CHILDBIRTH AND AFTER

The most important aspect of the Eastern philosophy of medicine is the concept of the balance of energy flowing through and contained in the body. The Chinese refer to Yin and Yang as being opposite yet complementary factors. Here are some examples of Yin and Yang.

YIN YANG

Inferior Superior

Front (abdomen) Back

Interior organs Exterior organs (skin)

Structure Function

Water Fire

Quiet Noise

Wet Dry

Slow Rapid

Storage Distribution

Curled up Stretched out

From these examples you can see that the process of development in the womb is predominantly influenced by Yin. Life, however, is one of balance and leading up to the delivery the balance is redressed by the more Yang-dominated energy of delivery.

It is best, therefore, to support the promotion of Yang as we move towards the latter part of pregnancy because a deficiency may create the problems that can be associated with delivery.

ONE MONTH BEFORE LABOUR

One month before labour there is going to be a strong desire to get all this hoo-ha over! In some

US clinics, weights are attached to the husband’s abdomen and chest and they are asked to wander around like that for a short time. We men are not aware of the strain and effort that goes into the later stages of pregnancy. A pregnant mother will be fed up with the restrictions but, hopefully, will have enjoyed the health that is usually associated with pregnancy.

It is around this time that thoughts turn to the preparation for delivery. A lot of intervention is not needed, of course, but certain preparations can be made to try to reduce any delays with the delivery.

RECOMMENDATIONS

RECOMMENDATIONS

Regular practice of the pain-relieving techniques taught through hypnotherapy earlier in the pregnancy should be practised.

Ensure that, by now, your partner has a grasp of the Shiatsu pressure points; if not, pack him off to the practitioner to learn.

Daily yoga, however uncomfortable it may be, should be continued to ensure good muscular tone.

Ensure relaxation, breathing techniques or meditation is continued to engender a sense of calm leading up to the event.

Contact your preferred complementary medical practitioner and glean any advice.

Ten days prior to the expected delivery date take the homeopathic remedy Caulophyllum 30 for seven days before bed, and for the last three days before the delivery date use Caulophyllum 200 before bed. This higher potency can be used for up to one week if the delivery date is passed.

ALTERNATIVE TECHNIQUES FOR INDUCEMENT OF LABOUR

There is rarely a good reason to induce a delivery but if there is no sign of labour two weeks after the expected date (remember that the date calculated from the last period and the day suggested by the scans during pregnancy may differ due to the length of the mother’s monthly cycle) then pressure may be applied by the midwives and consultant. The reasons are simple and sound: the baby may grow to a size that may make it difficult to fit through the pelvic rim; and the placenta may be unable to sustain the baby’s nutritional and oxygen requirements.

Provided that the obstetrician and the ultrasound scans agree that the baby is of correct size, then alternative techniques for induction of labour can be employed ten days after the expected delivery date.

The homeopathic remedy Secale cornutum 30, four pills every 3hr.

Acupuncture or specific acupressure (Shiatsu) points can be activated. The specific points are:

GB21 (gall bladder 21) – on the highest point of the shoulder where a perpendicular line drawn from the nipple crosses the top of the shoulder;

LI4 (large intestine 4) – in the centre of the flesh before the first and second metacarpal bones (in the hand);

LIV3 (liver 3) – in the depression up the foot from the big toe and the second toe.

BL67 (bladder 67)-on the lateral side of the small toe at the base of the toe nail;

SP6 (spleen 6) – three thumb-widths above the tip of the inner ankle bone and backwards to the edge of the bone; ‘ Fluid extracts of Pulsatilla or, if available, Caulophyllum can be taken, ten drops in water every three hours. 1 Raspberry leaf tea, one teabag in a mug four times a day. < Reflexology can be utilized on the uterine and pituitary points on the feet.

A brisk walk.

Sexual intercourse.

Nutrition

There is no need to alter the diet, particularly if all has gone well through the first eight months of a pregnancy. Always consider your intuition and cravings as being the best guidelines. You may encourage Yang energy building up towards the expected delivery date by adding the following foods into the diet. They should not be taken in excess nor too early in the pregnancy because, as explained above, the uterine environment is predominantly Yin and excess Yang may cause problems. The foods to increase are: lamb lobster and shrimps basil, dill, sage, cinnamon, thyme, clove, nutmeg, garlic, ginger and fennel.

