you will be sent for a glucose tolerance test to see if there is a need to treat you further. If so, you can (after consulting your natural health therapist) embark on the following treatments either as the sole therapy or as a adjunct to medical treatment, depending on the severity of your condition (but always with continued medical supervision). We don't recommend the glucose tolerance test as a routine procedure (see Chapter 11).
Other signs of gestational diabetes are unusual thirst, frequent and copious urination (unlike that of early pregnancy or urinary tract infection, when it is frequent but sparse), and fatigue (this may be difficult to distinguish from the normal tiredness of pregnancy).
- Vitamins B5 and B6 (with B-complex), chromium, manganese and zinc.
- Vitamin E (to avoid circulatory complications).
- Keep your stress levels under control.
- Eliminate all sugars. Avoid saturated fats (to keep the circulation healthy).
- Keep the complex carbohydrate levels and soluble fibre in your diet high by eating oats and oat bran.
- Use psyllium husks and Slippery Elm as extra soluble fibre.
- Eat bitter salad vegetables (dandelion leaves etc.).
- Consult a herbalist. He or she may use liver herbs (such as Dandelion Root, Globe Artichoke or Fringetree) or hypoglycaemic herbs (such as Goat's Rue, Bilberry and Gymnema).
In most cases, gestational diabetes resolves naturally after pregnancy, though, for those in the high risk categories, there is an increased chance of it remaining or returning in later life.
CONDITIONS OF THE IMMUNE SYSTEM
See Chapter 8 for a detailed discussion of allergies. We'd just like to mention here that there are herbs which can be very useful to reduce their incidence, including Hemidesmus, an immune modulator which helps to calm the excessive immune response to allergens, and Albizzia, an anti-allergy herb which helps to reduce the severity of symptoms. However, the most important aspect of your health care if you have a tendency to allergies is to keep your immune system robust (see below).
Colds, Flu and other Infections
It's important not to get yourself into the situation where you need medication such as antibiotics. Your naturopath or herbalist should be able to help you with natural medicines, but if you keep your immune system strong, infections are less likely to affect you.
- Keep taking your vitamin C every day (it's water soluble and you don't store it in your body).
- Keep your zinc status adequate (see Chapter 11).
- Take Garlic daily as a supplement as well as in your food (this helps to keep your blood pressure down too).
- Take Withania as a pregnancy tonic--it has immune enhancing properties, and boosts energy levels.
- Add Shiitake and Reiishi mushrooms to your salads, or use them as a supplement. These Japanese mushrooms are also very helpful in protecting you against the effects of radiation if you fly or use computers.
- Siberian Ginseng (Eleuthrococcus), another immuno-stimulant herb, has been shown to have beneficial effects during pregnancy. Although there are studies showing this herb to be safe, even beneficial, during pregnancy, there is also some (disputed) evidence of problems. Take it under professional supervision only. Like Withania, this herb is a good energy-booster, and also helps to protect against radiation effects.
If you are in a situation where you are at risk, take Echinacea as a preventative. If you are susceptible to infections every winter, it won't hurt to take this wonderful herb regularly anyway.
- At the first sign of an infection, start taking Echinacea tablets or fluid extract.
- Increase your vitamin C dosage (to 2 grams, 3 times daily), and your Garlic intake.
- Take two tablets of the celloid (or tissue salt) ferrum phosphate every two hours.
If a fever is involved, use Elder Flowers, Ginger and Lime Flowers as an extract or a tea. Small frequent doses are best in acute situations. Although keeping warm and inducing a sweat is a good way to reduce fever, you must take care, during pregnancy, not to let your temperature rise above 38.9°C.
CONDITIONS OF THE REPRODUCTIVE SYSTEM
As we're sure you are well aware by now, the accent in this book is not on how to deal with health problems as they arise, but on how to facilitate the healthiest possible environment for your baby's growth.
We've discussed how you can prepare for and support your pregnancy and your child's health through good nutrition, the avoidance and elimination of toxins, exercise and stress management, but there are also some 'tonic' remedies which support the healthy progress of your pregnancy and prepare you and your baby for a successful birth.
Nutrition comes into this category of 'tonics', but so do some traditional herbal remedies. We've discussed a few already like Nettle and Withania (see 'Preventative kidney support' earlier in this chapter), two renowned, tried and true herbs that have been used over time to enhance pregnancy and birth outcomes, and many other herbs we have mentioned have tonic actions on the systems which they affect.
