Pregnancy & Postpartum Care

PREGNANCY CARE
Your body will be experiencing many health changes, and each phase in your pregnancy may present with new symptoms.  Most symptoms you experience during pregnancy are due to your underlying imbalances being exaggerated.  In essence you are entering your pregnancy with certain constitutional imbalances, and pregnancy heightens them.

It is beneficial to prepare your body for fertility and conception.  The baby draws on your essence and requires nourishment that it draws from your kidneys, the blood and digestive organs.  If these organ systems are hypo/hyper functioning, then pregnancy related symptoms arise like nausea, fatigue, heartburn, and constipation.  Acupuncture, herbs, exercise, and dietary and lifestyle adjustments can support a healthy pregnancy and in essence proper nourishment for your baby.  My suggestion is to see your acupuncturist/herbalist once a week in order to maintain a healthy pregnancy.  

FIRST TRIMESTER (conception to 12 weeks)

• Frequent, small meals, all proteins should be consumed before 2pm, vegetarian meals for dinner preferably before 6pm, snacking on fruits after 6p is fine. Include fermented foods with your meals.
  
• Soupy foods, curries, and stews.
  
• Bone broth, fish head soup, oxtail soup, seafood (baby clams, squid) soup, chicken feet soup.
  
• Red, orange, purple foods like beets, carrots, yams, pumpkin.
  
• Black mushrooms.
  
• Sesame seeds.
  
• All beans, especially black bean and adzuki beans.
  
• Leek with salmon fish head soup.
  
• Cod soup with ginger.
  
• Adzuki bean, black rice, red date with ginger soup.
  
• ½ cup black bean, ½ cup adzuki bean, 10 red dates, simmer 3-4 hrs.
  
• Hot pouch: one placed on the kidney area and the other below umbilicus. Fill a long cotton tube sock with roasted ½ c flaxseed, ½ c white rice, and dried 1oz. lavender flower. Tie the sock, should be half full. Heat the pouch 2-3 minutes and apply to parts before bedtime.
  
• Raspberry leaf tea.
  

Avoid: Cold and raw foods; extreme physical activity; stimulants (coffee, alcohol, smoking); flying.

First Trimester Imbalances:
If you had an irregular menstrual cycle with pain and discomfort, then most likely you will experience nausea in the first trimester.  High levels of HCG and progesterone hormones are being released in this phase.

Morning sickness: symptoms may include nausea, vomit, headache, dizziness, and fatigue.

• Grind lentils into powder, 2 tbsp. with rice porridge, 3 times a day.
  
•  Ginger, grapefruit peel tea, 3 times a day.
  
• Steam carp with ginger and cardamom for 30 minutes.  Eat daily for one week.
  
• Ginger, orange peel tea, add a little brown sugar.
  
• Fresh scallion with fresh ginger juice, 2-3 tbsp., 3 times a day.
  
• Avoid overeating and heavy meats.
  
• Chamomile, peppermint and fennel tea.
  
• Millet porridge with fresh ginger.
  

SECOND TRIMESTER (13 to 28 weeks)
Usually women are feeling much better in this trimester. Progesterone relaxes the smooth muscle, causing decreased peristalsis and constipation.

Second trimester imbalances:
Constipation

• Increase intake of water and iron and blood nourishing foods, beets, avocado, blueberry, red or black Chinese dates, amaranth.
  
• Be careful with iron supplements, as they can be constipating.  Floradix, a liquid iron is more beneficial.
  
• Include fiber, flax oil, prune juice, acidophilus.
  
• 2 bananas on empty stomach followed by a glass of water.
  
• ·        5-10 figs on empty stomach followed by a glass of water.
  
• Fresh apple on empty stomach.
  
• Lightly steamed asparagus and cabbage for dinner.
  
• Beet soup.
  
• Avoid carbohydrates, sugars, and most dairy.
  
• Exercise daily.
  

