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Subchorionic Hemorrhage: What are they and what you need to know

Photo of a seated woman holding her abdomen with the words "subchorionic hemorrhage" over the photo
Subchorionic hemorrhage is a common cause of vaginal bleeding in pregnancy.

Subchorionic Hemorrhage

Lately we’ve had a few patients with subchorionic hemorrhage come through our office doors. We wanted to take a moment and share what SCH is, what do if you have one, and how acupuncture might be able to help.

First, what is a SCH?

A subchorionic hemorrhage is a collection of blood between the chorion (the outermost membrane that surrounds the fetus) and the uterine wall. It is a common cause of vaginal bleeding in early pregnancy, affecting up to 20% of women. Most subchorionic hemorrhages are small and go away on their own without any problems for the pregnancy. However, larger hemorrhages can increase the risk of some complications. The exact cause of subchorionic hemorrhages is unknown, but they are thought to be caused by a tear in the chorion.

Second, what should you do?

Any time you have any bleeding in pregnancy, your first call should be to your OB or RE. They can run some blood work and do an ultrasound to make sure your pregnancy is healthy and rule out miscarriage. They may recommend additional progesterone, bed rest, pelvic rest, or other treatments.

Third, how can acupuncture help?

To be clear, acupuncture should never be used in lieu of treatment from your doctor, we always recommend an integrative approach. There is evidence that acupuncture combined with progesterone can “improve the effective rate of patients with threatened abortion in early pregnancy complicated with subchorionic hematoma, regulate immune factors, promote the hematoma absorption, and has a better synergistic effect” with progesterone. It can also help alleviate anxiety as any bleeding during pregnancy is terrifying!

If you have questions, feel free to give us a call, 865-315-3845 or email us at info@TennesseeReproductiveAcupuncture.com, we’re always happy to help!

Why We Recommend Theralogix

One thing we often get asked about is supplementation and herbs to support fertility. While not every supplement is appropriate for every patient or in every situation, we often suggest some supplements to help support your fertility journey. For instance, being on a good quality prenatal is always recommended while trying to conceive.

At The Tennessee Center for Reproductive Acupuncture, the brand we recommend the most is Theralogix. We wanted to take a moment and share why this company does a great job with their supplements and specifically supplements for fertility. As always, please consult your medical doctor before starting any supplements. The following comes from Theralogix’s website:


Why we recommend Theralogix supplements

1.  Medical Advisory Board Oversite 

The Theralogix Medical Advisory Board (MAB) is a multi-disciplinary group comprised of physicians, nationally reputed scientists, and faculty members from leading U.S. medical schools. Each product formulation has been approved by the MAB after detailed review of the scientific data.

The MAB continues to meet regularly to conduct extensive reviews of scientific research and to offer guidance on improving existing formulations or developing new products.

2.  Research-Based Formulations

Theralogix will never sell a product that is not backed by solid scientific evidence. That is our promise to you.

3. High Quality Ingredients

Theralogix works in conjunction with top manufacturers to source the highest-quality ingredients for our products. Theralogix often specifies the raw material to be sourced, typically because we believe there is an advantage with a specific raw ingredient in quality, performance (bioavailability or other performance measure), or because a material is used in supporting research.

Whenever possible Theralogix will disclose the specific supplier of key raw materials on product labels.  All raw materials must meet the sourcing and testing requirements of the NSF International Certification program.  Theralogix will not source any ingredient that cannot be tested, identified, or that is not standardized.

4. Current Good Manufacturing Practices 

Theralogix products are produced by the highest-quality, U.S.-based manufacturing facilities under conditions that exceed the Current Good Manufacturing Practice (cGMP) standards set forth by the FDA.

cGMP refers to the Current Good Manufacturing Practice regulations enforced by the Food and Drug Administration (FDA). cGMPs assure that manufacturers follow proper design, monitoring, and regulations when producing dietary supplements. Adherence to the cGMP regulations assures the identity, strength, quality, and purity of nutritional supplements.

5.  Independent Testing and Certification

It is important to know precisely what is in the supplement you choose to take. To achieve that assurance, Theralogix works closely with NSF® International, a not-for-profit organization that is the world leader in standards development, product certification, education, and risk management for public health and safety.  

NSF certification guarantees that the product contains exactly what is stated on its label, that there are no contaminants or other ingredients that are not listed on the label, and that cGMPs established by the FDA have been met during the production of the product.

Since our founding in 2002, every eligible Theralogix product is tested and certified through the NSF International Dietary Supplement Certification Program. 

In addition to certification and testing by NSF International, Theralogix also voluntarily submits its products that contain fish oil for further testing.  International Fish Oil Standards (IFOS)tests for contaminants and heavy metals such as mercury, lead, and polychlorinated biphenyls (PCBs).  The fish oil used in our products is certified sustainable by the Marine Stewardship Council (MSC).

