Acupuncture

Acupuncture works on the idea that energy channels (meridians) run through your body. When you are completely healthy your energy (called Qi, pronounced "chee") flows along the meridians uninterrupted, but if you are unwell the energy becomes blocked, too strong or too weak at certain points. Special fine needles are inserted into these points to unblock, stimulate or sedate the energy flow, or finger or thumb pressure can be applied. In the UK acupuncture is one of the "top five" therapies and over 3000 doctors, nurses and physiotherapists are qualified to use it. Research shows that acupuncture affects brain structures, blood flow and nerve pathways and can raise your blood pressure so if you have high blood pressure or pre-eclampsia, inform your practitioner. Most acupuncturists use disposable needles to avoid the risk of infection. Sometimes mild side effects occur after treatment eg nausea, fainting or a temporary increase in pain. More serious complications are rare but if you suffer any unusual symptoms after treatment tell your acupuncturist. During pregnancy some acupuncture points must be avoided as they may stimulate contractions. Acupuncture is best avoided if you have a blood clotting disorder, but is acceptable if you are anaemic. Acupuncture can be very relaxing so you should not drive immediately afterwards or operate machinery. Acupuncture for nausea and vomiting and pain relief after operations has been shown to be effective but there is conflicting evidence about its benefit in treating backache, headache and pelvic pain during pregnancy.

Aromatherapy

Highly concentrated essential oils are extracted from different parts of various plants and absorbed into the body through the skin (in massage or the bath water), the lungs by inhaling the aromas, or as a rectal suppository or vaginal pessary. Most essential oils smell very pleasant, but the term "aromatherapy" is rather misleading because treatment relies on both the aromas and the effects of chemicals in them. Different essential oils contain different chemicals which have various effects on both your body and mood.

Essential oils have been shown to be extremely effective at combating infections, including the hospital-acquired MRSA, which is very resistant to drugs, and for HIV / AIDS patients. A particularly well researched essential oil is tea tree, which can kill bacteria, viruses and fungal infections. Regular aromatherapy massages can be very relaxing during pregnancy and may relieve some of the normal aches and pains such as backache which occur at this time. A large study was done in Oxford, UK in which over 8000 women were offered aromatherapy during labour to help them relax, relieve pain and make the uterus work more efficiently. The results were very positive and there were very few complications or side effects. This is an especially significant study because it was such a large trial, suggesting that the positive results were more than just a chance effect. Other maternity units have followed suit and introduced aromatherapy in the labour ward, largely as a result of the Oxford study, although the availability of aromatherapy on the NHS remains fairly limited.

Bach flower remedies

Bach flower remedies (BFRs) are liquids containing plant essences thought to have a positive effect on the emotions. A range of 38 remedies plus the Rescue remedy, a universal first aid / stress reliever, is available in health stores, together with booklets aimed at helping you to decide for yourself the most appropriate remedies. Rescue remedy has been researched for relieving examination stress in students, but the results were inconclusive. It is not known how BFRs work, although there are some similarities with homeopathy, but it is thought that, unlike drugs, they do not have a chemical action on your body. They appear acceptable to use in pregnancy, but no research has been done to test for safety. Although the remedies are preserved in brandy, only a very few drops are used at a time, but you may prefer to avoid them if you have moral objections to the alcohol, or have problems controlling alcohol intake or liver disease. If you suffer from any mental or psychological conditions you should only use the remedies on the advice of a qualified practitioner: Bach flower remedies can sometimes have an "onion peeling" effect on the emotions, gradually dealing with the predominant emotion, then revealing concealed feelings, which can, in a few people, lead to the need for professional counselling. If, after taking them for some time, you still feel emotionally unwell, consult your midwife or doctor for further help.

Homeopathy

Homeopathy works on the principle of "treating like with like", but considers you as a whole person, including your personality and the factors which make your condition better or worse. Extremely dilute amounts of substances are used which, if given in larger amounts would actually cause the symptoms which the remedy is intended to treat. The remedies are usually taken as tablets but they do not work in the same way as conventional drugs. It is believed that the remedies contain an energy force which is released from the original substance during the production process of repeated dilution and vigorous shaking; the more dilute the remedy, the more powerful it will be. Homeopaths believe that pregnancy is a normal life event and aim to encourage your body to work efficiently, adapting treatment according to your individual needs. At first you may feel slightly worse before you start getting better, but this is normal and usually indicates that the remedies are working effectively. Research has shown that homeopathy may be useful for women with infertility or menopausal symptoms. Arnica to relieve pain, bruising and infection after surgery or injury has also been studied although the results are inconclusive. Homeopathy is a very gentle therapy, but it is also very powerful, so it important to use it correctly.

Hypnotherapy

Hypnotherapy, or hypnosis, is an altered state of awareness, similar to "day dreaming". It involves deep relaxation and triggers to help you change behaviour and is useful for anxiety, pain and stress-related conditions such as infertility, asthma, irritable bowel syndrome and high blood pressure. Addictions respond well to hypnotherapy and group sessions may be used, for example if you want to stop smoking. You may also be lucky enough to find private antenatal classes in which you can be taught hypnosis for labour. Hypnotherapy is generally considered safe for pregnant mums, but if you have a history of mental illness or epilepsy, check with your doctor before treatment. It has been successfully used to help women prepare for labour, reducing their perceptions of contraction pain, which may also indirectly have a positive effect on the length of labour. Usually expectant mums are given several sessions of hypnotherapy during pregnancy and taught how to trigger hypnosis themselves so that they can use it when their labours start. Alternatively, it may be possible for your partner to be taught how to hypnotise you when you are in labour. One study in which mums used hypnosis for labour, also showed a reduction in the number of mums who developed postnatal depression. Other pregnancy conditions which have been helped by hypnotherapy include sickness, pre-eclampsia and even breech presentation, when the baby is in the bottom-first position.