Avoid: stress, tension, spicy foods, fried foods and meat.

 Hemorrhoids: most of the time due to improper diet.

• Comfrey, or thorney spinach, or epsom salt sitz bath.
  
• Witch hazel pads.
  
• Freeze an aloe slice, apply gel topically.
  

Bleeding hemorrhoids

• Taro root soup.
  
• Mash fresh plums and take with room temp water three times a day.
  
• Wash area with hot water, apply a cotton ball that has been soaked in garlic juice, change cotton every hour.
  

Avoid: tensing and pushing if constipated, rich, greasy, and spicy foods.

Heartburn: Progesterone relaxes smooth muscle, relaxing the cardiac sphincter and causing heartburn.  As the baby develops in later pregnancy it pushes on the stomach.

• Eat slowly and chew food properly, avoid tension and stress while eating, reading or watching TV while eating.
  
• Peppermint, nettles and lemon balm tea.
  
• Kava tincture.
  
• Beneficial foods include papaya, sweet potato, apple after each meal.
  
• Blend daikon radish juice and take after meals.
  

Avoid: rich, greasy foods, and spicy foods.

Pubic pain: pubic symphysis joint begins to separate slightly between 24-26 weeks to allow for easier passage, and this can lead to inflammation.

• Acupuncture treatments can address this effectively.
  

Leg cramps: relates to change in blood volume and calcium/magnesium deficiency.

• Bone soup.
  
• Pure collagen.  Consult with your herbalist. 
  

Insomnia: due to overwork and stress; kidney qi and digestive function are insufficient to support healthy sleep.

• Dinner soup with lima beans, turkey and sage.
  
• Toast ¼ c amaranth until slightly brown, then steep in a cup of hot water for 5 min. sip before bedtime.
  
• Celery and beet tops tea, drink 2 hrs. before bedtime.
  
• Passionflower, chamomile tea. Consult with your herbalist.
  

Edema: mild is considered normal due to increased body fluids.

• Carp fish soup with adzuki beans. Use 10 c of water and cook down to one cup; consume only the liquid. Can use other fish if carp is not available.
  
• Blended juice of apple, carrot, green onion twice a day.
  
• Tea from ginger skin.
  
• Coconut water.
  
• Parsley leaf tea, or jasmine tea.
  
• Watermelon rind tea.
  
• Soupy pearl barley.
  
• Stew beef for 2 hrs. in water and drink the liquid.
  
• Cook squash with vinegar until soggy, eat on empty stomach.
  

Avoid: rich foods, salty foods, lamb, garlic, alcohol, pepper, shellfish, fatty foods, greasy foods.

 Carpal tunnel syndrome: often with edema conditions.  Median nerve is being compressed.

• Acupuncture is effective in resolving carpal tunnel.
  

THIRD TRIMESTER (28-40 wks)
Imbalances can involve heart, liver, kidneys, blood and spleen.  This trimester determines your postpartum health.

Third trimester imbalances
Anemia

• Get plenty of rest.
  
• Cooking vessels should be cast iron.
  
• Bone broth soup, squid soup.
  
• Bean soup or stew, blend adzuki, black bean, and red bean.
  
• Beets, ½ of avocado daily.
  
• Blueberries, raisins, figs, red or black dates.
  
• Chicken soup with ¼ c dried goji berries, red jujube date, dang gui root, astragalus root, fresh ginger. Eat daily.
  
• Amaranth.
  
• Sweet rice porridge with red dates and pearl barley.
  
• Puree lima beans with roasted garlic and fresh basil, eat in between meals.
  
• Cook one chicken with 15 grams of dang gui in 6.5 cups of water, simmer for one hour.
  
• Lamb with ginger, jujube date, astragalus, scallions, ginseng and dang gui. Consult with an herbalist for contraindications.
  
• Moxibustion. Consult with your acupuncturist on which points to moxa.
  

Anxiety: affects every organ system.

