The desire and demand for integrative healthcare during pregnancy is soaring. Women across the world are seeking collaboration from providers outside of the conventional medicine paradigm. With this direction of care, women can receive proper holistic health to address their physical, mental, and emotional concerns throughout pregnancy. 

In this article, we'll dive into prenatal integrative care, the therapeutics that are useful, the types of practitioners that can collaborate in care for women in pregnancy, and functional medicine labs that can assist in patient care. 

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What is Integrative Prenatal Care?

An integrative approach to prenatal care considers both conventional medicine care and complementary medicine to create a holistic, comprehensive care plan. Holistic prenatal care seeks to support the transformative pregnancy journey with care that allows you to experience in-depth physical, mental, emotional, and spiritual well-being. The least invasive methods to the health of you and your baby during pregnancy are often followed in this model. 

Tapping into the tools offered by the varying integrative practitioners, such as integrative OB/GYNs, functional medicine practitioners, midwives, acupuncturists, chiropractors, yoga instructors, or physical therapists, can add an abundance of support during this journey. In this way, you can have a pregnancy that allows you to explore beyond the physical changes of pregnancy. One of the main ways in which this is different than conventional care is that it is often patient-led, allowing you to play a dynamic role in expressing what it is your body truly needs.

Common Therapies Used in Integrative Prenatal Care

Incorporating holistic modalities can greatly benefit you and the development of your child. Here are some areas that integrative practitioners can help you address throughout your pregnancy. 

Nutrition And Diet During Pregnancy

Your nutritional intake during pregnancy is important for maintaining your health while also being a conduit for the development of your baby. Getting adequate vitamins, minerals, and macronutrients through food is key during pregnancy. Depending on the type of integrative practitioner, the dietary approaches may vary some. But the main objective of getting the essential nutrients and adequate calorie intake should be similar. In terms of calories, increasing your calories by about 300 extra per day will support fetal development. Maintaining or implementing an emphasis on eating a variety of fruits, vegetables, complex carbohydrates, protein, and dairy (if tolerant) should be the goal. Processed foods, raw protein, high-mercury foods such as swordfish, and unpasteurized products are items to caution around, especially if you do not know the exact sourcing. 

If you are struggling in this area, there are specific nutrition plans like the Core Food Plan that a functional medicine practitioner can work with you on. This nutrition guideline is tailored to your needs with a focus on balancing whole foods-proteins, low-glycemic, high-fiber carbohydrates, phytonutrients, and healthy fats. It's important to note that your habits prior to pregnancy are a predictor of how you will eat during pregnancy. If you find this to be an area you struggle with, working with an integrative practitioner that is trained in nutrition could equip you with the tools necessary prior to conception. 

Exercise And Physical Activity Recommendations

Movement during pregnancy is supportive of your health and vitality. If you exercised prior to pregnancy, the general recommendation is that you can continue your routine with modification. An exercise goal should consist of 30 minutes of moderate-intensity exercise per day, at least five days a week. This can be anything from walking, swimming, stationary bicycling, low-impact aerobic classes, and pregnancy geared workout classes such as yoga. The benefits of exercise range from maintaining a healthy weight in pregnancy, increasing your physical strength and fitness for delivery, reducing aches and pains, easing constipation, and decreasing your risk of preeclampsia, gestational diabetes, and the need for a cesarean section delivery. In the postpartum phase, exercise can help you get back to your pre-baby weight and reduce symptoms of postpartum depression.

Prenatal Screenings And Medical Examinations

When you see your OB/GYN or midwife, they'll want to do prenatal screenings and physical examinations. Conventional OB/GYNs tend to run the full gamut, which includes a pelvic exam, urine tests, and blood tests. Urine tests will detect infections, gestational diabetes, or preeclampsia, while blood tests look at anemia, blood type, Rh factor, and sexually transmitted infections and measure the antibody status of rubella and chicken pox. They also recommend a variety of specialty tests depending on your history, age, or results of previous blood work. Some specialty tests include amniocentesis or a chorionic villus to test for genetic disorders and nonstress tests. 

