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Miscellaneous Discomforts of Pregnancy

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See also:

Subsections on this page:

General Remedies

A nice page with lots of remedies for general discomforts

Natural Remedies for Discomforts of Pregnancy by Dr. Marina J. Rose in Los Altos, CA

Search down for Complaints during pregnancy from REPERTORY by Oscar E. BOERICKE, M.D.

Miscellaneous discomforts and remedies from a homeopathic perspective

Aromatherapy For Childbearing

Aromatherapy For Discomforts of Pregnancy


A local naturopath recommended the Ulna Gemmo Black Currant buds for energy.

Some of my clients find their energy really improves when they take some supplemental MCT oil.

Iodine Deficiency Common in Pregnancy, Docs Warn - It's possible that an iodine deficiency is causing her fatigue.  Many of my clients use natural salts, which aren't supplemented with iodine. An endocrinologist friend encourages her clients to get iodine by eating those little seaweed packets from Trader Joe's twice weekly.


Have no fear re: your "low" blood pressure. It is entirely normal reading. You may wish to look at other reasons why you may be light-headed such as low blood sugar levels at the time, in which case, eat! Or, for some women, after they eat, all the blood goes to the digestive system, and that's when they experience lightheadedness.  Try experimenting with drinking fluids a half hour before eating, to build up your blood volume before diverting it to your digestive system, or try eating more frequent, smaller meals.

Re: anemia -- beware, the latest research (for the last few years now!) has shown that a hemoglobin count of 9.5 is optimal for fetal growth and maternal well-being, because this reflects an appropriately expanded blood volume.. This is way below what has and still is being strived for. Usually when a reading like this comes in the doctors are recommending transfusion. True! Also for the faintness -- homeopathic carbo. veg. 30x is affective.

Shortness of Breath

I am 15 weeks preg and for the past 10 days feel I need to take in deep breaths through my mouth to overcome this feeling of lack of oxygen! I was really worried but my Gyn found my pulse and blood pressure normal and sent me off saying it was physiological----! But I still feel uncomfortable. Anyone out there experiencing the same or have any helpful advice to offer. I sometimes feel as if I'm getting into a habit of taking long sighs.

I did a lot of research on it, saw my midwife, an allergy specialist, and my GP, and the most likely explanation we can come up with is that I'm not (probably due to the overall muscle relaxation effects of pregnancy) clearing my lungs completely of carbon dioxide, which sends the "gasp for air" message to the brain. I find it helps to work on completely exhaling when you feel this sensation, THEN inhaling. This is completely different than the sensation later in pregnancy where the uterus is so big that is crowds the lungs and you can't catch your breath, there's not one, obvious, generally accepted reason for it, hence some doctors reluctance to accept it as a "real" condition.

I have this too.  I read a great explanation of it on the group about a month ago.  It had to do with hormonal effects on the tissue in your body. I find that the need to breathe deeply repeatedly sometimes makes me dizzy also.  I was at an event for my children last week, and between the excitement of cheering for them and the not breathing well thing I darn near fell out of my chair!     I am confident that this will pass in time.

Allergies/Dry Nose

 5 Tactics for Surviving the Spring Allergy Season [4/11/16] - Some helpful tips from Dr. Mercola.

Many times hormonal changes during pregnancy cause drying of the nose.  AYR brand saline nasal gels/drops/mists can help soothe and moisturize dry nasal membranes.

(They also make Baby AYR, which contains the same saline formula to help loosen mucus and clean a baby's nose.)

See Supplies/Free Samples

Cramps in Legs/Twitchy Legs

The best current research indicates that iron deficiency can contribute to restless legs syndrome.  This can be a normal change that occurs around 20-28 weeks of pregnancy, and it will probably resolve on its own as the body gradually increases iron levels.  But you might want to focus on increasing your iron levels until the restless legs problem disappears.

Neurology 2004;63:1065-1069

Restless Legs Syndrome Common Among Pregnant Women

NEW YORK (Reuters Health) Sept 27 - During pregnancy, one in four women will experience restless legs syndrome (RLS), Italian researchers report.  . . . The only risk factor for developing RLS during pregnancy was a low hemoglobin level, the investigators report.

"Our results on a significant difference in iron storage indicators support a hypothesis that a relative iron deficit could play a role" in RLS, Dr. Manconi said in a statement. However, he said, "the rapid improvement of RLS symptoms after delivery give more power to a hormonal rather than iron-related hypothesis."

[Ed. - This statement makes no sense - the implication is that the improvement is too rapid to be associated with changes in iron levels.  However, because of the drastic reduction in blood volume that occurs soon after giving birth, a woman's iron levels do rise dramatically afterwards.  And, the iron levels drop drastically around 28 weeks along with the drastic increase in blood volume that happens around that time.  To me, this makes it sound as if changes in iron levels are very relevant to RLS.]

An Evaluation of Restless Leg Syndrome (RLS) - free CME

Apparently, dehydration can sometimes cause leg cramps.

If you're taking a calcium supplement without balancing the magnesium, you may have a magnesium deficiency.  There's a product just for pregnant women - Mama Calm

The Magnesium Web Site's Online Library

I recommend 25 mg magnesium at bedtime.  Some clients do better with the Floradix balanced calcium/magnesium supplement.  Experiment to see what works best for you.

The cure for me is a Citracal and a glass of water.  I sleep like a baby.

One of my clients felt that high doses of vitamin C/bioflavonoids were causing leg cramps.

The remedy is to lower carbohydrates in the diet - up the fresh vegetables and down the potatoes, pasta and bread.

Could this be a pH problem?  Too acidic?

You can also balance the sodium/potassium ratio of your blood by drinking raw beet juice or eating raw grated beets mixed with equal parts of raw grated apple (tastes basically like apple).

optional additions:

poppy seeds
sunflower seeds
jicama, julienned
grated carrot

If you're eating a lot of high potassium and high calcium foods and/or taking extra supplements this might do the trick instead!

I always found that mineral water and bananas worked well with crampy legs. I used to have a bottle of mineral water beside the bed.

Case 1: Pregnant and Restless [Medscape registration is free]

Restless Legs Syndrome from the Restless Legs Syndrome Foundation

I have a woman in my childbirth class who is having a terrible time with twitchy legs (aka restless legs?). She gets them every night as she goes to lie down for bed. If you've never encountered this (I had it once during my pregnancy), it's this weird nervous feeling in your legs, like the nerves are firing and you want to stamp your feet to stop it. Am I making sense? The woman in my class says it's the physical manifestation of anxiety. That sounded like a good description to me. Anyone have any remedies for this?

I have heard of this, and several women in my family had this and it was due to lack of potassium in their diet. You might want this Mom to contact her care provider.

calcium-1000-2000 mg

Liquid Calcium  (we recommend Marietta's brand, as it works the best of ANY we have tried or seen)  helps reduce leg cramps.

Go for the Calcium + bananas or Emergen-Cee for potassium. Worked for me, and works for the clients we've used it on.

I would consider calcium- magnesium or potassium . Look at a diet sheet. Potassium would be the easy just add a banana or some orange juice, lemonade.... Calcium & magnesium are a bit trickier , general consideration that some supplementation is need.

I regret that I cannot recall the source now, but I have read in one of my maternity nursing books that this symptom often is associated with iron-deficiency anemia. The pathophysiology was not explained. A woman's health care nurse practitioner I work with has heard the same. Has anyone heard of an association between this symptom and Fe-deficiency anemia?

Restless legs can indicate a calcium deficiency or anemia.

I have had several ladies find Gatorade or Sportsall helpful with this. They generally report drinking 3-4 glasses a day.

try magnesium - as much as she can without loose stools

A banana a day, plenty of potatoes, kiwi's, almonds...Lots of walking and especially stretching before bed...

One of my clients said that almond milk worked well for her.

The questioning has led me to try to do more lit. searches to see if there is anything out there already to back up some of the stuff we are saying. On the restless leg syndrome it seems that many of the articles I found and the web site for restless leg syndrome mention anemia as something that will cause this syndrome and should be treated. I also found reviews about 2 small studies done in different years in Romania by the same doctor they concerned magnesium deficiency and sleep disorders, including restless legs. I did not find anything about potassium , but I sure as heck will recommend a glass of juice or a banana before I would consider recommending the drugs. I will have to re-visit pub med and copy the citations I read them over on line but didn't save them. here is one for a sample on the anemia, it is like the grocery store article someone else wrote about. The Romanian articles were in the Rom. Journal Neuro Psych 1993, and one in 1987.

Restless legs syndrome. A review.

O'Keeffe ST.
Department of Geriatric Medicine, Royal Liverpool University Hospital, England.
Arch Intern Med 1996 Feb 12;156(3):243-248

Restless legs syndrome is characterized by unpleasant, deep-seated paresthesias in the legs and sometimes the arms. These sensations occur at rest and are relieved by movement. Sleep disturbance is common. Many patients also have periodic movements of sleep. Mild symptoms of restless legs occur in up to 5% of the population. Restless legs syndrome is idiopathic in most patients, but it may be the presenting feature of iron deficiency and is also common in uremia, pregnancy, diabetes mellitus, rheumatoid arthritis, and polyneuropathy. Treatment of the underlying cause, when possible, usually relieves the symptoms. For patients with severe symptoms, levodopa, bromocriptine mesylate, opioids, carbamazepine, clonazepam, and clonidine hydrochloride have proved to be effective.

Low Back Pain / Pelvic Pain

See also: Chiropractic Care

Pelvic Girdle Pain in Pregnancy Linked to Parity - This isn't such a big surprise, but some moms find it helpful to know that it's not surprising that they have a little more pain with each pregnancy.  However, I've seen moms who turn to chiropractics for the first time in pregnancy, and it helps eliminate all their pain, so don't despair!

Sleeping with a pillow between your legs can help align your lower back, pelvis and legs to relieve discomfort.  This Firm Knee Pillow has a strap that goes around one of your legs to hold the pillow in place.

Water aerobics good for pregnancy back pain - Water aerobics can help ease the pelvic and back pain that plague many women during pregnancy, Swedish researchers report.

Back Pain During Pregnancy from the Mayo Clinic

The new memory foam technology can be a tremendous help to pregnant women in relieving back and pelvic pain.  Try the Ergonomic Seat Cushion.  You can get it cheaper from Dr.Leonard's.

Back Pain and Pregnancy: Active Management Strategies by Julie Colliton, MD

Editorial - Pelvic girdle pain in pregnancy
Exercises may help, and evidence is increasing that acupuncture reduces pain
BMJ  2005;331:249-250 (30 July), doi:10.1136/bmj.331.7511.249

Undergarments for Relief of Back Pain and Vulvar Varicosities

Effects of acupuncture and stabilising exercises as adjunct to standard treatment in pregnant women with pelvic girdle pain: randomised single blind controlled trial.
Elden H, Ladfors L, Olsen MF, Ostgaard HC, Hagberg H.
BMJ. 2005 Mar 18; [Epub ahead of print]

CONCLUSION: Acupuncture and stabilising exercises constitute efficient complements to standard treatment for the management of pelvic girdle pain during pregnancy. Acupuncture was superior to stabilising exercises in this study.

Homeopathics for Lower Back Pain

Many women experience lower back pain near the end of their pregnancies. Homeopathic Rhus Toxicodendron suits a wide variety of injuries and strains. Rhus Tox 30X can be taken 3 to 4 times a day. (Remember -- low potency homeopathic remedies are safe for mother and baby.)   For other tips on homeopathics for pregnancy and birth, see the EMAZING.com archives of the Homeopathic Health Tip of the Day

I searched MedLine for "back pain pregnancy" and found lots of interesting article abstracts.

3 that caught my attention:

Lecithin for Back Pain

In my midwifery training, we were taught that Lecithin works great for pelvic/hip pain caused by loose ligaments in the pelvis. It doesn't effect the pelvis' ability to move and expand during labour, but does help 'keep things together' and thus avoiding the pain during pregnancy.  [You can also increase B12 and folate supplements, which support methylation and increases natural lecithin levels.]

Laying on your back, keep the left leg straight. Flex the right hip to 90 degrees and place the right foot on the left side of the right knee, with the left foot flat on the ground. Have your care provider abduct the right knee toward your left while holding your right shoulder to the ground. When the knee is as far as it can go, a small surge of pressure on it will serve to "relocate" the subluxed SI joint. This will apply pressure to the right sacroiliac joint and almost immediately improve the pain. Studies have shown it to be effective and extremely safe. I have taught it to my pregnant patients for about 10 years.

It can be repeated p.r.n. and there are no documented problems for the baby as the procedure puts no pressure on the uterus or the baby.

The procedure can be repeated on the other side.

The most recent article in the medical literature on this procedure, that I am aware of, was written by Paul Frame, M.D. The word "sacroiliac subluxation" was in the title.

Tailbone Pain

Sometimes women will complain of tailbone pain, but if you ask them to show you where the pain is, it's actually the sacrum. I think the combination of extra weight pulling on the utero-sacral ligaments along with weak abdominals (which we probably all have) could be the culprit. In this case a belly/hip support would be helpful. Cat stretches would probably help stretch out some of the muscles in the area as well as the cow face pose and pelvic tilts would be excellent.

Unless a woman has fallen on her tailbone (coccyx) or broken it in a previous birth, the tailbone is rarely sensitive.

I've found that in addition to these stretches, I was often able to relieve this reported discomfort with my massage clients with therapeutic massage of the supporting muscles of the pelvis.  So, if she doesn't get complete relief with the stretches, refer her to a good prenatal massage therapist.

Buoyant salt baths come to mind.  Try acupressure on the back of the legs.  One point is near the center of the back of the thigh right at the crease below the buttock.  Another point is on the center line of the back of the legs, at the base of the gastrocs/calf muscles.

Chiropractic Care

This section has been moved to its own web page - Chiropractic Care

Ligament/Symphysis Pain

See also: Chiropractic Care

Sources for a Trochanter Belt

Prenatal Cradle® Products calls it a Hip Brace

In a pinch, you can use a belt around your hips . . . tighten it until you get the support that relieves the pain.  Since the belt holes are often an inch apart, you may not be able to get the best fit without stuffing additional washcloths in along the sides.

One of my clients had relief from her SPD by sleeping with a small pillow between her legs to relieve torque on the pelvis.

Pelvic Pain in Pregnancy

Oftentimes, pregnant women with pubic bone pain may have asymmetrical motion in the sacroiliac joints, with secondary pain at the pubic joint.  The pelvic bones are large bones which articulate at the back with the sacrum, and form the pubic joint at the front. There is one sacroiliac joint on each side of the sacrum; the sacrum being in the middle. If one or both of the sacroiliac joints (in the back) are relatively “stuck” it will cause more stress on the associated joints, particularly the pubis.

At night during sleep with decreased motion, the blood flow to the joints would decrease, and the viscosity of the connective tissue would increase, thereby making the symptoms worst in the morning: Analogous to a car sitting overnight needing to be warmed up before driving off so it works better after being warmed up. With movement the condition would feel better because the blood flow to the joints would increase and the connective tissues would be more pliable with movement: Just the reason why any one who exercises warms up first before going into more strenuous exercise.

Though this may not be the case, it is worth having it checked by a chiropractor who has worked with pregnant women.  This can be done safely without the need to take x-rays to look at the joints, for the very obvious reason that she is pregnant. This can be easily and painlessly evaluated by in-office orthopedic tests.    If that is the case, by skillfully performing one or two chiropractic adjustments to the sacroiliac joints, it can make a huge difference, very quickly.  The adjustments are performed very comfortably and without pain.

I really like the book by Cecile Rost, "Relieving Pelvic Pain During and After Pregnancy". It has a set of exercises that she can do and if those don't help, she can take the book to a PT and they will know how to help. Aquatherapy has been great for a couple of my clients.  Consider getting her a handicap sticker for the car if walking is a big problem

I usually advise them to take Arnica 30 PO 2 pellets under the tongue 4 times a day, and they can also use Arnica cream directly on that area. If she's getting a lot of nerve pain in there she can also use Hypericum 30 same dose if she needs it.

The other things are a good chiro that deals with preg women, and if she doesn't like a belly belt then she can try one of those body cradle wraps that are used for the same thing. It made a different way than a belt but it lifts the baby up off the pubis area. I hate to put them on bed rest, but I have had one or two that it's so bad that I've had to..

The right chiro can work wonders.  I took a G3P2 around 30 weeks.  She had SP pain since her last pregnancy.  Quickly it became so debilitating that she was immobilized with pain.  She could barely move.  Within two weeks of seeing a chiro specializing in pregnant women, her SP moved back in place (it had been separated 1/2").  She completed that pregnancy, birth and PP without any more discomfort.

Pelvic Pain (Symphysis Pubis Dysfunction) from KMom - Pubic or pelvic pain, low back pain, sciatica, pain turning over in bed or while putting on clothes, etc. all are symptoms of SPD.  Pubic pain may also be associated with a higher rate of baby malpositions or a more difficult birth.  Information about causes, precautions, and treatments. Very important information! 

Pelvic Pain (Symphysis Pubis Dysfunction) - this is a fabulous and comprehensive resource!

Homeopathic sepia 30c is reported to be wonderful for symph pain related to pregnancy...

Our local chiropractor says that most symphysis pain is caused by driving a stick shift.

I have found that 1gram of liquid cal mag before bed time makes a huge difference with most of my moms who have chronic ligament/muscle related pain.

