Pregnancy and labour

It’s baby time

Jenifer Worden discusses the use of homeopathy during pregnancy and birth

So the test is positive and you are pregnant. But what happens next? What can you safely take for morn­ing sickness or sore breasts or heartburn or any of the other harmless but upset­ting symptoms associated with a normal pregnancy? Let me guide you through this exciting time from start to finish, with homeopathic medicines for every stage of pregnancy and labour. My per­sonal approach is to treat problems at this point in your life as they arise but some homeopaths will have specific remedies for each stage of pregnancy or will treat you constitutionally through­out. Homeopathic medications are safe to take at all stages of pregnancy or labour; but take care with herbal reme­dies unless they have specific instruc­tions for use when pregnant.

The first trimester
This term refers to the first three months of pregnancy, from the moment of con­ception onwards. Most women nowa­days find out that they are pregnant from almost the first day of a missed period, thanks to modern technology and ever more sophisticated pregnancy tests. Some women know the moment that they conceive but most of us have to wait a little longer to find out. Pregnancy is dated from the first day of your last period by doctors and mid­wives so even if you are sure when you became pregnant, the estimated day that your baby will be born will be worked out from your last menstrual cycle. This is why when you see your GP following a positive pregnancy test, he or she will say that you are a little further on in your pregnancy than you think you are, so be prepared for this.

Nausea and sickness
One of the first signs of pregnancy is a feeling of nausea or sickness. Some women may actually vomit. The term “morning sickness” is somewhat of a misnomer as many women feel sick all day long, or not until the afternoon or evening. This symptom usually lasts until you are 14 to 16 weeks pregnant but occasionally can persist through the whole pregnancy. If very severe, it is referred to as “hyperemesis gravidarum” and may require a hospital admission and/or conventional medication.

If the nausea starts as soon as you lift your head off the pillow, then Cocculus indica can be very helpful. It is derived from the cockle flower and can be taken at a dose of 30c three times a day. It is especially useful when the nausea is related to movement so may also be taken if you find that you are inclined to motion sickness in your preg­nancy. If the nausea is worse in the morning, and you keep being sick with small amounts of food and mucus, then try Nux vomica at the same dose as the Cocculus indica. If the smell of food trig­gers your sickness and eating does not help stop the nausea, then try Sepia, again 30c three times daily. If symptoms are very severe, you can take any of the above remedies every two hours, at the same strength, but I would advise that you seek urgent medical advice if you are unable to keep any fluids down whatsoever or are feeling very unwell.

Breast tenderness
Another common problem in the first trimester is breast tenderness or dis­comfort. This is due to the hormonal changes occurring in your body at this time and homeopathic medicines that are used for breast pains before and dur­ing periods can also be used in early pregnancy. The remedy that I most often recommend is Pulsatilla. Usually 30c taken once or twice a day will soothe things down. Don’t forget that wearing a good supportive bra throughout this time will help to prevent damage to the delicate supportive ligaments of the breasts which are put under strain in pregnancy due to the increase in size.

The second trimester
During months three to six your bump will be getting bigger and you will find that you start to waddle like a duck due to a combination of your growing womb and your pelvis enlarging slightly as your ligaments stretch due to the effect of pregnancy hormones. This can give rise to backache, leading to the typical image of a pregnant woman resting her hands on the small of her back for comfort. Kali carbonicum for a back which feels weak and tired and with a dragging pain in the middle and lower region is a good option and can be taken at the 6c strength, up to four times a day. If you find that your back feels better by lying on something hard or by getting some­one to press firmly into your back, then it is worth trying Natrum muriaticum, at the same strength and dose. If your back is hurting due to an injury or strain, then take an Arnica 30c, followed by Rhus toxicodendron 6c, every six to eight hours, for up to seven days if the backache persists.

