Dr S G Biju
Stick to Your Doc’s Schedule
Your doctor will typically want to see once a month till you have completed 28 weeks of pregnancy. Then the visits will be scheduled once every fortnight till the 36th week of pregnancy. In the final stages of pregnancy, you will be required to see your doctor every week. It is important for you to not miss any of the appointments as the regular checkups carried out will give you a clearer picture of your state of health.
Talk to Your Doctor
For antenatal care to work properly, you should take cased with following histories
- Family history,
- Medical history
- Record of previous pregnancies,
- Complications during pregnancy
- History of abortion or miscarriage.
- Partner’s History & Mental /emotional status for healthy Baby ( Stress can lead to preterm labour and delivery)
Take the Medicines
Allow mothers to take prenatal vitamins. They need to take these medicines. Prenatal vitamins are supplements that provide for essential nutrients required during pregnancy. Prenatal vitamins contain folic acid, calcium and iron as these help in the development of the baby.
Foods those are rich in proteins, carbohydrates and healthy fatty acids. Such foods can be lean meat, fruits and vegetable. Foods that are high on the unsaturated fat content should be avoided. Eating in small portions is best during pregnancy as it helps in keeping the symptoms of pregnancy such as nausea, heartburn and constipation in check. . Also remember to include fresh fruit juices and deliciously healthy smoothies in your antenatal care diet. Dehydration is extremely harmful for you and the growing foetus and it can give rise to complications.
Show Bad Habits the Door
Excessive caffeine intake. These can in fact retard the growth of baby and also lead to pregnancy complications such as miscarriage. Quitting these habits will also help one lead a healthier lifestyle during pregnancy and the unborn child will benefit from it.
Antenatal care is important so that you can give birth to a healthy little angel. It will also ensure that post delivery; you recover faster and can get back to leading a normal life!
Morning sickness: (Emesis gravidarum) Most women do experience some degree of nausea during pregnancy which gradually settles down soon after the end of first trimester. Sometimes the nausea is excessive and can be accompanied with excessive and persistent vomiting which calls for medical attention. Sharp and unpleasant odours and consumption of greasy and fried foods tend to aggravate it.
The sudden increase in the human chorionic gonadotrophin hormone in blood is attributed to it but the increased incidence in primigravidae points to the psychological aspect of the complaint. Normally these conditions do not call for any medical intervention. But if vomiting becomes excessive and leads to dehydration then it warrants urgent attention. (In cases with excessive vomiting-Hyperemesis gravidarum, there is no alternative to fluid transfusion to compensate the fluid loss)
- The advice of consuming small frequent feeds avoiding spicy and greasy foods, and consuming a protein snack at night is recommended.
- Munch a few crackers before getting up in the morning.
- Eat several small meals a day so that stomach is never empty.
- Avoid spicy, rich and fried foods when nauseated.
- Drink plenty of liquids, especially if there is vomiting. Try crushed ice, fruit juice or frozen ice pops if water upsets stomach.
“Sepia is reputed to be one of our best medicines for this trouble. Apomorphia 6 should be considered in obstinate cases.” Other common medicines are:
- Arsenicum: Very great debility and exhaustion; vomiting of fluids as soon as she takes them. Very uneasy and restless.
- Ipecac: There is constant sensation of nausea. Tongue is clean and there is profuse salivation and no thirst. Vomiting is of greenish fluid. There may be spasmodic colicky pain in the abdomen.
- Kreosote - Obstinate cases of dyspepsia with great and constant nausea, without vomiting.
- Symphoricarpus racemosa: Useful in cases not relieved even after Ipecac.
- Cuprum ars: Constant nausea; vomits everything, very weak. Spasmodic uterine pains.
- Gossypium: great distress, weakness and prostration. Nausea particularly after breakfast. Has been useful in very bad cases. (Guernsey)
2. Heartburn: This common complaint is the result of reflux of acid contents of the stomach as a result of relaxation of oesophageal sphincter. Over eating, late eating and spicy foods contribute to the problem.
- Pillows at bed time to prop her up and medicines can help in relieving the complaint.
- Eat smaller meals more often, but eat slowly.