I have three women who are all complaining of supra-pubic pain that is making their lives a misery. i have ruled out uti etc. i am putting it down to the head going down into the pelvis and also the symphysis rubbing etc.....what can i advise apart from the usual hot pack/bath/massage?

i had pubic symphysis pain w/ my last pregnancy - these are some suggestions from my midwife, which worked well for me

- tell your client to move slowly, even "sliding" towards her side before getting up after lying down

-apply heat packs to the area as needed

- there is a maneuver her partner can help her with:

he/she should put hands on mom's hips, then basically give her a nice, strong "squeeze" or hug. this pushes the symphysis inward and relieves the discomfort. this can be done as often as mom needs it, and she should tell her partner if she wants more/less pressure - of course have her check w/ MW or OB before trying

i've known women to use the following and claim they felt relief (how's that for careful wording [GRIN]?):

I'm not a midwife but I suffered from pubic symphyseal separation during my pregnancy.  It was not a complete separation as has occurred during some pregnancies and deliveries, but a partial separation resulting in inflammation of the symphysis.  Apparently the relaxin kicked in in my system early.  My doctor diagnosed it by asking me if it was painful to walk but not painful to go up stairs.  That was exactly the case.  The direction of movement of the pelvis caused the pain.  And there really wasn't much that could be done.  Rest, minimal walking, lifting and bending.  It improved, and since my delivery two and a half years ago it has mostly disappeared.  But not completely.

Two things helped me:

First, my naturopath, who is also a home birth midwife, gave me a supplement called "Ligaplex". It contains all natural products (don't read the label, though, or you'll be grossed out) that support your ligaments, so they're stronger for longer. I took this until the last three weeks of pregnancy, when you really WANT them to soften, and it made a tremendous difference.  Remember, though, to stop taking it several weeks before you're due to allow
the pelvis to stretch.

Second, I had my chiropractor adjust my public bone. I didn't have this done during pregnancy, but several months later.  (I don't know if it can be done during pregnancy safely or not).  It made a big difference, especially in terms of menstrual pain. It might be worth looking into.

I had a separation of my symphysis pubis, too, but it occurred during the birth of my first daughter due to poor positioning and vacuum extraction. Here's what Elizabeth Noble has to say in "Essential Exercises for the Childbearing Year":

"The connective tissue uniting both pubic bones becomes softer during pregnancy and the increased mobility at this joint may become painful. No muscles span this joint, therefore no specific exercises can be don to protect it. In fact, Exercise usually makes the condition worse, especially moving one leg. Keep your thighs parallel during exercises and rolling in or out of bed. A diagnostic test is to get on your hands and knees and raise on e leg off the floor.if this does not aggravate the PS symptoms at the center of your vulnerable midline, you may have adductor tendonitis or round ligament spasm, the discomfort  of which is felt on one side. Treatment: Local polarity therapy. Position: Lying on your side, a partner places all five fingertips firmly at the union of your pubic bones, and the other hand rests flat on your sacrum. The hands should remain still on these two points until warmth, tingling, vibration, pulsing or other evidence of your body's electric field can be felt equally in both of your partner's hands. Usually one or two treatments is necessary. I have successfully used polarity balancing to treat painful PS laxity for fifteen years."

Elizabeth Noble has a degree in physical therapy, among other things, and founded the Women's Health Section of the American Physical Therapy Association and has trained over 2000 instructors in prenatal and postpartum exercise.

Things that can help:

Homebirth is no problem; just be careful about abducting thehips. Use a piece of string to measure how far you cancomfortably open your legs. Use the string in labour so asnot to allow anyone to open your legs more than thisdistance! --If the condition gets quite bad you may needcrutches. Hydrotherapy is really useful.

One of my clients has been told by her doctor that she has a separation.  She is able to walk sideways with no pain in one direction, but not forwards or in the other direction with no pain.

The symphysis pubis is a joint that is meant to be mobile especially as the head engages and the presenting part descends but if this joint becomes over stretched then there is often constant pain particularly on walking. One of the interesting things I have noticed with this condition is that walking backwards is easier but obviously not practical! It does help with the diagnosis however.

yep, sounds like a PS separation. a chiro should see her. Might be able to help some. time is the best cure.

most advise strapping it to prevent motion. There are all kinds of ways to strap -- expensive inventions. Sometimes an ace bandage wrapped tight and low helps a lot. Sometimes women can wear one of those back support belts (you know, the wide things you see workers wears sometimes). She'll have to get one large enough and strap it really low.

liniments help some:; mineral gel, ben gay etc.

warm tub soaks of course. and the tub will probably be the best help for her in labor. She might get confidence if you point out to her that her pelvis is now a good deal larger than before! Symphysis section was an operation used in the old days (still in some countries). it opens the pelvis a LOT, and will make a lot more room for her baby. She's unlikely to have any trouble with CPD!

It might take a couple of weeks, but she'll improve.  and a chiropractor might be her best friend!

It is also not recommended that she has an epidural as then she can overstretch the joint.  A good birthing position is side lying in left lateral.  Mary Cronk suggests tying a scarf around the knees at the max of the pain free gap to ensure that in labour the legs are not opened further than this.  After the birth she can have X-rays to see the extent of the SP opening and treatment can be offered depending on this.

Round Ligament Pain

I'm 32 weeks pregnant with my second and I've been experiencing a lot of discomfort on the ligaments around the pelvic bone and the growing, more on one side than the other, I don't think is pubic symphysis because is more on the sides.

What about Arnica? I remember reading that Natropaths/Midwives give it to pregnant women orally the last month of prenatal and the first 2 months of post-natal periods to help with bleeding and recovery. I also read that placed topically was safe the entire pregnancy. I've used it successfully in my massage practice as it is a natural anti-inflammatory. It works on muscles and ligaments. It also helped a client with the pain of pubic separation (I did not suggest this, but was quite happy to hear it worked).

If you haven't already done so I would apply ice to the area and go and see a good Chiropractor as soon as you can. Next you need to start wearing a really strong abdominal support - not the flimsy ones! Also when turning or moving from side to side in bed, do it VERY slowly and hold your belly as you turn; don't rely on your muscles any more - sorry! :(  

When we tweak, or as in your case, pull or possibly tear somewhat the Round Ligament it will feel very uncomfortable for several days after - it is now badly bruised. It is now also weakened so it will be more easily pulled or torn again although you have not done any long lasting damage and it is not dangerous to you or the baby, but it is a nuisance.

Of course avoid lifting or too much yoga for the next week or so. From a pain relief perspective you can use deep heat type medicines and gentle massage. Absolutely I would avoid any of the anti inflammatory meds like Motrin Advil etc as they are now contraindicated at this time but Tylenol is OK (not that it will do too much for the pain) Believe it or not Vicodin is something that is given at this time for severe pain so if it is no better then go see your OB but start first with the Chiropractor.   

I went to see the Chiropractor yesterday and I feel so much better already, I 'm really amazed at the change, I have also used an homeopathic ointment topically called Traumeel. I've used it before pregnancy for soreness and pain and it really works, it has arnica and other herbs in it, it's not contra indicated for pregnancy use.

Maya Abdominal Therapy, the Arvigo Techniques (TM) are wonderfully effective in addressing and providing relief for RLP , especially during pregnancy. My suggestion is to find a practitioner close to you asap.


See also: Chiropractic Care

Sciatica can be caused either by the increased blood volume or by pinched nerves in the pelvis as it softens under the influences of relaxin, especially in late pregnancy.  The standard recommendation is to see a chiropractor, which usually does help.

Exercise for Sciatica

 I had the same problem throughout my subsequent pregnancies, and after learning from MT and my chiro, we were able to take care of it at home.  It involves mom lying down on her side (the opposite of the affected side) on a firm (preferably raised) surface, with the hips "stacked" (that is, mom should not be tilting her top hip back or forward).  The bottom leg is bent at the knee (at about 90 degree
angle, or however much is comfy) and the top leg is straight down.  Partner stands at mom's foot, gently taking the ankle in both hands and pulls GENTLY straight back, holding this stretch for about 30 seconds.  The partner should be careful not to raise the leg....just pull it straight back.

This really does work, and it is Soooo simple.  I still recommend going to the chiro first, though, if you can.

Homeopathics for Sciatica

Sciatic pain can occur at any point along the course of the sciatic nerve from the lower back down the back of the leg to the foot. Homeopathic Magnesium Phosphoricum can relieve the pain. Spinal manipulation and massage are often helpful as well.  [From the EMAZING.com archives of the Homeopathic Health Tip of the Day]

Carpal Tunnel Syndrome and Wrist Pain

I have a lady due now, whose right hand has been numb off and on for a week. Any suggestions?

If it is her thumb, index, middle finger and 1/2 of her ring finger, it is probably carpal tunnel syndrome.

vit B6 100 mg qd is supposed to help, but takes several weeks. Splints to keep the wrist in slight extension (aka "cock up" splints) help. If she does repetitive hand movements (knitting, computers, sewing, sports, she may need to stop). At night, (if she doesn't want the splints), have her sleep with this hand on a pillow to try to keep it slightly extended.

One other thing that helps is Ice packs to the wrists when it is especially bad. While this usually goes away within a few weeks of pregnancy, she needs to monitor it carefully, as permanent nerve damage can occur if it is a true carpal tunnel and not just from edema of pregnancy. I had one gal like this and she ended up with bilat carpal tunnel release's 8 wks PP. Never did get all the function back in right thumb. Have her watch for wasting of the muscle in the palmar thumb muscle pad (thenar prominence) and major weakness. If this occurs, she needs to see orthopedist soon.

Late pregnancy can sometimes bring on or exacerbate carpal tunnel, mostly due to water retention.  some women have found that a skilled lymphatic drainage massage practitioner can help move the excess water out of the tissues and relieve the extra pressure on the nerve as it passes through the wrist.  your client might also find some relief by eating diuretic-type foods/veggies, as well as daily cups of turmeric milk to relieve the inflammation.

I'd also recommend Dandelion LEAF, as it's a fantastic natural diuretic.  We combine it with Nettle, which helps support the kidneys in the elimination of the excess fluids.

Don't forget to tell your clients that Tums has a lot of sodium! This can cause painful swelling in the wrist.

Long ago, in a midwifery practice I was part of, we treated wrist pain just like carpal tunnel pain, by healing the nerves that were being squished by the extra fluids in the body, etc. Here is what we used for pregnant and lactating mothers:

B-Complex 150mg doses (Nature's Plus brand is what I recommend). Take one in the am only (may keep you awake at night--more than usual that is!).
Zinc (chelated is probably best) 40-50mg  once daily
Magnesium 400mg up to three times a day. (may make stools loose or try Magnesium citrate to reduce loose stools)

We had fantastic success with pain reduction and increased use of hands, wrists, arms.  I recommend this combo all the time now.

I've heard of Tenex, a company that produces an instrument for doctors to treat tendinosis (chronic tendon pain). If rest, ice, etc. doesn't work for you, this may be an option. I have no personal experience with this, but you might consult one of these local physicians who have adopted the technology.

Danger of B6 Overdose

I had a patient tell me she red an article by a nutrition phd that warned of neuro toxicity with more than 200mg of B6 qday. I frequently have patients use 200-300 qday. some..a fair amount respond better to 300mg or so I think.

Original work in NEJM about 1984 (?) showing reversible peripheral neuropathy (mainly numbness and tingling) at doses above 200 mg per day. It has been my habit ever since, to rec. 200mg or less a day.

Sensory neuropathy from pyridoxine abuse. A new megavitamin syndrome.

Authors: Schaumburg H. Kaplan J. Windebank A. Vick N. Rasmus S. Pleasure D. Brown MJ.
Source: New England Journal of Medicine. 309(8):445-8, 1983 Aug 25.

Abstract: We describe seven adults who had ataxia and severe sensory-nervous-system dysfunction after daily high-level pyridoxine (vitamin B6) consumption. Four were severely disabled; all improved after withdrawal. Weakness was not a feature of this condition, and the central nervous system was clinically spared. Although consumption of large doses of pyridoxine has gained wide public acceptance, this report indicates that it can cause sensory neuropathy or neuronopathy syndromes and that safe guidelines should be established for the use of this widely abused vitamin.

Bleeding Gums

Pregnancy Gingivitis: What Every Expectant Mother Should Know By Sheila Wolf, RDH.  [Home page for MamaGums.com]

What do you suggest for a mom with pregnancy-induced friable gums? Is there any treatment, or do you just let them suffer through it?

One of my sisters is a consultant in Periodontology (gums to you and me!!!)

As I remember from what she said when it happened to me:

I think it's one of the effects of oestrogens during pregnancy and some women (arguably) are particularly susceptible to it. The main problem seems to be persuading women to KEEP ON brushing their teeth and flossing despite the bleeding - which will keep their gums in good nick. If they stop - because of the bleeding - or brush them more gently, then they're probably more likely to aggravate the problem in the long term. It's best to encourage them to be even more careful about their dental hygiene during the pregnancy or to try a softer toothbrush. Otherwise the old wives' tale about loosing a tooth for every baby is likely to become reality because of rampant gingivitis.

Delivery usually makes it go away.

In my own case, it stopped within 12 hours of all three births!!

Good dental hygiene: brushing and flossing conscientiously -- maybe even get a cleaning because plaque builds up more easily in pregnancy and gingivitis is more common.

Other helps:

Reassurance. This isn't an abnormal condition. It is brought on by pregnancy. Gums might temporarily be more tender, maybe even bleed more after a clean and increase in flossing but this should be short lived and those measures should help in the long run.

She might want to switch to a softer toothbrush.

A good cleaning at the dentist and good oral hygiene usually will heal this condition. I also agree with the Vit C

I worry about teeth cleaning during pregnancy. . . from what I understand, dental bacteria can be a real problem systemically if it gets into the blood stream during a cleaning and require a course of antibiotics to get rid of. I think I'd suggest it only as a last resort, and start with mega doses of vitamin C, regular brushing, and rinsing with 1/3 salt water, 1/3 mouth wash, and 1/3 hydrogen peroxide (recommended to me after MAJOR mouth surgery when I couldn't brush).


For swollen ankles, you might try wearing airline popsocks.  If I put them on in the morning they kept my ankles fine all day. If I didn't wear them they looked dreadful. The popsocks have a nice wide band at the top which is not too tight and so does not cause constriction which might cause further problems with varicose veins etc.

I recommend homeopathic arnica (6X or 30X, 3 tablets under the tongue once/hour until it's better, and then three times/day until the tendency changes).  Baths also help move the fluid back into the bloodstream, where it can be eliminated.

Normal baths may not help much.  I suggest trying to find a place where she can get submerged so that only her head is out of the water (that is how the original studies on using immersion to help edema were done). When I am advising hydrotherapy for edema, I am very specific and sometimes will write it down.
1) first empty your bladder
2) be sure to have water to sip while you are in the tub or pool
3) get into water so that only your head is out of the water.  relax in whatever position is comfortable.
4) be prepared to get in and out several times to pee. as the water presses on your skin, it pushes the fluid back into your blood stream where your kidneys pick it up. once they recognize that there is too much fluid, they send it to the bladder.  so you have to pee.
5) you need to spend a minimum of 20 minutes in the water, but with trips up to the bathroom the whole process may take as long as an hour.  SO plan accordingly.

Also, I would check on how much protein she is getting.  One of the things that can lead to peripheral edema is insufficient albumin in the bloodstream.  For most of our moms, insufficient protein is not an issue, but every once in a while it will be.

It sounds like your client is "third spacing" the fluids- which is fairly normal to a certain degree at this stage of pregnancy especially. The fluid which is/would be normally in the venous system is in the tissues (so-to-speak). This is partly because of the hormonal influences in pregnancy- esp. the increased progesterone causing vessel relaxation and the pressure gradient to be thrown off (the pressure usually keeps the fluid in the vessels as opposed to letting it "seep through"). As long as she doesn't have any of the S/S of PIH- and it sounds as if those have pretty much been ruled out- this is called "gestational edema" or "edema secondary to pregnancy". Many women find considerable relief by getting into a pool and soaking - the pressure of the water in the pool helps to counteract the edema in many cases. She could try lying in the tub and fill it as high as possible with water - the more volume of water the more pressure-. Tubs aren't generally very deep though. The only other thing I can think of at the moment is just reminding her to elevate her legs higher than her hips for a few times a day to help relieve some of the leg/ankle edema. You could also try adding a calcium supplement and/or magnesium supplement if you are really thinking it might be PIH related.....

A favorite around here this time of year is watermelon smoothies --- -- blend the melon WITH THE SEEDS until smooth... Folks swear by it! The seeds are supposed to be the "active principle"...

Try eating lots of celery and cucumbers.

Sinus Congestion and Sinusitis

How to Flush Away Sinus Ills and How to Treat Sinusitis Without Drugs and from Dr. Mercola.

Why You Don't Need Antibiotics for Sinus Infections - Most sinus infections are viral, not bacterial, so these powerful meds do little to help [5/8/17 from Consumer Reports]

Why You Don't Need Antibiotics for Sinus Infections
(from Consumer Reports) - Most sinus infections are viral, not bacterial, so these powerful meds do little to help

Sinus Rinse or Neti Pots work very well for many people. They should be used with distilled water, some new studies show tap water can have some contaminants (bacteria).

Got A Sinus Infection? Antibiotics Probably Won't Help by Scott Hensley [2/14/12]
People who got the antibiotic didn't have milder symptoms or have those symptoms go away faster than the people who got the placebo, Dr. Jay Piccirillo, senior author of the study tells Shots.

Amoxicillin for acute rhinosinusitis: a randomized controlled trial.
Garbutt JM, Banister C, Spitznagel E, Piccirillo JF.
JAMA. 2012 Feb 15;307(7):685-92.

CONCLUSION: Among patients with acute rhinosinusitis, a 10-day course of amoxicillin compared with placebo did not reduce symptoms at day 3 of treatment.

Many pregnant women find that their increased blood volume results in increased sinus congestion and occasional bouts of sinusitis.  It's best to take care of these bouts before they turn into such painful infections that you feel that you must resort to antibiotics.  My favorite preventive measure is the neti pot - here's a nice metal one that won't break.  (Neti pots are famous for breaking, and pregnant women are famous for dropping things in the later months as their joints relax with the hormones of pregnancy, so . . . )

If the neti pot seems like too much to start with, she can try using a saline spray (Ocean - or home made) and using a vaporizer day and night.

