Traditional Chinese Medicine and Pregnancy

What is Traditional Chinese Medicine (TCM)?

Traditional Chinese Medicine (TCM) is the practice of therapeutic knowledge which originated from 3,000 years of clinical experience based on observation and diagnosis. TCM treats a person as an integral biological system and maintains that symptoms of diseases do not usually happen alone.

TCM aims to stimulate the body’s natural healing potential by treating the root cause of the problem and normalising the body’s internal biological balance.

Typically, a woman will experience menstruation, pregnancy, delivery as well as breast-feeding at different stages of her life. Tradtional Chinese Medicine mainly helps to maintain a good and healthy female reproductive system, and attempts to treat any ailments early to prevent further pathological changes.

“Qi” is a kind of life force or energy in the human body that relates to the most basic and minute biological substances and also preserves life.

In TCM, the most important organs that govern the regulation of qi and blood are the liver, spleen, and kidneys. The liver is responsible for maintaining a smooth and even flow of blood and qi in the body. If the liver malfunctions, it will result in menstrual disorders.

The spleen is the main “factory” which generates blood and qi. If the spleen is not functioning, there will be deficiencies in blood and qi. This may in turn disrupt the regular menstrual cycles. On the other hand, the kidneys play a big role in excreting biological waste products and water from the body.

Traditional Chinese Medicine and habitual miscarriages
A miscarriage may be triggered by several factors, which greatly depend on the health status of both the mother and the foetus. A miscarriage may also be related to an unhealthy lifestyle including excessive alcohol intake and smoking. If three consecutive miscarriages occur, it is known as habitual (recurrent) miscarriage.

In TCM, treatments include replenishing the qi, nourishing the blood and strengthening the physiological functions of the spleen. To replenish the body’s qi and nourish the blood reserves, the mother needs to have a nutritious diet and consume foods such as broccoli, spinach, soya beans and milk. In addition, she should  have adequate rest with moderate exercise, such as tai chi, yoga, frequent slow walks or just simple stretching movements. This ensures the smooth flow of qi and blood in the body. There are old grandmother’s healthy concoctions in TCM, such as red date tea and ginger tea, for the day-to-day well being of mothers. These teas help to slowly replenish and nourish the qi and blood in the body.

Chinese herbs in pregnancy
The Chinese pay special attention to herbs used for pregnant mothers. TCM physicians have formulated many well-known TCM formulations or Chinese prescriptions that are deemed effective to prepare women for the different stages of pregnancy.

In order to understand how these prescriptions work, we need to take a closer look at how Chinese herbs interact with each other. According to the basic principles in TCM, every single herb has its own function or group of functions to keep the internal body environment balanced and in harmony.

During pregnancy, it is important to keep the qi (energy flow) and blood in harmony to ensure a smooth pregnancy.

When a TCM physician puts single herbs or groups of herbs together, he/she produces a prescription. Every TCM herbal prescription is customised for each individual. Therefore, not every formulation is suitable for all. It is prescribed according to each patient's specific set of symptoms. For example, in TCM, if a patient has fever, herbs with cooling properties will be used.

The herbs in the prescription help restore the internal balance and state of the body and also help combat some pregnancy-related symptoms, such as nausea and dizziness. Hence, it is important for anxious mothers to understand the principles behind the herbs before they decide to take them as medicine, nourishment or a tonic, or as practised in old wives' tales. But a word of caution; if herbs are used inappropriately, side effects such as miscarriages, induced abortions or damages to the foetus may occur.

The proper combination of herbs is based on their natural functional properties.

There are several basic ways Chinese herbs can work together. For example, when herbs with similar properties are used, they enhance or boost the healing power within the entire formulation. Likewise, if herbs of different properties are used, the functions of the herbal couplet may suppress or antagonise the whole formulation.

There are basically two groups of herbs which pregnant women are advised to keep away from. Table 26.2 shows a list of herbs which are toxic and uterotonic. These herbs are strictly prohibited for use during pregnancy.

Table 26.3 shows herbs that should be used with great caution and prescribed only by well-experienced TCM physicians. These herbs are not toxic in nature, but they do have undesirable functions and may cause disruptions to the growing foetus.

Supplements used in Chinese medicine and their safety
1. Bird’s Nest (燕窝 Yan Wo)
Benefits:
(a) Helps to stimulate appetite and aids in digestion.
(b) Provides a unique pre-digested form of protein and nutrients that help speed up recovery from chronic illness.
(c) Facilitates normal body functions such as repair of tissues and immunity.

Risks:
In general, no documented side effects.

2. Chinese Ginseng (中国人参 — Zhong Guo Ren Shen)
Benefits:
(a) Restores strength and energy level after giving birth or severe loss of blood during delivery by improving blood circulation.
(b) Revitalises and aids the recovery process after serious illnesses or major operations by boosting the body’s immunity.
(c) Promotes digestion and improves appetite for the mother to produce adequate milk for the newborn.

Risks:
(a) Do not use when pregnant.
(b) Chinese ginseng is not suitable for all age groups or medical conditions.
(c) It should not be taken with high doses of caffeine or other stimulants. Chinese ginseng should not be consumed by new mothers who experience hot flushes or skin rashes after delivery.

3. Chinese Angelica Root (当归 Dang Gui)
Benefits:
(a) Commonly used herb in treating many kinds of gynaecological problems such as irregular menstruation, painful menstruation and infertility.
(b) Efficient in treating anaemic conditions.
(c) Commonly used to relieve pain due to blood stagnation, e.g. abdominal pains or traumatic injuries.
(d) This is an important herb for the postpartum period, and even during pregnancy, as it aims to increase blood production as well as revive weakened blood circulation.

Risks:
(a) No major side effects with oral administration.
(b) Pregnant women should consult a licensed TCM physician before using it as it may induce uterine contractions.
(c) May not be wise for women who experience excessive menstrual flow since this herb promotes better blood circulation.
(d) Used in large doses, Chinese angelica can have adverse effects on blood pressure, heart action and respiration.

4. Royal Jelly (蜂皇浆 Feng Huang Jiang)
Benefits:
(a) Protects against infections and increases resistance to diseases.
(b) Accelerates the formation of bone tissue and helps wound healing.
(c) Moisturises dry skin and soothes dermatitis.
(d) Increases endurance and energy levels. It also improves the libido.

Risks:
(a) Allergic reactions (most common) from oral intake of royal jelly can range from very mild (e.g. mild gastrointestinal upset) to more severe reactions, including asthma, anaphylaxis (shock), intestinal bleeding,
and even death in people who are extremely allergic to bee products.
(b) People who are allergic to bee pollen, honey, conifer and poplar trees should not consume oral royal jelly.
(c) Topical use of royal jelly has been reported to cause skin irritations occasionally.

5. Lingzhi (Ganoderma Lucidum)
Benefits:
(a) Known as “mushroom of immortality”, this fungis is a qi tonic. It promotes longevity.
(b) It treats fatigue and enhances immune response.

Risks:
(a) May cause dizziness and diarrhoea.
(b) No data on its safety on pregnant women. Use as advised by a TCM physician.

 " The New Art and Science of Pregnancy and Childbirth". A Pregnancy Book written by Dr. Tan Thiam Chye, Dr. Tan Kim Teng, Dr. Tan Heng Hao, Assoc Prof John Tee Chee Seng. KK Women's and Children's Hospital.
* Available at all major book stores and Pharmacy in KK Women's and Children's Hospital.

Ref: X08