- Eliminate heartburn triggers such as fatty or fried foods, alcohol, chocolate, pepermint, garlic, onion, caffeine.
- Avoid coffee.
- Don’t eat for 2-3 hours before going to bed, and raise the head of bed 4-6 inches. Reflux is worse when lying flat.
- Arsenicum alb: Burning pain in stomach along with sensation of heaviness. Appetite is lost; vomiting as soon as food reaches the stomach. Thirst for small quantity of cold water at frequent intervals. All the troubles are marked in first trimester.
- Acid Sulp 30
- Cajuputum 30
- Nux vomica.
3. Constipation: The increased circulating progesterone levels during pregnancy causes sluggish bowel peristalsis, which leads to hardening of the stools and constipation.
- Try to have a regular schedule regarding eating and defecation.
- Drink plenty of liquids- at least 8-10 glasses a day.
- Eat several servings of fruits, vegetables and grains. Eat plenty of fruits, salads. Inclusion of leafy vegetables and fruits in the diet provide roughage which helps in overcoming this problem.
- Oral medication of iron often aggravates the problem.
- Additional dietary fibres (Isabgul) may be recommended if need arises.
- Exercise moderately every day.
- Alumina: Hard, dry, knotty stools with no desire. Rectum sore dry. Evacuation preceeded by painful urging long before stool, and then straining at stool.
- Nux vomica: Frequent urge for stools after every attempt of eating.
- Opium: Obstinate constipation, faeces protrude and recede. Round, hard, black balls.
- Platina: Faeces scanty, evacuated with great difficulty. Adheres to the rectum, like soft clay.
- Sepia - Sense of weight or ball in the anus, not relieved by stool.
4. Haemorrhoids: Constipation during pregnancy tends to aggravate the varicose condition of the veins of the rectum. Straining at stools, prolonged sitting and spicy foods further aggravate the condition and even cause bleeding piles.
- Avoid constipation.
- Don’t strain excessively during bowel movements.
- Take frequent warm baths.
- Collinsonia - Known to be the most common medicine for piles during pregnancy.
- Lachesis - For Haemorrhoids during Ist month of pregnancy
- Sulphur - Burning & intolerable itching of the anus with constipation <at night
- Sepia - Painful protruding haemorrhoids during stool < when walking
- Muriatic acid - Most painful piles, Even slightest touch of linen makes her crazy.
- Ratanhia - Intense burning in the anus , Remains even for 1 or 2 hours after stools.
5. Urinary frequency: The pressure of the gravid uterus during the first trimester and the pressure of fetal head when it engages in the pelvis near full term causes irritation of the bladder base, predisposing to urinary frequency.
- Causticum: Frequent desire to urinate, a small portion passing involuntarily. Also there are signs of paralysis of bladder from prolonged over distension.
- Coccus cacti: The urine does not form the usual jet, but runs down over the surrounding parts. Does not cut or burn.
- Merc sol: Constant desire to urinate, the desire not lessened by urinating. Sour smelling urine.
- Ruta: At every step after micturition she feels as if the bladder were full and moved up and down. Involuntary emission of urine, whether at rest or in motion.
6. Pain over round ligaments: A sharp and sudden short lived pain over the groin during sudden movement is attributed to the spasm of round ligaments. Management:
- Avoidance of sudden movements and local heat fomentations are helpful.
- Homeopathic Medicines like Belladona, Rhus tox can be used symptomatically.
7. Syncope: The enlarging uterus compresses the veins at pelvic brim, impeding venous return and contributes to pooling of blood in the lower limbs. Prolonged standing may thus lead to fainting spells.
Measures to avoid this include use of stockings and exercising the calves to increase venous return. In later pregnancy, the gravid uterus compresses the inferior vena cava in the supine position causing supine hypotension. A left lateral tilt with a wedge below the right hip alleviates the problem.
Homeopathic Medicines: Carbo-veg, China, Camphor can be used.
8. Backache: It is due to the relaxation of the ligaments of the pelvi-vertebral region.
- Avoidance of excessive weight gain,
- Eliminate as much back strain as possible
- Maintain a correct posture
- Lift correctly
- Back muscle exercise and use of low heeled or flat foot wear to avoid postural strain go a long way in providing relief.
