Integrative Medicine in Pregnancy: Combining Conventional and Alternative Therapies for Optimal Outcomes

A study published in 2021 signified the importance of complementary and alternative medicine for pregnancy, as it reported 87% of pregnant women utilize some CAM for their health and wellness. This number continues to grow as women seek different approaches to support their physical, mental, and emotional health throughout pregnancy. With the expansion and acceptance of integrative and complementary healthcare providers, it's hopeful that collaboration with the conventional medicine paradigm will be mainstream. In this article, you'll get a deep understanding of what integrative care can offer you during your pregnancy and transition into motherhood. 

[signup]

Understanding Integrative Medicine's Role in Pregnancy-Related Care

Integrative medicine can play a significant role in all stages of women's reproductive health, including pregnancy. A holistic and bio-individual approach to healthcare involves the use of both conventional medicine and integrative medicine modalities that supports a patient's mind, body, and spirit. Integrative medicine practitioners address healthcare with the mindset that health is not just the absence of disease but a state of optimal well-being. Whether a woman is set up to have a picture-perfect pregnancy or she is suffering from perinatal mental health concerns, gestational diabetes (GD), preeclampsia, postpartum depression, or other pregnancy complications, there are opportunities for a collaborative role in supporting a woman's health. Regarding pregnancy, integrative care can assist in optimizing nutrition, stress management, correcting sleep disturbances, implementing exercise regimens, and co-managing disease processes. 

Common Integrative Practitioners That Can Complement Traditional Pregnancy Care

Each practitioner brings a different perspective and area of expertise to patient care. While one provider may be better suited to deal with the musculoskeletal discomforts of pregnancy, others are fantastic at supporting the mental and emotional changes women may face. Each profession also utilizes different therapeutics to address conditions and concerns, many of which can be implemented and complementary to one another. Here is a list of integrative providers available to pregnant women and the benefits you can expect from their care. 

Integrative Obstetrician/Gynecologist

Medical doctors can obtain additional training and certification through the American Board of Integrative Medicine (ABOIM) to gain credentials as integrative practitioners. OB/GYNs that go through this program will get advanced knowledge in nutrition, botanical medicine use and prescribing, mind-body medicine practices, education on complementary modalities such as acupuncture, and how other integrative medical systems can benefit patient care. With this skill set, they can assist women in their prenatal care from both a conventional medicine route and implement holistic interventions. This ranges from integrative nutrition and fertility to managing gestational diabetes as part of their comprehensive care.  

Functional Medicine Practitioners

Board-certified healthcare providers can become certified functional medicine practitioners through a variety of programs. The most esteemed and gold standard is the Institute of Functional Medicine (IFM). This training has modules similar to an integrative medicine program with the major addition of functional medicine testing, assessment, and implementation of integrative treatment protocols. The IFM coursework entails seven modules covering applications of functional medicine in clinical practice, gastrointestinal system, environmental health factors, immune system, cardiometabolic, bioenergetics, and hormone health. A functional medicine practitioner could assist you in optimizing your health during pregnancy which could aid in the prevention or treatment of iron deficiency anemia (IDA), GD, preeclampsia, or symptoms of hyperemesis gravidarum (HG). 

Certified Nurse-Midwife (CNM) 

Some women choose to go with a Certified Nurse-Midwife for their prenatal and delivery care. They are Western medicine-trained nurses who then go on to specialize in obstetrics. They entail prenatal exams, laboratory testing, care and management of your pregnancy, and in-hospital or home-birth deliveries. Midwives are also trained to address the mother's health holistically, in which they give nutrition, supplementation, and herbal medicine recommendations and focus on health promotion. Their care is evidence-based but provides a more personalized approach to care. In general, working with a midwife has been shown to lower the risk of pregnancy complications such as cesarean sections and premature birth. 

Acupuncturist 

An acupuncturist is a Traditional Chinese Medicine (TCM) trained healthcare provider. Acupuncturists use a whole-person approach by assessing energy flow in the body and then applying treatment using small fine need insertions at specific therapeutic points on the body. Roadblocks and imbalances in the movement of energy, or Qi which is the TCM term for the vital energy force that moves through meridians, is what acupuncturists are addressing with their care. The areas that this complementary approach can assist with in pregnancy are nausea, low back and pelvic pain, depression, anxiety, insomnia, and labor pain. Pericardium 6, a point located on the wrist, is one of the most widely used acupuncture points to treat, which brings women great relief from nausea. 

