Abstract
When I started my acupuncture career in 1995, I bypassed pregnant patients. Besides not knowing exactly what to do for them, there was a bit of trepidation that these patients were high risk for malpractice. In fact, Medical Acupuncture rarely approached this subject, articles were infrequent if not nonexistent in the journal, and seldom did the topic or demands from the readership query thoughts in this direction. So, why the change? Over the years, I heard “tales” that in Australia and New Zealand, pregnant females were routinely treated with acupuncture more so than in the United States. But still, that did not inspire my motivation for a “reconciliation” of this patient population. When I again avoided to treat a near-term female's back pain and told my staff, “We do not treat pregnant females,” I probably came to my senses and asked myself, “What makes these patients so different not to treat them?” I finally made the decision and approached Vicki Cohn, Chief Editorial Officer, Mary Ann Liebert, Inc., publishers, to make her aware of my embarking on a Special Edition of Acupuncture and Pregnancy. Right from the start, I can tell you that it was difficult to find guest editors to help spearhead this project. I persisted, and eventually people volunteered for this edition. And despite being encouraged that we might receive many articles, nothing happened for quite a while. Again, not being discouraged easily, we decided to launch a roundtable discussion to discuss the virtues of acupuncture and pregnancy. And it took place. Wow! I was impressed with these experts, as they exceeded my expectations on this subject. I had invigorated enthusiasm to push forward with this Special Edition. And now you are reading the culmination of many months of hard work and dedication from all the participants as you leaf through the journal. In fact, the response from the readership, slow at the beginning, was so enthusiastic that a second Special Edition dealing with Acupuncture and Pregnancy will be published in the December 2019 issue.
What did I learn? First, I learned from the roundtable discussion that pregnant females should be treated like any other nonpregnant patient. The risk for malpractice is very low. Pregnant females respond very well to acupuncture and will be very grateful to you for helping combat their pain, especially back pain. Perinatal depressive disorders can affect 50–80% of all mothers. Many types of antipsychotic medications and mood-stabilizing drugs such as lithium may be dangerous to the nursing mother. In the article by Nader Soliman, “Auricular treatment of maternal depressive disorders,” auriculotherapy may be a realistic substitute for medication that could negatively impact the newborn. Yang et al. guide us with the challenges of polycystic ovary syndrome. Their “Commentary on the use of acupuncture in overweight/obese women with polycystic ovary syndrome” reminds us that acupuncture may offer help to these patients by overcoming stress, irregular menstrual cycles, and infertility. If you are ever requested to treat with acupuncture postpartum voiding dysfunction after vaginal delivery or catheter removal, you will be glad you read Sudhakaran's article dealing with “Urinary retention in pregnancy and puerperium-acupuncture treatment.” One of the mentioned review articles states 92% woman achieved spontaneous micturition within 1 hour. Sudhakaran's treatment advice will prove to be very useful. How many of the readership have asked to treat patients undergoing in vitro fertilization? I certainly have been asked on many occasions. In “A UK support network for maternity acupuncture: A survey of acupuncturists belonging to the acupuncture childbirth team,” Debra Betts et al. describe 114 invitations that were sent out to this network and 99 replies received back dealing with conditions that acupuncture treated. We learn that 65.8% referrals came from medical health professionals for pregnancy challenges, in particular 19.5% for fertility and 9.7% for menstrual conditions. But the article is more informative than I mention here. Do we have any other organized networks elsewhere? Murali Chakravarthy and Anitha Prashanth in their clinical trial entitled “Evaluation of percutaneous nerve stimulation of the auricle for relief of postoperative pain following cesarean section” achieved reasonable pain control by electrical stimulation of the thalamus, shenmen, and the uterus points. Patients can be treated with a portable full-time ear stimulator. This is a very unique innovation. We all wonder in what manner acupuncture can play a role to enhance an IVF program. In their article “Electroacupuncture can enhance the number of mature oocytes and fertility rates in IVF program through inhibition of granulosa cell apoptosis,” Kusuma et al., focused on Bax, Bcl2, GDf9, BMP-15, and oocyte maturation index, delineate an in-depth focus of electroacupuncture in fertility challenges.
If all of these articles are not enough to demonstrate the relevance of acupuncture for the various stages of pregnancy, several interesting case reports are also included: “A discussion of GV 20: Its role in in vitro fertilization and frozen embryo transfer: A case report” by Torrents, “Successful natural pregnancy using whole systems Traditional Chinese Medicine in a complex, anovulatory patient after multiple unsuccessful in vitro fertilization treatments: A case report” by Rosenthal et al., and “Pre-labor acupuncture to prepare normal delivery in multiparous over forty years old: A case report” by Handayani and Balgis.
I wish to thank our guest editors for their editorials, recommendations, and numerous reviews. Thanks also to our editorial staff who helped with an overflow of reviews. Most importantly, I have to acknowledge with deep gratitude and thanks Dr. Yael Ben-Porat, DAOM, MPH, the Managing Editor. How she kept things straight and on track is beyond me? She is my “Wingman!”
—Richard C. Niemtzow, MD, PhD, MPH