- Kali carb- It is for backache during pregnancy and during labour. Backache while walking, feels as if she must give up and lie down
- Aesculus hipp- It is another important remedy for backache during pregnancy. Backache along with constipation & haemorrhoids
9. LEG CRAMPS: This may be due to lack of diffusible serum calcium, or elevation of serum phosphorus.
Massage of the calves, local heat, supplementary calcium and vitamin B1 (30 mg) daily are of help.
Homeopathic Medicines like Cuprum, Mag-p, Nux-v, and Verat can provide symptomatic relief.
10. Varicose veins: Varicose veins in the legs and vulva or rectum (haemorrhoids) may appear for the first time or aggravate during pregnancy.
- For leg varicosities, elastic crepe bandage during movements and elevation of limbs during rest can give relief.
- Stay off your feet as much as possible and elevate them as often as possible.
- Wear loose clothing around legs and waist.
- Apis mel: Burning and stinging pains in the varicosed veins, either with or without constipation.
- Arnica: The varices are very sore, with a bruised feeling. Especially useful for varicose veins of the vulva or vagina.
- Carbo veg: Painful discharge or complete suppression of urine attends the varicosed condition of the vagina. The varices have a bluish appearance and are hard.
- Hamamelis: Varicosed veins are hard, swollen and painful.
11. Ankle oedema: As a result of impeded venous return, the patient may notice increasing ankle oedema as pregnancy advances. This may cause difficulty in wearing footwear, it may also cause heaviness in the feet which is aggravated by prolonged sitting or standing. Oedema subsides on rest and elevation of the feet.
- Use cold water compresses.
- Eat a low salt diet.
- Lie down and elevate legs for an hour in the middle of the afternoon.
- If face swells often, visit the doctor.
Apis mellifica: It is a common medicine for oedema feet during pregnancy, esp. pitting oedema. < Hanging the limbs down, < Prolonged straining, < Long walk & standing, < Heat in general, > Profuse urination & from rest.
12. Vaginal discharge: Increased vascularity during pregnancy causes increased discharge of a creamy to thin discharge from vagina.
Management: Assurance to the patient and advice for local cleanliness is advised.
- Cocculus: Purulent, gushing leucorrhoea; very weakening.
- Sepia: Leucorrhoea yellowish greenish with much itching.
Some special conditions in pregnancy: These conditions require timely care and support during pregnancy. If controlled properly they are not of much concern but most of these conditions can be fatal if ignored.
13. Hypertension in pregnancy: It occurs in about 8-10% of the population. It includes: a sustained rise in systolic B.P of >/=30mm Hg.
- A sustained rise in diastolic B.P>/=15mm Hg.
- A sustained systolic B.P of 140 mm Hg or more, and/or
- A sustained diastolic BP of 90mm Hg or more.
Hypertension that develops before the 20th week of pregnancy almost always is due to pre existing hypertension. High blood pressure that occurs only during pregnancy is called gestational hypertension and may start late in pregnancy. This form of hypertension does not have any ill effects on the mother or fetus; also it resolves shortly after delivery. Women with pre-existing hypertension when become pregnant have increased risk of developing Pre-ecclampsia ( Proteinuria + Hypertension+ Oedema) or Ecclampsia (with convulsions). It can lead to fatal consequences or permanent damage to the system. Preeclampsia and ecclampsia are a major cause of maternal death and premature death worldwide.
- Low salt-high protein diet,
- Bed rest,
- Weight control.
- Apis, Plumbum, Acid phos or Terebinthina remove the albumin from the urine, without any purgation, and with the patient taking a full diet.”
- Other frequently indicated medicines are:
- Kali chlor: It is a very good remedy for toxaemic conditions during pregnancy when associated with renal symptoms.
- Rauwolffia: It is a wonderful remedy for reducing blood pressure, most effective in mother tincture form.
- Glonoine: A remedy for high blood pressure with rush of blood to head in pregnant women. There is a throbbing headache, which is better from uncovering the head.
- Helonias: Albuminuria during pregnancy.