Two particularly notable herbs are Raspberry and Squaw Vine. These both act specifically on the uterus, preparing it for labour. They can be safely and effectively used in the second, and particularly in the third, trimester. In our next book, on birth and bonding, we will look also at herbs and remedies to be used to encourage labour and deal with any problems associated with delivery, but these two herbs may be used by all pregnant women.
- The Tonic Effects of Red Raspberry Leaf. This herb tones the uterus and cervix and all the pelvic muscles and acts as a 'partus preparator' (preparing the uterus for birth). It is a rich source of calcium, iron, folic acid and vitamin E. It has been used extensively to prevent miscarriage and is one of our recommended herbs for morning sickness. Taken later on in pregnancy it can facilitate safe and easy labour, during birth it can help prevent haemorrhage, and it helps the pelvic area and uterus recover post-partum. During later pregnancy, if used as a tonic, it's best taken as a tea or infusion. You should drink 1 cupful three times daily. If used as a remedy for a condition causing concern, it may be more effective as a fluid extract, or in capsule form. In this case consult a medical herbalist about dosage.
- The Tonic Effects of Squaw Vine. This herb has many similar properties to Raspberry Leaf, being a general uterine tonic and astringent, and is helpful before, during and after birth. It's also a gentle diuretic and may help with fluid retention. It may be used safely as a partus preparator in the last trimester, and particularly in the last six weeks before birth, but also has a reputation as being useful if bleeding problems arise, and as a remedy for nausea. The method of preparation and the dosage are similar to Raspberry Leaf.
- The Tonic Effects of Reflexology. The benefits of regular reflexology treatment, especially in the latter half of pregnancy, are well established. One study performed in a London hospital showed a remarkable reduction in duration and problems of labour. The women in this study also showed a reduced level of fluid retention, backache, heartburn and hypertension and a generally increased level of overall health and wellbeing.
- Candida and other Genito-urinary Infections. Thrush is a very common complaint during pregnancy, and we have discussed appropriate treatment in Chapter 8. Using a tea-tree cream or a local application of acidophilus yoghurt can be an effective way of keeping the vaginal problem under control, though avoidance of sugar, and regular inclusion of acidophilus yoghurt in your diet are also of importance.
One infection that may persist into pregnancy, regardless of your preconception health care, is herpes, as the virus is impossible to eradicate. It's a particular problem if there are lesions present in the birth canal at the time of delivery. This can have severe repercussions for the health of the baby, including brain damage, blindness or death, and a Caesarean section may be necessary. If the disease is first contracted during pregnancy (rather than recurrent attacks being experienced), there is an increased risk of miscarriage. Natural remedies can be effective in keeping the virus dormant and in treating the blisters.
- Dormancy. The secret is to keep your immune system strong. The following may help:
- Eat well with an emphasis on fish, though avoid nuts high in L-arginine, for example, almonds and peanuts (which are not, strictly speaking, nuts).
- Keep your stress levels under control.
- No smoking, alcohol, drugs (of course!) or chocolate.
- Keep your dosages of zinc, manganese, magnesium, vitamins A (or preferably beta or mixed carotenes), B1, B6 (with B-complex), E and C (with bioflavonoids) at recommended levels as a minimum.
- Take the amino acid L-lysine (1200 mg daily) and avoid L-arginine. Lysine-rich foods include salmon, halibut and turkey.
- Take Evening Primrose and Deep-sea fish oils (or Flaxseed oils), and include raw seeds, fish and cold-pressed vegetable oils in your diet.
- Take Echinacea, St John's Wort (in small doses only and under supervision), Lemon Balm, Clivers, Reiishi and Shiitake mushrooms, and Garlic to boost your immune response.
- Warning signs. The warning signs of herpes include:
- Genital pain, itching, tingling pain with urination, vaginal discharge, tenderness in the groin
- Fever, headache, general aches and pains, depression
- Small red spots around and on the genitalia
- Lymph node swelling in groin
- Treatment. Once the warning signs are noted, and even before the blisters come out, you can apply the following remedies. Areas of severe itching and soreness are likely to be the sites of future blisters. Avoid sexual intercourse (or use a condom) to prevent infection passing back and forth.
- Take Garlic in high dosage as soon as warning signs are felt and repeat the dose every three to four hours.
- Increase dosages of immune stimulant herbs (see above).
- Apply ice to the site.
- Use Witch Hazel, Calendula, Golden Seal or Solanum Nigrum as an extract or ointment, or apply Aloe Vera (best taken fresh from the inside of a fleshy stem) directly to the area.
- Cotton wool balls soaked in ether can be applied to reduce the pain. (Warning: ether is highly flammable.)