Exercise

RECOMMENDATIONS

Ensure that stretching exercises are practised regularly throughout the day. The act of squatting with your knees as far apart as possible and the back supported by your partner or a wall is excellent.

Practise holding certain positions that you may choose at the delivery and hold these postures for as long as you can.

Walk and swim: 15min of swimming and 40min of walking (provided that your back is all right) is a sensible plan.

Medication

It is not necessary to consider the use of medication for, or leading up to, delivery. However, certain treatment protocols can be used if mild problems or symptoms are arising. These should be dealt with according to the symptoms and in consultation with your health practitioner.

RECOMMENDATIONS

See earlier in this section for the use of

Caulophyllum.

Pulsatilla fluid extract – 1 teaspoonful in water four times a day, starting the day before delivery is expected.

Apply a combination cream of Arnica, Calendula and Urtica to the outer aspects of the vagina, the perineum and around the anus. Do so three or four times a day to prepare the area for the stretching that it will undergo. Arnica or Calendula creams will suffice, as will olive oil, if the combination is not readily available.

BRAXTON HICKS

These contractions, named after the gynaecologist who felt that attention should be drawn to them, can occur any time from six weeks before the expected date of delivery. They tend to be infrequent, which differentiates them from the contractions of the first stage of labour, although Braxton Hicks contractions may be very powerful and can lead to the concern about early labour.

RECOMMENDATIONS;

If you have any doubts, be reassured by your GP or gynaecologist.

If the contractions create anxiety, you may use Aconite 6, four pills every hour for three doses.

DELIVERY (LABOUR)

I prefer to use the word delivery because it has the connotation of the arrival ofa wanted gift. The term labour, whilst accurate, has a somewhat negative ring to it! Delivery is divided into three parts: the first, second and third stages of labour. Before discussing the details of these, let us cover one or two other points.

At the onset

When delivery seems imminent – by the ‘show’, the breaking of the waters or by frequent contractions – the following can be recommended.

RECOMMENDATIONS

Walk about. The Yang energy is encouraged by movement.

Increase the glucose levels in preparation for expending energy by eating light meals, preferably of complex carbohydrates (whole grain bread, brown rice, honey).

Sleep as much as you can, especially in the breaks between contractions.

Cry if you wish and be open to demanding love and support at a notoriously insecure time.

Placenta previa

Placenta previa is the medical term for the positioning of the placenta within the uterus in such a way that it covers the opening from the uterus through the cervix into the vagina.

A full placenta previa has never been corrected by a complementary medical technique in my experience, although many times I have seen a partial placenta previa ‘move’ after therapies. It should be mentioned that this may occur in any case as the uterus enlarges.

Osteopathy in combination with Tibetan or Chinese acupuncture and herbal treatments has most often proved successful.

Do not allow an excess of ultrasound investigation to be performed. Once a scan has identified a placenta previa, do not have repeated tests; have a rescan one month before delivery and if things have not changed then consider orthodox management of the cervix and the first 4cm of dilation. At this time a ‘show’ may occur, which is the exiting of the mucus plug that has been a major protective factor in the cervical ‘os’ or opening. The ‘waters’ (the protective amniotic fluid sack) may break before the first stage of labour or in the early part. This natural lubrication is an important indication of delivery and excessive drying of the fluids should be avoided. Contractions should be occurring at 10-20 minute intervals and lasting up to 30 seconds.

Dilation from 4cm to 10cm can take a matter of minutes or several hours. The recommendations below can help to shorten this timespan. During this dilation, contractions will last for 20-90 seconds, be profoundly intense and painful and can occur anywhere between 10 minutes and 30 seconds apart.

Your natural instinct with regard to breathing, and the training you will have received through your antenatal care and yoga classes is never more important than at this stage. The desire to push down and expel the baby is at its strongest, but pushing too early can tear the cervix and lead to difficulties. Your midwife will be very experienced and supportive, leaving you with little doubt as to how your breathing should be. Do not worry!

