Valerie Gommon Midwife’s Blog

Archive for the ‘diabetes’ Category

Guest blog by Susan Quayle

I became interested in reflexology about fifteen years ago when I bought Laura Norman’s book, The Reflexology Handbook: A Complete Guide. At the time my sister-in-law was pregnant and had morning sickness so badly that she was bed ridden and under threat of hospitalisation. I got my book out and looked up morning sickness in the back and worked the reflexes it showed – having no real idea of what I was doing – and the result was instantaneous. She felt much better than she had for weeks.

It would be a further twelve years before I would work on feet again but this time it would be to train as a reflexologist. About a year after I’d qualified I received an email asking if I would be interested in attending a course in Maternity Reflexology. By this time I’d had two children and was the bearer of double C-section scars so was very interested in what maternity reflexology could offer the pregnant woman. I went along to the course expecting something amazing but not  really prepared for the actuality of how utterly brilliant reflexology is for pregnancy and labour. I came away thinking that Maternity Units were crazy not to have maternity reflexologists working alongside midwives or midwives trained as maternity reflexologists.

Reflexology is fabulous for for everyone but is utterly perfect for pregnancy and labour. They really go together like, like….mother and baby!

Apart from the very serious conditions that are potentially life threatening to mother and/or baby there isn’t a pregnancy related condition that can’t be alleviated and, more impressively, prevented with reflexology. Because pregnancy isn’t an illness but a temporary condition the usual parameters relating to conditions such as oedema, constipation and other digestive related problems, even gestational diabetes, are different from at any other time and if caught in time respond extremely well to reflexology. I say caught in time because some conditions such as oedema need to be treated early as they worsen on a daily basis.

During a treatment mums drift off into deep relaxation, babies squirm excitedly before relaxing with mum into a blissful baby/mummy zone of bonding. During this relaxation blood pressure reduces, energy is restored and reserved, anxiety levels drop and a sense of self and safety permeates the body. Reflexes are worked to balance the internal organs and systems of the body and allow the free flow of blood and energy to every cell of their being. I am always amazed at how early in pregnancy it is possible to feel the subtle changes that take place in the mother’s body – usually the liver and spleen reflexes as the volume of blood increases to produce the growing baby’s blood supply.

I have had many successes with morning sickness, heartburn and fatigue, SPD, constipation, reducing blood pressure, oedema, early onset labour (this treatment was to stop labour at 33 weeks), re-starting labour 5 hours after it had stopped, lack of sleep, discomfort, positive mental attitude toward the growing baby and also toward the mother’s own body image. Regular treatments can also result in a faster labour with less need for pain relief – studies have been done to back up these claims. Women I have treated with regular treatments feel very in touch with their babies and their pregnancies, they tend to say that their labour was easier than previous ones and that they felt more relaxed about the whole experience. They also say that their babies are very relaxed and laid back and that both mother and baby have found breast feeding much easier than in previous births. Reflexology promotes healthy pregnancies, healthy mothers, faster births often with less need for pain relief, happy mothers and happy babies.

I often feel great sadness that I didn’t know about maternity reflexology when I was pregnant as both my birth experiences were over-medicalised and with the use of reflexology might not have been. So this is the message that needs to get out there to all pregnant women – there is help out there to complement and work alongside normal medical practices. You are not ill – you are pregnant and you are doing what your body was made to do. Reflexology can help you to have a happy, healthy pregnancy and baby.

Susan Quayle is a Complementary Therapist based at the Exeter Natural Health Centre in Devon. She is a founder member of Maternity Reflexology South West who work tirelessly to promote maternity reflexology. She lives with her husband, two children, cat and chickens.

To find out more about her visit her website at http://www.lovereflexology.co.uk

This item is reproduced (with consent) from Birth Sense a common-sense guide approach to normal birth www.themidwifenextdoor.com/?p=747.  In the UK we sometimes use a large Lucozade drink or a heavy sugar syrup drink, and we probably wouldn’t do four blood tests, probably only two, however, this test is increasingly being used for all pregnant women in the UK and I agree with the points raised in this article.  It is certainly worth discussing whether you want/need the test with your midwife.