6.  Transparent Labeling

Theralogix follows a clean label policy. All products are artificial dye-free, gluten-free, and contain no proprietary blends or undisclosed ingredients.  We strive to reduce or eliminate excipients as much as possible within our production process. Theralogix bottles are made with materials that are recyclable.   

7.  Clinical Trials

Theralogix products have been used in over a dozen clinical trials conducted by esteemed universities and research institutions across the United States. Several of these clinical trials have been funded by the National Institutes of Health (NIH), one of the world’s foremost medical research centers. 

Our products have been chosen for use in clinical trials because of their high-quality ingredients and verified content-accuracy.  We are truly honored to be trusted by so many of the country’s leading research institutions.

8. Our Nutrition Experts

Nutritional Science is the core of our company. From our Chief Scientific Officer to our registered dietitians, we are here to help you achieve optimal health. We strive to ensure our science-based formulations will deliver the highest-quality nutrients to support your individual needs. For answers to your nutrition questions, please call 1-888-899-3899, ext. 2 to speak with one of our registered dietitians.

Please use our PRC Discount Code to receive Theralogix’s best pricing. We receive a small commission from every sale using our PRC code.

Theralogix Supplements: Online Store Now Available

Check out Theralogix’s new online store with our provider discount already applied!

Theralogix sells excellent quality prenatal vitamins, CoQ10, our favorite inositol for PCOS, and many other supplements including our recommended male “prenatal” vitamin, Conception XR RHF.


We wanted to share a link to their online store with our provider discount already factored in so you can order your supplements from the comfort of your own home and not have to hassle with in-office ordering. Or, if you’d prefer to use the code directly with your order, our Provider Reference Code is 137923.

Click below to be taken right to the site!

 

Please see your provider for specific supplement recommendations or with any questions and always check with your physician before starting any supplements. 

Never Say Never

“You’ll never be able to get pregnant.” 

Have you had anyone ever tell you this? These 7 words are one of our biggest pet peeves. So often, I’ve heard this come from other providers without a proper diagnosis and exam or even friends and family members and it is absolutely devastating to the couple involved. Thankfully, Knoxville’s reproductive endocrinologists are careful with their words and would never say such a thing without first doing a careful exam and diagnosis and discussing all the options with you. Much of the time, they are able to present a treatment plan that will eventually result in a healthy pregnancy. We are truly lucky here in East Tennessee, but I digress.

NEVER is such a strong word (assuming, obviously, you have the necessary organs, etc). In my 10 + year career as an acupuncturist, I have been blessed to be a witness to some amazing miracles in women who seemingly have little chance. 

My patients hear me talk about this all the time when encouraging them to try while they wait for IVF or during an unlikely cycle (if, of course, they don’t feel it would add undue stress on them). I finally decided to write about never saying never because one of our miracle patients just delivered healthy twin boys. She had been trying to conceive for over 4 years and went through cycle after cycle, IUI, medications, and more, finally deciding to move forward with IVF. During her retrieval cycle, her response was much less than her doctor anticipated, so the tough decision was made to cancel the retrieval and, instead, do an IUI. She agreed to the plan, with hopes of repeating the retrieval with a different medication protocol in a coming cycle, but was understandably not feeling positive about the IUI at all. We used acupuncture and timed her treatments with our standard IUI treatment protocol. Then, on a day I’ll never forget, I got a phone call. “Uh, so, uh, my pregnancy test was positive.” The shock and disbelief was palpable and understandable!  After congratulations (and some tears), we started with our prenatal wellness protocol. After 9 healthy months, two sweet baby boys were born. 

Do I think acupuncture was the reason this miracle happened? No. Acupuncture, as much as I wish it was, is not magical. Who knows exactly why it happened. She had an excellent fertility team, a healthy lifestyle, had been doing acupuncture regularly, and the right egg and sperm finally met. Everything just came together. Acupuncture can improve blood flow, help regulate hormones, calm stress, and reduce side effects, but it isn’t magical. 

Acupuncture makes a great complement to any type of treatment cycle.

Upon reflecting back on my patients over the years, there have been a number of equally miraculous situations:

-A patient with one tube fell pregnant when she had only one mature follicle on the side without a tube (there is evidence that eggs can transfer to the other tube during ovulation).

– A woman with severe diminished egg reserve who became pregnant on her own after multiple failed IVF cycles with some of the most well known clinics in the country. For the record, she was not doing acupuncture when she got pregnant. They had stopped “trying.” She shared the news with me after a healthy 20 week anatomy scan. 

-A woman who ovulated a second time after her trigger shot and IUI and became pregnant with that follicle based on the timing of her positive pregnancy test and beta hCG numbers. 

– Many patients who’ve become pregnant naturally before moving forward with an IVF cycle, surgery, etc.

And many more whose details have softened over the years. While I wish every patient had this story, we are so happy for those who do. 

