Anyone who has been pregnant knows it’s no walk in the park. From the intense nausea, vomiting, and strange cravings of the first trimester, to all the aches and pains of the third trimester, carrying a baby can feel like a marathon! It’s no wonder pregnant women look high and low for any form of relief. Two questions we are asked frequently here at MotherToBaby are-“Can I get a massage?” and “Is acupuncture safe during pregnancy?”

Want a massage? Here’s the rub…

At 38 weeks pregnant, my feet hurt, my back hurt, sometimes it felt like even my hair hurt! All I wanted was someone to knead all my aches and pains away. I wanted a massage, so being a MotherToBaby information specialist, I set out to research massage during pregnancy. On the plus side, studies have shown that massage can benefit pregnant women. Massage during pregnancy not only helps with those aches and pains, it has also been shown to decrease stress, help ease symptoms of depression, and increase feelings of wellbeing. Sounds pretty good, right?

So, should you run out and book that massage right this second? Not too fast – there are a couple of things to keep in mind. The safety of massage in the first trimester hasn’t been studied well. Because of this, some massage therapists and medical professionals recommend avoiding massage during the first three months of pregnancy. If you do decide to get a massage in the first trimester, it’s better to choose a massage that doesn’t use heat (like a hot towel or hot stones), especially around the stomach area or lower back. This is because overheating during pregnancy can increase the risk of birth defects. See our fact sheet on hyperthermia for more information: https://mothertobaby.org/fact-sheets/hyperthermia-pregnancy/.

When getting a massage at any point in pregnancy, choose a massage therapist who is trained to work with pregnant women. These therapists will know to avoid pressure in certain areas and will also know which places can get especially sore when you’re carrying a baby. It’s also best to avoid massages that apply a lot of pressure, like deep tissue massages, since these haven’t been well studied. Finally, make sure your therapist knows whether you have any allergies to certain oils and that they are using products that are not known to increase risk during pregnancy.

If you’re getting a massage in late pregnancy, the massage therapist may offer to apply pressure to certain points on your body that are thought to bring on labor. Studies have not shown that this actually induces labor, but to be on the safe side it’s better to wait until you are at least 39 weeks pregnant to try.

What about acupuncture? A few points…

Acupuncture is a technique in which a trained practitioner inserts very small needles into certain points of the body. Stimulating these points is thought to help with pain, indigestion, infertility, and much more. Acupuncture is usually recommended to pregnant women to help with nausea and vomiting, and to relieve pain.

The available studies do not show an increased risk of birth defects or other pregnancy problems when pregnant women use acupuncture. The most common risk with acupuncture is to feel a little pain when the needles are placed. While the risk from acupuncture is low, studies also haven’t shown that acupuncture necessarily helps with nausea, vomiting, or pain during pregnancy.

If you do decide to get acupuncture during pregnancy, be sure to find a trained practitioner. You may want to find a practitioner with experience working with pregnant women as well. Make sure your practitioner is not re-using needles from other clients as this may increase the risk of certain infections. Like massage, there are a few acupuncture points that are thought to bring on labor. Studies haven’t shown that this will bring baby earlier, but it’s best to avoid these points unless you are at least 39 weeks pregnant.

As with any treatment, it’s best to talk to your healthcare provider before starting. Remember, we’re here to help too! If you have any questions about massage, acupuncture, or any other exposure during pregnancy, you can contact an expert at MotherToBaby by calling 866-626-6847, texting 855-999-3525, or by live chat or email at https://mothertobaby.org//a>.

Bethany Kotlar, MPH, is a teratology information specialist with MotherToBaby Georgia. She holds a Masters in Public Health specializing in Maternal and Child Health, and is a Certified Childbirth Educator. She enjoys exercising, traveling and Netflix.

