What do I mean, are you ready? Of course you’re ready, you want a baby and you want one NOW. You’ve been patient, you’ve been trying really hard, you’ve been really good and brave and now you want to see a positive result on a pregnancy test stick. The blue line, the PREGNANT sign.
I see many patients who are in the process of undertaking IVF but who aren't really mentally or emotionally ready for it. Panicked by their age, or the staff at the clinic they are using who have told them they must start IMMEDIATELY (let us not forget, are also running a business) or the crushing monthly feeling that takes over when a period makes its unwelcome appearance. The momentum carries them through from the panic at being told their AMH levels are low, or polycystic ovaries, or they are just a bit past their sell by date and if they don’t do it NOW they will have left it too late, to the point where they are booking in for treatment without taking stock.
Yes, time is a factor. Egg reserves are a factor. But not the only factor. Panic, fear, stress can all contribute to creating the wrong conditions for a positive result and you only have to look at the statistics to know that they are also against you.
To quote the quite wonderful Zita West, fertility is a whole body event. It is not something that takes place independent of your brain, your emotions, or your physical state.
So please, please, please, make sure you are feeling kind of ok. That you have come to terms with the IVF option. That you aren't railing against your fate, crying in toilets a lot, and feeling angry / resentful / depressed that you are going to have to try and conceive in an expensive, intrusive way. Some questions you can ask yourself (and be honest about the answers, you are only lying to yourself, after all.)
How healthy are you? You should be exercising regularly. This doesn’t mean embarking on some crazy regime but you need to be getting your heart pumping a few times a week whether you swim, run, walk, practice yoga or love Zumba.
If you don’t exercise habitually then start walking every day. This is important for bringing oxygen into your body, promoting healthy blood flow and circulation, which will help your mental state as well as your physical state. Exercise reduces stress, lowers blood pressure, improves sleep and increased your overall wellbeing – all of which are beneficial for anyone on the IVF train, which can be a huge strain. So not only will you improve your odds but you will also feel better.
BMI: If your BMI (body mass index) is over 30 then you are categorized as obese and studies show this can affect your response to IVF and a successful outcome. If you are an NHS patient they may not fund a round of IVF until your BMI is lower, and if you are paying for a round then unless you have money to burn and an emotional equilibrium like Teflon you need to address this.
If your BMI is under 20 then a risk of miscarriage is higher.
To calculate your BMI divide your weight in Kg by your height in Metres, then divide the answer by your height again. Or go online and find an easy online calculator to do it for you.
Have you been eating right? You know that too much coffee, skipping meals and drinking too much are not going to help. So make sure you are getting omega 3s, leafy green veg, lots of protein and just a little bit of whatever you really love so you don't feel like you are being punished twice. You honestly can have the odd cream cake or glass (glass, I said) of wine.
Are you (both) prepared for a bit of a rollercoaster? IVF can be bruising, no doubt about it, so you need to be going into it holding hands, a team. From the initial tests, to the drug stimulation, egg collection, fertilisation and embryo transfer you can go from hope to disappointment, so brace and try to rise above it all. These are all things you can't really control.
Could you deal with a multiple pregnancy? The chances of a multiple pregnancy are 1 in 5 with IVF, vs. a national average of 1 in 80, according to the HFEA. If you are undergoing IVF then on the one hand a multiple pregnancy would seem the answer to a ready made family. Two for the price of one, so to speak. That's true, but carrying twins (or triplets) carries far greater risks for you and your babies. If you are doing this alone, can you truly afford / cope with two? Or even three? If you don’t think you can then perhaps you should talk to your clinic about the number of embyros they transfer per round.
Are you strong enough to cope with any disappointments? If you think failing a round of IVF will pull you under then please just wait. It's unlikely to work if you are that fragile anyway. Have some counselling. Try acupuncture, CBT, or hypnotherapy, or anything else that can improve your state of mind and help you feel a bit more robust. The statistics don't lie and IVF can be a bit of a long game.
So if you need a month or two to get your head in the game, take it. It's important for you, your partner and for the months to come. And I absolutely promise it will help.