• Proper rest, calming foods, calming activities.
  
• Exercise is important.
  
• Blend of mushrooms tea. Consult with your herbalist.
  
• Toast ¼ cup amaranth until slightly brown, steep in a cup of hot water for 5 minutes, drink once a day.
  
• Make hummus with garbanzos or pinto bean or lima bean with parsley, basil and chives.
  

UTI: bacterial infection may cause pain on urination with frequent urination.

• Drink lots of water.
  
• Drink watermelon and pear juice three times a day.
  
• Drink carrot and celery juice three times a day.
  
• Drink cornsilk tea. Consult with your herbalist.
  
• Eat squash soup for at least 7 days.
  
• Drink fresh strawberry or unsweetened cranberry juice.
  
• Empty the bladder immediately after intercourse.
  

Avoid: heavy proteins, meat, dairy products, onions, scallions, black pepper, alcohol, caffeine, chocolate.

SERIOUS COMPLICATIONS          
Preeclampsia: When a woman develops high blood pressure and protein in the urine after the 20th week (late 2nd or 3rd trimester) of pregnancy.  Symptoms include high blood pressure, swelling in the feet, legs and hands.  Women with preeclampsia who have seizures are considered to have eclampsia, which is a medical emergency.

Gestational diabetes: blood sugar levels too high causing excessive weight gain, hunger, thirst, frequent urinary tract infections.  Women tend to have bigger babies, increasing chance for a c-section.  This condition usually resolves after pregnancy.  Special attention to diet.

PUPPP ( pruritic urticarial papules and plaques of pregnancy)/Obstetric cholestasis:  The rash of PUPPP begins in the stretch marks (striae) of the abdomen. The rash consists of small, red wheals in the stretch marks that grow together to form larger wheals on the abdomen. Sometimes the rash can include small vesicles. Rash can spread over the thighs, buttocks, breasts, and arms.  The rash is very itchy.  This condition is harmless to mother and baby.  It lasts an average of 6 weeks and resolves spontaneously 1 to 2 weeks after delivery.  The most severe itching normally lasts for no more than 1 week.

Bleeding during pregnancy:  If mild, it isn’t too risky.  If severe with abdominal cramping, seek medical attention.

POSTPARTUM CARE
Post delivery, the qi and blood has been exhausted and your strength to resist illness is impaired. As a new mother, you need support, be sure to reach out and allow others to nurture you. Traditionally, new mothers moved in for one month with either their mother’s home or their in-law’s home, the mother assisted in caring for the newborn, preparing meals and all the daily chores while you recover. This makes sense.

Immediately following birth, in the delivery room, have a thermos with cinnamon tea handy. It will assist in the expelling of the placenta and ease contractions after birth. In addition to the tea, eat your chicken herbal soup or chicken broth after delivery. Keeping your body warm and protected from the wind is essential. Even if you are feeling warm, wrap a shawl around your neck and wrap the belly tight with a warm shawl, and bundle up. You should not be exposed to wind. Those herbal pouches are going to serve you now, place them on the kidney area every evening. How you expend your energy during the next month will determine how quick you recover with minimal post partum symptoms and be able to nurture your new born properly.

“Sitting Month”

• Rest: your activity should be minimal.
  
• Warming foods, warm drinks, moxabustion, warm clothes.
  
• Placenta medicine.
  
• Abdominal wrap: wrap your abdomen tight with a warm shawl.
  
• General tonification treatment with your acupuncturist/herbalist.
  

Nourishing foods

• Porridge, three grain cereal: millet, quinoa, amaranth, goji berries, walnuts, soy or almond milk.
  

          Combine equal parts millet, quinoa, and amaranth. Use a ratio of 1 cup of grains to 2 cups of water. Add a pinch of salt and handful of goji berries. Cook slowly for 30 minutes. When done add walnuts and milk.