14. Anaemia in pregnancy: A pregnant women is considered to be anaemic when the hemoglobin count in the body is less than 11gm/100ml or less. Anaemia during pregnancy can be physiological (due to disproportionate increase in plasma volume, RBC and Hb mass), deficiency of iron, folic acid, Vitamin B12 and protein in diet.
- Adequate treatment should be given to eradicate the likely cause of anaemia e.g. hookworm infestation, dysentery, malaria, bleeding piles, urinary tract infection etc.
- A realistic balanced diet which is rich in iron, proteins and vitamins and which is easily assimilable is prescribed. The foods rich in iron, are liver, meat, egg, green vegetables, green peas, figs, beans, whole wheat and green platains, onion stalks, jaggery etc.
- Supplementary iron therapy..
- Ferrum phos 3X and Calcarea phos. 3X, 4 tablets each, taken twice daily are found to be useful.
- China officinalis.: Helps in assimilation and uptake of iron from the gut when, even after improvement of diet, anaemia does not improve.
- Ferrum metallicum,
- Natrum muriaticum,
- Lecithin- Best action in 6X potency. It increases the number of RBCs and the amount of Hb in body.
- Vanadium 30
15. Gestational diabetes or pregnancy induced diabetes: It is a type of diabetes that occurs in pregnancy and normally disappears just after pregnancy. It occurs due to insufficient amount of insulin production as that required by a pregnant woman leading to carbohydrate intolerance.
Murex & Zincum Met are medicines for DM along with drugs if you are giving
16. Threatened abortion: Bleeding per vaginum, often painless but may be accompanied by mild uterine cramps and backache. The bleeding is usually fresh and scanty. Pain appears usually following haemorrhage.
- Complete bed rest for about 5-7 days after the bleeding stops.
- Constipation should be avoided.
- Coitus is counter-indicated during this period.
- Belladona: Bearing down sensation, as if all the viscera will come out. Hot gushes of blood, with pain in loins.
- Chamomilla: Profuse discharge of dark, clotted blood with labor like pains. Pain spasmodic, pressing upward.
- Phosphorus: Painless flow of bright red blood in tall lean thin women.
- Ipecac: Profuse, bright blood with nausea. Pain from navel to the uterus.
- Crocus sat: Bleeding from overlifting.
- Sabina: Pain from sacrum to pubis, and from below upwards, shooting up the vagina. Haemorrhage, partly clotted, worse from least motion.
- Secale cor: Threatened abortion around the third month. Burning pains in the uterus.
- Viburnum op: An excellent remedy to prevent miscarriage, especially in the 8th month. It even neutralises the effects of abortifacients. Given at 1X it acts as uterine sedative, can be used for long periods as preventive of abortion.
- Sepia, habitual abortion from 5th to 7th month of gestation
- China off: Haemorrhage with fainting, loss of sight and ringing in ears from debility
- Miscarriage in 3rd month: KREOS
Consult a Gynaecologist:
The mother is advised to consult a gynecologist for consideration of admission in the following circumstances:
- Painful uterine contractions at interval of about 10minutes or earlier and continued for at least an hour—- suggestive of onset of labour.
- Sudden gush of watery fluid per vaginum — suggestive of premature rupture of the membranes.
- Active vaginal bleeding however slight it may be.
- Homeopathic Medicines for other complaints in pregnancy:
17. Pendulous abdomen:
- Belladona: When there is much sensitiveness to touch, to pressure or to jarring while riding in a carriage or when walking. Under the influence of Bell the tenderness ceases, and the size of the abdomen will be greatly reduced gradually.
- Sepia: Sensation of painful emptiness in the pit of the stomach. Little darting, shooting pains in the region of the cervix uteri; constipation.
- Secale cor: In women of very lax muscle fibre, and who are of a thin, scrawny appearance.
Other medicines which can be considered are: Crocus, Platina, Podophyllum, Calc. carb, China, Colocynth, Nux vomica
CHLOASMA: Sep, Lyco, sol
TOOTHACHE DURING PREGNANCY: Aluminium, Belladona, Calc-c, Nux-v, Staphys.
PRURITUS PUDENDI: Dr. Hughes advises Collinsonia, Caladium and Ambra as the best internal remedies.