In the UK a quarter of women giving birth start their birth experience with a medical induction.
I’m sorry, what was that? A quarter, like 25%, you mean 1 in 4? Erm, yep. Given babies naturally only want to go one way (and no, Yazz, the only way isn’t up) and the very best, most efficient way to deliver most babies is by a woman going into labour spontaneously, the current rate of induction seems more than risk averse, it seems like some sci-fi Handmaid’s Tale kinda shit is going down.
So as you might imagine, it’s no exaggeration to say I get enquiries every week from women looking for ‘induction’ with acupuncture, understandably keen as they are to avoid more intrusive procedures.
So how can acupuncture help? Well I will say now it’s not a magic bullet. If a baby isn’t ready to make an appearance then one treatment a day before an induction is booked may not be enough to tip you into labour. What we are trying to do when we meet women in the later stages of pregnancy is encourage her cervix to ripen. And like all fruits when they ripen, well, you can imagine…
Things that might stop that happening? Working up to the last minute, fear or anxiety, not feeling ready, home improvements (I can’t tell you the number of couples I know who are expecting a baby and then undertake major home renovation projects, or a house move) – basically anything that messes with your adrenalin and cortisol levels (ie stress) can affect the hormones that help your body transition to the next stage.
The very best way to help you avoid induction in my opinion is to support your body in the final weeks of pregnancy time with acupuncture, reflexology, or better still, both. Pre-birth acupuncture from 38 weeks (see HERE for a dedicated post about this) is a wonderful way to support your body in the final weeks and encourage the ripening process. It could also help you deal with sleeplessness, anxiety around the birth, or what happens after the birth (yes madam, that’s yours now, yes, you have to take it home and keep it alive), and any other shifts and changes that might be experienced.
Now, please let me be clear, I don’t mind one way or the other if you choose induction. It’s your right, your decision, your body, your baby and your birth experience. So you get to choose. And in some cases, for some women and their babies, it is absolutely the safest option. For the rest of us, I say try acupuncture in the final weeks of pregnancy. It’s like putting a banana in the fruit bowl.
Anxiety and depression are often lumped together though completeley different, as they exhibit some of the same symptoms. However whilst many of us suffer a 'low mood' from time to time, or get anxious about a big life event, it doesn't feel too disruptive. The HADS (Hospital Anxiety and Depression) scale - which you can access here - is a downloadable checklist to rate your feelings and help you understand what might be going on for you, but what do you do about it? Is a natural approach worth considering?
There are many tools as our disposal as we understand more about brain chemistry and how we work. Doctors may well prescribe exercise, getting more sleep, CBT or mindfulness training now before they suggest antidepressants. Whilst research around acupuncture and anxiety or depression isn't extensive the British Acupuncture Council has reviewed it and info from their website is replicated below or can be accessed here.
I have worked with many patients who are suffering with some level of anxiety or depression. Loss of a loved one, struggling to conceive or coming to terms with not having children, social anxiety, the menopause, work stresses, or relationship difficulties, whatever the cause is the approach is the same - treat the individual. Not one single person is the same, so although I may see five people in a day for 'the same thing', its really not the same thing at all. This completely tailored approach means that we can work together to get to a better place as quickly as possible. So whether anxiety is the main concern, or it's a secondary symptom of a bigger life issue, getting to the root of it is what yields results.
Completely safe, a course of acupuncture can be undertaken side by side with any other treatments, including antidepressants. British Acupuncture Council info - Research has shown that acupuncture treatment may specifically benefit anxiety disorders and symptoms of anxiety by:
Well hurrah for Mercury no longer being retrograde, or whatever other excuse I can use to account for my laziness, but I have finally got my shizzle together to bring you a rather lovely pdf guide to acupressure in labour.
There are three very good reasons to use acupressure during labour. It promotes efficient labour, reduces the pain of contractions and helps maintain calm - what's not to love about that? Beautifully illustrated by the supremely talented Marion Rhoades, the pdf illustrates five acupressure points that are invaluable in labour, giving directions to locate them and what to use them for. I show these to couples as a matter of course during pre-birth acupuncture sessions, and I hope you find them useful.