We often get feedback about how hopeful we are as we walk with our patients on their infertility journeys. We nervously anticipate pregnancy tests, ultrasounds, blood work numbers right alongside our patients and feel the highs and lows of the rollercoaster ride. But our optimism, while sometimes a bit foreign to our patients who’ve been through so much, is rooted in these stories. We encourage our patients to try on their own (when it is possible, of course, and won’t cause too much stress) while they wait for a cycle to begin, surgery, etc. Because, you never know what might happen. Never say never


If you have any questions about adding acupuncture to your cycle or how we might be able to support your journey, please give us a call or an email. We are always happy to help.

Our Postpartum Kit is Now Available

We are so excited to share our postpartum recovery kit with you! Most of our mama’s take so much care planning for their birth, the weeks after baby arrives are often neglected. To follow up with our recent post on planning for this time, we’ve put together a kit with our favorite postpartum must-haves!

Sarah, our acupuncturist, developed this kit personally. After the birth of her daughter in February, she tried everything in this kit (and more that didn’t make the cut) and put together something that would really benefit postpartum mamas.

So we’d like to go through exactly what’s in each kit and why it was chosen:

Urban Herbs: Nourish the Mama Bone Broth Herbs: 

This herbal mix put together by Urban Herbs  is a fabulous addition to a bone broth (or vegan/vegetarian bone broth) to help nourish your body after birth. According to Chinese Medical theory, new mothers should try to consume warming foods in the month after birth. This herbal mix is the perfect way to add extra warming nourishment to yourpostpartum diet. These herbs help support your energy level, sleep, stress, and general recovery after birth.

Tip: Make your herbal broth ahead of time and freeze so it’s ready to go quickly. You can use it as a base for your favorite soups or drink on its own.

Mother Warming:

Mother Warming is another Chinese Medical treatment that helps the new mother recover after birth. Typically done a few days after birth, the warming, soothing moxa treatment done over your lower abdomen feels absolutely delightful! Moxa, a Chinese herb also known as mugwort, strengthens and tonifies the body. It is wrapped in paper, like a cigar, and burned near the skin to gently warm specific acupuncture points supporting recovery. Mothers love this treatment! There are more specific guidelines in our longer post on Mother Warming.

Perineal Spray:

 We cannot say enough good things about this herbal perineal spray from Earth Mama Angel Baby. After birth, using the bathroom can be uncomfortable! You’ll find many women recommending ‘padsicles’ to relieve this swelling. We don’t recommend these as they are often too cold for too long a time and can prevent blood flow and hinder the healing process. Instead, use this perineal spray every time you use the restroom or as needed. It is wonderfully cooling, refreshing, and can support healthy perineal healing. And, as a bonus, if you don’t use all of it before your perineum is done healing, it makes a wonderful after sun toner for your skin!

Tip: For extra cooling, keep it in the refrigerator.

Herbal Sitz Bath:

According the Earth Mama Organics website: Take care “down there” with herbal compresses filled with organic herbs traditionally used to soothe and comfort “down there” during pregnancy or after childbirth. Packed in easy-to-use, individual herbal sachets, each one is perfect for one use. The compresses can be cooled and gently “tucked” to help ease those pretty places, or use the brewed infusion to make postpartum padsicles or use as a sitz bath. Which is kind of like making tea for your nethers. Which is a totally lovely and perfectly polite thing to do.

Imperial Tonic Recovery Herbs: 

This Chinese herbal formula from Evergreen Herbs is an adaptogenic formula designed to support recovery after childbirth. It helps boost energy levels, support the immune system and healthy blood production, and promote general physical and psychological wellness. Generally, this formula is recommended 1-2 weeks after birth and taken for about a month to promote optimal recovery.

Nipple Cream: 

Earth Mama Angel Baby has, again, knocked it out of the park. Many mothers will claim this the best nipple cream on the market. While breastfeeding should not be painful (if it is please seek the care of an independent IBCLC), a good nipple cream applied after breastfeeding can keep nipples from drying out or cracking.

Tip: This is also an excellent salve for cuts and scrapes and make a great lip balm.

So there you have it! All packed up in a cute little storage bin perfect for the nursery, our postpartum  kit is a great way to get your postpartum recovery off to a great start! After all, your body, mind, and spirit deserve to be celebrated after your transformation into a new mama!

Postpartum recovery kits are available in the office or online.  We do ship, if needed. These also make a great gift for a friend or loved one!

Sitting the Month: 6 Tips to Help You Navigate Your Postpartum Time

Our 6 best tips to plan a restful and rejuvenating postpartum month!

There is a saying in Chinese, “zuo yue zi,” or “Sitting the Month” that refers to the idea that the  month following the birth of a baby is a sacred time reserved for rest, regeneration, and bonding with your new baby. After all, birth is an incredibly transformative event, it is rather silly to expect your body, mind, and soul to bounce back to normal activity in a short period of time. In fact, this rush to get back into action quickly is not healthy and can lead to a much longer recovery period.