Pain relief

Delivering babies is painful. Pain is relative and some mothers are better equipped anatomically and physiologically than others to handle the discomfort. But nobody has a pain-free birth unless they have a very high-level meditation technique!

Do not be ashamed or embarrassed to ask for pain relief.

Use the self-hypnotherapy techniques taught to you for the pregnancy. Use acupressure techniques .

BL31 (bladder 31) – a tender spot at the base of the spinal column approximately one hand-width above the buttocks in the mid-line. Please note that the use of these pain relief points may shorten contractions and therefore should be used only at the point in time when pain is most severe, otherwise labour may be prolonged.

ST36 (stomach 36) – four finger-widths inferior to the knee cap and one finger outwards.

BL60 (bladder 60) – in the depression half-way between the outer ankle bone and the Achilles tendon, level with the most prominent point of the ankle bone;

Use Chamomilla 6 (four pills every 15min) for intolerable pains, especially associated with the back. If fear or shivering is present, consider Aconite 6 (four pills every 15min).

Use the ‘gas’ (nitrous oxide) as much as you like.

If these measures are not effective then do not hesitate to ask for an epidural. It may take some time for the anaesthetist to arrive, so call for the best friend you will ever have, sooner rather than later!

The delivery of the head is the most difficult and time-consuming part of this second stage. Hopefully the process will be swift, but delays can occur. The most unpleasant aspect is the sensation that the perineum (the area between the vagina and the anus) is tearing. This is not often the case and the use of the mixed Arnica, Calendula and Urtica cream beforehand generally reduces the risk. The midwife will be applying considerable pressure in this area to avoid tears.

RECOMMENDATION • Make sure that the midwife is aware of the sensations you experience and encourage her to give more support or apply more pressure.

DELIVERY – SECOND STAGE OF LABOUR

Now we are getting down to it, the waiting is nearly over. There may be a break between the first stage and second stage, especially in a first pregnancy, and if this is the case, rest.

The second stage starts when the cervix is fully dilated and ends with the delivery of the baby.

Delivery position

There is no correct or incorrect position to deliver a baby. Instinct combined with particular and individual anatomy will make this decision for you . The principal options are:

A Lying semi-prone on your back with feet together and knees apart or feet in stirrups;

B Lying on either side with the upper leg raised;

C Standing with buttocks supported against the bed;

D Squatting, using your partner’s knees and thighs as an ‘armchair’ support;

E On the knees leaning against the bed or on all fours.

Any of these positions can be utilized and changes from one to the other will be determined by how you are feeling.

RECOMMENDATIONS

Choose your atmosphere. There is no right or wrong.

Be comfortable with those in attendance. If grandmother, mother, sister or milkman provide you with the most support, then invite them to be present. Do not crowd out the midwife, however! • Unless there is a medical reason, avoid monitors. The presence of modern medical technology creates the perception of the possibility of something going wrong. Both Mum and Dad already have their fears, especially in a first delivery where they are launching into the unknown, and asking the midwives only to use equipment when essential is not risky but better for the psyche.

DELIVERY – THE THIRD STAGE OF LABOUR

Birth ends when the placenta is expelled in this, the third part of delivery. Occasionally, bleeding may persist and the midwife may push down hard above the pubic bone. If this does not stop the bleeding, a drug derived from a natural plant extract called ergotamine may be injected into the mother’s arm. This causes the uterus to contract and applies pressure to the bleeding vessel, thereby stopping the haemorrhage.

The midwife will gently push any blood that is in the umbilical cord towards the baby and within a couple of minutes the cord, which actually pulsates, will come to rest. At this time the midwife will cut the cord by placing two clamps near the baby’s tummy and cutting in-between. The clip nearest the baby will remain in place anywhere up to 24 hours or so before the cord closes off completely and the remnant drops away, leaving a sealed umbilicus or belly button.

Occasionally bleeding may occur and, if too prominent, ergotamine may be injected to encourage uterine contractions.

Follow the midwife’s instructions and if any problems have arisen let the professionals get on with their tasks.

The remedy Secale cornutum 30 should be taken every hour for three doses to encourage uterine contraction.