Massage can be really, really, divorce-threateningly annoying when you are in the throes of labour, which is why this is called acuPRESSURE and not acumassage. Firm, strong pressure is required. Thumbs at the ready, birth partners!
More tips on pressure and location can be found here thanks to the kindness and wisdom of Debra Betts, who is at the forefront of acupuncture in pregnancy and birth.
Elvis may not seem the most obvious inspiration when you are 'training for labour' but he wasn't 'the pelvis' for nothing. Yes, it was a great excuse to include a photo, but still, not tenuous. Here's why. A lot of women suffer with backache, pubic symphysis pain or sciatica when they are pregnant and in the latter stages are told this is normal, yada yada. Yep, normal. However ignore it at your peril.
In case your attention span takes you no further, this is what you need to do - get checked out by an osteopath or chiropractor who specialises in pregnancy, when you hit the third trimester. Or earlier if you have backache. In order to accommodate a growing baby, your bones need to move in a certain way, supported by the ligaments and muscles around them. If everything is working in harmony, then your baby has its very own deluxe mansion with sea views. However, so many babies end up in the equivalent of a bedsit on a grotty main road. And if the space is cramped, i.e. if the pelvis is misaligned in any way it may reduce the amount of room available to a developing baby. This restriction is called intrauterine constraint and it can also make it difficult for the baby to get into the best possible position for delivery. Which in turn can lead to interventions.
A baby in breech position may not have room to move into the optimum position, so if you have been told your baby is breech I strongly recommend you both see an acupuncturist and a chiropractor or osteopath. Babies move around a lot, so a baby that is breech at 34 weeks can still move - but this is much harder if the room isn't there to move into. In my clinic I have found that combining the acupuncture protocol (I will write a separate blog post about this soon) with a treatment from a specialist bodyworker like Mary Anne Shiozawa or Nancy Nunn, delivers brilliant results.
Hypnobirthing could possibly benefit from a rebrand as it seems to have the faint whiff of patchouli for some, but I have totally drunk the Kool-Aid on this, hypnobirthing works and there's no two ways about it. To the uninitiated it is basically mind training, with a fat dollop of breathing techniques thrown in to help you help your body. I mean, yeah, I am part of the London Hypnobirthing team so a bit of love for it might be expected, but for me this is the foundation of any 'training programme' for childbirth.
It's not just for those who want a natural birth. Just because you sign up for a hypnobirthing course, it doesn't mean you have to sign away the option of pain relief, or will end up feeling like less of a mother because you have an elective caesarean. Whether you think you want to give birth in your front room, or with all the medical help known to man, hypnobirthing offers a lot of incredible benefits.
1 - the relaxation techniques that you learn, and have to practice daily, will help those last weeks of pregnancy pass more comfortably and easily. There's a deep relaxation mp3 that we used to listen to at bedtime that would send us both to sleep in minutes. I think I heard the last 20 minutes twice in two months. Which meant that I actually managed to sleep during labour as I was so deeply relaxed and my body was used to going to sleep when I heard the mp3 start.
2 - the power of breath, and understanding how to use it properly, can transform your labour. Honestly. I really wasn't sure I had much of an ability to cope with pain, and if you ever see anyone give birth on the telly you kind of get the idea that walking over hot coals would be more manageable. But they lie!! Breathing well will help bring oxygen to the muscles that are working their hardest to help your baby make its way down the birth canal and into this world and you have the power to help yourself on this one. Not only that but it transforms the pain from something you have to suffer through, to something dynamic that is helping you achieve your goal. You just have to take one breath. Then the next. And the next.
3 - your birth partner learns how to practically help you during the hours of labour and in the first hours after childbirth. There are a million ways that someone you love and trust can irritate you to the point of murder when you are in the throes of trying to push a new life out into the world, but if they take their homework seriously they are less likely to make you hate them temporarily.