One of the most troublesome symptoms of the middle stage of pregnancy is con­stipation. This is due to added pressure on your bowels from your growing baby and also the effects of the hormone progesterone. Keeping up your intake of fresh fruit and vegetables, and not forgetting natural laxatives such as dried fruit or prune juice, is vital to keep things on the move but if you find everything is becoming a strain, then the following medications may help. Hard, small stools that are difficult to pass, leaving you feeling as if you have not really emp­tied your bowels are typical constipa­tion symptoms that may be helped by a 6c dose of Lycopodium up to four times daily. No urge to have your bowels open and trouble passing even a soft motion is an indication for Alumina (same dose as Lycopodium) and large, hard stools which make you feel as if there is a ball inside your rectum, causing pains to shoot upwards can be helped by tak­ing Sepia 6c four times a day.

Varicose veins
As your womb grows, it presses on the main arteries and veins in your pelvis, leading to a feeling of faintness if you lie on your back, but more upsettingly, to the appearance of knobbly veins in your legs, otherwise known as varicose veins. These can be prevented by wearing sup­port tights, not crossing your legs and keeping your feet up at every available opportunity. However, the latter is not always possible if you are a working woman. Avoiding long periods of stand­ing is essential at this point in your preg­nancy and if your legs are particularly uncomfortable, try a twice daily dosage of 6c Pulsatilla to help. Pulsatilla can also help the discomfort of varicose veins in the rectum which are more commonly known as “piles”. These usually accom­pany constipation, which is why they are common in pregnancy. If the Pulsatilla does not help, then try Carbo vegetabilis at a similar dose, especially if your piles result in a burning pain in the rectum after a bowel movement.

The third trimester
You’re on the home straight but the final three months of pregnancy bring their own problems. Nearly half of all preg­nant women suffer from heartburn, which is due to the relaxing effect of the progesterone hormone on the gullet (oesophagus) and increased pressure on the stomach from your growing bump. Eating small meals and often can help, as can avoiding difficult to digest foods such as fried, spicy or fatty ones. A simple antacid can also relieve discom­fort but speak to your GP, midwife or pharmacist before taking any over ­the-counter medicines when pregnant. If your heartburn is worse around mid morning, causes a gnawing sensation in your stomach and milky foods make your symptoms worse, try taking Sulphur 6c four times daily. Lycopodium is also a good remedy if you find that eating small amounts of food tends to help you feel better. If you are suffer­ing from a severe burning sensation behind your breastbone, then Capsicum may help, again at the 6c strength, four times a day.

Urinary problems
The other major problem at this stage is urinary in origin, principally urine infections and incontinence of urine. Al­though urine infections (UTIs) are com­mon throughout pregnancy, they can occur more often in these final three months. Symptoms of infection, such as a stinging or burning when passing urine and having to go to the toilet more often (cystitis), may be less noticeable in preg­nancy. This is one of the reasons that the midwife or doctor will test a urine sam­ple when you go to see them, as you may have a UTI without realising it. Anti­biotics are very necessary to treat urine infections in pregnancy but homeopathic remedies can be taken alongside them to make you feel better more quickly. It is important that urine infections are ­treated properly when pregnant to avoid serious kidney complications.

Cantharis is a good remedy to take if you have constant stinging or burning in the area of your bladder (lower abdomen) and noticeable discomfort on passing urine. Try a 30c strength tablet every two hours alongside any conven­tional treatment necessary. If you are passing large amounts of cloudy urine frequently and find that the urine is burning you as you pass it, and you need to go to the bathroom mostly at night, then Phosphoricum acidum 6c two hourly may be a better option. For itch­ing and irritability of your bladder and urethra (the tube from your bladder to the outside world), with dribbles of urine passed frequently but only with some difficulty, I would suggest Nux vomica 6c at the same dose.

Because of the weight of the baby on your bladder at this time, you may find that you leak or dribble a little urine when you cough, sneeze or stand up. You may also find it harder to hang on to your urine when your bladder is full. Of course, these problems will persist until your baby is born, as they are due to a very physical reason, but you may wish to try taking Causticum to see if this helps you. I would recommend a 6c tablet twice daily.