• Sweet potato porridge: ½ cup jasmine rice, 12gm Shan Yao (can get this at our clinic), 1 medium sweet potato. Wash rice and soak 30 min. Discard water and cook rice with 2 ½  cups water over low heat for 30 min. Add potato and Shan Yao cook or 30 min.
  
• Green papaya soup: 1 medium onion, 2T minced ginger, 2-3 lbs chicken with bone, 4 cups water, 2 cups green papaya cubed, 2 cups spinach.  Saute onions until tender, add ginger for 3 min. Bring water to a boil.   Add onions, ginger, chicken. Simmer 30 min. Add papaya and cook 10 more min. Add salt and pepper to taste. Add spinach.
• Seaweed soup: 1oz dried brown seaweed, 1T sesame oil, 3 cups soup stock, 2T soy sauce, 2 cloves garlic, finely chopped. Soak seaweed 30 min, take out and squeeze excess water. Saute cut seaweed in sesame oil, 2 min. add garlic and soy sauce. Saute 2 min. Pour stock in and simmer 20 minutes.
• Azuki bean soup with Ginger: ½ cup azuki beans, 3 thin fresh ginger slices, 6gm chen pi (can get at our clinic). Wash and soak beans overnight with a tsp. of lemon juice. Bring 2 cups water, beans and chen pi to boil. Cover and simmer 25 min. Add ginger and cook 25 more min.
• Herbal chicken soup: 2 chicken legs, 4 slices of ginger, 1T rice wine, salt, get your blend of herbs from the clinic (Astragalus, goji berries, dazao, dang gui, ginseng) Place chicken, herbs, rice wine and salt in a large pot. Pour water into pot to level that covers all ingredients. Bring to boil and simmer 1 hr. Drink broth and eat chicken.
• Cook duck with ginger, scallions and black beans.
  

A very important book that should be a required reading for every new mother is “Sitting Moon” by Daoshing Ni. This book address the physiological changes that occur postpartum.

Physiological changes Postpartum
Plunge in hormones. During pregnancy progesterone and estrogen increased ten fold. Approximately three days after birth, these hormones return to their pre-pregnancy state. This often results in “baby blues” in first week postpartum.
After pains. Shortly after birth, mini contractions continue spurred on by the hormone, oxytocin, which helps the uterus shrink back and expel any pregnancy materials that need to be eliminated. This usually lasts 3 days.

• Abdominal pain: boil tea with cinnamon and brown sugar.
  

Lochia. Vaginal dischage (blood and accumulated tissues) for approximately one month post partum.
Request a moxa stick from your practitioner and moxa SP1 for 10 minutes every day.
Perineal pain. Due to stretching or tearing during birth.        ·  Sitz bath with epsom salt or lavender flowers.
Breast pains due to milk coming in (1-3 days after birth) and possible engorgement.

• Obtain moxa from your acupuncturist and moxa SI1, ST36.
  
• Mastitis. This is inflammation of the mammary glands, often occurring 3-4 weeks after delivery. It results from an obstructed mammary duct and is accompanied by a bacterial infection. There is distention of the breast, swelling, redness on the surface, and fever. If the condition progresses, symptoms may include chills, fever, increase in white blood cell count, swollen and painful lymph glands in the armpits, pus and ulceration of breast.
  
• Raw cabbage leaf applied topically.
  
• Peeled raw potato applied topically.
  
• Tea from malt (sprouted oat), drink 3 times a day.
  
• Mix egg white with green onion, apply topically, change 2-3 times a day.
  
• Dandelion tea with honey, drink 3 times a day for 5 days.
  
• Combine honeysuckle, mint and licorice, drink tea and apply herbs topically.
  
• Combine cabbage, lettuce, and dandelion to make a poultice.
  

Avoid: spicy, stimulating foods, coffee, smoking, alcohol, dairy products, breast feeding.
Lower abdominal pain due to C-section

• Rosehip seed oil to reduce scaring.
  

For educational purposes only. This information has not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure, or prevent any disease.