 

Unfortunately, our society idolizes women for bouncing back and rushing back into work, life, exercise, and their pre-baby bodies. Celebrities, likely with extreme diet and exercise regimens put forth by their teams of professionals, often are the examples of this unattainable image.

 

If this isn’t your first child, you know how tough those first few weeks can be. Your newborn is dependent on you for everything and you are working so hard to figure out what each cry means, teaching yourself how to breastfeed or quickly make bottles while your baby gets more and more upset, and, all the while, expected to feed yourself and maybe sneak in a shower. The whole thing is exhausting and can be emotionally draining.

 

In China, women are encouraged to “sit the month” after birth and remain in bed with baby. Family, partners, and friends take care of the house, cook nourishing meals, and ensure the mother gets the rest she desperately needs. I think we should take a lesson from China and incorporate these theories into our postpartum plans.

 

During pregnancy, you likely found yourself researching, downloading, and revising your birth plan until it was a perfect vision of what you wanted for your birth. The time after baby comes is often ignored. We should, in fact, be putting at least as much effort into the weeks following baby’s arrival to allow for space for healing and recovery.

 

Aside from a much needed list of delegated tasks, desires, meal trains etc, a plan should be worked out to allow you to get the rest and recovery you need and the time you want to bond with your new baby.

 

So here are our tips for navigating your postpartum time:

1. Rest: Your body just went through one of the most single transformative times of your entire life. Give it a break! You nourished and grew a new person, birthed that person, and took on a new role as a mother. This is an amazing feat and it takes time to recover from and get acquainted to your transformed life.

  • For the month after birth, rest as much as possible. Lay in bed with your baby, sit on the couch with your baby, sit outside with your baby. Spend time staring at your baby and, of course, catching up on your favorite Netflix shows. If you feel like getting up and walking a little, by all means get off the couch, but listen intently to yourself. If you feel any soreness, increased perineal pressure, notice an increase in your lochia (the bleeding you will have postpartum), or have any discomfort back off and get back on the couch.
  • Spend time skin-to-skin with baby. Skin-to-skin was likely something you remember from your birth plan, but the benefits of this go well beyond the hour after birth. Skin-to-skin can help support good breastmilk supply, help baby regulate body temperature, and facilitate bonding. So, put on a robe or button up shirt, cuddle up, and enjoy!
  • Limit guests: I know everyone will want to come see the baby, but give yourself a few weeks without a stream of well-intending friends and family. Allow those who will take on a task, laundry, dishes, etc, and tell everyone else to come back later. Entertaining, or feeling like you have to entertain, cleaning your house, and preparing snacks is a lot of unnecessary pressure while you’re becoming familiar with your new role. Additionally, your new baby does not need the exposure to the coughs and sneezes your guests might bring.

 

2. Eat warm nourishing foods: One very big part of Sitting the Month is proper nutrition to replenish your body and support your recovery. The Chinese recommend a diet of warming foods and herbs. Some examples of things to add to your diet are:

  • Ginger: Use in soups or teas. Caution: Occasionally ginger can increase bleeding, so if this is the case for you, stop using it.
  • Wam spices: Use cinnamon, cardamom, chile, etc for cooking.
  • Bone broth (or vegetarian/vegan bone broth): with added warming spices or herbs.
  • Mushrooms: you can add these to your soups and broths for benefit to your immune system.
  • Eggs: These are a great source of protein and are great for pregnancy and postpartum support.
  • Red raspberry leaf tea: to help regulate hormones and reduce your uterine size back to normal.
  • Water, water, water! When your milk comes in you will find your thirst increases quite a bit. Combat that by increasing water consumption. This will also help reduce water retention and prevent headaches and muscle cramps.
  • Avoid cold foods: ice water, smoothies, ice cream, salads, raw veggies/fruits, etc.

 

3. Perineal Support: Whether you gave birth vaginally or not, you will notice some perineal soreness.. If you’ve had stitches or minor tearing you will definitely have some discomfort or even pain as your body heals.

  • Say No to Padsicles:  We recommend against the ‘padsicles’ you might find on Pinterest. That much cold placed right on tender, healing skin can reduce blood flow, increasing overall healing time. Instead, if you’d like to use something cold to reduce swelling, wrap an ice pack in a towel, so the cold you feel is more cool. Combine with an herbal perineal bath and/or spray to speed healing.
  • Perineal sitz baths: A sitz bath made from healing herbs can increase healing time and soothe your sore perineum. You can also use these herbs in a bath with epsom salts for extra relaxation.
  • Perineal Spray: Earth Mama Angel Baby makes a fantastic herbal perineal spray that will quickly become your best friend. The combination of herbs in this spray is soothing, cooling, and can help promote healing. Use every time you use the bathroom or as needed. If you have any leftover after healing, it makes a great after-sun face toner!
  • Prevent Constipation: Your first bowel movements after baby can be really tough, especially if you’ve had any pain medication or dehydration causing constipation. Taking magnesium or a stool softener in the first week or so can really help make going to the bathroom much more comfortable. Also, make sure you are drinking enough water, as this, of course, will help.