Midwives tend to take a less aggressive approach. They will run initial blood work and urine to make sure the mother is healthy and genetic testing if there is a concern. Both approaches offer ultrasound, glucose tolerance tests to test for gestational diabetes, and Group B streptococcus swabs to make sure there is no infection prior to vaginal delivery. While some tests may be necessary, care also really depends on what level you are seeking and comfortable with. 

Importance Of Adequate Sleep And Relaxation Techniques

Restorative sleep is essential to the well-being of both the mother and the growing fetus. Optimal immune function, cognitive function, emotional health, appetite, blood pressure, and blood sugar regulation all have ties to getting proper sleep. Relaxation is also key to successful pregnancy outcomes. A regulated nervous system can set the stage for your body to adapt more effectively to the changes that pregnancy brings. 

One study review found that relaxation techniques during pregnancy benefit the mother, the fetus, and birth outcomes. The findings reported more positive emotional states for the mother during pregnancy, fewer complications and hospital visits, reduced cesarean section births, optimal fetal heart rate, and higher birth weight. Utilizing integrative therapies such as massage, yoga, and breathing techniques are all great avenues for supporting relaxation and sleep. 

Complementary Therapies & Approaches Used During Prenatal Care

Integrative care practitioners can assist with areas of health and wellness by using holistic and complementary tools. 

Acupuncture And Acupressure During Pregnancy

Traditional Chinese medicine (TCM) encompasses the practice of both acupuncture and acupressure. This form of Eastern medicine assesses energy flow in the body and then applies acupuncture needles at spots specific to therapeutic points on the body. Treating points that are unique to your clinical presentation can help the movement of energy, or Qi, and restore the flow of energy between organ systems in the body. The areas that this complementary approach can assist with in prenatal care are GI upset-like nausea. Pericardium 6, which is a point on the wrist, is a commonly treated acupuncture point for nausea. 

A needleless form of this modality is acupressure, which is firm pressure to treatment points. One study looked at the literature on acupressure in pregnancy. It found that women had improvement in leg cramps, headaches, and low back pain. Additional areas of prenatal care that TCM can benefit are depression, anxiety, sleep challenges, pelvic pain, and labor pain. Working with a skilled acupuncturist that can evaluate these imbalances and treat them accordingly can truly support your pregnancy journey.  

Chiropractic Care For Prenatal Health

Holistic prenatal care can greatly be supported by chiropractic care. Pain, particularly low back and pelvic pain are common complaints in pregnancy. Seeing a chiropractor who is an expert in treating musculoskeletal pain has been shown to be beneficial in treating pregnant women with low back pain, pelvic pain, and joint pain. Some chiropractors obtain specialty training in treating pregnant women, known as the Webster Technique, offered through the ICPA in order to provide more specific care. 

Herbal Remedies And Natural Supplements

Natural substances can be both therapeutic and soothing for the mind and body during pregnancy. When it comes to herbal medicine, there are some great options to address things such as nausea, stress, insomnia, and labor preparation. Ginger teas, lozenges, and supplementation are often used for upset stomach and nausea during pregnancy. It's a soothing and effective way to ease those discomforts. Lavender is commonly used to help with symptoms of anxiety and stress. In pregnant women, a study showed that using lavender cream can help ease those symptoms, plus depression in pregnant women. Lemon balm tea is another great herbal medicine, one that can relax the nervous system and assist with restlessness and insomnia. At the end of pregnancy, incorporating red raspberry leaf tea can help prepare your uterus for delivery. With the help of a skilled midwife or trained herbalist, black cohosh can be used to help induce labor in particular situations. 

When it comes to supplementing with vitamins and minerals, there are some key nutrients that all prenatal vitamins should include. Nutrients that are crucial to the mother's well-being and development of the fetus include folate, iron, calcium, vitamin D, iodine, choline, and omega-3 fatty acids. Working with an integrative doctor that can test your nutrient status and provide you with appropriate nutrition and supplemental recommendations will set you up for success in this area. 