ARRESTED DEVELOPMENT OF FETUS: Secale cor
BREASTS NODULES DURING PREGNANCY: Fl-ac
ASTHMA DURING PREGNANCY: Natrum sulph
ABNORMAL CRAVINGS during pregnancy: Calcarea-carb, Calcarea-phos, Alumina.
FOETAL DISPLACEMENTS: Pulsatilla -”It is an excellent remedy for putting the foetus in the right position” giver in 1M potency 3 days before EDD.
Dr. Borland says that, Rubella, or German measles if acquired during pregnancy, especially during the first four months, may have an adverse effect on the unborn child. In the event of exposure to infection during pregnancy it would be wise to prescribe the Rubella nosode.
Homeopathy During Labour
FEAR, LABOUR OF
- Aconite 200: Allays anxiety and fear, and also checks complaints arising from it.
Delayed and prolonged labour:
- Caulophyllum 30: It is used during labour when there is spasmodic and severe pains which radiate in all directions. Timely administration of this medicine furthers progress of labour. This remedy acts as tonic to the uterine muscles. It improves the power of contractility thereby shortening the labour and ensures a smooth and uneventful delivery.
- Gelsemium 30: When labour pains are wanting, prolonged labour with exhaustion. Gelsemium restores labour pains and ensures smooth and successful delivery.
- Pulsatilla known to correct malpositions and convert difficult labour into easy deliveries, corrected want of expulsive power. irregular pains.
- Pains with chilliness – more severe the pain, more severe the chill. Pain appears suddenly and leaves gradually.
- Kail carb -backache in pregnancy and labour.
- Gelsemium-in rigid os with chilliness in the back;
- Cimicifuga-Useful for ladies of nervous excitable temperament with rigidity of os during labor. Intolerable, irregular, spasmodic pains that radiate to hips, thighs or back. Electric shock like pains causing faintness. Intense nervous excitement causes shivering, without coldness, false labour pains, rigid os;
- Cinnamonum-ineffectual or false labour pains, severe pains
- Cocculus indicus: Terrible pain in the small of the back; lower limbs feel paralyzed; frequent vomiting.
- Secale cor: A sensation of a constant tonic pressure in the uterine region; this causes great distress; wishes fresh air; don’t like to be covered much.
- Platina: Very great sensitiveness of the organs; severe cramping pains in the region of the uterus; constant oozing of dark, grumous blood from the vagina. Horrified by her thoughts.
- Sepia: Numerous darting pains, shooting upward from the neck of the uterus; flushes of heat; cold feet.
- Conium: If there are scirrhosities in either the breasts or uterus and labour does not progress normally — pains spasmodic’ vertigo, particularly on turning in bed; rigidity of os uteri.
- Belladonna: Pain appears suddenly & goes suddenly.
- Nux vomicaPain with ineffectual urge for stool or urine.
- Pain ceasing: Bell, Kali-c, Op, Puls, Sec-cor
- Spasmodic: Cham, Gelsem, Hyos, Puls.
- Hour glass contraction: Belladona, Chamomilla, Gelsemium, Cuprum
The Murphy Repertory gives the following medicines for easy delivery:
Condition of Cervix during labor
- Contracted, spasmodically – CAUL., CIMIC., GELS.
- Dilated – Gels.
- Half open – Sepia
- Hard: Sep
- Rigidity of – CAUL., CHAM., GELS.
- Soft: Ust
- Cervix dilated, os open, no pains, bag of water bulging, patient drowsy, face flushed: Gels
- Deficient pain: Bell, Caulo, Puls, Ust
- Ineffectual pain: Caul, Kali-c, Puls
- Child’s head is in the opening of pelvis and the action of womb is insufficient for expulsion: PULS
- Agony and sweats, with desire to be rubbed – Nat. carb.
- Atony, uterus during – Caul., Puls.
- Premature – Caul., Cimi., Puls.
Post partum haemorrhage or PPH: Haemorrhage in excess of 500 ml from the genital tract after delivery up to the end of puerperium which adversely affects the general condition of the patient. It may be immediate, occurring within first 24 hours after delivery or delayed, after 24 hours. It may be due to atonic uterus of multiparae, anaemia, prolonged labour or even due to blood coagulation disorders. If neglected it can lead to shock and even death of the patient.