 

4. Lactation Support: So many women wanting to breastfeed go into it assuming it is a natural and easy process. And, for some, this is absolutely true. For others, it couldn’t be farther from the truth. It is so important to have an ally for your breastfeeding journey. They can make sure you are getting accurate, up to date information. We recommend a prenatal breastfeeding class and a visit from an independent IBCLC in the days after birth to check for tongue/lip ties and check baby’s latch to help support breastfeeding. Check out our resources page for our favorite lactation consultants. Many will do home visits, so you don’t even have to leave your house.

 

5. Mother Warming Ritual: Moxa, made from the leaves of the mugwort plant, is used to gently warm points along the lower abdomen in mom’s who’ve given birth vagainally or through a Cesarean birth. This is typically done about 3-4 days after birth and promotes healing, milk production, and alleviates discomfort. It is used on an as-needed basis after the initial warming.

  • This is a great way for partners to help out with postpartum healing.

 

Acupuncture can help treat and prevent many postpartum issues.

6. Acupuncture: There are so many benefits to a course of postpartum acupuncture. We can begin work on restoring your body, support healing, and help treat any issues you might be having with breastfeeding, digestion, sleep, anxiety/depression, etc.

  • Our recommended postpartum protocol is just 3 weekly visits starting at 2-3 weeks postpartum and as needed after that.

 

 

We look forward to working with you during your pregnancy and into your postpartum time! Please give us a call at 865-31503845 or contact us via email with any questions!

 

Why You Should Consider Hiring a Birth Doula

A doula is an excellent addition to your birth plan!

As our patients struggling with infertility finally get pregnant, aside from the joy of finally seeing those two lines, there are many decisions that need to be made. What provider is right for my pregnancy? What type of birth do I want?

Many of our patients have never allowed themselves to consider any of these things for fear of ‘putting the cart before the horse,’ so to speak. So this process, while exciting and wonderful, can be overwhelming and stressful.

One thing we often discuss with our patients, as they get closer to delivery, is their birth plan. It is our desire for our patients to be informed about their choices and have a provider they trust and feel totally comfortable with.  One thing that can really help during your pregnancy and birth is having a doula. As highly trained, non-medical birth experts, they can walk through your needs, fears, desires, etc and help you come up with a birth plan and guide you and your partner through labor.

I asked a trusted doula friend of mine to do a post for our blog about what role a doula can play and why you would consider working with one. So, without further adieu, here is Hillary Ebling with East Tennessee Doulas. 

Hilary and Danielle of East TN Doulas

Congratulations on your pregnancy! I am so glad Sarah was able to help you reach this point! Did you know, she can continue to help you throughout your pregnancy?

I am Hillary Ebling, and I am a birth doula and postpartum doula in Knoxville, TN . I work with fellow doula, Danielle Anthony, at East TN Doulas. Working as a doula, we work with expectant families so they may have the best chance of achieving their ideal birth. Our goal is that you feel confident, cared for, and respected during your childbearing year.

As you begin researching how to have a happy, healthy childbirth, you may run across the words “birth doula” and see that this is a person who supports a family during pregnancy and birth. That sounds awesome… but you already spent money on a medical provider, birth location, and higher price tag baby items like a car seat and a crib. You may think a doula is a luxury you should go without. Before your accept this, however, check out these compelling reasons to spend the money on a birth doula.

First, what is the role of a doula?

“Doula” is a Greek word meaning a woman who serves. I’m using a more formal definition of birth doula to refer to a specially trained birth companion (not a friend or loved one) who provides labor support. This labor support includes comfort measures and emotional support. “Comfort measures” means using massage, position changes, water, hot/cold packs, mindfulness, and breathing to help deal with the intensity of labor. “Emotional support” means using reflective listening, positive presence, and reassurance to help increase your confidence and satisfaction of your birth experience.

It is important to notice that doulas play a completely “non-medical” role. Doulas do not diagnose or treat in any modality, nor do we take blood pressure or temperature, fetal heart tone checks, vaginal examinations or postpartum clinical care. What this means as a client, is that you also need a medical provider, whether that is a midwife or a doctor, to attend your birth. In short, your medical providers keep you and your baby safe, provide all medications, deliver the baby, and take care of the mother postpartum, whereas the doula keeps the mother encouraged, comfortable, and confident.

Now that we have clarified the role, what are the benefits of having a doula for my clients?

 

First, a doula is the only team member entirely focused on the laboring parent’s physical comfort and emotional well-being.

Your medical providers attention is inherently split between two different people – exactly as it should be! We all want a happy, healthy mother and baby at the end of a birth. Their training is scientific and this is where their focus should be. Medical providers are often expected to care for multiple patients at a time and usually work shifts of time in the hospital or on-call period.