Rehydrate as soon as it is comfortable to drink water. Any persisting soreness should be treated with Bellis perennis 30 every 3hr.

Arnica 200 should be taken every 12hr for six doses, to deal with the inevitable physical and mental strain.

The baby

Instinct will take control for both mother and baby. The baby will either rest or seek the nipple and the first feed is extremely important because it provides a special type of milk called colostrum, which aids digestion. Baby’s breathing will be very smooth and natural and is stimulated by the cooler temperature and will not need the much-heralded slap on the bottom. This is not a nice way to start life and the midwife should be asked not to do this. Nowadays, most midwives wouldn’t consider it, but some die-hards may habitually use the technique!

PREGNANCY AND CHILDBIRTH

The baby should be allowed to suckle as soon as possible after birth.

RECOMMENDATIONS

Allow baby to suckle as soon as possible but do not force the point.

Refuse antibiotics in the baby’s eyes and, in preference, when baby has finished his first feed squeeze a few drops of breast milk into the eyes to cleanse them.

Until all controversy has passed, do not give the vitamin K injection. There may be some problems with this vitamin in injectable form and it can promote a tendency to jaundice.

The baby will have bonded with his mother well before delivery and possibly even with the father through hearing his voice. Time spent together at this early stage is very worthwhile.

PHYSICAL PROBLEMS AFTER DELIVERY

For example, mastitis is more common through lactation but because it can occur elsewhere it is covered in its own section. A few problems are specific to postpregnancy and these are mentioned below.

Episiotomy

Occasionally tears will occur in the perineum, simply because the baby is fractionally too large and the stretch of the vagina is too little. There is not much that can be done at the time although the repair process afterwards can be hastened and the appropriate techniques are mentioned below.

Iatrogenic – ‘caused by the physician or, in this case, the midwife – episiotomy is sometimes required. The process involves injecting local anaesthetic (although this is frequently not required) and a surgical incision is made back from the vagina towards the anus. It is a messy and bloody procedure that can be quite a shock if the delivering mother and attending partner are not aware of this. Done properly, the area is stitched up after the delivery and does not cause complications. It is sometimes safer to have an iatrogenic episiotomy rather than allow nature to create its own tear, although a natural tear is thought to heal quicker. Should an episiotomy of any sort occur, the following recommendations should be followed after the delivery.

RECOMMENDATIONS

Splash alternate hot and cold water over the area for two minutes four times a day until healing is complete.

Apply Arnica or Calendula creams to the area and flush the vaginal vault with a dilute solution of Arnica or Calendula fluid extract.

Use the homeopathic remedy Bellis perennis 6 (four pills four times a day) until healed. If the wound has not completely resolved or discomfort or discharge prevail after five days, then bring the problem to the attention of your gynaecologist, health visitor and complementary health practitioner.

Painful nipples

Whilst this can happen through chafing at any stage of life, painful nipples are most commonly associated with suckling.

RECOMMENDATIONS

A tablespoon of olive oil with the juice of half a lemon can be applied four times a day (but wash off before feeding) at the first hint of nipple soreness. If the nipples have a tendency to crack, this should be done twice a day as a prophylactic.

Cracked nipples will benefit from the homeopathic remedy Graphites or Silica, potency 6, taken every 2hr at the onset and reduced to every 4hr once healing has started.

It may be necessary to express milk by hand or pump to give the nipple time to heal away from baby’s mouth.

Nipple guards (transparent plastic covers) may be used until the problem has resolved.

Abdominal muscles

More than anything, a pregnancy causes abdominal muscles to stretch. In an ideal situation a pregnancy would be started with good abdominal musculature because this will return much more easily to its pre-pregnancy state.

RECOMMENDATION • Exercise as frequently as possible through the early part of pregnancy, with gentle abdominal exercises, and return to these as soon as you are capable after the delivery.

Engorged breasts

Engorged breasts occur for two reasons: because the production of milk exceeds the demand and use, and because of engorgement of the breast tissue by excess fluid, encouraged by the persisting high levels of female hormones.