A combination herbal formula of stinging nettle and quercetin should work great!  You could get this from Whole Foods or a health food store.

Acupuncture can also help.

Confessions of a Neti Pot Convert

I had a persistent sinus infection this season and the thing that kicked it for me was to do a straight colloidal silver nasal spray.  I bought a empty nasal spray bottle at my local herb shop and put colloidal silver inside.  A couple of sprays in each nostril a few times a day and it was gone within 4-5 days.  This was the BEST thing that I had tried and I won't hesitate to do this again if I get another sinus infection.  The lady at my herb shop recommended that I do this.

Last year I was on the verge of surgery for repeat sinusitis infections - I had over 7 courses of antibiotics in less than 6 months. Then I reached out to the group here.
Someone suggested the Grossan sinus rinse machine which you can get on amazon and it has worked wonders. I have not had a sinus infection since although I do ritually use it daily. It's $100 but it is soooo worth it.
It has saved me from surgery and I can't recommend it highly enough. IMHO it is much better than the manual rinse ones.
Good luck and thank you to the person who recommended it to me.

Between outbreaks of sinusitis, a cleanse (like neti pots or cleansing machines) are great. Keeping things moving works wonders in preventing the
actual sinusitis.  ONCE you have a sinusitis however, stop using the neti pot or cleanse, as it will spread the infection rather than stop it.

Two suggestions you can consider that have worked for me: (Both came from chinese medicine doc's and both worked great for me. One had completely stopped my sinus issues before I had a baby (I'd had chronic issues for years & after doing #2 below they lessened until I didn't have any sinus infections, etc. for over 3-4 years) And the other was from a different TCM doc as after having a child my immune system and everything else took a major nose-dive and I was sick all the time again. I've now not had a sinus infection for about  2/1/2 years after having done #1 below (*the Saccharomyces* *boulardii yeast, which is what florastor is)*

#1Buy florastor and have her sniff it up her nose three times per day (each side, one side at a time, block the opposite nostril while doing it). This doesn't hurt, it smells like fresh bread (because it is a friendly flora yeast) and for me is much more tolerable than saline washes, which I just can't handle and may be hard for a little one. This friendly yeast displaces the pathogenic bacteria which causes the chronic sinusitis.

#2 Go to a REALLY GOOD Chinese Med Doc who sees lots of kids (are you in the bay area? If so consider Randall Neustaedter  in the South Bay or Efrem Korngold in the City) and they will customize a brew just for your child.

I've had significantly better success with TCM and my sinuses than conventional medicine (which with conventional medicine got to the point where only zithromycin and cipro would work and they wanted to do sinus surgery - ugh!!!!)

You may want to check into molds.  Either outside molds or inside molds can cause an immune reaction which triggers chronic sinusitis.  Dr Mercola had a write up on his site.  SO strengthening the immune system should help.

Another suggestion.. one that worked for my father who has had chronic sinus infections since his teens...cutting out all dairy and beef proteins from your diet.  Chronic sinus and phlegm issues are a common indicator that you have a sensitivity to dairy.

The concept of a neti pot can be really daunting - I find that it helps to breathe out a little bit as I'm doing it - just a gentle outbreath so I don't feel like I'm drowning!  Or you can figure out how to do a glottal stop to block off the backflow down the throat.

If you're not quite ready for a neti pot yet, try one of the commercial squeeze bottles of saline solution - avoid the ones with thimerosal or other mercury compounds.  It might be easiest to try this in the shower the first few times.  You can just spray a fine mist up your nose to moisten the tissues and help drainage, or you can get fancy and tilt your head back and actually allow the saline to flow through the back of the nose and into the throat.  This can liberate a lot of gunk that you can then spit out.  As I said, this is all easier in a nice, warm shower!

I suggest the Grosan nasal irrigation machine. 5 years ago I had sinus infections all the time--constantly on antibiotics. I started using this machine and I have not been on an antibiotic since that day.  Honestly it has been 5 years and I have never felt better.

If you have a chronic sinus infection, consider the possibility that it may be a yeast infection.  Many of the dietary and lifestyle changes necessary to overcome vaginal yeast infections may also be necessary to overcome sinusitis due to yeast.

If you feel like you ARE getting sinus irritation/infection other than just the headache symptoms, (this sounds gross, but it works...) buy some saccharomyces boulardii capsules (that don't have any other herbal things mixed in) open it, put about the same amount as the size of a small dry lentil  on your finger, close the other nostril and snort it up in. Do both nostrils. It will smell like bread yeast & isn't as gross to do as it sounds. My Chinese Medicine guy had me do this and it staves off sinus infections really well. From what I understand this stuff is a "good yeast" which takes over the bad yeast, which is often a precursor to enabling a bacterial infection to take hold (??something to that effect, but it works...)

Also, often what I think are sinus headaches are actually tension, and a chiro adjustment resolves it immediately.  Might want to see if that would help...

Steam Tents - Standing in a warm, moist shower helps a lot, but you can't possibly stand in water that is hot enough to do a good job of fighting a brewing infection.  A steam tent allows you to get hot steam up into your sinuses where it counts!  It's like putting a hot compress on an infected cut; the heat helps kill the germs, and it increases the bloodflow through the area, bringing more white blood cells to fight the infection, and carrying away the deteriorating infection.

Especially if you think you might be coming down with a sinus infection, start steam tents right away.  Heat a big pot of water to boiling; while it's boiling, set up your space at a table.  Make sure the table is protected from moisture if necessary, and have a nice big ceramic bowl ready to receive the boiling water and a chair ready to pull up to the table.  Have a large, thick towel or beach towel or doubled flannel sheet ready to make the tent.  Make sure there are no children or animals running around that could cause an accident with a bit pot of boiling water!!!  Oh, and make sure you 've got some hankies handy, as this will loosen up lots of the congestion, and it's nice to be ready to blow your nose gently and relieve the congestion!  Then pour the boiling water into the ceramic bowl, sit in a chair with your head over the steaming bowl, and use the cloth to make a tent over yourself and the steaming water.  Be judicious in breathing in the steam - don't breathe it in if it seems dangerously hot.  So breathe it in slowly, breathing in through your nose and out through your mouth, so the hot steamy air can accumulate in your nostrils instead of being blown out with each breath.  You can just do this until the water gets so cool it's not steaming anymore.  Or you can get fancy and work each side of your nasal passages; block off one side and breathe in and out through the other.  Try breathing in through the mouth (which can get a bigger gulp of steamy air) and then gently blow it out one side while blocking the other.  I've heard that yogis can do all sorts of fancy stuff moving steam and water around their nasal passage.  You don't need to get fancy - you just need to get the steamy air in contact with the infected mucous membranes as much as possible.


See also: Chiropractic Care

One of my clients said that eating significantly more protein relieved her headaches and prevented them from returning.

Sometimes headache can be caused by dehydration.  As you become dehydrated, your blood volume drops slightly, and your blood pressure may rise in accommodation.  Well, the increased blood pressure may break some little capillaries in the brain which, well, it hurts!  If you're prone to headaches, try staying really well hydrated.

This is so very true.  I've had a number of clients who tell me that their headaches go away if they drink enough water.  Next time  you have a headache, try sitting down and drinking lots and lots of water - more water than you could ever imagine - 5 or 6 glasses.  Notice whether your headache gradually gets better.  If so, start a strict regimen of lots of water intake and you'll soon figure out whether it keeps your headaches away.

I had never heard of grapeseed extract for headaches prior to being on the list. I get headaches more frequently than I like (I had a severe whiplash injury six years ago and residual problems with my neck seem to be the cause). The remedy I have discovered lately that I really like is St John's Wort tincture (25 drops) plus 5 or 6 drops of skullcap for nasty headaches, and a few drops of valerian if I want to sleep. It does seem to really work. The other thing that I have found helpful is rubbing a drop of rosemary oil on my forehead if I can catch the headache early on before it is too intense. I have also found ice on my neck helpful, and a product I bought from a chiropractor that one rubs on sore muscles called Bio-freeze. To my knowledge, all of these remedies are safe in pregnancy.

Headaches: I suggest lavender, skullcap, and/or feverfew for headaches, during pregnancy or otherwise. What I find most helpful is lavender essential oil, rubbed onto the temples or added to a carrier oil (e.g. olive) as a massage oil. [Ed. - There is some concern that almond oil applied topically may be associated with preterm labor.]  This works for me for migraines as well as other headaches. Feverfew is wonderful for migraines and is best used fresh, although good quality capsules are effective too. It may cause mouth ulcers in sensitive people and should be discontinued if this occurs. To help avoid this, when using the fresh leaves, it's suggested that you place a leaf or two between two slices of bread! Skullcap is very relaxing and can help with any sort of nervous or tension headaches. One good idea is to make a small pillow and fill it with dried lavender flowers. Sometimes people with migraines find a heavy eye pillow helpful...you can combine these two ideas by filling your pillow with flax seed or rice /and/ lavender flowers, even adding some lavender oil to the mix. This pillow can also be heated or chilled (microwave/freezer) for more relief and is good for back aches and more. I make a tincture of equal parts lavender and skullcap that works well for most types of headaches too. Massage is helpful for many types of headaches. There are also two acupressure points that may help: one is in the meaty part of the hand, between first finger and thumb. You'll know you've got it if the person winces and jumps in pain! Squeeze as hard as you can without creating unbearable pain, both sides if possible. You can do this to yourself, one side at a time, but it often works better if someone else does it. The second point is right in the center of the top of the head. Sort of between where you'd find the two fontanels! It too will be tender during a headache. Direct pressure or a circular firm massaging pressure can stimulate this point.

If the headaches are tension/nervous headaches the following may be helpful (best drunk daily, not just when there's a problem!):

3 parts lemon balm, 1 part passion flower, 2 parts oat straw, 3 parts chamomile.

If they are fatigue-induced, drinking this daily may help:

3 parts peppermint, 1 part squaw vine, 1 part ginkgo, 1 part gota kola, 1 part raspberry leaf, 1/2 part ginger

For either formula, use 4-6 tablespoons of herb mixture per quart of water. Place herbs in cold water, bring to a simmer over low heat, keeping pot covered. Remove immediately and let infuse 20 minutes or longer, keeping covered. Strain and drink. I suggest making a quart each day and drinking it throughout the day. These two formulas can be combined into one tea.


See also: Headaches

Magnesium is a great relaxer and can help with migraines.

FDA Approval: Electrical Nerve Stimulator for Migraine Prevention [5/1/14 - Medscape CME/CE]

www.unlockthemysteryofyourmigraines.com -Suzanne can guide you through a 21-day program for purification that reduces migraines, heartburn and improves general health.

Quick, Natural Tips to Relieve a Migraine towards the bottom of this page from Dr. Mercola : Migraines—What Causes Them, and How You Can Best Address Them - It is possible to stop headaches by stimulating your body's natural painkilling ability. By putting pressure on a nerve just under your eyebrow, you can cause your pituitary gland to release painkilling endorphins immediately.

Acupuncture shown to relieve migraines

Medical Resonance Therapy Music - recognized by the World Health Organization as the most successful “anti-stress remedy in the world” at the International Conference “Society, Stress and Health”.  Here's their article on Headaches and Migraine: Digital Pharmaceutics: Harmonic Help 

What Can Cayenne Do For My Migraines?

Taking the cayenne inside the nose helps to open up the blood vessels. This enables the blood to get nutrients to all parts of the brain. To stop a migraine follow these simple steps:

  1. Open the capsule and dip the flat end of a dry toothpick into the cayenne to pick up 3-4 grains.
  2. Block one nostril and gently put cayenne up the other nostril.
  3. Sniff deeply 3-4 times until you feel the flecks of pepper in your throat. (If you don't feel this, do it again).
  4. Once you feel the warmth in your throat, you headache should be gone in minutes
If the headache returns, you can do this procedure over again as it is not harmful to the body.

I used too much when I tried it, and my nose burned, my throat burned, and my eyes watered, but the migraine went away! It was a pretty nasty one too. At least it's non-pharmaceutical.

I wouldn't call it a non-pharmaceutical at all--merely an unpublicized pharmaceutical. I intend to start prescribing it, but first a few details please. First, can you use it after pain has already started, or must you do it prior to onset of pain during the "aura?" From your post, it sounds like the pain was already well underway because you described it as a "pretty nasty one." Second, does it matter which nostril you use--does it have to be the nostril on the side of the HA? Third, have you ever tried this with muscle contraction HA's? All the other migraine treatments I have ever tried before were also efficacious for muscle contraction HA's also.

The cayenne can be truly amazing. Basically, you put a few grains of Cayenne on a toothpick and hold one nostril shut and snort it! The grains need to land in the back of the throat. If they land in the nose, it burns and the nose waters, and sometimes you can sniff it in the rest of the way.

Somehow, this opens up blood vessels, and relieves the headaches. It can be repeated if needed - sometimes takes more than one try for me, and it isn't much fun because the Cayenne burns, and the eyes and nose waters, but amazingly, often, the headache will go away.

I have used this at the onset of a migraine, but often after it has been "brewing" for a few hours.

Cayenne taken internally is also very good for migraine sufferers. It helps regulate circulation. I've known people with chronically cold hands and feet who began to take Cayenne regularly, who say their feet and hands stay warm now. The hands and feet often become very cold with a migraine, as well.


For immediate treatment of a migraine you sniff (snort) a couple of grains, until they hit the back of your throat. Your nose and throat will burn a little, and your eyes will water, but that's the worst of it.

Coenzyme Q10 deficiency and response to supplementation in pediatric and adolescent migraine.
Hershey AD, Powers SW, Vockell AL, Lecates SL, Ellinor PL, Segers A, Burdine D, Manning P, Kabbouche MA.
Headache. 2007 Jan;47(1):73-80.

CONCLUSIONS: Deficiency of CoQ10 may be common in pediatric and adolescent migraine. Determination of deficiency and consequent supplementation may result in clinical improvement. Further analysis involving more scientifically rigorous methodology will be required to confirm this observation.

Visual Disturbances / Visual Migraines

You can get visual migranes, and these can present in pregnancy for the first time – you don’t need a headache to have a migrane. I had visual migranes in my last pregnancy and have never had one before or since. It involved loosing patches of vision – I would be looking at someone and they had no middle – most bizarre. I got investigated, but basically said it was fairly normal and nothing to be done about it. [Ed.: This assumes that you have ruled out pre-eclampsia.]

This could also be caused by low blood sugar.


See also: Food Allergies

If you can afford this fabulous Essentia adjustable bed, it will help a lot with nighttime discomfort!  (There's a shop in Berkeley!)

Pregnant? Have Heartburn? 5 Tips for Natural Relief from Aviva Romm

Esophageal Guardian claims to create a temporary barrier to keep the acid in the stomach instead of coming up into the esophagus.

15 Natural Remedies for the Treatment of Acid Reflux and Ulcers - Dr. Mercola's suggestions aren't specific to pregnancy, but this is a nice summary of alternative approaches.

One of our local hospital midwives writes, "You may get several responses for more natural remedies like Papaya enzyme etc. but from my experience the moms with really bad heart burn seem to respond very well to OTC Zantac starting at 100 mgs and then if necessary up to 300 mgs daily. The side effects of the burning esophagus are much worse than the effects of the medicine. "  [Ed: If you're taking antacids, then there may not be adequate acid in your stomach to digest your food.  And if you're not digesting your food properly, you might not be able to absorb the nutrients you need for a healthy pregnancy and a healthy baby.  You might ask your care provider about taking digestive enzymes with your meals.]

A tablespoon or so of swallowed chia gel chases away heartburn "in a matter of seconds."  Chia seeds are also a great source of fiber and omega-3s. (If you take 0.4 ounces per day, you'll be getting about 1500 mg of omega-3s, which is about the right amount of supplementation that won't make the baby's head too big.  ) [from Nutrition - Chia - ... far more than just a furry green "pet"!]

Gut Health = Great Health!: Why Healthy Gut Function is Essential for Overall Health  by Dr. Douglas Husbands

from "Tricks of the Trade" Midwifery Today, Spring, 2009

Acid Blockers for Mom During Pregnancy Increase Baby's Risk of Asthma: Presented at AAAAI
March 24, 2008 -- Taking acid-blocking medications for heartburn associated with pregnancy increases the baby's risk of developing asthma by more than 50%.

Heartburn is one of those things where you may be just a little out of balance with your acid / alkaline status.  Some people find that eating citrus makes the heartburn worse.  Other people find that taking alkaline supplements or relaxants can make it worse.  For example, you might be taking something to help with asthma, anxiety or some other high-acid condition.  You may need to experiment to find the level that's ideal for you.

Or you might try focusing on your systemic pH to find the level that's ideal for you.  Good luck!

Heartburn – there's a difference between gastritis, hiatal hernia and indigestion Do you want to block stomach acid or  heal stomach lining?  Many women, pregnant or not, get relief from heartburn with appropriate digestive enzymes.   PLEASE, be cautious with ANTACIDS (including nexium, zantac, pepcid, tums, rolaids…)  If you can afford it, it's best to be working with a knowledgeable enzyme therapist, but if you can't afford it, you can always start with simple digestive enzymes such as papaya; this is especially helpful if you're having obvious signs of digestive difficulty, such as sour stomach after eating or intestinal bloating.  If the digestive enzymes don't help, you may have gastritis - inflamed stomach lining; a good treatment for this is DGL, De-Glycyrrhizinated Licorice, which helps to heal the stomach lining.

This excellent explanation of heartburn also proposes the most sensible remedy I've ever seen - Cell Tech's Contain supplement. [pdf document]

Pregnancy folklore revisited: the case of heartburn and hair.
Costigan KA, Sipsma HL, DiPietro JA.
Birth. 2006 Dec;33(4):311-4.

CONCLUSIONS: Contrary to expectations, it appears that an association between heartburn severity during pregnancy and newborn hair does exist. We propose a shared biologic mechanism involving a dual role of pregnancy hormones in both the relaxation of the lower esophageal sphincter and the modulation of fetal hair growth.

