[Kate Levett]

Are you?

Sorry – I didn’t realise!! Are you in Sydney too? Mel Chivers is as well, on the Northern Beaches – we should get together (when we get out of lockdown) – assuming you’re around here!!

[Kate Levett]

Hi BrodieI looked up the O&G College guidelines:https://ranzcog.edu.au/statements-guidelines/covid-19-statement/covid-19-vaccination-informationAnd the State recommendations:https://www.health.gov.au/sites/default/files/documents/2021/06/covid-19-vaccination-shared-decision-making-guide-for-women-who-are-pregnant-breastfeeding-or-planning-pregnancy-covid-19-vaccination-shared-decision-making-guide-for-women-who-are-pregnant-breastfeeding-or-planning-pregna_0.pdf
And the Australian Breastfeeding Association recommendations:
https://www.breastfeeding.asn.au/bfinfo/covid-19

Not sure what country you’re in, but the national and state guidelines are usually a fairly good way to find synthesised information. However it’s often on the conservative side, so way up the pros and cons.
Hope this is a good start
ThanksKate

[Kate Levett]

This discussion of Ki9 had me thinking about point prescriptions from the classic literature. This is the list of indications for Ki9 (not sure of the original source).

1 Strong spirit disorders – anger, cursing, mania.

2 Deficient yang, cold, in the abdomen – shan disorder, hernia, pain a/or retraction of the scrotum.

3 Useful in a detox prescription to assist the cleansing, especially with respect to emotional outbreaks

The second indication struck me as the cold lodged in the abdomen (and then the male centred indication), could also be thought of as post-partum pain due to lack of yang movement to retract the uterus maybe?

I do find that post-partum pain often has to do with inflammation of the bowel also, and the pain arises as the uterus retracts down it presses against the bowel and pain radiates.

Just thoughts!!

[Kate Levett]

Hi Diana

For breech/malposition, my advice is generally to continue with the moxa for the prescribed 10 days, even if the baby has turned cephalic. But I have also been told by my teacher Shimamura Sensei, that consuming sugar following cephalo-version with moxa will make the baby go breech again! He followed his wife around after their baby went breech again after having moxa, and concluded it was her sugar consumption! Can you imagine 😉

I think he said that the heat from the sugar consumption rose to the head, causing the baby’s head (the hottest part) to go back up! So, just in case I recommend they also don’t consume sugar until 39 weeks, when the sugar (in the form of honey or dates usually) will help to soften the cervix (according to Kiiko Matsumoto).

Putting my researcher hat on, the research would suggest that moxa is successful in around 50-60% of cases, and that it’s most effective between 34-37 weeks’ gestation. Having a manual ECV (external cephalo-verstion) is also successful in about 50% of cases and is recommended from 37-38 weeks. However, fewer than 10% of women attempt an ECV due to the perceived associated discomfort.

A trial conducted at Western Sydney Uni also followed women after conducting moxa for breech and some of whom went on to also have an ECV. They reported on those who then had both procedures, and they found that when a woman had had moxa for 10 days (once per day for 20 mins), then had an ECV (if moxa unsuccessful), the overall success rate was about 75%.

So, I also encourage women to explore having an ECV if they are comfortable with it.

Thanks

Kate

[Kate Levett]

Hi Ali

In Japanese acupuncture Ki9 has 2 locations, the standard location at the edge of the gastrocnemius muscle or located 3 cun below Ki10, where there is a tender spot. Much of its function comes from being a xi cleft point – it has connections to the organ and meridian ensuring flow of blood.

It is so wonderful for pregnancy – it is used as part of a dexot treatment, so again the idea of cleansing the uterus, but also for the skin with conditions like eczema, which can break out during pregnancy. It is also part of a thyroid treatment, if the person’s thryoid is part of their fertility picture or thyroid function is changed in pregnancy, or if they are quite cold and the thyroid reflex is tender.

Ki9 is also indicated for releasing Sp20 indicating some emotional component. Sp20, up in the chest/front of the shoulder, near Lu1, in the 2nd intercostal space – if tender can indicates an emotional component – kind of like a protection that someone brings their shoulders forward when they are experiencing some sadness or worry. And that creates some tightness in that area, and Ki9 relaxes the area.

I love this point – it is one of my favourites! 🙂

[Kate Levett]

This is great Sarah

Thanks so much for sharing.

Kate

[Kate Levett]

Hi Ciara

Would you have said she was blood deficient to begin with, or Ki or Sp deficient? What was the background status. If she’s had 14 pregnancies and 7 live births, were the miscarriages interspersed in all the pregancies or toward the later end of her childbaring?

Interested to know a little more about her constitution.

Thanks

Kate

[Kate Levett]

This is a great point combo! GB13 is a point where “essence and marrow gather” and it has the purpose of connecting the Shen and Essence – so when combined with Ren 4 or BL23 brings the Essence to the head. Great for depression – brings a clear headedness. And for calming the mind when there’s restlessness (mania, but not so dramatic as that).

But as a local point, it subdues Lv Yang so good for headaches too! And I’ve used it for epilepsy and it has an immediate effect in clearing the mind when the person’s head feels muzzy.

This is a lovely combo 🙂

[Kate Levett]

Hi Brodie

Sorry if I’m repeating myself, but I said something similar in a post in response to Ciara’s hidden abruption post.