4 - this course did more to engage my husband in what was happening than anything else we did. From being determined I should give birth in hospital with a doctor on hand to actually considering homebirth as one of our options was a mark of how the course helped him address the fears he had around it all, as well as educate him on what it was I was going to have to try and do. Sometimes you can feel like you are the only one thinking about what happens next, ie getting that great big lump of baby out, so this is very cheering. And uniting.
5 - the positive affirmations that you post around the house are colourful and friendly and help you feel quite celebratory about what is going to happen, as opposed to raddled with fear of the unknown.
6 - birth plans are an act of hope. We all have ideas about how we would like labour to unfold, or how our babies are born and we should do everything we can to enable that but sometimes nature has other ideas. The techniques you learn in hypnobirthing can help you stay calm enough to adapt to the turns your labour may take. After all, what counts is that you take a baby home, right?
After the hypnobirthing course with Hollie de Cruz, I truly started to embrace the possibility that I could actually, potentially, possibly enjoy labour. Scrub that, I bloody well knew I could. You know what? I did. The meaning of the word 'enjoy' took on new nuances, but yes, enjoy it I did.
Up next? I got physical. Like my facebook page here if you want to know when the post goes live.
'I am not a marathon runner, just to be clear about my physical abilities from the get go. Stamina, endurance, commitment and physical pain haven't traditionally held much attraction for me to be honest, so you can imagine how much I was looking forward to giving birth. Yes, that much. I mean I knew I could use acupuncture and acupressure in labour to help, but still, my feelings about childbirth were similar to those about running a long distance race where you take your poos by the roadside. Really not my bag. I didn't have much faith in my body, or my own ability to deal with physical pain and I really, really didn't want to have to poo in front of people.
But here's the thing; when I thought about it I realised that I wanted to enjoy it. It took so much effort, and so many years, to get pregnant that I kind of wanted to make the most of my one shot at labour. You know, become one of those women who smile serenely while popping out a ten pounder. So I decided I needed to start training. And as a member of the London Hypnobirthing team, I started by picking the brains of my inspiring colleagues about what I needed to do.
Now it's not often you get the chance to test drive your colleagues, and its a huge relief (though really I was in no doubt) that they did indeed take me over the finish line, euphoric and triumphant. So if you have never given birth, or are determined to do it differently the next time, and would like some first hand insight into the different ways you can think about training for labour, I'm your gal.
Personally I can't stand really long blog posts (and I haven't got time to write them) so I will be rolling out my 'training programme' over the next few posts, rather than bore on here.
Like me on Facebook here if you want to see when these posts go live.
It's late summer the season of abundance - or so we hope. If your attempts to grow tomatoes in this pretty dismal summer have been anything like mine you still have unsatisfying plants of green fruits, who have been sun-starved and won't ripen. Boo. But the runners beans have thrived, so yay!! But for me it's a cheerful time of year - the pure sunshine of fresh corn on the cob, raspberries, blackberries, apples, chard, squashes, yada yada, suffice to say if your heart doesn't gladden at nature's bounty then as an acupuncturist I think you probably need to come and see me, because it should quicken with joy!
So at this time of year, the harvest season, I tend to naturally find my thoughts turning to my own personal harvest. What is working in my life, which areas feel rich and abundant, and which are delivering diminishing returns, or not satisfying me as fully. Like my sorry tomato crop. One of the basic tenets of Five Element Acupuncture and living in a state of health is to live in the rhythm of nature, and this process is something that we should find ourselves naturally doing about now.
I have so much to be thankful for, and many many reasons to be cheerful (my new haircut, my 10th wedding anniversary, a practice I love, the man in the cake shop who seems to be my newly appointed 'feeder'), but like most of us, still put energy and time into areas of my worklife, friendships or other relationships that don't give me the harvest I need, or perhaps that they should. Wrong soil, wrong fertiliser, wrong time, whatevs. And that's fine, there's a wax and wane for everything. What's right for now is to take stock. Not in a heavy way, but simply recognise what has borne fruit and what hasn't, so we can decide what to let go of and what to take forward.
So maybe over this weekend spend a few minutes pondering some simple questions - do you have the capacity to enjoy your harvest? Or do you struggle to recognise what abundance is, or means to you? Are you living in harmony with nature and her gifts?