Chocolate, wine and spicy foods may be OK for heartburn

NOTE - It's not clear whether this research result applies to pregnant women.

Are lifestyle measures effective in patients with gastroesophageal reflux disease? An evidence-based approach.
Kaltenbach T, Crockett S, Gerson LB.
Arch Intern Med. 2006 May 8;166(9):965-71.

"Although there was physiologic evidence that exposure to tobacco, alcohol, chocolate, and high-fat meals decreases lower esophageal sphincter pressure, there was no published evidence of the efficacy of dietary measures. Neither tobacco nor alcohol cessation was associated with improvement in esophageal pH profiles or symptoms (evidence B). Head of bed elevation and left lateral decubitus position improved the overall time that the esophageal pH was less than 4.0 (evidence B). Weight loss improved pH profiles and symptoms (evidence B). Weight loss and head of bed elevation are effective lifestyle interventions for GERD."

Organic Herbal Tea for Pregnancy Heartburn at  Earth Mama Angel Baby - this is new, and I'd like to get feedback about it.  If you use this, please e-mail me about your results with it.  Thanks!

Gastro-esophageal Reflux Disease (GERD) from Cyberounds

Boiron Acidil Homeopathic Medicine for Heartburn or sour stomach

Some people say that drinking peppermint tea can exacerbate heartburn because it relaxes smooth muscle.

I was one that the almonds also pretty much did the trick, but also always had my bed elevated and ensured that I didn't drink the majority of my water in the evening.  Just reading in another birth article, a homeopath suggested a couple of things: Magnesia phosphorica and Carbo vegetabilis, says to dissolve the Mag phos in water and sip.  What she states did the trick for her was charcoal in  capsule form (not homeopathic, but was all that worked for her!).

For some people, eating certain foods will prevent or cure heartburn.  Try eating just the soft inside of French bread, or drinking Perrier.  Or try eating yogurt before going to bed at night, if that's when heartburn is worst for you.

If you want a really fast antacid that works, seek and ye shall find. The current crop of TV ads for help from heartburn can't hold a candle to the pills and plants mentioned in the Bible, suggests the U.S. Department of Agriculture's top plant researcher. For instance, to block the burn, make a salad using these plants mentioned in the Bible: almond, chicory, dandelion, garlic, lettuce, mustard, olives, onions and walnuts.

For heartburn during pregnancy: Chew a few pieces of diced papaya before meals. Papaya tablets are also safe-just follow the directions.

The best way to handle heartburn, however, is to prevent it. No super-spicy meals, eat small meals more frequently, bananas soothe the stomach, do not lie down after a meal but try walking or moving your body a bit. The sphincter muscle at the top of your stomach relaxes right along with all the rest of your body to soften up for birthing, and food/stomach acid can get pushed up. This is where the burning part comes in.

Another handy little remedy is slippery elm throat lozenges available from health food stores. Slippery elm bark is safe for pregnancy and it soothes the stomach, but take it only if/when the above suggestions do not work.

There are many alternatives to over-the-counter or prescription drugs to treat heartburn. For the acidity, bloating, and occasional nausea of heartburn and gastric reflux, use homeopathic Robina as the label directs for relief.

Two simple remedies can help: sleep with one or two more pillows than you are used to; it will prevent the content of the stomach from burning your esophagus. And 1/2 hour before each meal take one or two tablets of slippery-elm; this will coat and protect the area that gets burned from the acidity of the stomach content.

If you don't have a problem eating dairy, you might find that milk works wonders for your heartburn.

Kal Enzyme Gum. You can buy it in small packages or large bottles. The mother can take it before and after meals or anytime needed.

Raw celery. Calcium pills, papaya.

Slowly eating raw almonds and/or sitting up tall and flapping the arms up and down like a bird (high enough that the hands meet above the head).

I recommend chewing raw cashews until they are a paste in the mouth and then swallowing.  Also, small sips of Perrier water sometimes does the trick.

While on the subject of heartburn etc.... How about discussing some other 'helps". Calcium pills, and papaya have already been mentioned.... Has anyone had success with the old time apple-cider vinegar cure? (Just take a teaspoon of the stuff -if you can stand it straight.. Or put it with a little honey in a little hot water, and drink like tea). The idea behind it is that "acid stomach" may actually be an "alkaline" condition and acid like vinegar might help...... Several of my clients have gotten quick relief with vinegar....(odd as it sounds [grin])

I found candied ginger. papaya enzyme and enzyme gum at my local health food store. Bought some to try on myself before recommending to pregnant women.

I understand raw almonds work well too. Can't you just shred ginger into hot water an make a tea. I think like anything, too much can be a problem, but I understand it does help with nausea and heartburn.

I have used this remedy for so many years that I can't remember where it came from. It seems to have helped even the most difficult and stubborn cases. One tablespoon of liquid chlorophyll (I prefer the mint, which might also help) to two tablespoons aloe vera juice taken 1/2 hour before meals. It can be mixed in juice or water if necessary. It usually only has to be taken twice a day.

Take 200mg B6 per day.
Increase water intake (more than 2 qts./day).
Check air conditioning, etc. for mold in filters.
Take extra folic acid (800-1600 mcg beyond what's in a standard prenatal
Take 200 mcg. chromium picolinate.
Increase all B vitamins.
Wear a good pair of UV blocking sunglasses when outside.
Avoid fluorescent lighting.

Papaya is available without calcium carbonate...or how about fresh papaya? Another trick that I have used with great success is aloe vera juice (2tabl) combined with liquid chlorophyll MINT (1 tabl) taken 1/2 hour before meals. Usually its only necessary twice a day, if that. If ladies are getting the heartburn at night, I tell them to try it before the evening meal. It was a recipe given to me by a naturopath and certainly cures heartburn.

One thing that works for some women is chewing gum after meals (peppermint sounds good to most). This increases the flow of saliva and helps dilute the stomach acid. Make sure you are drinking plenty of fluids too. I hope this helps! Janet

I can definitely relate to wanting TO EAT while pregnant. What helped me the most with heartburn was papaya tablets (usually in vitamin sections even in supermarkets) and any kind of bubbly water -- Perrier, seltzer, etc. I think that I drank it just about every day in the last few months of my pregnancy. Hope that this helps!

Here are some things that did seem to help:

When I was pregnant with twins I had terrible heartburn. I used green apples, just nibble on them whenever you get it

Heartburn - Pressure Point

I thought I would see this in the response posts for heartburn because it works so well: a technique taught to me by my naturopathic chiropractor when I was pregnant and suffered from heartburn. It is a pressure point to treat hiatal hernia. Standing up, gently place the first two fingers of each hand side by side-index finger next to index finger-on the top of the diaphragm, centered in the little hollow at the base of the rib cage (above the fundus if really pregnant). Then bend at the waist, with your fingers in the same place. When bent as far forward as comfortable, start applying pressure, with both sets of fingers in the direction toward one's feet (although when you are bent over it feels like you are pressing toward your spine). Slowly straighten up keeping the pressure firm and steady. When standing straight, the direction of the pressure should be clearly toward one's feet, instead of toward the spine. Hold for as long as comfortable. Repeat twice. Do this every time you think of it, or when heartburn strikes. What I think this adjustment/pressure point does isclose the little valve that is supposed to be closed, but when open( called hiatal hernia)lets the digestive acids travel upward causing heartburn.

If the heartburn is interfering with your sleep, you might try sleeping on a foam wedge pillow that supports you at about a 30-degree angle, so the acid stays down in your stomach!  No, this isn't the same as "sleeping on your back", which is rarely a problem anyway.  Dr. Leonard's offers a Bed Rest Wedge for $18.99 or $29.99, depending on height.

2011: Easy Comforts carries a Comfort Wedge foam pillow

There are more expensive memory foam wedge pillows.

2012: The Feel Good Store offers a standard dual-position folding Comfort Foam Wedge, a lower graduated Sleep Wedge or a Memory Foam Adjustable Leg Wedge.

Braline Discomfort

For the past week, my client has been experiencing a burning sensation on her skin, especially in a band of skin 2 inches wide underneath her breasts. The pain feels like it is isolated to her skin, and there are no visible marks of a rash or irritation on her skin at all. It seems to hurt more when she is sitting or lying down. Putting on cream/lotion helps for a little while but then the pain comes back. Moving or adjusting her position sometimes helps, sometimes not. Leaving her skin exposed, especially to cool air also seems to help.

 I have heard of this and to some extent had it happen to me when I was pregnant with my second baby - so I can tell you its a really strange feeling and although not painful for me I could tell it could get painful as it is like an electrical shock sensation across the top of the baby/fundus.

I think it it originates from a Muscular/Skeletal issue as opposed to the baby pushing up though although I have never seen it in early pregnancy and it is only when the baby gets up there that the sensation comes. You didn't tell us how pregnant your client is but I suspect at least 32 weeks. Not sure why some women get this and some don't but I would certainly check in with a Chiropractor and if that doesn't work then try acupuncture. It does go away and is quite similar to the floating ribs having to be pushed out of the way so it may be related to that also happening at the same time?

Hope the Chiropractor works for her and if not when the baby drops it may get better.

I had this also with one (or two) of mine.  An exquisitely sensitive area across the very top of my fundus.  It was very uncomfortable for even clothing to brush over it.  I chalked it up to stretched/irritated nerve endings.

Itchy Skin - Cholestasis - PUPPP - PEOP

PEOP - Polymorphic Eruption of Pregnancy

formerly called

PUPPP - Pruritic Urticarial Papules and Plaques of Pregnancy

In its severe forms, this is a very serious pregnancy complication, but it often starts out as a mild itching and stays that way.  Please consult your midwife or doctor if your itching is severe and accompanied by other symptoms.

A Clinical Approach to Intrahepatic Cholestasis of Pregnancy.
Diken Z, Usta IM, Nassar AH.
Am J Perinatol. 2013 Jan 28. [Epub ahead of print]

Intrahepatic cholestasis of pregnancy (ICP) has a varying prevalence worldwide. The etiology behind this disease remains not fully understood with multiple factors influencing its development including genetic variations, dietary factors, hormonal changes, and environmental influences. Presenting mainly during the third trimester with generalized itching and resolving spontaneously postpartum, this condition is still associated with fetal morbidity and mortality. The diagnosis is based on clinical presentation in association with biochemical abnormalities. Elevation in total bile acid levels is the most frequent laboratory abnormality and seems to be the most important for gauging further management of the disease. The most appropriate gestational age for the delivery of women with ICP is yet to be determined. In this review we discuss the epidemiology, clinical features, diagnosis, etiology, and management of ICP, trying to shed light on some controversial aspects of the disease.

Diagnosing Dermatoses in Pregnant Patients [11/26/12] - Medscape registration is free.

PUPPPs Rash During Pregnancy

Itch Relief Tincture works on the liver, and does take a few days to kick in, but it does work within a few days and provides lasting results.  It's used for cholestatis, PUPPPS, and the like.  I've gotten glowing reports back from clients on how well it's worked for them and what blessed relief they've gotten.  It has worked in every case I've dealt with so far, which have been many over the years.Rescue Remedy cream used externally will help relieve the itching during the time until the tincture kicks in.

Intrahepatic cholestasis of pregnancy (IHCP) is characterized by intense generalized pruritus (itching) during pregnancy without a primary skin lesion. This page has a nice little differential diagnosis guide.

Obstetric cholestasis - "May have serious consequences for the fetus, and needs to be taken seriously.  Obstetric cholestasis (or intrahepatic cholestasis of pregnancy) remains widely disregarded as an important clinical problem, with many obstetricians still considering its main symptom, pruritus, a natural association of pregnancy. Obstetric cholestasis is associated with cholesterol gallstones. It may be extremely stressful for the mother but also carries risks for the baby. " [BMJ 2002;324:123-124 ( 19 January )]

The Dermatology Atlas has a section on skin disorders in obstetrics (pregnancy related) and gynecology

Here's their section on PEOP

Intra-Hepatic Cholestasis of Pregnancy - An account of coping with ICP and actually reversing the disease through non-pharmaceutical treatments.

Intensely Pruritic Eruption on the Abdomen of a Pregnant Woman [Medscape registration is free]

Pruritic Urticarial Papules and Plaques of Pregnancy - created by a woman who had PUPPP with her first pregnancy and wanted to help other women in the same situation.  You can help increase knowledge about this very difficult condition by taking the PUPPP Survey.  You may also want to join the PUPPP Yahoo Group.

Obstetric Cholestasis

What Is Obstetric Cholestasis? - by Natalie Forbes Dash , Homebirth Access Sydney , Blue Mountains Homebirth Support, online at BirthLove  [backup copy]  [Ed: birthlove.com is not available at this time.]

Intrahepatic Cholestasis of Pregnancy

Skin Disorders of Pregnancy


Pruritic Eruptions of Pregnancy

This can be a miserable condition, but obstetrics doesn't seem to have many suggestions other than induction.  If some of the remedies below work for you, please, please, please send me feedback so we can increase our knowledge base about this condition and natural remedies.  Thank you!

Actually, a lot of people are 'unfamiliar' with intrahepatic cholestasis of pregnancy and are therefore also 'unfamiliar' with the potential associated risks. BTW Not just any itching but particularly itchy palmar surfaces of the hands and feet in late 2nd/3rd trimester is a cardinal symptom combined with confirmation of abnormal blood work.  In any event, ICP usually manifests in those persons with a previously unappreciated genetically-mediated predisposition, and with all due respect to those with varying opinions and approaches towards this condition, the fact is it can ultimately pose moderate to severe risk to the fetus depending on the severity to which it is affecting the mother.

'Clinical studies clearly show that when obstetric cholestasis complicates pregnancies it may lead to premature births in up to 60%, fetal distress in up to 33%, and intrauterine death in up to 2% of patients. The cause of fetal death is acute anoxia. Unfortunately, this diagnosis can be easily 'delayed' as it takes up to 2 weeks after a woman presents for care AND an astute practitioner orders testing to determine bile acids levels. Ultimately, confirmation of this condition does open the door for 'interventions' in pregnancy but then it also increases risk status and could justify those 'interventions' as necessary and appropriate. That said, I think it would probably be wise to offer care for women with this condition through a combination of modalities including collaborative evidence-based obstetrical and/or midwifery monitoring in conjunction with complementary and alternative treatments. The aforementioned link is a good resource for more detailed information on this disease.

I have had severe Intrahepatic Cholestasis of pregnancy with all three of my pregnancies beginning in 1989.My doctors have tried dozens of medicines including Phenobarbitol,Atarax,Promethazine and Questran( and many,many others) nothing has ever given me much relief. My doctor has now prescribed me "Actigal" his reasoning was that since gallstones are made up of bile salts and that is the cause of my itching and Actigal breaks down gallstones it may work and it has!! I am going on my second week with Actigal and I feel 75% better! No medicine has even come close and it supposedly works even better after 3 weeks.I really hope that this information can help someone else suffering as I have.It is rather expensive costing almost $3.00 a pill(in my area anyway) but well worth it!

There's some thinking that PUPPPs and other toxicoses of late pregnancy are associated with fetal hypoxia, meaning that the fetus isn't getting enough oxygen for some reason.  (I would encourage a good ultrasound to check the condition of the placenta before pursuing any other alternative therapies!)  Apparently chlorophyll was supposed to be a remedy for fetal hypoxia.

[Antioxidants in the combined therapy of late pregnancy toxicoses and chronic fetus hypoxia].
Ailamazian EK
Akush Ginekol (Mosk) 1991 Mar;(3):30-4

[Antihypoxic effect of chlorophylly and the method for its clinical use in maternal and fetal tissue hypoxia].
Shramkevych AF, Sol's'kyi IP, Rozumenko MB
Pediatr Akush Ginekol 1979 Sep-Oct;(5):55

I have the rash now for 3 weeks............miserable 3 weeks. I was determined to get relief. My doctors wanted to do all sorts of creams and ointments. None worked. Benadryl made me sleepy and I was not going to use steroid creams.

I went to a homeopathic DR. and within 4 days the rash is just a faint memory. No itching, a little tenderness but I can sleep. I also have to say that Heat is your friend! A hot shower and i mean hot, let the water sit on one place at a time. The pain is immense, then the itch that is the worse then just wait, the relief. It draws out the inflammation and when you go and lay down, let it air dry. The bumps go down and then just light pink. Relief for several hours. The homeopathic DR. gave me some stuff that i put on it when it would flare up. Now it is gone.

I had a rash early in pregnancy that didn't respond to the usual treatments.  Then I started taking Evening Primrose Oil for its natural prostaglandins and EFAs, and that worked!

I've seen Hypericum perforatum (Saint John's Wort) oil work well on the rash during pregnancy.  It has a local anesthetic effect which really decreases the itching.  And, it promotes healing by preventing secondary infection...

Black cohosh infusion applied topically has a history of treating the itching of poison oak and ivy.

Something that some of my clients have had success with for the PUPPPS rash is Hemp Cream from the body shop.

Severe pregnancy rash indicates kidney and liver stress even if it's not registering on a lab test.  Topical treatments may be mildly soothing but largely ineffective.  She needs support to gently detox the reticuloendothelial system.  I might try dandelion or milk thistle capsules or a homeopathic liver formula.

At the end(last 2 days) of my 2nd pregnancy I began getting a rash on legs and abdomen. By several days after birth I was totally miserable with it. The family practice dr. said it was PUPPP - some kind of rash with pregnancy. Have any of you had it and if so do you know of ways to get rid of(or avoid) it without using steroid cream? I'm 32 weeks into my 3rd pregnancy. No sign of it yet but I was told that it often gets worse with subsequent pregnancies.

This has a few names..."pruritic pustules of pregnancy" or "pruritic urticaria of postpartum"...according to a couple of docs who have dx'd women I have worked with. Apparently due to hormones...some women get it, some don't, it doesn't necessarily continue to occur in the same woman for subsequent pregnancies, though it can. Benadryl is usually the allopathic treatment.