RECOMMENDATIONS

Ensure that the baby gets all the milk he or she desires; any excess should be expectorated by hand or pump and kept for up to 12hr in the fridge. This might allow Dad the opportunity of a feed and give Mum a rest.

Soak the breasts in a hot bath or apply hot flannels or heat pads. Occasionally, ice wrapped in a flannel may benefit if heat does not.

Supplements may help breast fluid retention and can be taken without unduly influencing mother’s milk. The mother should use the following: Vitamin B6 (50mg), Evening Primrose Oil (l,000mg two or three times a day) and zinc (15mg before going to sleep).

The homeopathic remedies Phytolacca 6 or Natrum muriaticum 6, taken every 15 min, may help.

Acupuncture and herbal treatments may be of benefit in recurrent problems and a practitioner could be consulted.

The use of paracetamol is acceptable as a last resort but should be taken after the baby’s feed so that the body can metabolize it before the baby’s next meal.

Stretch marks

The increased size of the abdomen through pregnancy can stretch the skin and create a scar-like appearance.

RECOMMENDATIONS

Prevention is the best bet and application of olive oil with lemon juice (half a lemon squeezed into a tablespoonful of pure virgin olive oil) may make a difference.

Gentle massage regularly may increase blood flow and recover the overstretched elastin fibres.

Return to abdominal exercises as soon as the baby is delivered and Mum is up to it will help.

A Calendula- and Arnica-based cream (if a mix is not found, use one of each) applied four times a day.

Vitamin E oil may also benefit if applied regularly.

Breast-feeding

Many women find it difficult or unpleasant to breast-feed and I am reluctant to make the statement ‘breast is best’ for the sake of those mothers who may take on an element of guilt or unworthiness. But …

Nature has been at breast milk formulation for millions of years, as opposed to the pharmaceutical industry who have done a good job over the last 40 years. Breast milk contains a variety of nutrition that is well balanced for a human baby. Formula preparations come close but most use cow’s milk as their matrix, which is harder to digest and, despite complex formulation, does not contain everything that breast milk does.

The breast milk also contains high levels of immunoglobulins, which are part of the baby’s first line of defence against infection, and breast milk is not capable of creating an allergic or intolerant response. Eczema, asthma and hay fever are less common in breast-fed babies and studies have shown that there may be a slight increase in the breast-fed baby’s IQ. Colic is often associated with an allergic response and therefore breast babies may suffer less.

Mother and baby may bond slightly more if the child is suckled, and breast-feeding is much more convenient as far as travelling and the need for equipment is concerned. Sterility is not a problem, of course. An even greater advantage for the mother may be that there is a decreased risk of breast cancer in mothers who feed their babies by the breast longest.

Not enough breast milk

It is not infrequent for a mother to find that her baby is still hungry after a feed. This is often because there is not enough milk. This may be due to dehydration or deficiencies in the mother’s diet or simply because of exhaustion.

RECOMMENDATIONS

Ensure a water intake of at least three-quarters of a pint per foot of height to be drunk throughout the day.

Ensure a well-balanced diet or discuss suitable supplements with a complementary medical practitioner.

Try to get as much sleep as possible.

The herb Galega officinalis may be used: a teaspoonful of fluid extract three times a day in milk sweetened with a teaspoonful of honey. (Galega may bring down sugar levels.)

Weaning

There is no set time to wean (introducing foods other than breast milk) but a good guideline is when the child is not getting enough from mother’s milk, which is recognized by the child failing to put on weight or remaining hungry after a feed.

The breasts will still produce milk and engorge if the milk is not expressed. This can make weaning an uncomfortable period.

RECOMMENDATIONS

If the choice is available, breast-feed for at least four months after the birth.

Cut down by one feed per 24hr over one week

Try to obtain some jasmine: in fluid extract, essential oil or even from the garden. Three drops of the extract or oil should be rubbed into the breasts, or the flowers should be steeped in water for 24hr and a teaspoonful drunk three times a day.

THE FATHER AND SIBLINGS

Fathers will at some stage realize how useless they are during a delivery. Massaging and pushing a few acupressure points does not really seem like sharing the burden and the pain that the mother is suffering. Fathers, please do not be too disheartened. Every little bit helps and ‘being there’ means a lot.