A doula’s training, on the other hand, focuses on the “art of labor support,” that is, the emotional needs of people in labor, and non-medical physical and emotional comfort measures (as mentioned in the examples above). Our sole focus is on the needs of the mother, not the baby. Unlike medical providers, doulas work with one client at a time. We will join you when asked, either in early labor or later in active labor. We will stay with you throughout, often with only very brief breaks.

 

Second, having a doula can help you have shorter, more satisfying birth with less interventions.

Although the exact reasons for this are unclear, there have been numerous studies showing that doulas help families. The largest systematic review of continuous labor support, reported the combined findings from 20+ randomized controlled trials, including over 15,000 women. These trials focused on the benefits of continuous support (having a support person constantly present throughout labor, not coming and going as family and medical providers often must). Women with continuous labor support are

  • 28% less likely to have a cesarean section
  • 31% less likely to use synthetic oxytocin to speed up labor
  • 9% less likely to use any pain medication
  • 34% less likely to rate their childbirth experience negatively

Why can’t a family member or partner fill the same role for free?

Outcomes were most improved and intervention rates were most dramatically lowered in the group with doulas as their support person, not a nurse, friend, or family member.

But do you need one if your partner is really supportive?

In a perfect world, your doula and your partner work together to give you the best birth possible. We cannot possibly replace the loving, intimate relationship of your partner. We don’t stand in the way of your partner being great labor support – we help him or her achieve it!

Our birth culture puts a lot of pressure on partners. A pregnant parent often expects her partner to be knowledgeable – and good – at a host of new things. You may expect your partner to help you emotionally (by providing reassurance, encouragement, and confidence in you) or physically (by encouraging coping mechanisms like breathing and relaxation and providing comfort measures like massage). Lastly, you might expect your partner to fulfill other roles, like updating family and friends of your labor progress. That’s a lot of expectations for one person to handle! For many partners, this may be the first time he or she has ever set foot in a delivery room or seen labor! Add the love your partner feels for you and your discomfort to the equation, and it can be completely overwhelming!

With a birth team of both a partner and a doula, though, we share the weight of these expectations. You will have twice the emotional support and reassurance. We can alternate providing physical support so your partner is less fatigued by the labor. We stay with you if your partner needs a break for food or to update your family. This way, you are never unsupported and your partner can have peace of mind while handling these tasks. We have seen many labors and can use our experience to provide helpful suggestions for new things to try for both you and your partner.

 

Last but certainly not least, doulas provide informational support to the family.

By “informational support”, I mean explanation and discussion of practices and procedures, and assistance in acquiring any knowledge necessary to make informed decisions about your care. We help you find reputable, evidence-based information that will help you make informed decisions about your birth and your new baby’s care.

In essence, a doula doesn’t tell you how you should give birth. Instead, we share information with you so you can make informed decisions and then support you, whatever your choices.

Ok, so you definitely want a doula, but aren’t doulas expensive?

Often, yes – we are trying both to answer a calling and make a living. Although not usually covered by your insurance, some insurance companies will pay a portion or allow you to pay for your doula out of a health or flexible savings account. Contact your health insurance provider for more information about your specific situation.

DONA International’s Vision is “A doula for every woman who wants one”. With this in mind, many doulas offer some way to cut costs. I offer gift certificates so friends and family can donate to help financially (consider asking for this for baby shower presents!!). We do offer some packages of our services to save a little bit of money when bundling services. I am of course happy to answer any questions you have about my current options email us or give us a call at (865)315-8548.

Bottom Line: With all this information in mind, I urge you to consider carefully the benefits and options to offset the cost before you write off having a doula off as a luxury you can’t afford!

The One Year Anniversary of The Tennessee Center for Reproductive Acupuncture: Wisdom Teeth and Gratitude

Thank you, Knoxville, for a successful first year!

On March 1, 2016 the Tennessee Center for Reproductive Acupuncture finally opened it’s doors to Knoxville and the surrounding areas. We are Knoxville’s first and only acupuncture practice specializing in fertility and prenatal wellness. It was my goal to provide East Tennessee with an integrative option for the treatment of infertility and help each of our patients navigate this complex journey. We have officially been open for our patients for one year (and counting) and I wanted to touch on my thoughts for this first year in practice here. 

It was my intention to post this retrospective on the 1 year anniversary of my practice, but I spent the morning driving my husband to and from his wisdom teeth removal appointment. Luckily, all went well, and I was able to fill my afternoon seeing the patents that are truly the heart and soul of TNCRA. Minus the wisdom teeth extraction (who wants to do that!?), I wouldn’t have wanted to spend the one year anniversary of my practice in any other way.