Labour is defined medically as having started when the cervix (neck of the womb) can be felt to dilate (stretch). This is determined by a physical examination vaginally by your obstetrician or mid­wife. False labour pains can last for hours or days before true labour starts but feel the same and are responsible for numerous false alarms in mums-to-be. Babies will arrive when they are ready and I would not advise trying to hurry nature along unnecessarily but keeping active in late pregnancy is a good idea. Sex has been suggested as one way of getting things going but only if you are in the mood!

Speak to your hospital consultant or midwife if you want to use homeopathy during your labour. Most hospitals are sympathetic but some obstetric depart­ments confuse herbal and homeopathic medicines and have a blanket ban on all complementary treatments. It is better to sort things out before you go into labour. I always write out a detailed plan for the parents-to-be on how to use the homeopathic medicines I recommend for birth and am more than happy to advise local obstetricians or midwives should the occasion arise. My comments and advice below refer to normal deliv­ery, after 37 weeks of pregnancy, unless otherwise specified.

Some women like to take Arnica 30c daily from week 39 onwards, to help prevent bruising after the birth, but don’t worry if your baby arrives a little early. You can take it immediately after your baby has been born, two to three times daily, until your bruising has gone. This applies to normal deliveries, forceps/ven­touse deliveries or Caesarean sections (C-section).

As having a baby can be somewhat of a hectic time, I keep my advice for the labour room itself simple and recom­mend three principle homeopathic med­ications to take in with you.

Colocynthis 30c is indicated when there is a lot of pain in your abdomen but with lack of progression in labour. The midwife will usually assess the lat­ter by the dilatation/stretching of the cervix, and movement of your baby’s head through the birth canal. A prob­lem with either of these and pain that seems out of proportion to the progress of your baby is the time to take Colocynthis as needed, up to every ten minutes. If your midwife advises that the situation is not changing or your baby is distressed, it may be best to use conventional means.

If your contractions seem to have died off or pains flit around your abdomen without doing very much, then Caulophyllum 30c can be taken hourly for a total of four doses. This stage in labour may coincide with you feeling exhausted and being quite tearful and emotional. If there is no improvement, then Caulophyllum 200c can be taken in the same way. It is vitally important to take the advice of the midwife and to check that she is happy that the baby is in the right position for a natural birth. If the labour seems to have become com­pletely blocked by lack of progress and despair on your part, then a single dose of Arsenicum 200c can be tried.

I always advise that a glass of spring water containing four drops of Bach Rescue Remedy is available to everyone in the delivery room, from birthing part­ner through to midwife!

After the birth
At this time, you probably are either exhausted or on an emotional high. Babies are often tired too and need to rest straight after delivery so this is a good time for both baby and new mum to relax. Many hospitals now discharge you within 24 hours of an uncompli­cated birth and within six hours if you want. If you have had a home delivery, it is still important to rest; let someone else put the washing machine on!

Continue taking Arnica 30c and add in Hypericum 30c twice daily if you have had an episiotomy or stitches to a vagi­nal tear. If you have had a Caesarean sec­tion, then I would advise Staphisagria 30c to be taken with the Arnica, in pref­erence to Hypericum, particularly if you had to have a catheter in your bladder for any amount of time.

Remedies can be taken until things feel back to normal.

Late arrivals
Finally, if your baby decides to arrive later rather than sooner, Caulophyllum 30c can be taken twice daily to promote labour if you go more than a week over your due date, but again, check first with your GP, obstetrician or midwife that they are happy with the position of your baby.

Jenifer Worden MB ChB MRCGP MFHom is a part-time NHS GP in Ringwood, Hampshire and has a private homeopathic practice in Highcliffe, Dorset. She treats patients with a wide range of conditions and across the complete age range.