“Of all the tests pregnant women are expected to endure, glucose testing is probably the most dreaded.  Women groan, and tell me they’ve heard horror stories from their friends about how sick the drink will make you feel, or how they couldn’t hold it down.  There are two types of glucose tests.  The first involves drinking a sugary, flat soda type of drink (called a glucola), then getting your blood sugar levels drawn one hour later.  This is a screening test only, and helps practitioners decide who needs the three-hour test.  The three-hour test involves drinking a sugary drink on an empty stomach (after fasting 12 hours), and getting four blood draws: one before you drink the glucose; and subsequent draws at one, two, and three hours after drinking the glucose.  Having elevated blood sugars on any two of these four draws confirms a diagnosis of gestation diabetes.

The mystery to me is why glucose testing continues to be performed on nearly ALL pregnant women, regardless of risk factors.   The American Diabetes Association recommends categorizing women into high-risk, average-risk, or low risk groups.

High risk women are those who begin pregnancy with a high body mass index (BMI), have a personal history of GDM, or have a strong family history of diabetes.   Other risk factors include older maternal age (over 35) and African-American, Native American, or Hispanic ethnicity.  These women should be screened in early pregnancy, and again at 24-28 weeks.

Low-risk women, who do not need to be screened, are under age 25, normal weight at onset of pregnancy, do not belong to a higher-risk ethnic group, and have no personal history of GDM, poor obstetric outcome, or family history of diabetes in a first-degree relative.

Women of average risk, who are not in the high risk category, but don’t meet all the criteria for low-risk women, should be screened at 24-28 weeks.¹

However, evidence to support these recommendations is lacking, according to the Cochrane Review and the United States Preventive Health Taskforce (USPHT).  The USPHT recommends, “Until there is better evidence, clinicians should discuss screening for GDM with their patients and make case-by-case decisions. Discussions should include information about the uncertainty of benefits and harms as well as the frequency of positive screening test results.”²

When is the last time a pregnant woman receiving typical modern obstetric care was treated on a case-by-case basis?  Most women are treated with cookie-cutter, one-size-fits-all obstetric care.

A recent study found that testing fasting blood sugar by a simple finger-stick (which a woman could do herself at home) may be just as predictive of women who need a three-hour glucose screening as the one-hour test.³  Additionally, there are other tests which are alternatives to the one-hour test, and may be  more appealing to some women.4  These tests include a pancake breakfast, or eating a specified number of jelly beans.  Concerns about these tests as substitutes are that they may not  be as accurate as the one-hour glucose in predicting which women need the three-hour test, but they are used in government health agencies, including the Indian Health Services, which serves a high-risk population.

Many of my clients say to me, “I don’t eat refined foods when I’m pregnant, so why should I drink a big glass of refined sugar?”  The politically correct answer is, “So we can have an ‘approved’ diagnosis of gestational diabetes.”  But many women would prefer not to take the glucola test, especially if they are already very health-conscious and physically fit.

I have also worked with clients by loaning a glucose meter that is calibrated to simulate identical blood sugar levels as when you get your blood drawn from your arm.  They can check a fasting blood sugar when they first wake up in the morning, and then blood sugars two hours after a typical meal, on two or three different days and times.  I believe this provides a more accurate picture of how the woman’s body is handling her normal diet, although I admit it does not give us the “official” diagnosis of gestational diabetes.

Common-sense tip for today:  Talk with your provider about the USPHT recommendations.  Are you at increased risk for GDM?  Then consider testing, whether it is glucola or an alternative.  Are you at low or average risk?  You may wish to consider skipping testing, unless it seems that the baby is growing faster than usual, you are having consistent problems with sugar in the urine, or you are experiencing symptoms such as jitteriness/dizziness/nausea.

1.  American Diabetes Association.  Gestational diabetes.  Retrieved 03/25/10 from:  http://www.diabetes.org/diabetes-basics/gestational/

2.  National Guideline Clearinghouse.  Screening for gestational diabetes mellitus.  Retrieved 03/25/10 from: http://www.guideline.gov/summary/summary.aspx?doc_id=12507&nbr=6437&ss=6&xl=999

3.  Agarwal MM, Dhatt GS, OthmanY, Gupta R.  Gestational diabetes: fasting capillary glucose as a screening test in a multi-ethnic, high-risk population. Diabetic Medicine, 2009.  Retrieved 3/13/10 from: http://www.ncbi.nlm.nih.gov/pubmed/19709144?dopt=Abstract

4.  Indian Health Services. Alternatives to oral glucola testing.  Retrieved 03/15/10 from: http://74.125.95.132/searchq=cache:EWcHFJkuecMJ:www.ihs.gov/MedicalPrograms/MCH/M/documents/AltGlu4505.doc+IHS+alternative+glucose+testing&cd=1&hl=en&ct=clnk&gl=us


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