A Guide to Integrating Conventional and Alternative Pregnancy Medicine

The Whole Pregnancy Handbook
by Joel M. Evans, M.D.

The first book by an obstetrician to combine the latest in alternative and conventional prenatal medicine provides accessible, engaging, and authoritative guidance from preconception through postpartum

At last, everything you need to know about the latest in alternative and conventional healthcare before, during, and after pregnancy - in one comprehensive, jargon-free guide.Whether you embrace the philosophy that mind, body, and spirit work together to promote good health or you're just looking for a way to have the healthiest, most comfortable pregnancy possible, The Whole Pregnancy Handbook has the information you need to make educated decisions and take charge of your prenatal care. The Whole Pregnancy Handbook features

• Complementary treatments and techniques to improve your pre-conception health and fertility, such as nutritional medicine, mind-body medicine, acupuncture and herbal medicine

• Comprehensive and compassionate information about genetic and prenatal testing

• Techniques such as massage, accupressure, herbal medicine, and mind-body exercises to help you relax and feel more comfortable as your pregnancy progresses

• A fully illustrated chapter on prenatal yoga with pose variations for all three trimesters.

• How your pregnancy unfolds month by month and how you can connect with your baby while you're expecting

• The best practices of doulas and midwives

• The pros and cons of giving birth in a hospital, birthing center, or at home

• Effective pain management for your labor - from epidurals to hypnotherapy

• Everything you need to know about inductions, assisted deliveries, and C-sections

• What happens postpartum - physically and emotionally

• Candid recollections and insights from other moms and patient stories from Dr. Evans's practice, The Center for Women's Health

The Whole Pregnancy Handbook is an informative and reassuring guide that will empower you to combine the best of conventional and alternative medicine with confidence at every stage of pregnancy.

Pregnancy is a magical and mysterious time of life. As it progresses and you move toward parenthood, you're aware of all the profound ways life is about to change it will be filled with joy and responsibility, challenges and love. It can all be exhilarating and overwhelming. The purpose of this book is to help you make the best choices for yourself and your child from before you conceive all the way to the first weeks after birth. It's my hope that The Whole Pregnancy Handbook will help you experience your pregnancy as a fulfilling and transforming first phase in your life as a parent.

Embracing a Holistic Philosophy

Over the years, it's been my privilege to participate in the physical and emotional journey of pregnancy both as a doctor and a father. In that time, my approach to my entire medical practice has changed. I started out as a classically trained, conventional ob-gyn, but through a series of lessons taught to me by patients, I gradually began to practice integrative medicine, embracing a holistic philosophy that focuses on self-care and the principle that true wellness reflects the coming together of emotional, spiritual, and physical well-being.

My orientation shifted to a holistic approach about five years into my medical practice. Over the course of a couple of months, two colleagues, nurses whom I had worked closely with, came to me after being diagnosed with cancer. Both were told by their oncologists that there was 'nothing' they could do but show up for their chemotherapy treatments. They were told to relax and let the chemotherapy fight their cancer, but they didn't feel comfortable with that. Both wanted to be more proactive in their care. So, after each asked me questions that I couldn't answer about what she could do to help heal her cancer, we began a journey together, discovering how mind-body medicine combined with alternative modalities like acupuncture and herbal medicine could improve not only their responses to treatment, but also the quality of their day-to-day lives.

The lessons I learned with these women about the importance of self-motivation and participation resonated with what I'd learned practicing prenatal care. As a young obstetrician just out of residency, I quickly realized that my approach was too dogmatic. I'd often say to a pregnant woman, 'This is the way it is just do what I say.' In that situation, the woman might do what I asked, but she didn't believe in my recommendation. This problem hit home after a birth where a woman had experienced complications in labor and required a C-section. Afterward, she developed a wound infection, a not-unusual postoperative event that meant she had to come into the office two or three times a week. As she was leaving one of these visits, she said under her breath, 'This never would have happened if I hadn't had the C-section.' I was surprised that she felt that way because she was basically okay and her baby was healthy. So I asked her to stay to talk about the Cesarean. I learned that she didn't trust my decision to perform the Cesarean because she hadn't felt she'd been a part of it. I realized that this lack of trust and her sense that she was an observer instead of a participant in her birth experience couldn't have begun in the labor room. Instead, I believe it reflected the fact that over the course of the nine months of her pregnancy, we hadn't developed a real partnership.

That single, under-the-breath comment was the 'aha' that helped me to see that I needed to change, to become a source of support, information, and comfort to pregnant women, someone they could turn to for guidance, but not someone who would impose proscriptive or dogmatic opinions. I changed my entire approach to prenatal care. I learned how to be open and listen to my patients in a new way, to follow their lead as we work together with the shared goals of a healthful, vital pregnancy, a childbirth anticipated with excitement instead of fear and anxiety, and a newborn brought into the world in a room filled with love, all the while realizing the mystery and sacredness that surrounds the experience.