Massage

Massage is the use of touch which relaxes muscles, stimulates circulation, lowers blood pressure, helps with excretion of waste products and toxins and aids digestion. Research has shown that touch relieves pain and triggers the release from the brain of endorphins, the body's "feel good" factors, which are pain-relieving, anti-depressant and relaxing, thus promoting well-being. Massage is usually performed using a base oil, such as grape-seed, avocado, sunflower, sweet almond, apricot or peach kernel. Regular pregnancy massage is relaxing, relieves anxiety and eases discomforts such as backache, headache and constipation. In labour massage can keep you calm and relaxed and aids pain relief, although you may discover that you prefer not to be touched at this time. Direct massage of varicose veins, areas of thrombosis, burns, scalds, skin infections, open wounds or eczema should be avoided. If you have problems such as bleeding, excessively high blood pressure or a history of premature labour, massage should be done cautiously. Deep kneading massage should be avoided over acupuncture points which may trigger labour. If you are expecting more than one baby or have had infertility treatment your massage therapist should ideally also be a midwife.

Osteopathy & chiropractic

Regular osteopathy or chiropractic during pregnancy can help to relieve backache, sciatica and groin or pubic pain as well as headaches, migraine, heartburn, carpal tunnel syndrome (wrist pain) and chest and rib pain. Chiropractic has been used to good effect to treat children with asthma and infants with colic and cranial osteopathy is wonderful for fractious babies or hyperactive children. It is important to tell your practitioner if you think you may be pregnant as it may be inappropriate to treat you in early pregnancy. If you have high blood pressure (pre-eclampsia) and need to take aspirin routinely to prevent complications, or if you are already taking anticoagulant drugs or have a clotting disorder you should avoid these therapies.

Osteopathy and chiropractic work on the idea that your skeleton is the main framework of your body with everything else attached to it and involve manipulation of your joints, ligaments and bones in order to restore and maintain the correct balance of nerves, muscles and the skeleton. Practitioners are regulated by the UK General Osteopathic Council and the General Chiropractors' Council. Osteopaths use special techniques, including massage, to help joint mobility and re-align your skeleton and its attached organs. Chiropractors concentrate more on joint position and the relationship between the nervous system and the mechanical framework of the body and perform manipulation of the spinal joints, without massage.

Reflexology

In reflexology, the feet (or hands) represent a map of the whole body, with every part of the body reflected on one or both feet. Thus various conditions or discomforts can be treated via the feet, or it can be used for general relaxation, but reflexology is not just "foot massage". There is much debate about the safety of reflexology during pregnancy. There is no evidence that it causes miscarriage, but if you have any early bleeding, it is wise to avoid treatment. Reflexologists who are not midwives may decline to treat you until at least 16 weeks of pregnancy. If you develop complications such as placental bleeding, premature labour or high blood pressure (pre-eclampsia), treatment should only provided with the permission of your midwife or doctor. Reflexology research is fairly limited but it at least as effective as medical (drug) treatments of headaches, constipation, premenstrual and menopausal symptoms, asthma and other stress-related conditions.The relaxation, pain-killing and nerve-blocking effects of reflexology are well documented. Regular pregnancy reflexology may contribute to an easier and more efficient labour. If you have any condition affecting your feet, such as fungal infection, eczema, verruca, varicose veins, or a fracture, hand reflexology may be possible. If you have a high temperature or infectious disease, treatment should be withheld. It is important to inform your reflexologist if you have a history of kidney stones or gallstones, mental illness or other medical condition. If you are diabetic or epileptic, you should only be treated during pregnancy by a reflexologist who is also a midwife. If you have any major health problems such as heart disease, clotting disorders or conditions involving severe inflammation you should avoid reflexology completely as inappropriate treatment may make your condition worse.

Shiatsu

The shiatsu practitioner uses simple thumb, finger, elbow and even heel or knee pressure with holding techniques and gentle stretching exercises whilst the client remains fully clothed. Shiatsu is based on the principles of Traditional Chinese Medicine and, like acupuncture, uses the energy lines - meridians - which run throughout the body. Shiatsu massage is thought to trigger small electrical currents which are conducted away from the point of pressure to act on distant parts of the body. Research has shown an increase in the amount of oxygen in the tissues, which improves circulation and helps with excretion of waste products and toxins. Shiatsu also regulates nerve function, strengthens resistance to disease and makes joints more flexible. Shiatsu is relaxing and safe to receive regularly throughout pregnancy, although there are certain points which should be avoided as they may trigger contractions. It helps you to cope with fluctuations in your physical and emotional state, relieves tiredness and encourages the production of endorphins, the body's own "feel good chemicals". Shiatsu also eases discomforts such as backache, swollen ankles, breathlessness, chronic coughs, insomnia, vaginal and urinary infections, constipation, haemorrhoids, leg cramps, nausea, heartburn and poor milk supply. During labour, it can relieve pain and exhaustion and stimulate effective uterine contractions. A therapist may decline to treat you if you have a major skin infection or other infectious disease, slipped discs in your back, varicose veins or a history of thrombosis.