Management: The principles in management are:
- Diagnose the cause of the bleeding.
- To empty the uterus of its contents and to make it contract.
- To replace the blood loss.
- To ensure effective haemostasis.
- Considering the health and safety of patient to be our prior aim (the medico-legal consequences being the next), the case should be carefully and meticulously managed, regarding the need of surgical intervention.
- Remove the cause.
- Massage the uterus to make it hard and express the blood clot.
- Tight intrauterine packing with hot intrauterine douches can be done to stimulate the uterus to attain its tone.
- Arnica by fatigue of the organ. After a very rapid Labour, or after the extraction of the body immediately after the birth of the head, the uterus may suddenly fail, here Ignatia would be suitable.” Other medicines frequently indicated are:
- China: Dark clots with abdominal distension. Painful heaviness in the pelvis.
- Ustilago- Oozing of dark blood, clotted, forming long black strings. Flaccid uterus, dilated and relaxed os. Discharge of blood from slightest provocation.
- Nux vomica: Blood black with pain in the sacrum and constant urging to stool.
- Trillium pendulum: Gushing of bright red blood with sensation as though the hips and back were falling to pieces, > tight bandages.
Retained placenta or membranes: The placenta is said to be retained when it is not expelled out even 30 minutes after the death of the baby. It may be due to hour glass contraction of the uterus or incompletely separated placenta. The case can complicate to haemorrhage and Shock (if retained beyond 1 hour).
Homeopathic Medicines: Dr. Hughes says, “A dose of Arnica in all cases be given as soon as the child is separated. If this is insufficient, Pulsatilla or Secale may be given as for deficiency of uterine contractions during the previous stage. It is seen that the tendency to adherent placenta may be combated by Hydrastis.”
- Gelsemium: When, with the retained placenta, there are cutting pains in the lower part of the abdomen, usually running upward, or sometimes upward and backward.
- Secale cor: Constant sensation as of bearing down; it seems to her too constant strong to be effectual; passive haemorrhage; the parts feel to her as if relaxed, and there is an absence of uterine action; especially suited for thin, scrawny women.
- Sabina: Pain, or an uneasy, bad feeling, extending from the sacrum to the pubes; a slight sensation as of motion in the abdomen; intense after pains, notwithstanding the retention, with discharge of fluid blood and clots, in about equal proportions, with every pain.
- Gossypium: A powerful emmenagogue used in physiological doses. Useful in cases with retained placenta.
To promote expulsion :
- Pulsatilla; Secale cor; Silicea; Sabina;
- Cantharis to expel moles, dead foetuses, membranes.
- Kreosote: discharge of clots with a foul smell.
Homeopathy, as a science of healing helps the female to cope up with the changes in her body without affecting the growing child. Pregnancy is considered the ideal time for prescribing medicines which could help in establishing the health of both mother and her growing child.
Dr. Samuel Hahnemann also advised pregnancy as the ideal time for prescribing medicines. In Chronic Diseases he mentions, Pregnancy in all its stages offers so little obstruction to the antipsoric treatment, that this treatment is often most necessary and useful in that condition. Most necessary because the chronic ailments then are more developed. In this state of woman, which is quite a natural one, the symptoms of the internal psora are often manifested most plainly on account of the increased sensitiveness of the female body and spirit while in this state; the antipsoric medicine therefore acts more definitely and perceptibly during pregnancy, which gives the hint to the physician to make the doses in these as small and in as highly potentized attenuations as possible, and to make his selections in the most homoeopathic manner.
Homeopathy thus helps us to perform our responsibility of serving humanity by maintenance of health. As Dr. Guernsey puts it, “He is the true physician who seeks not only to relieve the present suffering, but at the same time to remove its cause in the constitution itself, and thus prevent the return of the evil. He is truly a benefactor of his kind who, not content with curing the generations with whose successive portions he mingles, thus seeks to improve his present opportunities in the light of an advanced and beneficent science, in such a manner that the race may be rendered more healthy in all years to come”.