About MotherToBaby

MotherToBaby is a service of the Organization of Teratology Information Specialists (OTIS), suggested resources by many agencies including the Centers for Disease Control and Prevention (CDC). If you have questions about exposures during pregnancy and breastfeeding, please call MotherToBaby toll-FREE at 866-626-6847 or try out MotherToBaby’s new text information service by texting questions to (855) 999-3525. You can also visit MotherToBaby.org to browse a library of fact sheets about dozens of viruses, medications, vaccines, alcohol, diseases, or other exposures during pregnancy and breastfeeding or connect with all of our resources by downloading the new MotherToBaby free app, available on Android and iOS markets.

The post The Pain of Pregnancy: Can Massage or Acupuncture Safely Help? appeared first on MotherToBaby.

Aryan* and Shanaya had been married for two years and very much wanted to start a family. When they were not successful at getting pregnant, they were tested for fertility (all tests came back as normal) and months of expensive medical treatments were tried without success. Emotionally and financially spent, the couple sought the counsel of friends and family. A childhood friend from India recommended an over-the-counter herbal fertility supplement called vasantha kusumakaram. The product is described as being “100% natural” so she was certain that it must be safe. Shanaya took this daily for 5 months and hoped for a baby.

In India, the traditional approach to medical care is referred to as ayurvedic medicine. In this 2000-year-old tradition, naturally occurring herbs are mixed with other substances and are prescribed for a range of symptoms. Vasantha kusumakaram is reported to be a treatment for many illnesses and problems including diabetes, lung, heart and kidney diseases as well as heavy periods, impotence and tuberculosis. It is also felt by some to be an aphrodisiac!

During the months that Shanaya took the herbal treatment she did not become pregnant. Eventually, her husband suggested checking in again with her primary health care provider because she had started to suffer from abdominal pain, constipation, fatigue and loss of appetite. At that return visit, her blood pressure was surprisingly elevated and her blood count was low (anemia)….the combination of symptoms was a dead ringer for lead poisoning.

After recognizing the symptoms of lead poisoning, her doctor took a detailed history.

• Renovating a home that was built prior to 1978 can expose occupants to high lead levels from old paint, but Aryan and Shanaya’s apartment had been built in 2002.
• Some occupations such as construction, plumbing, and auto refinishing cause exposure to lead, but Aryan was an engineer and Shanaya was an accountant.
• Hobbies such as pottery, target shooting and working with stained glass involve lead, but Aryan and Shanaya mostly spent their free time hiking with their dog and watching movies on Netflix.
• Her doctor knew that 1 out of 5 ayurvedic medicines purchased over the internet contain heavy metals such as lead, mercury, and arsenic suggesting that the vasantha kusumakaram might be responsible.

Lead Shouldn’t Be In Your Body At All
Lead levels greater than 5 micrograms/deciliter (ugm/dl) are considered harmful. Shanaya’s level was 114 ugm/dl! Unfortunately, the lead in her body had become incorporated into her bones where it would be released over the next decade.

At Shanaya’s next visit she reported that she had missed a period and had a positive home pregnancy test result. She and Aryan had thought that they would never be able to have children and now they had gotten pregnant on their own!

Lead + Babies = Not Good. Now what?
Lead is not good for babies. During pregnancy, calcium is released from bones to help form the baby’s bones… bringing any lead along with it. Thankfully, prior to Shanaya’s surprise pregnancy, she underwent chelation treatment in order to get lead out of her bones more quickly. This is a process in which a medication is given that sticks to the lead and allows the body to excrete it. The chelation worked and her lead levels came down to 70 and then 22 ugm/dl over 6 months of treatment.

After discovering her pregnancy, a repeat lead level showed a slight climb in lead levels to 30 ugm/dl. While Shanaya and Aryan’s developing baby was at an increased risk for problems such as miscarriage, brain and kidney development issues, and the potential for learning and behavior issues and decreased IQ, chelation was not an option to reduce lead levels. It is potentially harmful in pregnancy and unless lead levels climb above 45 ugm/dl, it is not recommended.