There is a fairly rare (for this country anyway) condition called cholestasis of pregnancy that could be the cause of severe itching. It usually begins in the third trimester, but can occur earlier. It supposedly begins with the itch and then jaundice develops, but I have seen a case where no jaundice developed. Serum alkaline phosphatase levels will rise as well as bilirubin and bile acids (which cause the itching). The management is to control the itch with Benadryl. Also I read that cholestyramine is helpful but don't know anything about that.

Hope this is helpful. Maybe some others have some great itching remedies besides oatmeal baths. I could use some more in my own bag of tricks.

Another important fact about cholestasis is that it has been linked to intrauterine fetal demise in some (rare) instances. Many providers feel that women who have been diagnosed with this condition should be monitored with weekly or biweekly NST's (nonstress tests), and some believe that an AFI (amniotic fluid index) with each NST is a wise precaution, as well.

This really is a miserable condition. The women who have it suffer from incessant itching, even inside their noses and on other mucous membranes. Since it is caused by the build up of bile salts in their blood, topical treatments don't really do any good at all.

Why do bile salts "build up" in the blood? Is there something one can do to counteract this? My midwife friend has her mother doing things like red clover, dandelion root and other liver stuff.

I have used homeopathic Apis with good results, one friend just tried it and it worked, her doctor said she would just have to suffer.

Well, I'm not an expert on this condition by any means. When I see it or suspect it, I consult with a physician. According to Williams' Obstetrics (yes, the one with copious amounts of male chauvinism and some very good information), it's an idiopathic (meaning they don't have a clue why) condition which appears to be genetically influenced as it is most common is some ethnic groups (Scandinavians and a particular group of Native Americans in Chile!). The bile acids don't get cleared properly from the liver tissues. There's no inflammation or overgrowth of liver cells, just stasis. Some researchers have recommended giving cholestyramine, a drug which binds bile acids and helps the mother excrete them, and others have found that it doesn't do much good and may disturb fat soluble vitamin transport. Some researchers have found more of an association with fetal demise than others. Some have found an increased risk of preterm labor. The recommendation in Williams' is that you induce after the fetal lungs are mature. I don't think there is enough data to know whether any particular herbal regimen would be efficacious. It's a rare enough condition that it would be hard to gather the numbers.

There are several conditions that can cause "pregnancy itch": papular dermatitis of pregnancy, prurigo gestationis, pruritic urticarial papules and plaques of pregnancy, and pruritis gravidarum. There are different lab tests that can be done to R/O or differentiate if a woman is suffering from any/or which of the above.

Papular dermatitis of pregnancy: will abate with delivery or during the early PP period; but may recur in subsequent pregnancies. Initial reports regarding an increased fetal loss associated with the dermatologic condition are controversial. It's a rare condition with unknown etiology.

Prurigo gestationis: also unknown etiology occurring 2% of pregnancies. Will spontaneously regress after delivery but may take up to 3 months and recur with subsequent pregnancies. No known associated maternal or fetal complications.

PUPPP: Unknown etiology that begins in 3rd trimester and slowly regresses during the 1st few wks PP. It's observed primarily in primigravidas and recurrence in subsequent pregnancies rare. There are no adverse maternal, fetal, or neonatal effects associated.

Pruritis gravidarum: Very common cause of pregnancy itch and due to intrahepatic cholestasis with the accumulation of bile salts. Jaundice may develop. There is an increased incidence of preterm labor and LBW babies with women who developed the cholestatic jaundice; but overall maternal and fetal mortality rates have not been affected by this condition. Regression occurs shortly after delivery.

I had a client last year that had the itch. Did all of the recommended labs, which didn't reveal anything. Benadryl, oatmeal baths, etc. did nothing for relief, she couldn't sleep. Referred her to an OB to make sure I wasn't missing something, but he couldn't figure it out either. She finally found something on her own that helped: Aquathor, looks like Vaseline and she found it at Costco.

My most recent client had what I think was PUPPP (Pruritic Urticarial Papules and Plaques of Pregnancy).  Violently itchy, she said she felt like she was going to go crazy it itched so much.   It looked just like the online pictures I found of it, seemed to fit the descriptions I've found.  So I tried her on dandelion root tinctured in cider vinegar that I had just decanted.  I was very lucky I made this tincture, as she will take no alcohol, even if you put it in water and let it evaporate, it is a religious thing.  I like dandelion root in vinegar anyway- seems to extract well, plus you can take it with oil on your salad, more fun than taking droppers full of it!  Anyway, after 8 days on it, her itchiness and rash went completely away!  She is thrilled and I am thrilled. Especially because the cases I've heard of with PUPPP, usually it doesn't go away until after delivery.  Granted, I'm not a dermatologist, maybe it was something else.  But it would be cool if women could take dandelion tincture instead of cortisone creams (and occasionally prednisone is prescribed) for this condition.  Might be a fun research topic.

For anyone curious, I used fall-dug dandelion root, tinctured in cider vinegar for 3 months (because I forgot to decant at 6 weeks).  Fall dandelion root is supposed to have a tonifying effect on the liver and kidneys, spring root is more of a cleansing action.  She took a dropper 3 times a day, noticed the rash lessening after day 3 or 4, rash and itching all gone on day 8.  If anyone has a client with PUPPP and decides to try this treatment, let me know how it works!

Also, the site I found with pictures of PUPPP is Dermatology Online Atlas.   It is pretty cool, they have pictures of all kinds of skin conditions, and also have a differential diagnosis page for each, where they list other conditions that are similar, with links to pictures of them.  It was very helpful in figuring out my client's rash.

Wishgarden Herbal Tinctures has a formula for liver strengthening that works wonders.  It contains motherwort, watercress, yellow dock and dandelion root.  Their number  is : 303-516-1803

I had success treating a client with PUPPP with Dandelion root tincture - a dropperful in some warm water 3 times a day.  Symptoms lessened by day 3, were gone by day 8 of treatment.  Dandelion has a tonifying effect on the liver, and PUPPP has been attibuted to liver problems in pregnancy, so it makes sense as a treatment.  Other treatment options are Benadryl, steroid creams and oral steroids.  Dandelion tincture sounds quite mild next to those, yes?  I've heard of people whose doctors induced them because they were going mad with the itching, and it usually doesn't go away until after the birth.  My client said it was 10 times worse than poison ivy itch.

I'm at 36 weeks gest and am dealing with (probably) the same.  I've been doing 8 hour infusions of burdock root, dandelion root, echinacea root and yellow dock root - 1/4 cup 4x/day.  I'm also on day three of treatment and it seems to be greatly improved.

I had severe puppps in my 34th week of my twin pregnancy.  Every book/article that I read, and my doctor said they wouldn't go away until after I delivered. I luckily found your web site, and your information saved me.  As recommended, I used the alcohol-free dandelion drops and the Aquafor lotion from Costco. They went away after 7 days. In addition, I also used the aveedo oatmeal bath soaks. Now, I find that my skin is dry, so I have been soaking in the Aveedo bath oil.

Tip for making an oatmeal bath: Toss a handful of oatmeal in an old sock or stocking, tie the top and chuck it in the bath water. Works like a giant tea bag and is a great way to get herbs etc. into the bath without gunking up the plumbing.

A woman on another list had this and said that she used Florasone homeopathic cream for itching and it worked really well for her.  So that might be worth a try.

I have a friend who also had PUPPP and she saw a homeopath.  She took apis mellifica.  Perhaps you have a homeopathic practitioner in your area.  The remedies are specific to the symptoms so a remedy for one person for the same disorder may actual be a different remedy for another person because the symptoms are slightly different for the same disorder.

Once I started wearing low cut undies and looser clothes so they weren't rubbing on my belly, it helped immensely, and the rash mostly went away. I have had a very itchy belly with all of my pregnancies, though, and as I recall, calendula cream helped to stop the itching.

I have found, at least for me personally, that pregnancy rash is associated with a lack of essential fatty acids in the diet.  While I am pregnant, my need for EFAs increases.  If I am not paying careful attention, I develop a rash that itches with an intensity that surpasses poison ivy (which I also have only had while pregnant).  To counteract this, I take either cod liver oil or flaxseed oil capsules.  The relief comes within hours.  I continue taking this for the remainder of my pregnancy and for a short period of time postpartum.

Externally I have used a pregnancy massage oil recipe from a book entitled Herbs and Healing by Kathy Keville.  It contains Vitamin E, almond or olive oil, cocoa butter and lavender for "scenting."  However, the key for me remains to increase my fatty acids. [Ed. - There is some concern that almond oil applied topically may be associated with preterm labor.] 

I was diagnosed with PUPPP at 20 weeks of pregnancy.  I was covered in the rash from my neck down to my thighs.  It was so itchy that I could barely function.  I could not sleep and was constantly bleeding everywhere from scratching so much.  My OB and my dermatologist said to take benadryl and steroid cream to help ease the itch.  They both also said that nothing could be done to get rid of the rash and that I would just have to deal with it until after I delivered.  Needless to say, The thought of 20 more weeks of hell and taking antihistamines and steroids were just unacceptable to me.  I saw a naturopathic doctor who related the rash to some extreme stress I had been experiencing.  She determined that my liver was weakened due to the emotional stress and sought to treat that.  Topically, I used calendula cream.  This was ok but then I switched to GOLD BOND lotion (found at any drugstore) which really worked well for me.  I was given homeopathic remedies, namely essential fatty acids (for the dry skin), Hepaticol (for the liver) and sulphur for the itch.  I took very small doses (a few drops under the tongue 3 times a day) for about a week and the rash COMPLETELY vanished!!  Strangely though, the itch lingered around even though the rash was no longer visible.  The itch eventually disappeared by around my 25th week.  I am now in my 38th week - rash and itch free.  Every day I am so grateful that I was able to get rid of the rash.  It was the most agonizing experience while it lasted.  So, my main advice, seek the advice of a naturopathic or a holistic doctor in addition to speaking to your OB and dermatologist.  It certainly worked for me!

I tried Benadryl and over the counter cortisone and had no relief.  I went to my doctor and was prescribed Claritin and Eloncon cream.  In addition I started taking colloidal oatmeal baths with baking powder and baking soda twice a day.  I stopped using anything on my skin except for the prescription cream.  I also changed detergent to Dreft and stopped using softener and dryer sheets.  The condition has definitely turned around and is much more manageable within in 2-3 days of the above changes.  I'm not sure what attributed to the change but I have noticed if I stop taking the Claritin or using the cream, the rash seems to come back.

As a GP and acupuncturist, I wanted to share that citrus fruits especially oranges can significantly aggravate PUPPP, as can other acidic foods.  And acupuncture is very effective at relieving itch!

I was diagnosed with PUPPPs in my stretch marks at 28 weeks.  At 34 weeks it had spread to the rest of my body, and by 36 weeks I could not sleep at all.  Realizing that the steroid creams and antihistamines weren't helping, I started to look for other solutions.  I tried patch tests with every lotion, cream, and ointment I had in my medicine cabinet.  Most creams and lotions provided some relief for an hour or so, but to my surprise, Miconazole made a lasting difference.  I never would have associated PUPPPs with yeast because I'd never seen such a thing on my skin.  It made sense though-- I'd been craving yogurt for quite some time, and yogurt is great for yeast infections.  Plus I realized that the rash had started just two weeks after I'd been put on an antibiotic for Strep, and I only get yeast infections when I've been on antibiotics.  Anyhow the rash cleared up right away. I ran out of miconazole, but I'm still using lots of yogurt and am also taking dandelion root.  Even rubbing plain yogurt on my skin makes it feel better.  I hope this solution will help others as much as its helped me.  [If you also find a connection between taking antibiotics and developing PUPPPs or other indications that it's related to yeast, please send me feedback.  Thanks!]

I am 20 weeks pregnant and have been diagnosed with PUPPPs.  Started taking prescription antihistamine this weekend and finding some relief.  Rash started about 1 1/2 weeks after taking a large dose of antibiotics for a teeth cleaning.  I have a heart condition, mitral valve prolapse which requires antibiotics during surgery or when bacteria can enter my system.

I am suffering from PUPPP at 39 weeks. It began about 1 1/2 weeks ago in my stretch marks & has spread to my arms, back, breasts & upper thighs. I have been prescribed chloropheniramine tablets & hydrocortisone cream to relieve the itching. They are not working (& I don't really like taking them, preferring to avoid drugs). Neither are calomine lotion or calendula cream. I took a course of antibiotics/penicillin 2 1/2 weeks
ago after a cat bite. This condition began at the time the course finished.

I developed PUPPPS in my 17 week (only a few spots, here and there at first. I thought it was flea bites).  Now at 22 weeks I have about 30 spots spread all over.  My OB/GYn diagnosed it as PUPPPS.  I had taken antibiotics twice before my pupps started.  Although I have rarely had bladder infections in my life, when pregnant the first trimester I got two bladder infections.  After the second bladder infection the Doctor prescribed antibiotics (I don't remember which one). I thought I took my antibiotics much earlier before my Puppps started, but when I just went back in my calendar to look, my antibiotics were prescribed on May 8 for seven days, the pupps started around May 14 or 15!

I just wanted to say that this website was a life saver for me.  I got your link from my sister-in-law's sister-in-law after I came down with the horrible rash.  My midwife told me that this rash is just something that some pregnant women get and some don't.  Also, that there was nothing that they could do for me other than keep me comfortable and that it would probably spread to my thighs, arms, etc.  I tried everything!  Cortizone cream, gold bond, calamine lotion, corn starch, baking soda, cider vinegar, oatmeal baths, benadryl, zyrtek and anything else that anyone would suggest to me.  I finally started taking dandelion root last Monday.  By Tuesday night I had already started noticing the difference.  Now, exactly one week later, the rash is now a very light pink and doesn't itch anymore.  I cannot emphasize enough how much I appreciate knowing this information.  I missed two days of work because of this rash and three nights of sleep.  I actually was considering calling my midwife to see if I could be induced.  I am so glad this information was sent to me.  My suggestion--start taking the dandelion root immediately.  I take two pills, three times a day.  You will notice the difference within two to three days after starting the pills.  Good luck!

I have had violent, itchy PUPPP for most of my 3rd trimester. No over the counter or prescription has worked to rid me of it, from corticosteroid to caladryl. Any topical treatment would work for a night or two, then lose effectiveness. Sarna, a lotion from the drugstore, numbed it, but lost efficacy. Ice packs helped a bit.

Finally something did help more deeply: acupuncture. In tandem with acupuncture, modify the diet to lots of melons (waste removal/filter aids) and NO fried foods, or foods that generate heat, such as onion and cayenne. The idea with the acupuncture is to liberate stagnant energy so that your immune system can handle the fetal cells causing the allergy. The idea with diet is to untax your digestive system so your immune system has more resources to do its job.

Acupuncture helped to: relieve the depression, remove the burn-like patches of red, raised welts all over my legs, and alleviate the itching. But after I stopped, PUPPP returned, albeit in a weakened state. The rash presents less contiguously, more patchily and the itch is not quite as violent (not itching till I bleed, e.g.), though still there.

I've had an itchy back (with no rash) and an itchy neck (with rash) since early in pregnancy but have only in the last couple of weeks (currently at 30 weeks) developed a rash on the inside of my forearms. I was prescribed an antibiotic a couple of months ago and since then have had thrush despite treatment.
I had thought the two unrelated but perhaps they aren't. I've also noticed that the rash on my arms has become worse as I stopped taking linseed on my cereal as the dairy was not advised with iron tablets.

Sleeping Difficulty / Insomnia

NOTE - Caffeine normally has a half-life in plasma of 3-7 hours; this increases approximately twofold in women who are in the later stages of pregnancy.  If you find yourself having more difficulty sleeping later in pregnancy, you may need to reduce your caffeine intake by at least half or move it to earlier in the day.

Maternity Air Bed - has a central air pillow to allow women to sleep on their stomachs!!!  It's supposed to help with hip, back and abdominal pain as well.  [I don't know anyone who's tried this, but it looks interesting.  If you're able to try it, please send e-mail feedback to ronnie at gentlebirth.org.  Thanks.]

Pregnant and struggling to sleep? Read on….. [9th February 2016] by Maggie Howell   

A brief scale IDs sleep-disordered breathing in pregnancy [5/30/14] - studies suggest that the use of continuous positive airway pressure (CPAP) can reduce the risk of preeclampsia in pregnant patients with sleep-disordered breathing.

Why Women Have More Problems Sleeping Than Men - lots of good sleep tips from Dr. Mercola

These can be more expensive, but beds with individually wrapped coils will keep one person's movements from disturbing another; this is especially helpful for the dad in the postpartum months, when mom is moving around at night to nurse the baby. \

Some insomnia can be caused by a slightly elevated blood pressure, especially during late pregnancy.  Magnesium is almost always helpful in pregnancy; it can help relieve spastic uterine contractions, leg cramps, constipation and insomnia.

Late pregnancy trouble falling asleep can be caused by elevated blood sugars.  If you're checking your own fasting blood sugars, notice the association between sleep and blood sugars.  Otherwise, you could try a few days of lower-carb nutrition and see how that affects your sleep.

Peaceful Sleep Now CD from HypnoBabies

Dr. Mercola's Guide to a Good Night’s Sleep.

DO'S and DON'TS for poor sleepers

Dr. Susan Lark used to offer a Muti Spritzer Oil called Peaceful Night. "This calming, tranquil blend of lavender, chamomile, orange, and other essential oils will help relax and soothe you before bedtime.  Just spray the oil a few times on your sheets, clothing, or skin. Then close your eyes while the soothing smell enters your nasal passages. Take deep, calming breaths as the scent travels through your limbic system to your brain where it helps you feel deeply relaxed."

Natural Sleep Remedies

Sweet Dreams!  Getting a Good Night’s Sleep in Pregnancy - a homeopathic approach


SleepNet's Sleep Link Reviews

Homeopathic Coffea Cruda helps a lot of people and is fine for pregnant women; it really calms the mind.