REAL VOICES

For me in childbirth it was important to have a provider that I trusted, who would include me in the decision-making along the way and treat me as a partner because you just can't anticipate every little thing that's going to happen.

Martha, mom of two

Over the last ten years, as I explored a holistic approach with all of my patients, I began to practice mindful meditation on my own. I studied nutritional, herbal, and mind-body medicine and collaborated with experts in traditional Chinese medicine/acupuncture, craniosacral therapy, reflexology, and Reiki. Through this work, I've been able to create an integrative medical practice, one that combines the best of conventional and complementary medicine.

I'm now a senior faculty member of the Center for Mind-Body Medicine in Washington, D.C., through which I've participated in and/or planned mind-body workshops in the Middle East, Macedonia, and in New York, working with firefighters after 9/11. I became the first and only (as of this writing) physician in Connecticut to be board certified in both obstetrics/gynecology and holistic medicine. As an assistant clinical professor at both the Albert Einstein College of Medicine and the College of Physicians and Surgeons of Columbia University, I teach medical students and doctors-in-training about holistic care.

My own journey has been both intellectually fascinating and personally rewarding and I truly believe that my patients are better served as a result of my embrace of a holistic philosophy of care.

Holistic Obstetrics

What does it mean for an obstetrician to practice holistic medicine? It means that I look to the women I work with, my patients, to be active participants in their care. It means that instead of focusing on individual symptoms, I try also to understand a woman's emotions and how the situations she faces in her daily life may be affecting her health. It means I always try to use gentle, noninvasive treatments that promote overall wellness and build on the body's ability to heal.

This approach is especially important when a woman is pregnant or trying to conceive. I firmly believe that conception, pregnancy, and childbirth are extraordinary biological events that the body has the wisdom to guide. I see my role as that of a helper who stays in touch with a woman's physical and emotional experiences, someone who tries to uncover and allay any fears that being pregnant may generate. I never expect complications or difficulties, and I never think of pregnancy as a series of medical disasters waiting to happen. But if something starts to go wrong during a pregnancy, I can apply my medical training to the situation.

At the same time, over the course of most pregnancies, I can offer the tools of complementary and alternative medical treatments to relieve typical pregnancy aches and pains, help prepare a woman for a positive childbirth, and support her overall physical and emotional health.

The Whole Pregnancy Philosophy

This book is designed to help you make choices that are right for you, your child, and your family. As in my practice, I don't try to dictate what you should do. For example, I don't believe there's a 'right' way or a 'wrong' way to approach pain management in labor. For some women, an epidural is a good choice; for others, a medication-free approach to childbirth is best. And while I do recommend using mind-body exercises to start to prepare for labor as early as the start of the second trimester, these are only suggestions. You can, and should, pick and choose what feels right for you on every front.

The goal of this book is simply to give you the information you need to make your own decisions. To show how an integrative approach to preconception, prenatal, and postpartum care can bring together the very best of conventional medicine with the best of complementary and alternative medicine. I try to answer questions you may have and help you experience the joy, confront the fears, and meet the challenges that pregnancy can bring. I hope that by presenting you with a range of approaches not only to your prenatal care but also to your own unique experience as a pregnant woman, this special time can become one of empowerment and self-discovery.

How to Use This Book

You can read this book straight through, but it's designed to be a resource you can turn to at any point, from before conception through postpartum. You can plunge in wherever you like and find the material you need. Whether you're thinking about getting pregnant, actively trying to conceive, currently pregnant, or have just given birth, there's something here for you.

The Whole Pregnancy Handbook is loosely chronological. The first chapters cover preconception, fertility, and the first trimester. Then comes a chapter that provides an overview of all nine months. It includes a discussion of the physical and emotional milestones of pregnancy; a description of fetal development and prenatal care; and mind-body techniques you can use to connect with your child emotionally, energetically, and physically, and to prepare for childbirth. Later chapters are on common physical symptoms of pregnancy; nutrition; exercise; prenatal tests; complications; and miscarriage, so you can easily find what you need when and if you need it. The final chapters of the book go through preparing for childbirth; the contours of labor and childbirth; and life postpartum.

Throughout, you'll find the voices of women describing their own experiences, as well as interviews with experts complementary practitioners, midwives, doulas, and others who have important insights to contribute to understanding pregnancy.

Copyright © 2005 Joel Evans, M.D.

About the Author

Dr. Joel M. Evans is a practicing integrative OB/GYN and Founder and Director of the Center for Women's Health in Darien, Connecticut. He is an assistant professor of obstetrics and gynecology at the Albert Einstein College of Medicine and a faculty member at the acclaimed Center for Mind/Body Medicine in Washington, D.C. A leader in the holistic medicine movement who lectures extensively on the subject, Dr. Evans is also a founding diplomate of the American Board of Holistic Medicine.