Many deliveries nowadays have older siblings present, the benefit of which very much depends upon the character of that child. A timid or young child who may not understand the process should not be involved because the apparent anguish of their mother will be very hard to comprehend. Remember that children are very self-centred and a young child will assume that the mother is in pain because of something that he or she is doing.

However, it is important to introduce the newborn to a sibling as soon as possible. It is hard to conceive that love is not a finite emotion and siblings may fear that the more people there are, the less Mum can love each one. Logic sticks its oar in and it is extremely important that a sibling feels that the baby is as much a part of them as it is a part of Mum and Dad. Bonding should actually start early on in pregnancy and children should be introduced to the baby as soon as possible. There will inevitably be some jealousy and it is important not to criticize an older sibling for this emotion.

RECOMMENDATIONS

Involve family members from the start of the pregnancy, and especially at the birth, where possible.

Do not involve timid or young children who may not understand what is going on.

There is plenty of love to go around. Continue to distribute it evenly.

Baby is going to take plenty of knocks in life, so do not be too critical of a sibling’s apparent rough handling. Baby has just come through quite a trauma and it can handle a push and a poke.

AFTER DELIVERY

The first month or so after delivery is an exhausting time both psychologically and physically. Although it sounds harsh, one must remember that pregnancy is in fact a parasitic infestation and the baby will have drained a lot of nutrients from mother whilst growing and will continue to extract goodness through the breast milk. Mother, meantime, is having her sleep disturbed and is having to adjust to a completely new lifestyle. Whether it is the first or twenty-first child, the situation will be no different.

RECOMMENDATIONS

Talk to friends and relatives who have been through the situation before.

Read as much about newborn babies as possible and realize that the experience is well-documented and that anything you are going through has been gone through before and there is someone out there with experience enough to help.

High-dose multivitamins, preferably natural food state, along with a strict adherence to five portions of fresh, organic fruit and vegetables daily should replenish the system within two weeks. Discussions with your complementary medical practitioner may be needed if recovery has not been achieved by then.

POSTNATAL DEPRESSION

There is a marked drop in hormone levels as soon as the baby is delivered and the subconscious will register this and notice that there is something ‘wrong’. In fact things are simply different but the brain will translate this into an anxiety or a depression. There is also a certain sense of anticlimax when parents realize that the delivery was in fact the start of a lifelong commitment and not just the end of a nine-month event. Tears will come easily; anger and irritation will be prominent but often counteracted with bouts of great joy and the tears that also go with that. Dad will feel this as well but most definitely will suffer the brunt of Mum’s depression and mood swings.

All this should pass within a few days and it is only if it does not pass, that a condition known as postnatal depression needs to be considered. Unrecognized or untreated, this condition may go on for years. I have had patients who have gone through several pregnancies and spent decades in a postnatal depression without realizing that this was the case.

RECOMMENDATIONS

Always feel free to speak to a counsellor with regard to any unwanted emotional state but especially so after a birth. Friends and family will try to say what they think you want to hear and resolution of depression is much slower if dealt with that way.

Never accept that ‘she should be over it by now’. Chemical shifts may be permanent unless readjusted.

Consult a homeopathic physician for a suitable remedy.

Consider using Bach flower remedies, paying particular attention to Larch, Pine, Elm, Sweet Chestnut, Willow, Star of Bethlehem, Oak and Crab Apple. These are all excellent for despondency or despair. If the emotion seems to be about responsibility, consider Chicory, Vervain, Vine, Beech and Rock Water. Take a few minutes to read about these in a suitable booklet and pick the most appropriate.

Take a multimineral/vitamin supplement at twice the daily recommended dose because depression may be associated with deficiencies.

Take phenylalanine (an amino acid) at three times the recommended dose on any proprietary package for three days and reduce it to twice the dose for up to two weeks.

Persistent depression should be dealt with by a complementary medical practitioner and counsellor: definitely one who has had children, and preferably a woman.

Artificial oestrogen has been shown to be beneficial when taken sublingualis Before trying this, make sure that other avenues have been explored and consider the use of natural oestrogens first.

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