I have had success with a couple of things.  Passion Flower capsules (help to calm the hyperactive mind) and then a combo of skullcap and california poppy (both in tincture form by Herb Pharm).  I take a 1/2 dropper full of each (skullcap and poppy) to equal 1 full dropper.  I take a full dropper of each if I feel really wound up.  Coffea Cruda has also helped a bit, but I think I have most success w/ the tinctures.  Acupuncture can also help and there are particular spots that help w/ sleep.

Extra padding underneath you can really help.  If you can afford a really high-end bed like a Duxiana . . . great.  A more moderate solution is The BedCozy Cuddle Ewe Underquilt™ - a wool mattress topper.  Or you might want to try a relatively inexpensive Visco-Elastic Comfort Zone® Mattress Topper and Pillow, along with a  Contour™ Leg Pillow , although you should know that these "memory foam" products, as with many other foam products, are made from urethane or polyurethane, which can cause health problems. (I would avoid these completely during the first half of the pregnancy, and stop using them if you notice any ill effects.).  Or you could just use a sleeping bag that adds extra cushioning underneath you.

Acupressure point for insomnia - Place the index and middle finger of your left hand on the inside of your right wrist, three finger-widths below the crease of your wrist.  Do this while you are seated comfortably.  Press gently and hold this position for up to 3 minutes, and then release. Switch hands and repeat.

Have her take a couple cal/mag citrate before bed. It's worked wonders in the past.

For women who are waking to empty their bladder in the middle of the night, they might try taking a warm bath right before bed.  This will move some of the fluid out of their tissues and help them get rid of some body fluids before they fall asleep.  During the night, some of the fluid that would otherwise end up as urine will migrate back into the tissues instead.

last time i had a client with insomnia  it turned out her diet was way too low in protein.  have her keep a food diary and comment on the nights sleep.  also could be a food allergy.

I love Valerian for sleeplessness, but even moreso, I love this homeopathic combination tonic by Boericke & Tafel called...ALFALCO.  Ah, it is wonderful for sweet slumber without that drowsy feeling that too much Valerian can give.

I think lavender oil is just great...esp if it follows a turkey sandwich, glass of milk and banana. If I had to choose just one, though, I'd choose the lavender oil (apply liberally to wrists, face, neck.)

I always recommend this sleep remedy to my pregnancy moms:

1 cup milk
1 t vanilla
1 t sugar

microwave or heat until warm. Tastes like a warm milkshake and my little boy used to always ask for this "special medicine" on Christmas Eve when he couldn't get to sleep because the thought of Santa Claus was just too much. It really tastes pretty darn good.

She might try a cool (not hot) drink of Chamomile tea (sweetened slightly if she likes) followed by a warm/hot bath with 3 drops of lavender essential oil added to the water while it is running, finally followed by a wonderful relaxing full body massage from her lover with a massage oil/lotion ratio of 1 part oil to 2 parts lotion with 3-5 drops of lavender and/or 3-5 drops (for a total of no more than 8 drops if mixed or 5 if single) sandalwood added to the mix (shaken very well to mix it completely).

She might also consider making a dream pillow containing 1 drop each of lavender, chamomile, and hops or valerian each put on a separate cotton ball and put into a small pocket of cloth placed under the pillow.

A great synergistic blend for exhaustion during pregnancy according to "The Complete Book of Essential Oils and Aromatherapy" by Valerie Ann Worwood is equal amounts of each of the following oils Lavender, Grapefruit, and Coriander for no more than 6 drops total for use in a bath, 5 drops total in 2 tsp. of cold pressed vegetable oil (grapeseed oil is the best) for an individual body massage, or 4-5 drops in a bowl of hot but not scalding water for a foot bath.

The previously mentioned book is an excellent resource for aromatherapy oils and their uses. It even has a section (Chapter 10 I believe) devoted to pregnancy, childbirth, labor and postpartum aromatherapy care.

You can also put lavender oil on the eye lids or make a sleep pillow out of hops, chamomile and lavender flowers - it smells great and it contains all those relaxing herbs. I have also used a homeopathic remedy called calms forte by Hylands which really seems to help me and my husband both get a good night of sleep when we really need it. All of this should be safe during pregnancy.

Benadryl can cause stimulation instead of drowsiness in certain individuals, but has few adverse side effects and is generally a safe and effective choice.  However it is not known to be completely safe in pregnancy.  Here are some precautions.

If insomnia during pregnancy is new for you, it might be that your liver is having trouble processing all the increased progesterone of pregnancy, which may be revving you up and making it harder to sleep.  Milk thistle can help with this.

Varicose Veins

Varicose Veins [Medscape registration is free.]

I can't find the article, but new evidence suggests that diabetes causes low-level inflammation in the lining of blood vessels.  I have observed that moms with bad varicose veins are more likely to have blood sugar issues.  Even if you pass your gestational diabetes screen with flying colors, it's still possible that you're not metabolizing other types of carbohydrates well or that your eating patterns or lifestyle are causing elevated blood sugar levels.  I recommend that all my clients test their own blood sugar (fast and post-prandial) for two days every month in the last four months of pregnancy.  I would especially recommend this for someone with significant varicose veins.

From an ADW Diabetes Newsletter: People with diabetes are more prone to blood flow problems known as peripheral vascular disease and nerve ending issues known as neuropathy. Excess glucose creates damage to the blood vessels and nerves especially the smaller vessels and weakens the veins. Although there is no direct link between diabetes and varicose veins, many people suffer from these conditions simultaneously.

Reviva Labs Private Label offers varicose veins prevention lotion.  Does anyone have any experience with it?  Does it seem to help?

Varicose veins can develop during or be aggravated by advancing pregnancy. Homeopathic Millefolium is one treatment option that will minimize the appearance and discomfort of varicose veins. [Note: Most homeopathic remedies are safe to take during pregnancy.]  For other tips on homeopathics for pregnancy, nursing and newborn care, see the EMAZING.com archives of the Homeopathic Health Tip of the Day

Women with varicosities of the vulva can birth their babies just fine.  The enlarged veins just seem to move aside for the baby. The discomfort before the birth is the main  concern.  Vitamin E --800 I.U. per day is well advised to be taken orally.  Find a high quality brand with natural D-alpha tocopherol in a health food store.

For clients with bad varicosities, I recommend lots of bioflavonoids and low-dose aspirin (a  baby aspirin or one adult tablet per day), especially if they're noticing any lump!

One of my clients started having pain/slight inflammation and engorgement of varicosities of the lower vulva/lower buttocks.  Now superficial veins very high in posterior upper thighs becoming engorged.

Have her reclining head down/reverse trendelenburg incline 2-3 times daily, also some knee-chest to get baby up a bit higher.   Avoiding crossing legs.  Tried compression/biker shorts but seemed too uncomfortable.  Not constipated, warned not to become so.  Warm sitz baths.  Extra vit. E and C.

Have seen vulvar varicosities, before, but these in lower buttocks new to me. When they first occurred were red, sl inflamed, responded quickly to extra reclining.  Concerned how else might help discomfort.  Client's mom got relief for her varicose veins in her legs via acupuncture, and I know a reputable clinician that we might try.  Plan NOT to squat for birth!

I have moms use topical witch hazel on varicosities that are easy to reach. Also Hamamelis 12x homeopathic ( homeopathic witch hazel that can be used internally) can be used through out pregnancy. Hamamelis herbal tincture( by mouth) in the last few wks of pregnancy. Also I highly encourage these ladies with ANY varicosities to use a good belly support-{ there are only a few I recommend} at 20 wks on. I have used these methods for many years and have always seen much improvement.

ps. Hamamelis works great for PP hemorrhage

Co-Q10 is a metabolic enzyme good for anything vascular, including heart or muscles, and especially varicosities. Available at Health Food Stores or Trader Joe's. Get the yellow-colored kind.

Nature's Way (easily found in any health food store around here) now has a product called "Leg Veins" which contains horse chestnut and all the other things mentioned as being helpful for varicosities. One of my clients recently brought in a bottle to find out if it was ok. She was happy with it and I have been just starting to recommend it. I am happy to have a product that people can easily find and use. I used to tell women about Rutin and Horse Chestnut, but I had no info on how to take it or how much.

Soaking in a warm bath until they soften and can be repositioned. Then a good cream - like prep H or comfrey/cod liver oil (the cream/oil helps stool to slip out without dragging and damaging tissue).

I had the beginnings of one varicose vein at about 28 weeks...you could see it and just feel it coming above the surface of my skin.

I started taking lots of antioxidants: grapeseed extract 800 mgs per day and vitamin c 3000 mgs per day...also flax seed, about 6-10 capsules per day. Antioxidants and bioflavinoids (someone had mentioned rutin) are supposed to promote tissue integrity/strength of connective tissue...veins would be included in that...as would skin, etc.

The little vein that was trying to make an appearance went away, no others have popped up.......nothing scientific, just my "study of one"

rutin - part of vitamin C complex, supposed to strengthen vein walls.

Have a 30 y.o p3 g2 who is experiencing varicose veins for the first time. She is quite concerned. In researching helpful ideas I spoke to alternative doc who recommended collinsonia root caps from Standard Process. In looking in my books I found a source that also recommends it highly for v.v. but it says that it is a mild diuretic. Does anyone know if it is truly safe in pregnancy. If it were for a short term use like Uva Ursi for UTI I would not be as concerned as for long usage for this particular situation.

I like garlic and white oak bark. The garlic is taken orally and the white oak bark is a decoction "bathed" onto the varicose veins.

I had a woman a number of years ago who had terrible varicosities. During her pregnancy we put her on the following

She did fine through pregnancy and delivery but afterwards she did not rest enough and developed thrombosis in one thigh with a very red hot spot. We put her on bed rest, used compressed with ginger and also did ultrasound treatment to the area every day and then every other day. This is what really helped. We also upped her Bromelain to 4 times per day and gave her Optibiotics ( immune support)

We've had good results with Butcher's Broom.

You take tinctured witch hazel internally about 20-40 drops daily. It is good for vulvar varicosities and hemorrhoids also. It is tinctured from witch hazel bark. Is very effective.

M. J. Hanafin RN CNM. C Hom. recommended in her workshop at the CAM conference that you could use Hamamelis 200c for varicosities, as well as for hemorrhoids and hematomas.

I have used Bellis very successfully for varicosities in pg. They do need to have matching symptoms. I have had several moms with bad v.v. and have none whatsoever now. One mom 42 has battled with them all her life and of course increased trouble in pg. the problem was not only remedied but cured her hemorrhoids too. Since the birth has had no sign of returning problems. I would just encourage people to try to find a homeopath and use an LM pot. I am using almost exclusively LM pot. in my practice they have almost immediate results and they are less likely to be proven

I suggest the following: drink lots and lots of oatstraw tea, use witchhazel compresses and do lots of hands and knees pelvic rocks, especially before bedtime, to ease the pressure on the leg veins.  Hot vinegar washes to the legs also help.

Compression Stockings

You can shop for compression stockings on the web.  Delasco has them; I'm sure others must, too.

Constipation and Hemorrhoids

Diagrams of hemorrhoids

Women suffering from hemorrhoids need something to smile about, so here, for the first time ever in my web pages, we present

St. Fiacre, the patron saint for hemorrhoid sufferers.

Of heliotropes and hemorrhoids. St. Fiacre, patron saint of gardeners and hemorrhoid sufferers.
Bonello JC, Cohen H, Gorlin RJ.
Dis Colon Rectum. 1985 Oct;28(10):702-4.
During the Middle Ages, an integral part of the therapy for certain ailments included supplication to "patron" saints for possible divine intervention. Through legends surrounding his life, St. Fiacre, a 7th century Irish monk, has become the patron saint for hemorrhoid sufferers.

Hemorrhoid Treatment from Gloria Lemay

Hemorrhoids are often caused by chronic constipation, and it is almost impossible for the hemorrhoids to heal until the constipation is relieved.

My favorite remedies are:

high-grade vitamin C (avoided in the first trimester because of the theoretical possibility of miscarriage), taken "to bowel tolerance".  This can be up to 5000 or even 10000 mg per day.  There is no possibility of overdose as your body will simply excrete the excess.  Start with 2000 mg per day and add an extra 1000 mg per day until you achieve the desired results.

magnesium oxide - this is probably the best remedy for women who are also having a lot of charley horse pains or frequent, painful Braxton-Hicks contractions in late pregnancy.  Magnesium is a muscle relaxant; magnesium oxide is a form that is not well-absorbed, so it ends up in the target area to relax the bowels.  You can start with 400 mg per day and increase as needed.

Maltitol is a non-intoxicating sugar alcohol used in sugar-free treats.  When taken in moderate amounts, it tends to cause loose bowels; when taken "in excess", it can cause diarrhea.  Low-Carbohydrate Nutrition in Pregnancy lists many treats containing maltitol.  You might want to avoid this until 36 weeks if you're at risk of pre-term labor, as it could theoretically increase prostaglandins, hasten the ripening of the cervix and initiate labor.

For persistent hemorrhoids, it's worth getting a specialized ice pack.  The Hemorr-ice is a small, rigid plastic device filled with that "blue ice" cold gel stuff.  You store it in the freezer in its own container, and it's ready for use as needed.  It's about a half inch in diameter and is inserted about two inches.  It works wonders to relieve the pain and discomfort and seems to work better than anything else in reducing and resolving the hemorrhoids.  I recommend using it before bedtime and after moving the bowels.  It's more comfortable when used with some kind of KY Jelly or personal lubricant.  (Hemorr-ice can be ordered from Dr. Leonard's catalog - 800-785-0880 - item #7504.  The cost is around $12, plus shipping.)

"Hemorr-Ice® - Not a suppository...not an ointment...but a new, clinically tested method of treating hemorrhoids with cold therapy. Hemorr-Ice® has a special cooling liquid sealed inside so it acts like an ice pack. Simply apply the chilled inserter for two to five minutes. Hemorr-Ice® shrinks the blood vessels... reduces bleeding...and promotes healing of inflamed tissues. Provides fast relief from pain, itching and bleeding. Safe to use, as often as desired.  I generally recommend that my clients use it after moving their bowels, since the strain pushes blood into the varicosed veins and stresses the delicate vessels; the sooner you relieve this situation, the better.  Then again, use it before bedtime . . . reducing the swelling before you lie down really increases the healing bloodflow while you sleep."

There are a couple of similar devices -  Anurex and HemorRelief.
Anuice claims to be FDA Approved Medical Device for Hemorrhoid Treatment.  It has an interesting "cold reservoir" that probably improves the comfort and effectiveness of treatment.

The Ultroid(TM) technology ensures safe and effective   hemorrhoid treatment. It has been clinically proven to be effective in treating grade I-III and some grade IV internal and mixed symptomatic bleeding or prolapsed hemorrhoids. The non-surgical procedure is simple to use, well tolerated and requires no sedation or anesthetic.

Squatting Platforms for the Toilet

Squatting platforms allow you to move your bowels in a squatting position over a regular American toilet.  The squatting position straightens out the rectum and can relieve constipation and hemorrhoids.

Here are some squatting platforms:

Nature's Platform(TM )

The Lillipad

And much, much more on the Internet:

Swimming can really help.  The buoyancy gets the baby off the blood vessels and the movement really increases circulation for faster healing, and the water pressure helps shrink the hemorrhoids.  The cool water can really feel good, too!

I've heard rave reviews about HerbLore's Hemorrhoid Salve - very healing and calming.  This will help relieve the pain and shrink the hemorrhoids.

Earth Mama Bottom Balm - "This healing salve helps relieve itch and shrink swollen tissues of prenatal and postpartum hemorrhoids and helps speed healing of postpartum vaginal bruising."

Witch Vera Cooling Gel Witch Hazel & Aloe Vera combined to soothe, cool, tone & calm, dry irritated skin.  From Dr. Kowalski's, am-products.com, springvalleyherbs.com or search for other sites.  "This curbed my bleeding hemmorhoids in a couple applications. Best of all, it's quick and easy to apply."

Chia seeds are also a great source of fiber and omega-3s, and they help with heartburn!. [from Nutrition - Chia - ... far more than just a furry green "pet"!]

I emphasize to my clients that constipation can be a chronic problem in pregnancy and they have to stop thinking about sporadic ways to deal with it.  Chronic constipation can only be effectively dealt with by long-term, daily habits to promote normal stooling, not just trying something to fix every episode of hard stool.

The basics are:

1) You have to have enough fiber in the diet DAILY - EVERY DAY - to hold water in the stool and keep it soft.  The bulk also helps with peristalsis.

2) You have to be drinking enough water so that the fiber can do it's job.  Many women aren't drinking enough even with enough fiber.  Other women drink a lot, but don't have enough fiber.  You have to do BOTH.

3) You need to MOVE your body to promote active peristalsis to move intestinal contents along.  Progesterone works to slow passage of food through the intestines for maximal absorption - unfortunately, the longer food hangs around in the intestines, the more water will be absorbed.  Regular exercise helps to prevent peristalsis that is overly sluggish.

All the suggestions so far have been great, but there is no quick fix that will last more than a day.  Clients have to put themselves on a daily program of fiber/fluid/exercise and stick with it for the pregnancy.

I have had good success with adding magnesium supplementation, either in the form of Mg rich foods (alfalfa sprouts and the like) or in a supplement.  I would also ask if the woman is using a lot of calcium or iron supplements - sometimes decreasing those will help a lot.  Also when we switched our standard PNV rx to one that includes EFAs our pt c/o constipation went way down.

For some women, drinking hot tea or even just plain hot water will help to get the bowels moving in the morning.

Most pregnant women are taking increased calcium supplements, which help to grow a healthy baby.  Unfortunately, if your calcium isn't properly balanced 1:1 with magnesium, you may be suffering from a magnesium deficiency.  Low magnesium causes increased levels of adrenaline, which can lead to constipation.  You can read about Calcium and its Relation to Magnesium - great explanation of the importance of balancing calcium with magnesium.  Peter Gillham is also the creator of MamaCalm, which is helpful for pregnant women who are experiencing anxiety, constipation or muscle cramping.