- Apply zinc sulphate solution directly to the vaginal area.
- Essential oils which can be applied directly (though diluted or in a cream) include Rose, Lavender, Lemon, Sandalwood and Bergamot.
- Tea tree oil can be applied directly to blisters.
- The homoeopathic remedies Rhus Tox or Nat Mur may help.
Mastitis or Sore Breasts
If your breasts swell uncomfortably or become tender, try these remedies.
- Keep up your supplementation of the B-complex vitamins (especially B1, B3 and B6). B6 may need to be increased considerably (see Chapter 4 for more on dosage). Other important nutrients are vitamins C and E, selenium, zinc, manganese, calcium and magnesium.
- Keep taking and eating Garlic, Evening Primrose and fish oils.
- Useful ointments include St John's Wort and Poke Root (not to be taken internally).
- Steam or bruise a cabbage leaf and wear it inside your bra.
- Massage your breasts and under your arms.
- Drink Clivers tea to encourage lymphatic drainage.
- Avoid coffee, dairy food, refined carbohydrates, salt and all animal foods containing chemicals. We certainly hope you are doing this already!
- Don't worry if you notice increased surface blue veins in the breast, or if your nipples become darker.
This is not always a precursor to miscarriage, and although it should be heeded as a warning sign, some women bleed quite persistently throughout pregnancy without any major problems. If it is accompanied by cramping, the problem may be more serious. While it is important to seek medical advice as to the possible cause, there are several useful herbs which can staunch the flow of blood.
Shepherd's Purse, Beth Root, Raspberry and Squaw Vine are all helpful, as are Oak Bark, Cranesbill and Ladies Mantle. They can be taken as a tea or fluid extract, every four hours. Dong Quai and Peony have also been used to great effect, though Dong Quai should not be taken in the first trimester.
Increase zinc to improve collagen strength and improve connective tissue formation in the amnion (the membranous sac which encloses the foetus in the womb).
Step up your vitamin C to increase the strength of the capillaries and collagen. You can increase the dosage to the level your bowel will tolerate.
Increase your bioflavonoids intake to strengthen the vascular tissue of the uterus and the placenta.
Take it easy. Bed rest is advised if the situation persists, with your legs elevated above the level of your head. If you're not in bed, try not to stand for too long, and keep your stress levels under control--try not to worry!
Premature Rupture of Membranes
If the amniotic fluid starts to leak, it will not necessarily lead to a miscarriage, though medical advice should be sought. Zinc, vitamin C and bioflavonoids, beta or mixed carotenes and vitamin E have all been shown to contribute to healing. It may be wise to take immune stimulant herbs (see 'Conditions of the immune system' earlier in this chapter) and Garlic to help prevent infection. Acupuncture and reflexology can both be very helpful.
If the cervix has been weakened by previous terminations, or if it is inherently weak, the pressure of the baby and amniotic fluid, as the pregnancy progresses, can cause it to dilate and bring on a miscarriage. Once incompetency is diagnosed, the medical treatment is to put a stitch in the cervix during the pregnancy. Unfortunately this procedure requires anaesthesia and can itself cause miscarriage. If the pregnancy progresses through to term, the stitch is removed at around week 38 or 39 of pregnancy.
Obviously prevention is preferable to cure, and good nutrition and health care can help considerably, so if you are aware that this may be a problem, make sure that your nutritional status is good. We know of at least one case where visualisation (of a webbed hammock-type sling around the uterus) seemed to change a pattern of incompetence for the better.
Again, this is a case for prevention, not cure, as, once an ectopic pregnancy has occurred, surgery is unavoidable. If the Fallopian tube is not removed, then recovery can also be assisted with natural remedies. Good nutrition, with particular attention to zinc, magnesium, vitamin A (or beta-carotene) and vitamin E, is essential for the health of the Fallopian tubes, and the cilia (or tiny hair-like projections) that line them. These nutrients can also assist the healing of scar tissue. Since tubal blockage or dysfunction is the principal reason for ectopic pregnancy--where the egg is prevented from reaching the uterus and implants in the tubes--preventative care, especially where there has been a previous history of the condition, is essential. Remember that high levels of copper or the heavy metals contribute to zinc deficiency.
With ectopic pregnancies there is usually severe pain, and immediate surgery is essential. One confusing factor is that the pregnancy itself may be unrecognised, as urine tests may not show positive (though blood tests will). There is certainly no place for natural treatment of the condition, but Calendula and Golden Seal, two herbs which are not advised in pregnancy, can aid recovery, helping to regenerate healthy tissue. Silica tissue salt (or celloid) can also be useful.