Chiropractor

Pain relief during pregnancy is one of the most sought out forms of care in pregnancy. Chiropractors are doctors that specialize in the treatment of the spine, nervous system, and connecting tissues such as muscles, ligaments, and tendons. They are experts in helping patients get out of musculoskeletal pain and have been shown to be beneficial in treating pregnant women with low back pain, pelvic pain, and joint pain. Although all chiropractors are trained to care for pregnant women, some will choose to do advanced training, such as the Webster Technique with the ICPA, to provide more specific care. 

Prenatal Yoga Instructor

There are many forms of yoga, all of which can greatly benefit mental, emotional, and physical well-being. When seeking yoga to support your pregnancy journey, you'll want to attend classes with an instructor that is trained and well-versed in yoga for pregnancy. This type of yoga focuses more on breathing which can eventually assist with breathing during labor, stretching, functional posture, stretching, and relaxation. Areas of your health that this can help with are: reducing anxiety and stress, improving sleep, and increasing your muscle strength, flexibility, and endurance, while also lowering pain, nausea, and headaches. Implementing yoga for movement and overall health support is a great adjunct to care during pregnancy.

Pelvic Floor Physical Therapist

Physical therapists who specialize in addressing and treating the pelvic floor can significantly help women who have pelvic floor dysfunction. The pelvic floor is basically a diaphragm that supports and keeps the uterus, bladder, and colon in place. As your body changes and shifts happen in pregnancy, your pelvic floor can become dysfunctional and weakened, which leads to signs and symptoms of incontinence, low back pain, hernias, and constipation. Research has shown that working with a physical therapist who specializes in this area can greatly improve the strength of pelvic floor muscles, thus decreasing urinary leakage. A review of studies also revealed that pelvic floor training can reduce the duration of second-stage labor. If pelvic floor weakness is something you have dealt with in a previous pregnancy or you are experiencing signs of dysfunction, adding a trained therapist in this arena could benefit your pregnancy experience. 

Functional Medicine Labs That Can Help Individualize Treatment for Best Patient Outcomes During Pregnancy

Many integrative practitioners are trained to order and assess functional labs. These labs can provide them with data that will help optimize your health and wellness. Here are a few functional medicine labs to consider when looking into when implementing holistic pregnancy care. 

Pregnancy Panel

While establishing care with an integrative team, it's essential to get baseline bloodwork early on to evaluate your health status. Access Medical Laboratories offers an Obstetric Panel that looks at key markers of immune function and red blood cells, which can be used as a screen for anemia, which is a common culprit of fatigue, shortness of breath, headaches, or weakness. 

Comprehensive Stool Test

Nausea and vomiting are common side effects of pregnancy. While this is common, it could be a symptom of a more concerning condition such as gut dysbiosis. This imbalance of gut microflora can not only impact the growing fetus but can also be associated with the development of gestational diabetes, preeclampsia, and fetal development.

Micronutrient Testing

Nutrition is key to a healthy pregnancy. While you should aim to get adequate nutrition, sometimes your diet can lack essential nutrients that support your health and the development of your baby. Nutrient deficiencies have also been correlated to complications in pregnancy. For example, studies have found an association between micronutrient alterations and gestational diabetes. One option for testing vitamins, minerals, fatty acids, and amino acids is through a Micronutrient Test. This is a great option for investigating imbalances and providing individualized solutions.

Comprehensive Thyroid Panel 

Optimal thyroid function can benefit you both during pregnancy and in the postpartum phase. As hormones fluctuate in pregnancy, it can impact the function of your thyroid gland. Autoimmune Hashimoto's Thyroiditis is the most common presentation of thyroid dysfunction that occurs in pregnancy. Untreated, this disorder can cause anemia, muscle pain, weakness, preeclampsia, or postpartum hemorrhage. After birth, this can cause Postpartum Thyroiditis, leading to a plethora of debilitating symptoms.

[signup]

Summary

The best care in medicine is when we can take the knowledge of Western science and combine it with the therapeutic intervention of complementary and integrative medicine. When it comes to pregnancy, women look for support in many areas of their health. The most important aspect is a healthy growing fetus, but more and more, women are seeking ways to optimize their pregnancy experience. Collaboration between conventional medicine and alternative medicine is a cornerstone for providing this holistic approach to care.