I used to recommend licorice to help loosen up stools.  I no longer make this recommendation, based on the BBC's Warning on liquorice in pregnancy.

"I have struggled with constipation and 'roids' for most of my life. My mom said I was born constipated. I have had the unpleasant problem of a compacted bowel.

"One thing that really works for me is using flax seed oil. I take 1 tablespoon in the am and 1 Tablespoon in the pm. I put a Tablespoon of the oil in my mouth and then a big sip of juice and swish it in my mouth to mix it and then swallow. I could not handle the texture otherwise. It does not have a strong flavour. It works like a charm and if I missed a dose my BM's would get a little harder. Also try to do things you would normally do standing in a sitting position. I would pull up a stool to the counter when preparing dinner. Walking helps too ( not to be confused with standing still ). I also found it helped to NOT push. I waited till my bowels were ready to do most of the work themselves. This meant that I would have to relax, read a little, maybe some music : )." -A.L.

Buy "grey" salt at the health food store and salt your food to taste.
Drink plenty of water every day.  Lots of roughage to have big b.m. every day.
One whole cucumber eaten every day.
Lots of high quality protein.
Brisk walk that gets your heart pounding.
Extra rest and baths.

When i had them during my pregnancy, i followed my midwives' advice:  i soaked a washcloth with witch hazel & wrapped it around ice cubes then applied this to the area for about 10 minutes (i did this 2 or 3 times total).  then, i rubbed olive oil on it and tried to push it back it (i don't think it worked), mostly just after showers.  i also took flax seed oil capsules, one twice a day.

I also took some advice from dr. bradley, which involved using something to raise my feet up while having a bowel movement.  i just put a shallow rectangular plastic bucket (about 6" - 8" high) on the floor in front of the toilet and put my feet up on it, so that my knees were closer to my chest.  (he recalls a story in his book about people in india not having any history of hemmorhoids, and their "toilets" are not raised up off the ground -- they're literally holes in the floor.  he -- and a doctor from india -- believes that this is the "natural" position we're supposed to eliminate in, and getting our feet closer to our butts essentially puts us in a more optimal position for the appropriate muscles to do their jobs properly.  having actually done it, i'd have to agree that it's really more comfortable on the sphicter muscles.)

i followed all this advice and they went away -- BEFORE the birth.  it took only a couple of weeks.

Get those bowels loosened up, even if she has to take stool softeners (better than painkillers).  Increase water and fruits and veggies.  When she eats cheese she must eat it with applesause and 8 ozs of  water.  Lots of water during the day.  And walk everyday.  Doesn't  have to be far but she must leave the house and walk.

If you’re having trouble moving your bowels, try pressing your left hand against the outside of your right knee while pushing outward isometrically.  This contracts internal muscles to help move the bowels.

Magnesium citratealso helps by loosening the bowels...

My holistic doc recommended supplements to boost the liver (Standard Process) and increased my calcium/magnesium (2 to 1).

Vitamin C with bioflavonoids (Natrol Ester-C is a very good brand, priced moderately). I also take the Source Naturals proanthocyanidin, but I cut back to 100mg bid.  In the last few months, I added rutin to the mix, started at 50 and now up to 200mg qd (once). This, combined with a
topical cream containing horse chestnut (a noted supplement for correcting venous insufficiency) usually do the job. An added benefit of Vitamin C is softer stools.

Homeopathic hammemalis (sp?)-which is homeopathic witch hazel.  It's the only thing that ever worked for me, and sometimes for others.

4x4's soaked in witch hazel and applied, gingerly.  She could also soak a menstrual pad, after sticking it on her panties in the right position, with witch hazel, or use a cloth menstrual pad over a commercial one (the commercial one has the plastic liner to keep her panties from getting wet).

Drinking LOTS of water and eating a very good diet-high in greens and complex carbs, -to keep constipation to an absolute minimum, because any straining will aggravate the situation.

Regular exercise-in a swimming pool if walking on land has gotten to be a bit much with the weight of her belly.

Seems like I remember nettle infusion (very strong) being helpful as well.   And it tastes wonderful!  (my opinion)

Constipation is common in pregnancy due to the relaxing effect of progesterone on the entire gastrointestinal tract. Iron supplements often add to the problem. The condition can be helped by increasing your water and fluid intake, drinking fluids higher in fiber [prune juice, apple juice, vegetable juice] and eating a diet higher in fiber. To prevent straining and hemorrhoids, keep a small step stool [like a nursing stool] by the toilet to put your feet on so your knees are higher than your hips. When having a bowel movement, release the pelvic floor, sit up straight, and block the diaphragm by holding your breath...don't strain..just hold your breath.

Nature's Way Aloelax is a good, simple formula for constipation during pregnancy. Naturalax 3 is a good formula for severe constipation during pregnancy, especially if you're also having some nausea, as it contains ginger, peppermint leaves and red raspberry leaves.  [DO NOT TAKE Naturalax 2 while pregnant!]

Naturalax 2 is terrific for postpartum constipation - it contains herbs to support contraction of the uterus to prevent postpartum hemorrhage and herbs to support breastfeeding.  [NOTE - This formula contains goldenseal, which could cause preterm contractions, so do not take Naturalax 2 while still pregnant!]

If you have hemorrhoids washing after each time you go to the bathroom with a baby wipe with aloe eliminates the itching and burning. There is no way to prevent a small amount of stool sticking to the tissue when cleaning with dry paper. A bidet (Who's got one?) is wonderful but usually not available.

Another tip: If they swell and just wiping doesn't relieve the itching/burning get a potato, wash and grate some making sure there is some peeling in the 1 1/2 inch pile about 1/4 inch thick in the middle of a paper towel. Twist the place where the potato is making a small pouch, turn over so the single side of the towel is next to the rectum and put your panties on. The rest of the towel will catch any liquid.

We always recommend the "tuck and elevate" routine for bad hemmies. After a bowel movement, she needs to lie down and elevate her hips on
some pillows for 30 minutes (relieves pressure on hemmies).  It is also very helpful to just tuck the protruding little (or big!) ouchies back inside the anus with a finger.  This "tuck" combined with the hip elevation has been very successful with our moms.

Have you tried arnica?  Epsom salts baths?  I assume she has good pelvic floor tone and does regular Kegels (with the hemorrhoids tucked in, of course).

cold compresses
comfrey compresses (cold)
elevating the hips
cetacaine gel (did not make a dent in the pain)

I would advise this mother to see a doctor asap if she can't sit to urinate. He will allow her Prep-H, in the meantime she can try:

What will a doctor do, most likely prescribe her a medication to reduce the swelling.

few essential oils to add to the bag of tricks for piles...

cypress  }  contraindicated in pregnancy but have included them anyway as
juniper    }  they can be effective postnatally or in gyn care.

frankincense (ok for pregnancy)

can all be used, either in a massage oil (diluted) applied locally, or in the bath.   they help by improving the circulation generally and locally.

also, hope i'm not repeating anyone else here, but garlic (in the diet and / or capsules) may help.

our potato recipe;  grate half a small potato (fresh - don't be tempted do a load and save it in the fridge) and apply it locally.   can be kept in place with a bunny - the old-fashioned type which come with a belt are quite useful for this - tuck another one in behind the first to stop potato falling into underwear.  seem to shrink some piles - i think they "draw inflammation out" somehow.

also, witch hazel (which i know was mentioned already)  can be poured onto one of those round cotton pads you can buy to remove make up and kind of tucked in between the cheeks, where they usually stay in place.   these can be made in a batch and kept in a plastic container in the fridge - usually feels better if cold.

Try a sugar slurry. Sugar mixed with water whisk into a "slurry", kind of thick. This was recommended by a midwife/naturopath to me for a postpartum mom once. She was in major pain and had tried everything. The poor woman would get in the knee chest and have a sugar slurry applied to her bottom. 

Also homeopathic Kali carb.

Some of my clients have found that witch hazel compresses help.  Others have smeared honey on theirs with great relief.

One of my clients said to use pureed eggplant (raw) as a poultice or slopped on a pad and "mushed" onto the hemorrhoids.  She swears it was like a miracle drug.

Don't let her get constipated.  Hard stools aggravate (or cause ) the problem.

  1. Lots and lots of water so that her urine is clear and her stools are soft
  2. High fiber diet - Bran cereal for breakfast every day.  Raw fruits and vegetables (like carrots and celery - chewed well)
  3. Colase 100 mg po bid (if needed for soft stools)
  4. Anusol HC rectal supp or cream,  Or Proctofoam HC, also bid prn (the HC reduces swelling)
  5. Cold tucks
  6. Sitz baths.

Have you ever tried "bentonite clay"?  I have seen it work wonders in a very short time.  A client from years ago got a hemorrhoid as big as a child's  fist!  I'd never seen anything so huge!  She couldn't sit down, and of course,  as you said, it was extremely painful.  She went to the doc, who talked about surgical removal, gave her all sorts of creams and pain relievers, etc.  In the meantime, I had talked to another client who worked at Whole Foods, and she told me about Bentonite Clay, and brought me some.  I gave it to my uncomfortable client, and within a week, it was almost completely gone!  We were truly amazed!  She went back to the doc after the birth (hers also happened about 34-36 weeks), and of course he didn't believe the clay had done it.  She used it externally, made into a thick paste, and internally, mixed in with some juice.  Give it a try...

Ladies have reported that tea tree oil feels great on hemorrhoids.

I like to use Cetacaine on hemorrhoids if they are painful during labor.

As the sorry owner of once thrombosed hemmies, I would say she should get in and get them poked.  There really isn't anything in the world that hurts as bad, and even though the lancing is excruciatingly (sp?) painful, the relief is so blessed when the pressure is gone.  So what if it feels like you are pooping razor blades for a day or so.  It still feels better than having that dang clot in there.

I have done it on a pregnant woman, actually, it was my sister.  You just spray the area for about 30 seconds with ethyl chloride until if freezes, while holding the scalpel at the ready.  Then you make a 1/2 cm cut and the clot squirts out.  Then sitz baths like crazy.  All the potatoes in the world won't help a thrombosed hemmie.

Pregnancy Support Systems

BabyHugger - Fine Maternity Supports by TrennaVentions, Inc.

Undergarments for Relief of Back Pain and Vulvar Varicosities

Prenatal Cradle

Vulvar Varicosities

See also: Pushing with Vulvar Varicosities

Fembrace - A revolutionary new support garment for relief of the painful symptoms of Genital  Prolapse (Prolapsed Uterus, Cystocele, Rectocele, Enterocele) and Varicose Veins of the Vulva (Vulvar Varicosities).

The V-brace™ by Fembrace ® is a support garment for women who are suffering from the painful symptoms of Genital Prolapse and Vulvar Varicosities. Genital Prolapse is a general term that includes Uterine Prolapse, Cystocele, Rectocele, and Entrocele.  (877) 535-6800

Prenatal Cradle also makes the V2Supporter - a support for vulvar varicosities.

Undergarments for Relief of Back Pain and Vulvar Varicosities

I have a patient who is 24 weeks pregnant with severe vulvar varicosities. They are increasing in severity, and the patient is extremely uncomfortable. Does anyone have any suggestions about what I can do to help her now, and what I can do to prevent serious complications at delivery? I've never had anyone with such extensive varicosities in the vulvar region.

I have a similar patient, though she is now 32 weeks. We have had some difficulty in controlling her discomfort. The only thing I could find in a text was the suggestion to cut a firm piece of foam rubber to be placed in her underwear to apply pressure onto the varicosities. This did not work as well as simply using a large sanitary pad, though that did not work all that well either. Reducing her activity and standing up time did the most.

My source (William's) went on to add that my biggest fear, i.e., uncontrollable bleeding at delivery, was very rare. I sure do hope so, because some of those suckers are as big around as Number 2 pencils. I am not too much help, but at least you're not alone.

I was the varicose queen during my last two pregnancies. Bulbous, painful, throbbing, road -map type veins, from my vagina down to my mid thigh. For my 4 th baby when they started really bad I worn compression pants all the time (about the 4th month on). They look like the 80's type biker pants but are made with really tight lycra/spandex/elastic like material. You can find them in sporting goods stores. I even sewed in a panel so I could wear them to term. They helped a lot!

With my fifth (and going to a midwife) she suggested White Oak Bark capsules. Now THEY were a life saver. I took about 4 capsules a day and in acute times (on my feet a lot, sitting to long or just achy) I took two extra. The throbbing went away just by taking the pills and the maintenance dose helped to keep the swelling and pain down. I didn't even have to wear the pants!  Its worth a try.

The other thing that was recommended to me was Hamamelis in homeopathy. Apparently its an astringent that has the same affect. Check them both out!

I have heard reports of good (to startling) success with homeopathic remedy bellis perennis other sources have success with homeopathic colensonia as well as tinctured witch hazel---also dramatic success the evidence is anecdotal, but I do feel it is reliable..

Continuous pressure on the varicosities to keep them from getting too big. Don't cut episiotomy through them. They will go away postpartum. (Amazingly so.) I didn't believe it the first time I saw it. but they did. A male athletic supporter (Jock strap) can be used to hold big OB pads against the vulva.

Undergarments for Relief of Back Pain and Vulvar Varicosities

I would go to the health food store and get a bottle of homeopathic varicose vein medication.

What's in this ? Calcarea Iodata 6x, Carduus marianus 6x, Hamamelis virginica 6x, 12x, 30x,Pulsatilla nigricas 6x, Calcarea Fluorica 12x, Hydrofluoricum Acidum 12x Do you see it working? I have had a lot of success with this, have pg and older women who swear by it.

Speaking from my personal experience - what I liked about the Jobststockings was that they improved venous return SO WELL. They didn't just support the vulvar varicosities, but relieved aching and edema in my legs that was terribly painful.

Mine (not Jobst brand) were $100/pair. My insurance paid for them, but if I got pregnant again, I'd pay out of pocket for them in a minute. I had 2 pair so I could wash one. They were a godsend.

Cheaper than Jobst (a lot) : we have some clients wear bike shorts under everything. They snug right up on vulvar varicosities, take some of the ache away. Also collinsonia root, bioflavinoids, vitamin E, orgasms, rest times with hips higher than heart (a little trickier than just "legs up"). Have had some clients with thumb-sized veins protruding on both labia. Birth on side or lying down, easing baby out w/ blowing, counterpressure on babe's head. Have never had one of these pop.

One mom had such a swollen, enlarged vulva due to the varicosities that she wore a kotex and stretch panties to kind of "cinch" herself up in the morning...it helped her.

I just wanted to add a little something here. An OB/GYN N.P., who was in my practice many years ago, told me about this company in Michigan. I have recommended their products for years with WONDERFUL results. My understanding is that the company was started by two women who wanted to make a difference.

They call their company Prenatal Cradle. They make a prenatal cradle for mothers to wear for abdominal support, to ease back pain.(I used to have to convince women to take them off when they went to sleep at night, because they enjoy wearing them so much.) They also make a VAGINAL SUPPORTER that offers relief of vaginal pressure and pain during pregnancy. (I have seen this supporter give a great deal of comfort to women suffering from vulvar varicosities.) It reminds me of the same principle as support stockings for legs only its for the vagina. The number at the company is 1-800-383-3068. (if you want flyers)

Over the years, I have seen a good number of women helped by their products. I don't personally know them and there is no kick back for me, just thought I'd pass along the information in case it might help someone.

We've had some clients get bike shorts to wear for thigh and vulvar varicosities. They've been really pleased with the comfort and cost of them! Even the Amish will wear them, too.

Hmmm,,,, her varicosities are down in her calf..... but this is something that I would never have thought of. Good tip for someone with varicosities farther up.

I've been wondering as you've all discussed the bike shorts... Sounds like a great idea for the vulvar varicosities, but what about the venous return restriction from the lower legs when you have them on? Seems like the tight fabric around the thighs, then nothing on the calves might encourage varicosities to form in the calves or behind the knees, especially in women already prone to them. Anyone seen this problem?

Actually, I've seen the opposite. The veins in the lower leg actually seem to subside along with those in the upper legs and vaginal area. I've only had about 10-12 patients use these regularly (the bike shorts are great for umbilical hernias, sore backs, pendulous bellies, etc), but I've never seen anyone develop calf varicose veins afterward.

recently discovered a great trick......out of lack of anything else available [g]

Rescue Remedy, prn for pain, itch, discomfort....liquid not salve cypress essential oil in carrier client loved it ,worked better than all others for her (witch hazel, tucks, anusol, comfrey)

I suggest the witch hazel (either straight, as Tucks, or in a herbal suppository I get from Earth's Harvest in Oregon) but also POTATO wedges. You cut the potato into a wedge and cut off the tip of the wedge (the part that was the center of the potato) so that it's flat surface is maybe 3/8 inch across. Place the wedge agains th anus and lie down and leave it there as long as you can stand it. The potato will draw out the swelling. The other thing, if the hemorrhoid is bulging, you can press a fingertip against it gently but firmly to press out the congested blood and then see if you can tuck the floppy tissue inside the anal sphincter. This is causing continuous pressure which frequently allows them to shrink more rapidly.

This works better if done while in the bathtub; warm water seems to help.

Many people SWEAR by this home remedy!. Also, some around here make small "suppository sized potato inserts. I know, it sounds weird, but I'm often hearing from folks who say this works for them.

I've seen potatoes work well for hemorrhoids too. Thought I'd pass this on as well.. I was talking to a friend of mine yesterday who is studying traditional Chinese medicine. She swears by the herb alum and says it is effective when nothing else is. She told me to put the powder directly on the hemorrhoid. [I'm referring to the Chinese herb alum, also known as Ming Fan. To learn more about it one can reference Materia Medica by Bensky and Gamble. If anyone is considering using it, perhaps it would be best to obtain it using the Chinese name Ming Fan to avoid any confusion.]