Emotional And Mental Well-being During Prenatal Care

An integrative medicine approach will look at how your mental and emotional health is impacting your overall well-being during pregnancy. As humans, we do better when we have a sense of community and support. This rings true even more so when it comes to pregnancy. There will be emotional ups and downs and potential mental health hurdles like depression and anxiety, and it's important to have a support system that can recognize these changes and helps you get the necessary assistance. Therapists, meditation guides, yoga classes, and relaxation techniques are all great avenues to help you work through the challenges that may arise in pregnancy. 

Environmental Factors And Prenatal Health

We're constantly being bombarded with environmental toxin exposures. From the air you breathe to the water you consume and the food you eat, there are potential risks to chemicals, pesticides, and heavy metal exposures. Detrimental effects such as infertility, miscarriages, premature birth, low birth weight, and neurodevelopmental impairment have been associated with maternal exposure to a variety of environmental toxins. While it is impossible to avoid them altogether, you can mitigate some of these by incorporating some lifestyle changes. Buying organic produce will reduce pesticide exposure in your food, using a water filtration system at home can reduce harmful toxins in your drinking water, and using an air purifying system can reduce toxins in your home. 

Functional Medicine Labs Commonly Ran During Integrative Prenatal Care

When working with an integrative healthcare provider, obtaining root cause answers is often the goal. Optimal intervention and care can be recommended through clinical observation, physical examination, intake, and comprehensive testing. 

Micronutrient Testing 

Nutrition is key to thriving in pregnancy. Sometimes the foods you're eating are not nutrient dense due to soil depletion and lack of food variety. Evaluating your micronutrient status can provide insight as to whether or not dietary changes or supplementation is necessary. SpectraCell's Micronutrient Test looks at an array of minerals, vitamins, amino acids, and fatty acids.

Cortisol Evaluation

While stress is oftentimes a mental stressor in pregnancy, the body can respond by releasing cortisol to compensate. Testing cortisol via a series of Salivary Cortisol tests can provide insight as to whether or not stress is impacting your physical health. Prolonged stress that is causing excess cortisol secretion can also negatively impact a developing baby's brain. 

Thyroid Panel 

Chronic constipation, mental and emotional distress, and debilitating fatigue can be red flags for thyroid dysfunction. While these symptoms may be typical, ruling out a thyroid imbalance could be warranted. A comprehensive Thyroid Panel will look at seven biomarkers, including autoimmune thyroid markers, which can help catch things like postpartum thyroiditis early on. 

Environmental Toxins

Toxic exposures in the environment can negatively impact areas of prenatal health, as mentioned above. If you have a known exposure, are concerned with prenatal health, or would just like to optimize your health, there are a few key environmental tests you could get done. The RTL Tox Complete by RealTime Laboratories will test for common toxins, while a hair analysis by Mosaic Diagnostics will asses numerous heavy metals that could be contributing health concerns. 

Collaboration Between Different Healthcare Disciplines

Each integrative healthcare profession brings a different perspective and contribution to prenatal care. Collaboration amongst healthcare professionals who are trained to work with pregnant women and will assist their patients in directing care to a healthcare provider that will best suit them is really the key to integrative medicine. You may start off with your OB/GYN or midwife, but as situations arise, referrals to chiropractors, naturopathic doctors, nutritionists, physical therapists, mental health experts, etc., will provide you with well-rounded care and a truly holistic approach. 

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Summary

Collaboration efforts in interdisciplinary healthcare are the future of women's healthcare. With an abundance of opportunities to serve women throughout pregnancy, we would be doing them a disservice not to continue exploring and integrating these complementary medicines. An integrative approach addresses the deep needs of an expecting mother and honors the interconnectedness of the mind and body. This enhances her pregnancy experience, promotes optimal outcomes, and nurtures self-governing in the trajectory of her healthcare. My hope is that this shift continues and women have more opportunities to access care in integrative and complementary fields.