Essential Supplements Are Musts
As her OBGYN, I saw Shanaya and Aryan at 7 weeks along in their pregnancy. We were all relieved to see a healthy fetus with a normal heart rate! I made recommendations to improve chances for a healthy baby, including taking in 2,000 mg of calcium through diet and supplements to provide the calcium that the baby’s bones would need. Green leafy vegetables, almonds and dairy products are excellent sources of calcium. Because of her anemia, we had her start to take iron twice a day. Vitamin D is also involved with bone development so this was the final supplement that we added. At 7 weeks into her pregnancy, her lead level was 17 ugm/dl and by the second part of pregnancy it was stable at 13 ugm/dl.

We performed an ultrasound scan at 20 weeks and their healthy daughter is developing perfectly with no signs of birth defects. While it appears that all will turn out well for this couple, they are already investigating ways to enrich their daughter’s early years to make up for any possible small decrease in IQ as a result of the lead exposure.

Avoiding Lead Exposure
Lead is a metal that doesn’t belong in any of us, but especially in pregnant women. Sadly, though, the only two states that require pregnant women to have lead levels checked are New York and Minnesota. Here’s what you can do to avoid lead:

• Avoid natural or herbal supplements unless your doctor tells you that they are 100% safe.
• Don’t be misled by advertisements that are designed to sell products that haven’t been evaluated for safety and quality.
• Doctors should consider screening all women (not just those who are pregnant) exposed to lead through work or hobbies, who are recent immigrants, live in homes built before 1978, or who have cravings to eat non-food items (pica).

For more information, visit MotherToBaby’s Lead Fact Sheet, or contact a MotherToBaby expert via phone, text, live chat, or email. In addition, MotherToBaby has a whole section dedicated to lead exposure education including videos and brochures here.

*The names and some of the details of this couple have been changed to protect their identity.

About the Authors

Kurt Martinuzzi, MD, is an assistant professor and specialist in Obstetrics and Gynecology at Emory University in Atlanta, Georgia. His interests include resident and medical student education, recurrent pregnancy loss, premature ovarian failure and polycystic ovary syndrome. He has been an active member of the Region 4 Pediatric Environmental Health Specialty Unit since 2015. Over his 25 plus year career he has been awarded multiple teaching awards and presented at many national and regional Ob/Gyn meetings.

Claire D. Coles, PhD, is Professor of Psychiatry and Behavioral Sciences and Pediatrics at Emory University, Director of the Maternal Substance Abuse and Child Development Laboratory, and Director of MotherToBaby Georgia. Her expertise is in the developmental and behavioral effects of prenatal exposure to drugs and alcohol and the interaction of these effects with the postnatal environment. She was among the first to describe the behavioral effects of prenatal alcohol exposure and to investigate the effects of cocaine exposure on child development. Dr. Coles established the only multidisciplinary clinic in the Southeastern United States that provides specialized services to individuals prenatally exposed to drugs and alcohol. Her team also designed interventions for those affected, including the Math Interactive Learning Experience and the GoFAR intervention.

About MotherToBaby

MotherToBaby is a service of the Organization of Teratology Information Specialists (OTIS), suggested resources by many agencies including the Centers for Disease Control and Prevention (CDC). If you have questions about exposures, like lead, during pregnancy and breastfeeding, please call MotherToBaby toll-FREE at 866-626-6847 or try out MotherToBaby’s new text information service by texting questions to (855) 999-3525. You can also visit MotherToBaby.org to browse a library of fact sheets about dozens of viruses, medications, vaccines, alcohol, diseases, or other exposures during pregnancy and breastfeeding or connect with all of our resources by downloading the new MotherToBaby free app, available on Android and iOS markets.

References

Saper RB, Russell SP, Sehgal AS et al. Lead, Mercury, and Arsenic in US- and Indian-manufactured Medicines Sold via the Internet. JAMA 2008; 300(8):915-923.

Guidelines for the identification and management of lead exposure in pregnant and lactating women. https://www.cdc.gov/nceh/lead/publications/leadandpregnancy2010.pdf

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