Genito-urinary infections may also be involved. See Chapter 8 for more on these.
Miscarriage is most common in the first trimester, and it is estimated to affect 20 per cent of pregnancies. This rate may be even higher, as not all miscarriages are detected. The Miscarriage Association in Great Britain estimates that the rate may be as high as 35 per cent, or even 40 per cent.
Miscarriage is preventable, it is not just 'one of those things', and there is little point in giving just the advice 'to try again' unless attention is given to those factors which could cause miscarriage, and which are amenable to treatment. Miscarriage can be prevented by ensuring that the foetus is viable, the environment in which it grows is healthy, and that undue stress or trauma, of either physical or emotional origin, are avoided, especially during the first trimester.
Most miscarriages occur in the first three months of pregnancy, and are often the result of factors present at the time of conception. Because of this the best way to avoid them is to practice preconception health care for a minimum of four months before your pregnancy starts. This helps enormously to ensure that the foetus is viable and the environment in which it grows in the early weeks is healthy.
If you have been unlucky enough to lose a child during pregnancy, you can still feel very optimistic that you can prevent it happening again. Studies conducted in England by Foresight, the Association for the Promotion of Preconceptual Care, showed no miscarriages in a sample of 367 couples who completed the Foresight program, though the normal expectation for this sample would be 70.
If you are lucky enough to be pregnant right now, then putting into practice the advice in this book will go a long way to keeping your pregnancy and baby secure.
The first symptom of a miscarriage is bleeding, sometimes accompanied by cramping or a dull ache. Neither of these symptoms will necessarily lead to miscarriage when experienced separately, but when they come together, or if either is extreme, you should seek immediate medical advice. You can also use the remedies indicated here, though if the miscarriage is already under way, you may be too late. If these remedies are started at the first sign of spotting, or taken as a preventative if you have a history of miscarriage or have conceived under high-risk conditions (such as through IVF), there is a good chance of success.
Many women worry that they may be saving a non-viable pregnancy, and end up with a child with health problems, but this is unlikely to be the case. Natural remedies for miscarriage are unlikely, at this point in your pregnancy, to have any effect on the foetus, but can certainly affect the uterine environment to make it more hospitable and stable.
If you experience symptoms that concern you, if you are at risk, or if there is a sudden change in your condition, these remedies may help.
- Bed rest (with legs raised).
- Avoid intercourse.
- Ensure continued good nutrition with extra supplementation of zinc, 40 mg, twice daily; vitamin C, 2 grams, twice daily, and bioflavonoids (especially from cherries and citrus); B6 (with B-complex) 100 mg daily (or 250 mg daily if you have a history of low progesterone); beta-carotene (or mixed carotenes), 6 mg; vitamin E, 1000 IU daily.
- Reflexology, acupuncture (from a professional if possible).
- Homoeopathic remedies are Aconite, Arnica, Belladonna, Chamomilla, Ignatia, Pulsatilla and Sepia may all be helpful--but only one remedy is required. It's best to let your homoeopath choose.
- Herbs are excellent therapy. Traditionally, they have been used with much success and a formula should contain remedies to deal with several possible areas of concern.
- For continued adequate progesterone levels take Chastetree and Peony. These herbs are always helpful, but are particularly indicated if there has been previous low progesterone, as shown by symptoms of pre-menstrual syndrome, an inadequate temperature rise after ovulation, or a short post-ovulatory phase of the menstrual cycle.
- For possible overactive immune response take Reiishi, Shiitake, Hemidesmus and Albizzia. These herbs are particularly recommended where there is a history of allergy or auto-immune disease, and also where conception occurred as a result of IVF or other reproductive technology.
- For uterine "tone" and circulation, take False Unicorn Root, Wild Yam, Peony, Black Haw or Cramp Bark.
- For cramping, take Cramp Bark or Black Haw.
- For bleeding, take Shepherd's Purse or Beth Root (see further recommendations in 'Breakthrough bleeding' above).
- Raspberry and Squaw Vine have been used traditionally but are best restricted to the second (or third) trimester.
After a miscarriage, it may be necessary to proceed to a dilation and curettage (D&C). Your naturopath, herbalist, homoeopath, masseur, osteopath, acupuncturist or reflexologist can help you to recover physically, and you may need some emotional support to help you grieve and move on from what is, undoubtedly, a very traumatic experience. You should attend to your preconception health care before any future pregnancy.