When I think back over the past year, I am completely overwhelmed with a feeling of gratitude. I have been humbled by the reception that Knoxville has given to TNCRA. Over the past year I have met many families struggling with infertility and had a chance to help many of them achieve their dream of pregnancy. I have also met many expectant mothers and had the honor of working with them as they prepare to become mothers for the first, second, third, fourth, or fifth (and more) time. I have also met so many others whose passion for working with families during infertility and pregnancy just bleeds through their work: doctors, doulas, midwives, nurses, massage therapists, craniosacral therapists, nutritionists, chiropractors, photographers, lab technicians, yoga teachers, other acupuncturists, counselors, reproductive endocrinologists, ultrasound technicians, OB/GYN’s, and I’m sure there are few I am forgetting.

One thing I kept hearing in my first year of practice here is that it can be hard for people coming from outside of Tennessee to get a successful business going. I have found this completely and happily untrue. Knoxville has an incredibly welcoming atmosphere and a truly wonderful community to support families of all backgrounds on their journey from trying to conceive to becoming parents. I am honored to be a part of this community and look forward to many years of practice here.

So, thank you Knoxville for welcoming me with open arms. Thank you to the other practitioners who have taken time to learn about TNCRA and how we may be able to work together to help support our patients. But mostly, thank you to my patients. You have put your trust in my experience and training during the most sensitive of times and I am forever grateful to walk alongside you on this journey.

I am very excited for the years to come and hope to build upon the foundation that has been laid. I look forward to learning more each year and working with more families. Mostly, I look forward to pregnancy announcements, birth announcements, and holding space (or a hand) for those experiencing a loss or a failed cycle. These moments are truly what drives me to come to work each day. I love my job.

 

How We Use Acupuncture and Moxa to Help Turn Breech Babies

Moxa sticks, pictured above, are a useful treatment in encouraging a breech baby to turn.
Moxa sticks, pictured above, are a useful treatment in encouraging a breech baby to turn.

If you’ve been told by your midwife or OB/GYN that your baby isn’t in the best position for a vaginal birth, you know what kind of stress this can bring on! Most women facing a possible Cesarean section for breech presentation will search far and wide for things they can do to help their baby get into a better position for delivery.

If you end up consulting Dr. Google, you have probably come across others talking about using acupuncture and moxibustion (moxa) for turning breech babies, and you probably have some questions. It is true that we safely use these techniques to turn many breech babies and it can be successful much of time!

What to expect: At the Tennessee Center for Reproductive Acupuncture we use a combination of acupuncture and moxa to help encourage a cephalic presentation.

  • Acupuncture: We generally recommend acupuncture 1-2 times per week to help encourage baby to turn, reduce stress, and to relax any tight muscles that might be preventing an ideal presentation.
  • Moxa: You will be given moxa sticks and instruction for their use at home. Our protocol involves moxa treatment 2 times a day for 15 minutes for a course of 7 days (or until the baby turns).

After treatment, you will generally feel an increase in fetal movement, and an overall sense of relaxation and well-being. New to acupuncture? Here is what you can expect.

When to receive treatment: The ideal time to use acupuncture and moxibustion is between week 33 and 35 of your pregnancy.

Beyond week 35, the chances of success decreases as baby is starting to get larger, but many breech babies have turned in the last weeks of pregnancy or even as labor starts.

It’s best to call as soon as you find out you are breech and discuss your personal case with our acupuncturist. We can walk you through your options and what the best course of action is for your situation.

What else can I do?

  1. Swimming: any type of swimming with your stomach down in the water can take the pressures of gravity off your uterus and allow baby to move into a good position
  2. Dance: put your favorite music on and make sure to let your hips rock!
  3. Talk to your baby: Baby can hear your voice and some women have reported success with asking baby to adjust his or her position.
  4. Webster Technique: This is a chiropractic technique that is helpful in turning breech babies. Be sure to seek out someone trained in this technique.
  5. Spinning Babies: The positions on this website can help your baby settle into position and are highly recommended. We also recommend using this site throughout your pregnancy to help prevent breech presentation.
  6. Talk to your doctor about performing an external cephalic version or other medical interventions.

What are the chances that it will work?

In one study, where moxa and acupuncture was compared with a watch and wait approach, 75.4% of women treated with acupuncture and moxa had a cephalic presentation vs 47.7% of the control group. Both groups were offered external cephalic versions and results included the successful versions.

In addition to the recommendations here, we encourage all pregnant women to take advantage of Pre-Birth Acupuncture starting at week 36 to help get your body ready for labor and help support a vaginal birth. Prenatal acupuncture done in the last weeks of pregnancy can reduce the need for interventions like epidurals and emergency C-Sections.

Please give us a call at 865-315-3845 or contact us online for more information or to set up an appointment. We look forward to working with you!

