PCCと産後のサポートー自然懐妊のケーススタディ / Fertility Case Preconception Care Through to Postnatal Support
‘Sharon’ and ‘James’ are typical patients, presenting to my clinic after 8 months of trying to conceive without success. They are starting to get anxious, given their respective ages of 36 and 39. They have yet to get any investigations done, seeking my advice on what to do as they wish for a natural conception without medical assistance. They are well educated in healthy diet and lifestyle, however long work hours and stress with deadlines cause them to eat poorly, irregularly and with too much reliance on ‘fast food’, caffeine, sugar and alcohol. They are too tired to exercise and as a result feel flat and exhausted. Sharon has been having irregular periods over the last few years, which she attributes to stress. Her cycle is between 27 and 38 days. She experiences 1 week of ‘terrible’ PMT with tears, emotional outbursts, sugar cravings, insomnia, bloating and breast tenderness. James is generally well, however his recent blood test revealed some elevation in cholesterol and his blood pressure is high end normal. His stress levels are high and he needs to lose 5 kilograms of weight, which he knows is related to too much beer and not enough exercise.
In the first consultation I spend time discussing the basic science of Preconception Care (PCC) – how vital the 4 months prior to conception are for the health of the baby and pregnancy. During this time, prospective parents need to “Clean up and Build up” with the aim to improving fertility through improved egg, uterus and sperm quality. They also need to see their doctor for ”Check up” – various blood and urine tests, or perhaps for a referral for more complex tests. Finally, the woman needs to monitor her menstrual cycle through charting her sy
mptoms. (see Table 1 in Appendix for more information on the basic PCC list)
最初のコンサルテーションでは、私はまずPCC(Pre-Conception Care = プリコンセプション・ケア、受精成立前のカラダ作りを目的としたケア)について説明しました。赤ちゃんの健康と妊娠にとって、いかに受精前の4ヶ月が重要な役割を果たすのかを知ってもらうためです。この期間、これから親となるカップルには、質の改善された卵、子宮と精子でもって、妊娠力を高めていくことを目的とした、「浄化（クリーンアップ）と強化（ビルドアップ）」が必要となります。また、医師に受診して「検査」を受ける必要があります。様々な血液と尿の検査、場合によっては専門医への照会を受けてより複合的な試験も必要かもしれません。最後に、女性は自分の症状を表にしながら、月経周期の観察も行ってもらいます。
I then prescribe certain nutritional supplements and individualised herbal medicines according to both their medical condition and their naturopathic presentation.
In subsequent consultations the couple demonstrate that they have made a significant commitment to eating well, preparing homemade food, exercising in the mornings and eliminating caffeine and alcohol. They are feeling healthy and vital and positive about the changes they feel in their body.
Sharon’s blood tests reveal a mild degree of inflammation and poor progesterone levels, which may both contribute to poor implantation and early miscarriage. James’ semen analysis shows moderate reduction in sperm motility and quality. Treatment is adjusted in light of the results. Over the next 6 months, improvements are steadily made and Sharon conceives. Managing her anxiety about ‘holding onto the pregnancy’ is just as important in the first trimester as ensuring she eats well. In pregnancy, physical, mental and emotional health blends into one. A strong therapeutic relationship with a pregnant patient is essential for a successful outcome.
Various physical ailments bothered Sharon over the pregnancy, which were successfully treated with acupuncture, nutritional and herbal medicines. Her various nutrient demands changed and needed to be checked and adjusted. (See Table 1 in Appendix for some common ailments and key nutrients for each trimester).
By the time it came to the last appointment with me at 37 weeks, most of the time was spent discussing birth preparation and recovery. A well-prepared woman is an empowered one who can tap into her own internal confidence and voice her needs when necessary. Sharon drank a herbal tea from 20 weeks that traditionally is used to prepare the pregnant uterus for birth. Her labour was 6 hours in length and although she described it as overwhelming she felt so elated to have done it without drugs and to have a healthy baby girl in her arms. She recovered and breast-fed well, with the assistance of some herbs to help boost milk supply. Simple remedies were given to baby ‘Emma’ as needed over the first weeks and months. She has grown into a lovely, healthy child and a beautiful big sister to her little brother ‘Toby’, who was conceived naturally and within 4 months of trying the second time around!
Sharon and James’s story is an illustration of the fact that everything we eat, drink, breath, feel and do can have an impact on the health of our cells, tissues and organs. As a result, we can have profound positive effects on our fertility through making healthy diet and lifestyle changes and employing nutritional and herbal medicines to assist our physiology to regain homoeostasis.