Groin Pain

42yo client, expecting 6th babe, her only complaint in all her pregnancies is groin pain. This time it's so severe that she's only comfortable when she doesn't move. Walking is excruciating.

Could it be venous problems?  They do extend to the groin in some people... I would have thought you'd see things like varicose veins lower down first, but you never know.  In my second pregnancy, towards the end, I was getting lots of throbbing in my groin - it's only this time that it has materialised as the dreaded varicosities.

Is the pain on both sides of her groin, or more noticeable on one side? This could be an indicator.

Other ideas - SPD?  (see www.radmid.demon.co.uk/dsp.htm )?  Looseness in the hips?

Sounds exactly like my SPD, started in Sacro iliac, and now, at the front, and can be really sore.  Although it may have been the 2 hours on the back of the camel into the Sahara last week, that really set it off.  Seriously, prior to this, the pain was aggravated by doing anything that was weight bearing, or involved my knees not being locked together.  I have always slept on my side, and kept my knees together, but now do the same, when getting out of cars, etc.  I rest in the evening, lying flat, although that does make my indigestion worse.  I have my maternity belt, which holds me in, and can help, when I know I have to walk.  Interestingly, apart from getting on the bike, cycling is far more comfortable than walking, but I put that down to non weight bearing. [SPD == Symphysis Pubis Dysfunction , i.e. pain or separation of the pubic arch]

Gall Bladder

I had gall bladder pain with 3 pg, take 2 capsules of lecithin and 50 mg of b6 with every meal, I still have my gall bladder after 40 yrs.

Apple juice has malic acid which is supposed to soften gall stones. The liver/gall cleanse recipes often recommend at least five days of large quantities of apple juice, fresh made or other high quality,  before doing the olive oil liver/gall flush.

I had gall bladder pain with both my pregnancies.  During my first pregnancy it was enough to avoid fatty foods. However with this pregnancy the pain became severe even eating a very low fat diet and even upon smelling food. I was visiting a DEM friend of mine in April when I could barely converse with people because of the pain. I felt I had no choice but to do the cleanse during pregnancy (was about 32 weeks). I had tried the olive oil and lemon juice in the evening a few times already, but without any success. Under this midwife's care I had only organic unfiltered apple juice for 3 days. The trick here is that the straw never leaves your mouth, I drank almost a gallon a day. It really wasn't bad and I felt very energetic by the third day. At the end of the third day I had a cup of laxative tea (I was trusting here and didn't ask what was in it) and 1/2 cup olive oil mixed with 1/2 cup fresh lemon juice and went immediately to bed and laid on my right side all night. I pooped out about 170 stones the next day and haven't had pain since. I went on to have an 8lb baby at 40+4 weeks.

Annoying Braxton-Hicks or Toning Contractions

See also: Preterm Labor - Many of the remedies for preterm labor will also help tone down annoying toning contractions.

Toning contractions are unorganized or incoordinate uterine contractions that do not dilate the cervix; however they do "tone" the uterine muscle so that when the signals come for true labor, the muscle is strong for the job of labor.  As many mothers have said, "I doubt Mr. Braxton-Hicks has ever felt one in his life.  It is a hubris of medicine that Mr. Braxton-Hicks is credited with first describing them.  I suspect that many mothers and midwives knew about them long before Mr. Braxton-Hicks was born.  In any case, these contractions are better understood by calling them what they truly are - toning contractions.  When they occur far enough apart, they are usually painless.  However, if they occur closer together, the uterine muscle may become oxygen deprived or fatigued, and so they can be painful.  When they are close enough together to mimic the patterns of true labor, then they are called false labor.  A skilled midwife can sometimes tell the difference, but sometimes the only way to know is to check to see if they're opening the cervix.  [Ed.: I have replaced the word Braxton-Hicks with "toning contractions" in some of the snippets below.]

Black haw may be helpful; have her check with her care provider or local herbalist.  This web page from Tri-Light Herbs gives a nice description of how black haw "acts to gentle the powerful uterine contraction effect of blue cohosh to quiet an irritable uterus".

Can someone please help?  I am 39 weeks pregnant today and I have been having toning contractions every day for nearly 2 weeks, some wake me up during the night and go on for hours. At 37+5 I had them every 5 mins for a number of hours. Went into the hospital, CTG showed 1 in 3-5 mins but no dilation or effacement and cervix 'extremely' posterior.  The mw believed my baby was lying posterior. It's driving me crazy because they are keeping me awake for hours at night.   After a number of hours they fade away. The question is are these just toning contractions? or is true labour starting and stopping for some reason?  Thank you so much for any replies....

Be reassured that these pains are doing something - they're getting your baby into the ideal position for birth.  If your baby is in posterior position then these are needed to get him/her into an anterior position. The left lateral position is usually the best - hence why the contractions increase and baby probably moves more but really this is what you want!  I'd suggest everything that others suggested and maybe add some lavender to the bath for extra relaxation.  When you get the pains if you have backache with them, some firm pressure centrally but just above the dimples in your back/bottom in the sacral area can really help.

Here's hoping labour proper starts soon and is nice, quick and easy on you.

Toning contractions are a blasted pest aren't they. I agree often a warm bath is the best way to settle them. Also make sure that you are truly well hydrated, being dehydrated makes them much worse, so take a good litre of fluid with you into the bath tub and drink, drink, drink...of course then you'll be up all night for a different reason :-) They are all working to prepare your body for labour, so although they are a pain, try to see them as a positive thing.

So many women feel they have  been in labour for a week - or more! Get cleaning that kitchen floor on all fours daily, lean forward as much as possible, even lie upside down with your legs over the back of the sofa WHEN THE BABY I S MOVING. This will encourage the little darling to get itself in a better position.. These toning contractions will change in the way you feel them and become contractions. I think it was probably a man who described them as painless, tightenings, but they are part of pregnancy. If you  continue to be very concerned, do seek advice from your midwives, but your body is limbering up and there really is not  a lot one can do. Try a nice warm bath before bed, that may settle things down a bit so you can get some rest during the night. Good luck and it will stop when you go into labour!

Thanks, yes, I know something is happening because the baby feels very far down in my pelvis and I keep getting sharp little shocks down there.
I've been spending time on all fours, using birth ball, sleeping on my left side and so on.  The latter seems to set off the strongest contractions of all!

Black cohosh may calm these, but check with an herbalist first.

Liquid Calcium  (we recommend Marietta's brand, as it works the best of ANY we have tried or seen)  helps soothe braxton-hicks contractions which sometimes can become very annoying during the end of your pregnancy.

Some people like chewable calcium tablets also.

You might try increasing your electrolytes, perhaps with Alacer's Miracle Water or the Electro-Mix powder you can add to liquids.

A castor oil packcan be really helpful.

Other sites w/instructions:
How to Apply a Castor Oil Pack

For annoying contractions or prodromal labor, I recommend a castor oil pack as follows:

If you're finding the contractions bothersome during the day, there's something that you could try if you're so inclined. It's a castor oil pack, applied externally, not taken internally. It's thought to "regulate" things, in sort of the same way as the Centered Mama tincture, i.e. it helps to slow things down or speeds things up, depending on whether it's the kind of labor that brings the baby.

You can get castor oil at many grocery stores and/or Walgreen's, etc. To do a castor oil pack, you set yourself up in a situation where you can lie comfortably for a half hour or so, and lying on a towel or something where it doesn't matter if it gets some oil on it. Then you rub the castor oil over your belly, in whatever amount or thickness you like, and then you put a warm compress over it. The easiest way to do this may be to take one of the blue plastic absorbent pads from your birth kit, moisten it kind of generously, i.e. so there's a good layer of moisture to pick up and hold the warmth (maybe a half cup or a full cup of water??  not sure), put it in the microwave (if you have one.  Otherwise, start with hot water), wait until it's a temperature that won't burn your belly, and apply it over the castor oil.  Leave it in place for a half hour. I've seen this stop colicky contractions altogether, which might be something nice to give you a couple hours break in the afternoon for a nap.

Or . . . it might send you into full labor, although this is less likely during the day.  Still, the first time you try it you might want to make sure it's in the early part of the day when you're better rested.

Although this may seem counterintuitive,  I find that the prenatal herbal preparations seem to "regulate" the toning contractions I have.  Whereas without the herbs, I get random contractions of various intensity.  Once I begin them, they seem to come together in waves of consistency.

I have a primip at 36 weeks having contractions come every 5 minutes.  This has been going on for a month.  She is taking 1600 mg Cal/w 800 mag plus drinks loads of water.  Still they persist.

I had really distracting BH for a full 2 month before i finally gave birth.  If homeopathics could have helped, i would have used 'em.  I say, remind your client that BH increase circulation to the babe and are excellent toning contractions, emphasizing normalcy.

I have had women like this, one thing is they may be hyper-excited, overexaggerated pain because they are scared.  I think lobelia is great for this as it is a bit of a anti-depressant or something but it calms them down.  When they are scared it makes them feel more painful then need be, women need to know that ctx are normal to begin with, some just get so scared of PTL that they scare themselves into the symptoms when in fact they are normal BH.

Try Lobelia, 20 drops 3x daily and cramp bark, 40 drops 3x daily and maybe do a GBS screen?

Just from my personal experience of early onset and quite strong BH in 4 pregnancies-  I wouldn't be concerned. But be prepared for a fast one.  In my case I carried my babies very low and they went head down very early also...adding up to the discomfort of vulvar edema.  Seemed like just about anything would set off these BH- getting up from sitting,stairs, and walking uphill really brought them on. no preterm labor with any of them. fast labors- my shortest was 1/2 hr.   Only one mom I've had with similar BH, also carried fairly low & also shared the edema- (laying down/raised pelvis on pillow sessions helps of course)

Sometimes red raspberry leaf tea works for this, seems to settle down the uterus even though it's supposed to tone it. I've also had good luck with a combo of motherwort tct and St. Johns Wort tct. If she is really well hydrated, is it mostly water? Does she need some electrolytes?

Stretch Marks

Homeopathics for Stretch Marks

To prevent stretch marks that can accompany pregnancy, take Homeopathic Calcarea Fluorica 6X, twice a day. This remedy gives elasticity to the skin and is safe to take during pregnancy.

Bio-Oil is supposed to "help reduce the possibility of pregnancy stretch marks forming by increasing the skin's elasticity."  They do actually have some clinical trials.  I saw their advertisement in The Canadian Journal of Midwifery Research and Practice (CJMRP).

Stretch marks, can they really be prevented during pregnancy?

I'm very prone to them (adolescence and a few with baby) and found that eating plenty of fruit and drinking about a gallon of water during the latter stages of pregnancy helped stave off the worst, at least that was my hypothesis at the time---They could've been a lot worse!!  Also I used Mama Mio tummy rub oil religiously, two or three times a day. Lately I've become hooked on organic jojoba oil---it's so wonderful at hydrating and it really is amazing how it absorbs into the skin without all that greasiness or stickiness. I would add that in too---it can only help the skin maintain it's elasticity and healthy appearance.

I have used the typical cocoa butter for both my pregnancies (this current one being with twins), and have not had stretch marks.  However, I have also read that it is completely dependent on your skin and no lotion or salve will make a difference. Regardless, when you start to get really itchy, rubbing cocoa butter or shea butter on your growing belly makes a HUGE difference.

Maintain good circulation, Try not to let the skin get stretched too rapidly try keeping the weight gain slow and steady.  Exercise throughout the pregnancy and it will both improve circulation and help to prevent an abrupt stretch on the skin.  always cover your skin with runny lotion right after a shower when you are still damp.  Then also apply more concentrated greasy stuff like aquaphor on the spots that are most vulnerable and Also in corresponding spots -  like reach around to your back and rub the lotion from your back to front as if redistributing the skin to help in the effort. Remember whatever lotion you used is being absorbed into your skin and can reach the baby.  Anything you use regularly you should check at the ewg site  cosmeticsdatabase.org for the products toxicity profile

I would stay hydrated, use Carlson's fish oil or krill oil daily, and use extra virgin coconut oil and/or emu oil on the areas prone to stretch marks. I didn't get many with my 3 kids (even though the last kid was almost 12 lbs and I am 5'2") and I only used cocoa butter and fish oil,  but I wish I had known about coconut oil and emu, they are like magic to your skin. You can get them from any quality health food store.  (I buy mine from  vitacost.com or luckyvitamin.com as they seem to be way cheaper there.)  Oh and they do fade over time if you do happen to get any ; )

I never got stretch marks on my tummy after four pregnancies. I ate lots of protein, lots of vitamin C and lots of vitamin E internally. No oil rubbing. I did get them on my breasts, though.

I have known quite a few people who use coconut oil. No stretchmarks reported.

I remember being really upset at the irony because I made it all the way to the end of my pregnancy without getting any major stretch marks, and then I wound up getting big ones in the hospital during labor because the fluids they gave me made me balloon another 20 pounds  and I was sitting for days in labor - I got red lines on my hips - but now they are invisible.  Can't see them at all!  If I ever wind up in a hospital birth setting again I'm going to strictly monitor those fluids!!!!!!!!

I think it's a combination of genetics and nutrition, as well as how big your belly gets.  :-)

I've had some recent experiences that have really highlighted the difference in perineal tissue elasticity depending on a woman's diet.  I tend to pay more attention to perineal tissue elasticity than to belly skin elasticity, but they also seem to be related.

Someone I know is in the finishing stages of writing an excellent book on pregnancy nutrition, based on actual research instead of the parroting of unfounded advice that gets passed from one standard pregnancy book to the next.


His answer to preventing stretch marks is: coconut oil, collagen, and progesterone cream.

It also really helps to make sure you're getting a lot of vitamin C, which is essential to building strong tissues for the baby as well as for yourself.  5000-10000 mg/daily is not too much.

I always heard Cocoa Butter, that's what my mom used and she didn't get hardly ANY. Me? I got more than I've ever seen one person get from pregnancy! I used cocoa butter just about everyday. I would tend to think it's more of a nutritional thing...I didn't take any prenatal vitamins after about 2.5 months because I just couldn't...they made me so sick. I've always heard that skin "issues" are just and outward showing of what's going on inside your body. Maybe stretch marks could be the same? I'm sure there are lots of variables that come in to play, so that might just be one of MANY (size of baby, genetics, skin type, probably size, torso length, etc.) factors.

The best I have heard is in the burts bees. I hate to say this, though. I have used products, and I still got stretch marks. It is genetic. I hate them.

There are quite a lot of different belly butters and belly balms on the market; I don't know of any research into effectiveness, but these will almost certainly relieve some of the itchiness that can come from the stretching skin, and many women swear by them.

Reviva Labs Private Label offers belly balm and stretch mark prevention lotion.

One of my very astute clients noticed that as her pregnancy progressed, she needed to wear her underwear inside out because the serging on the seams was leaving stretch marks in her delicate skin.

I had a lady yesterday who is complaining of burning and itching of her stretch marks, (abdominal).  She's been using almond oil on them and sometimes vaseline.  I suggested cold compresses and a cream with Vitamin E, but couldn't think of anything else.  Do any of you have any other suggestions?  [Ed. - There is some concern that almond oil applied topically may be associated with preterm labor.] 

Is she taking oral VitaminE too?  400 IU in pregnancy, 800IU after.
homeopathically:  Calcarea florata 3 tabs three times per day.

There is a new product from: Mother to be  it has a stretch mark cream, (saw it at the MANA convention)  I don't know how that product works but the others I have tried or have pts. try and they seem to like it.  will look and try to find more.

I have stretch marks on my lower abdomen (all are contained beneath my umbilicus).  I picked up some of this "Mother to Be" stretch mark minimizer at the Midwifery Today conference.  I put it on most nights on my right side and put just any old regular lotion on my left side. I don't think there has been much difference but my stretch marks never got any bigger than they were at that time (about a month and a half ago I think??).  Maybe they wouldn't have grown any more anyway. I think putting some kind of lotion on them helps.  They don't really bother me.  I don't think there is any real difference in the Mother to Be cream and any other.

I would also think calendula would be helpful for stretch marks that were bothersome - itchy and sore.  I would think vaseline is a bad idea because it's a petroleum product.


Rib Pain - Breast Pain

My first thoughts... is she short? Short-waisted? Kind of fat? Does she have a good-sized baby?

All of these things can cause a "rubbing" on the upper ribs that is more than a lot annoying. When I was pregnant the first time, my son's knees or feet were *constantly* under my right rib and when I could dig my hand in there and shove him down, it felt immensely better.

Without shoving him down, the sensation was bizarre... kind of like if you rubbed and rubbed and rubbed the same spot over and over with a not-so-soft piece of cloth. Almost a burning sensation. It's so hard for a mom to describe this sensation, but I usually can elicit the, "yes! that's it!" after ruling out all the other descriptions like, "Is it inside or outside?" ("I don't know" is a common response because it *feels* inside, but anything on the outside irritates the heck out of it.) "Do you feel a sharp, pokie part of the baby when you push whatever it is down from your ribs?" "Does the baby kick back sometimes when you try to move him from that comfortable position?"

I also have women do the one arm over the shoulder and down towards her butt and the other arm around her waist with her hand heading up towards the over-the-shoulder hand and that helps lengthen the waist and women often have a huge sigh of relief for a few moments. I encourage their doing that many times a day.

For the women who *do* have this "bruising" of the ribs, the numb/painful/burning sensation often lasts until a couple of weeks past the birth of the baby. I forewarn them so they don't automatically think it will disappear immediately postpartum. I do see it as a bruise and it takes time to heal the area.

Ice is a great idea as is arnica gel and homeopathics. Positioning, however, seems to be the most beneficial for my clients. Yoga can help lots with this.

Ringing in the Ears - Tinnitus

Bio-Ear Naturally Puts an End to That Ringing in Your Ears - a Swedish product carried by Vermont Country Store



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