Anyway, if you need any inspiration for your own harvest list, Ian Dury is the man. Reasons to be Cheerful. Part 3.
I will admit to getting a little excited about the benefits of pre-birth acupuncture, a series of weekly treatments undertaken from 36 weeks to promote natural labour, having been offering this in my clinic for some time now. Research undertaken in Germany, where midwives routinely administer acupuncture to their patients, showed that the mean duration of labour in a group of women giving birth for the first time was reduced from 8 hours and 2 minutes to 6 hours and 36 minutes. The wonderful Debra Betts, who is widely acknowledged as one of the foremost experts on acupuncture in pregnancy and labour (and herself a former midwife) also reports from her own research that midwives using it report a reduced rate of medical intervention - including medical inductions and c-sections. Sounds good, right? So how does it work?
Pre-birth acupuncture will typically be working for the patient in two ways. The first is focused on promoting a natural, efficient labour. This is done by using a set of points (all on the lower leg) that help prepare a woman's body for birth, with an emphasis on affecting the cervix and pelvis. The needles are placed in the correct place and left for 20 minutes. These points nourish the blood, relax and soften the relevant ligaments prior to labour, aid in cervical dilation and promote the optimal position of the baby for birth. My own patients also all report feeling much calmer at the end of each session and this is really important - especially when women have been working right up to the last minute. These sessions create a calm, quiet, relaxed space for concentrating on oneself.
The second benefit of treatment at this time is to address the 'minor' issues many pregnant women are dealing with by now. Heartburn, constipation, swelling, difficulty in sleeping, etc. Whilst not in any way pregnancy or life threatening, they can make the final weeks that bit more uncomfortable, and being tired can really exacerbate anxiety.
Finally, many of the women I see work til quite late in their pregnancy as, understandably, they want to save their maternity leave for when the baby is actually here. But work stress, and the physical the strain of getting to and from work every day, can be incredibly draining - not ideal when giving birth is such a physical feat. Add a toddler into that mix and you are guaranteed one tired mumma who is going to have to dig really deep into her reserves just to get through the final weeks, let alone get through labour.
So signing up for a course of pre-birth acupuncture not only helps balance what the body needs to concentrate on with the demands of the 'in the real world' life of mums-to-be to, but also creates optimum conditions for a safe, efficient, shorter labour.
You can read more here about the research study here - http://acupuncture.rhizome.net.nz/acupuncture/research/prebirth/
Yep. I want to talk about cystitis. That stingy, nasty, painful blight that tends to make special (and often frequent) appearances that are seemingly designed to mess with your life. Triggers can include sex, alcohol, riding a motorbike (u-huh) and certain foods (for me, Red Bull is a guaranteed shortcut to an army of wee nettles) and is a pain in the coochie to shift. For some unlucky ladies it is almost a contraception in itself, with sex-avoidance a better option than inviting it back for another round.
Bacterial or non-bacterial, the good news is your body usually has the ability to get over it by itself within a couple of days (unless it travels to the kidneys - if you see red, get to the doctor NOW), but before your body gets itself in gear you can give it a hand with this AMAZING acupuncture point. The best thing to do is to come and see me and get a needle in there (please don't try this at home) but you can also use acupressure on this point to help give your bladder some relief.
Over the counter remedies can also be helpful in neutralising the urine so it doesn't sting as much, but a cheaper alternative is to dissolve a teaspoon of bicarbonate of soda in half a pint of water (please don't do this if you have high BP) and drink that 2 to 3 times a day.
Interstitial cystitis is a different condition. Non-bacterial in nature, it doesn't respond to antibiotics and its causes are unclear, but it can be a really difficult condition to live with and even more difficult to treat. I have worked with several patients who have suffered with this condition, so if you find you always need to pee, call me. Catchy, eh?
Passionate about the pins.
Please contact me if you would like to book a free telephone consultation. You can also follow me on social media via the links below.
Tues: 3pm-9pm HOLBORN (PAUSED)
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