Resources:

https://acupuncture.rhizome.net.nz/acupuncture/research/moxabustion-breech/

https://www.ncbi.nlm.nih.gov/pubmed/20430289

https://acupuncture.rhizome.net.nz/acupuncture/fact-sheets/evidence-base-acupuncture-and-moxibustion-breech-presintation/

https://www.ncbi.nlm.nih.gov/pubmed/15280133

http://www.cochrane.org/CD003928/PREG_cephalic-version-by-moxibustion-for-breech-presentation

http://jamanetwork.com/journals/jama/fullarticle/188144

Preventing Miscarriage with Acupuncture

Acupuncture can be helpful in preventing miscarriage from certain causes.
Acupuncture can be helpful in preventing miscarriage from certain causes.

Finally seeing those two lines on a pregnancy test is a long-awaited, and rightfully celebrated, moment for all of my patients! This joy can quickly become sadness if the pregnancy is not viable. Miscarriage is a very common occurrence with 10-25% of all pregnancies ending in miscarriage. The most common cause of miscarriage is genetic abnormalities that cause the embryo to be non-viable. Other causes of miscarriage can include:

  • Hormonal abnormalities: PCOS, low progesterone, diabetes, etc
  • Lifestyle issues: smoking, excessive alcohol use, excessive caffeine, drug use,exposure to toxic substances, etc
  • Maternal age: the prevalence of genetic abnormalities increase with age
  • Thin or low quality endometrial lining
  • Immune system issues
  • Trauma: generally only very severe trauma leads to miscarriage
  • Structural abnormalities in the uterus: adhesions, polyps, septum, etc
  • Blood clotting: anti-phospholipid syndrome

For less than 1% women, miscarriages can become recurrent. This is typically diagnosed after having 3 miscarriages. A thorough workup is done to try and find out the cause and determine what treatment is appropriate. Fortunately, many causes of recurrent miscarriage are treatable. Even in the case of genetic abnormalities, like chromosome translocation, preimplantation genetic diagnosis (PGD) can be utilized in combination with IVF to help decrease the chance of miscarriage.

What can I do to prevent miscarriage?

There is a lot you can do on your own to help prevent miscarriage. Much of this work involves managing chronic illness or hormonal imbalances and modifying complicating lifestyle factors. For example:

  • Quit smoking as soon as possible in your conception journey
  • Limit coffee and tea to 1-2 cups daily
  • Maintain a healthy BMI
  • Seek the help of your physician in managing diabetes, PCOS, or other health problems
  • Eat a healthy whole-foods diet high in fruits, veggies, and protein and low in sugar and processed foods
  • Limit exposure to toxic chemicals or environments
  • Avoid dangerous situations or activities where severe trauma may occur.

How Can Acupuncture Help?

Acupuncture can be a very useful for assisting in the prevention of miscarriage when not related to chromosomal abnormalities by treating many of the common causes of miscarriage. Acupuncture can be helpful in the following ways:

  • Increasing the thickness and quality of the endometrial lining
  • Helping regulate hormones
  • Helping to treat PCOS 
  • Reducing uterine contractions in early pregnancy
  • Improving uterine blood flow to help prevent blood clots
  • Regulating the immune system
  • Stress reduction

What does the research say?

Research on acupuncture and miscarriage is very promising. One recent study on acupuncture done along with IVF showed a 50% decrease in the miscarriage rate.

Another study suggests acupuncture may even be a potential supportive treatment for threatened or recurrent miscarriages due to its beneficial effects on serum cortisol and prolactin levels during IVF.

Acupuncture’s known effects on stress are also a possible mechanism by which miscarriage rates could be reduced. According this same study, it is possible that stress in very early pregnancy may cause overactivity of the hypothalamus-pituitary-ovarian axis leading to reduced progesterone levels. In reducing this stress, progesterone levels may stay higher.

When should I start acupuncture?

Acupuncture can be started at any point along your journey. Some basic recommendations are here:

  • If you are pregnant: We recommend acupuncture weekly through the first trimester to support blood flow to the uterus, reduce stress, and support progesterone levels before the placenta is fully developed.
  • If you are trying to conceive: Generally, it is recommended to begin acupuncture 3 months prior to conception for most causes of recurrent miscarriage. This allows the treatments to affect overall cycle health, hormone balance, and egg quality as it takes 90 days for an egg to prepare for ovulation. However, the effects of acupuncture are beneficial at any stage of your journey, and accumulate over time. We see many women while they are actively trying to conceive naturally or with fertility treatment. We have protocols for IVF, IUI, medicated cycles and couples trying naturally.

Please give our office a call to discuss your specific situation or to schedule an appointment. We are more than happy to answer any questions you may have. We wish you the best of luck!!

References:

http://www.huffingtonpost.co.uk/jacquelinehurst/acupuncture-to-support-fe_b_5958722.html

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3342918/

http://americanpregnancy.org/pregnancy-complications/miscarriage/

http://www.acog.org/~/media/For%20Patients/faq100.pdf

http://natural-fertility-info.com/increase-egg-health

http://eastwindsacupuncture.com/acupuncture-in-ivf-linked-to-lower-miscarriage-and-ectopic-rates/

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