The main contributing factor to placental abruption is anaemia in the western context. I have copy and pasted with the RAZCOG say with regard to optimal haemoglobin ranges for the prevention of adverse outcomes below (including abruption).

So, if your clients have persistent anaemia, perhaps encourage them to address this with medical professionals, and focus on the St36, BL17 moxa treatments to supplement. Thoughts anyone?

What I notice with the Western associations noted below for anaemia is not only abruption but post natal depression, which is what we see in the TCM blood deficiency picture.

Also, haemorrhage is the leading cause of maternal death world wide, and anaemia is associated with a higher risk of haemorrhage. In developing nations, this is mainly due to malnutrition due to lower food intake, but in Western countries malnutrition may be associated with a lack of balanced nutrition, or poor gut absorption etc.

So, always good to keep a close eye on the early and persistent anaemia clients.

4.1.2 The optimal haemoglobin range

There is evidence indicating an association between maternal anaemia and adverse pregnancy
outcomes, including:

• low birth weight and preterm birth when mothers are anaemic in the first or second trimester96

• placental abruption,97 maternal mortality98 and postnatal depression.99

Studies that have generated this evidence have used the statistical definitions of anaemia outlined
above; however, many confounding factors are present. A more specific Hb range that results in optimal
maternal and perinatal outcomes (other than absence of statistically determined anaemia) has not been
established. In light of evidence that higher Hb levels may also be associated with adverse pregnancy
outcomes,100 it would seem reasonable to assume that normal pregnancy haemoglobin levels lie between
103 and 146 g/L.

[Kate Levett]

Hi Ciara

What women are being told here is that in absence of evidence to wait, because they don’t know if there are any adverse outcomes. Not because they’ve observed any issues. However, we are not facing the same issues as you are in Canada/USA, so I would see if the Mum feels like she wants to get vaccinated for her own security.

We have only had 18 pregnant women with COVID in total, so not enough to make any recommendations.

[Kate Levett]

I have not had this experience specifically, but agree about the liver gummies (kori in Japanese acup) being amazing to release tight cervixes. I also learned this from Claudia at the in-hospital programme and it has been a mainstay of my preparations for the A-type folk!

One thing that I have consistently noticed, which has been different from Claudia, is that when I use this on women who are a little ‘up tight’ (said with love!), for labour preparation/cervical ripening, they nearly always have a ‘hot flush’ when the gummies (kori) are being massaged. I now keep going until the hot flush has passed the peak and is calming down. They usually then report a deep feeling of relaxation.

Has anyone else noticed this?

[Kate Levett]

Hi Ciara

According to the research, the main contributing factor to abruption in Western contexts is anaemia. Any clients who have persistent anaemia should be watched for any signs of abruption. In the case you’ve outlined, it’s tricky because wasn’t any bleeding, which is usually the main sign. But sometimes the blood pools in the uterus and hence there is pain, but no bleeding straight away. Any pain during pregnancy should be investigated though – and I imagine that her pain would have been quite significant, so it’s even more unfortunate that your client’s pain was not investigated properly.

How is she doing?

Thanks

Kate

[Kate Levett]

Hi Kari

The online acupressure videos that Evidence Based Birth uses are my ones that I filmed a couple of years ago. You or your clients can access them via my website if you think that’s helpful. The link is:

https://drkatelevett.com/video-resources-acupressure-for-labour

Or anything else that you offer online will be more useful than not doing it, so depending on your current restrictions in your area, good to have some connections with the local birthworkers and parents. Start with friends and get the gist of the online delivery.

Thanks

Kate

[Kate Levett]

Hi Sarah

The thryoid reflex and treatment is a Japanese acupuncture technique/practice, which I have learned variously from Kiiko Matsumuto, Yoshi Shimamura and Paul Movsession in Australia.

I find it to be a really great part of the fertility and pregnancy treatments, and is often a subclinical presentation, with signs of fatigue and usually thinning eyebrows at the edges, but not positive on blood tests. But if the reflex is positive, I will use the treatment. If bloods are positive, I will definitely use the treatment. There is a difference for hypo and hyper, but mostly it’s hypo which is indicated.

I did a weekend workshop years ago, where I received the treatment several times over the course of the weekend, and I have no demonstrable thryoid issues, however it runs in my family, with my 3 sisters and father have varying levels of hypothyroid. After the weekend I felt absolutely amazing after a whole weekend of working on it! I am often slightly fatigued because life is busy, so this was a real boost to mood and energy.

The reflex is either at St9 (beside the Adam’s apple), where the thyrohioyd muscle is or at the base of the SCM, where the muscle bifurcates. In palpating toward the midline in both cases, if there is tenderness, that is a positive reflex. I use the pads of the first two fingers, so that it’s not too sharp a palpation and gently press towards the midline.

You are looking for the treatment points which are tender, and reduce the tenderness of the reflex point at St9 or SCM. They must release the reflex, or they are not your point.

Points are Ki9 + L.I.15 (detox Rx) + Lu4 + TW4 + eustacian tube points + BL39/40, 58 and 60. I also add Lv8 if it reduces the reflex and if their L middle pulse is deficient (Lv blood xu).

Hope that helps

Kate