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Holistic medicine; alternative, complementary, and integrative medicine these terms are sometimes used interchangeably, but they're not exactly interchangeable. To clarify what I mean when I use them, here are basic definitions of terms I use throughout this book, along with a discussion of how to find practitioners who are right for you.

In this chapter you'll find:

• Defining Holistic Medicine
• Finding a Complementary or Alternative Medicine Practitioner
• Quality matters
• Figure out your needs
• Collect names
• Set up a consultation

Defining Holistic Medicine

• Holistic medicine is based on the fundamental principle that good health comes from physical, emotional, and spiritual well-being. Holistic practitioners believe that each of these elements body, mind, and spirit needs to be accounted for in any medical treatment. In other words, no one symptom for example, chronic headaches or gastrointestinal problems is understood or treated as an isolated event. Holistic medicine embraces prevention and self-care, using noninvasive treatments that support a person's natural abilities to heal.

• Alternative medicine generally refers to diagnostic and treatment methods (also known as 'modalities') that are independent of those taught and practiced in most American medical schools and hospitals. Because they often encompass entire systems of medical theory that developed separately from what we in the West know as conventional medicine, they are typically considered 'alternative' only in the U.S. Ayurveda, Tibetan medicine, traditional Chinese medicine, and herbal medicine are all examples of alternative medicine. In theory, alternative medicine is used independently of conventional medicine and some alternative treatments must be used alone. In practice, alternative treatments are often used alongside conventional care. Medical schools in the U.S. are now beginning to teach some modalities of alternative medicine (primarily herbal medicine and nutritional therapies). However, knowledge of alternative medicine is not required for a medical license in any state.

• Complementary medicine combines alternative and conventional medical treatment. For example, using regular massage therapy sessions to reduce stress and lower high blood pressure or having acupuncture to supplement fertility treatment.

• CAM is an abbreviation for 'complementary and alternative medicine.' CAM is most often confused with complementary medicine, but CAM is the umbrella term for both complementary and alternative medicine.

• Conventional or allopathic medicine is the mainstream medicine taught in U.S. medical schools and delivered in U.S. hospitals by licensed professionals, such as a medical doctor, physician's assistant, or certified nurse-midwife.

• Integrative medicine shares holistic medicine's philosophy; it emphasizes prevention and self-care, and uses conventional medicines and surgery only when necessary. An integrative medical doctor understands how alternative and complementary treatments can be used alongside or instead of conventional medical care.

• Functional medicine also shares the principles of disease prevention, self-healing, and noninvasive treatment with holistic medicine. It fine-tunes that approach by focusing on improving the function of the body's digestive, immune, and hormonal systems, primarily through nutrition, dietary supplements, and lifestyle changes.

There are hundreds of types of complementary and alternative medicine modalities. In this book I focus on those that are widely available and generally recognized as effective and safe during pregnancy. These are: mind-body medicine; acupuncture and Chinese herbs; nutrition and dietary supplements; herbal medicine; and manual therapies like chiropractic, massage, craniosacral therapy, and reflexology. I also discuss the therapeutic role exercise and yoga can play during pregnancy. (For a description of these complementary and alternative modalities, see the Glossary of CAM Terms, page 525.)

Note: Homeopathy is a well-known form of alternative medicine that uses individualized remedies to treat specific physical complaints and illnesses. Generally speaking, during pregnancy, homeopathic remedies may be used to treat various nonthreatening but uncomfortable side effects, as well as everyday viruses and bugs, as long as your primary medical practitioner knows you're using them. Homeopathic remedies sold in health food stores have such small amounts of the active ingredients that they shouldn't pose a problem. (Avoid any preparation homeopathic or otherwise containing blue cohosh, which is used to stimulate uterine contractions.)

Classic homeopathic remedies are tailored to the individual, and require a long, in-depth patient-practitioner interview before they can be prepared. In the United States, homeopathy lacks standard accreditation or licensing in any state. Therefore, its safety and effectiveness depend heavily on the skills of the practitioner. For these reasons I don't use it regularly in my own obstetric practice, and, for the most part, it won't be included in this book.

Q: Do you always recommend the same complementary or alternative treatments for particular problems?

Dr. Evans: No. In some cases I may recommend a particular therapeutic approach, but for the most part, I don't. For example, for pregnancy-related back pain in the second and third trimesters, acupuncture, massage, and chiropractic are all treatments that can help. If a patient wants to work with an alternative practitioner for typical, pregnancy-related back-pain relief, I will ask about her preferences does she like to be touched, is she afraid of needles and explain what each treatment is like. Then, I leave it up to the patient to decide which approach is right for her. Sometimes, since I work with a group of alternative practitioners regularly, I'll recommend massage therapy over acupuncture simply because I sense the patient will get along especially well with the massage therapist. And if a patient asks for a specific recommendation, I always give one that takes into account the personality of patient and practitioner, and the nature of the treatment.

That said, there are times when I recommend one treatment over others because my clinical experience has shown it to be especially effective. For example, I always recommend acupuncture combined with herbal treatment for women with elevated levels of follicle-stimulating hormone (FSH) or other symptoms of early menopause (known as perimenopause) because in my practice, we've had consistently good results with that approach. (For more on elevated FSH, see page 38.)

Copyright © 2005 Joel Evans, M.D.

Tags: Alternative Medicine, Pregnancy & Childbirth

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.