Supporting Optimal Timing for a Successful Pregnancy
October 25, 2016 by Mark Newman, MS
Dr. Rices’ experience in women’s and pediatric care allows her to continually work to create programs that provide calm and stable atmospheres for pregnant and nursing women. We look forward to getting your comments and questions down below.
Let’s be honest: pregnant women are scary to treat. We may as well throw the nursing mothers in that topic as well. This blog is designed to make you healthily aware of the very precise amount of scrutiny you need when treating females that are wanting to get pregnant, and continuing care through pregnancy, delivery, nursing, and post-partum. The seriousness of making a baby is just as serious as losing a baby. I want you to be able to share in the joy of creating a healthy body for an anticipatory mom, and be able to celebrate this with full confidence.
In the realm of research, not a lot of money has gone into pregnancy and nursing besides what you CANNOT do, or what you SHOULD NOT do. This is frustrating as a physician, and as a patient. As a provider, you ALWAYS perform due diligence in what your appropriate scope of practice allows and what you feel comfortable with in regard to treatment in this area. There are specialists that are trained to take on these challenging patients; if you are not one of them, please pass them along to a more confidently trained practitioner. This blog is focused more for the in-betweeners; the practitioners that are trying to assist in getting women pregnant and possibly get them back after a baby has been born.
In regard to fertility, and getting women to that point of pregnancy, it is your responsibility to assure that your recommendations are safe when your patient DOES become pregnant. You want to create a calm and stable atmosphere for these women. Once your patient has delivered you can continue to properly support mom and her hormones.
Fertility seems like a simple topic. Then the body gets involved, and it can become much more complicated, especially if there are other practitioners and medications added in the mix. Completing a DUTCH Cycle Mapping test can outline a woman’s cycle, provide information about where her estrogen and progesterone surge are to help with ovulation, quantify estrogen and progesterone, and determine the length of the estrogen and progesterone surge during the cycle.
For fertility, we are trying to support optimal timing, as well as the quantity of hormone levels. Estrogen is necessary to supply the LH surge for follicle development; it is also needed for continued endometrial building and lining. Progesterone is supposed to jump on board after the LH surge to continue helping in creating a nice comfortable environment for when the egg moves out of the fallopian tube. Once the egg attaches to the tissue, the progesterone continues to support embryo development until the placenta is engaged and it takes over for continued embryo development.
Successful fertility is a super happy story. What can you do to get an anticipatory mom there? You need to know where her hormones are and what treatment to prescribe.
Black Cohosh is a great estrogenic herb to support healthy estrogen levels if needed. Estrogen (biest), and in some fertility clinics – clomid, can also support healthy estrogen response for follicle development. This should not be continued with pregnancy.
Bioidentical progesterone (oral, topical, vaginal) can be greatly helpful in regulating progesterone levels. Chaste tree is a wonderful herbal addition for progesterone support. This may be something necessary to continue once pregnancy is confirmed. Loss of progesterone can lead to loss of pregnancy. This needs to be tested routinely with the occurrence of pregnancy and managed with stability.
DHEA and cortisol support
DHEA is best managed with lifestyle (stress management and blood sugar regulation). After DHEA is managed, it comes down to cortisol. Again, there are great herbs and amino acids that can support cortisol levels such as adaptogens, stimulators, and suppressors. However, the ones that can continue to be taken during pregnancy are the glandulars; the ones without any suspicious herbs. That is not to say that herbs cannot be used to their advantage before and after pregnancy. However, during pregnancy, safest is best and this includes certain vitamins, minerals, and glandulars.
*note: this is also to say that Thyroid management is crucial when looking at fertility in the realm of hormone levels. So many things can contribute to creating optimal health for an anticipatory mom – such as vitamin status (ferritin/iron, vitamin D, omega levels, etc).
Most of the time, the rules for pregnant women also apply to nursing women. There are certain things that are transmitted through breast milk, and some that are not. It is generally safe to say that what goes for pregnant women, goes for the nursing ones as well.
Do not be discouraged by the want-to-be-moms! You can definitely get them started in their goals for pregnancy and all the way through successful delivery. Ensure that your patient has someone you trust for referral when they DO become pregnant. Most of the time, I am not worried about the baby getting what the baby needs once the pregnancy is stable. The focus continues to be on making sure that mom does not become deficient AFTER pregnancy and nursing. Keeping an anticipatory mom balanced before pregnancy is the best way to keep her optimal during and after pregnancy. Celebrate this joyous occasion with full confidence in knowing that you are taking the correct steps to success.
*This blog post is not intended to diagnose, treat, cure, or prevent any disease. The information provided on this site is not intended as a substitute for advice from your physician or other healthcare professional. Please consult with a healthcare provider before making any changes to diet, supplements, medications, lifestyle, or if you suspect you might have a health problem.