How Does Traditional Chinese Medicine (TCM) Nourish Pregnancy?

Prenatal Care During Pregnancy

Prenatal care during pregnancy in TCM focuses on two main aspects: the mother and the fetus. Since the fetus resides within the mother, the health and well-being of both are closely interconnected.

From the moment of conception, the fetus begins to attach and grow within the mother's body. This journey from conception to a fully developed baby ready for birth spans approximately 38 weeks or 266 days. However, as the exact time of conception is often unknown, pregnancy duration is generally calculated from the end date of the last menstrual period, adding an estimated two weeks, totaling a 40-week pregnancy.

Pregnancy is broken down into ten months, each corresponding to a 28-day lunar cycle, which equates to four weeks per month. These ten lunar months are commonly referred to as the “ten months of pregnancy.”

The TCM approach divides the ten-month pregnancy into three main phases: early, middle, and late.

• First three months: During this period, the fetus is not yet fully formed, so the focus is on nurturing and stabilizing.

• Middle six months: Here, the emphasis shifts to nourishing and supporting fetal development.

• Last month: This phase focuses on preparing the mother's body for childbirth.

Each phase in TCM involves specific dietary and lifestyle recommendations to ensure optimal health for both mother and fetus, following nature's rhythm throughout the pregnancy journey.

First Three Months of Pregnancy

Let's discuss the first three months.

What is happening during this period? From the perspective of the fetus, it has just implanted, like a seed freshly buried in the soil, starting to sprout; its growth is not yet firmly established, and the fetus has not yet fully formed.

From the mother's perspective, the fetus is considered a foreign entity, leading to some physiological barriers. The sudden presence of this new life disrupts the body’s usual functioning, which has not yet adapted to this state.

There are several aspects to pay attention to during this time. If the mother's body is not properly adjusted, it can lead to blockages, resulting in what is commonly referred to as pregnancy symptoms, or morning sickness. These symptoms primarily manifest in two ways:

1. Disruption in the upward and downward flow of Qi can cause vomiting.

2. Disruption in the internal and external flow of Qi can lead to swelling.

These are two of the most common occurrences during pregnancy. They are essentially the body's gradual adjustment process and are not considered illnesses; they typically resolve once the body adapts.

However, due to individual constitution, some people may have pre-existing issues, such as dampness in the middle burner, which can exacerbate morning sickness. Some might even experience severe nausea that prevents them from eating. In such cases, certain medications can help alleviate these symptoms, with Ban Xia being a key herb, as used in formulas like Gan Jiang Ban Xia Ren Shen Wan.

Some individuals may experience more pronounced swelling due to sluggish circulation of Qi, blood, and body fluids. In this case, medicinal herbs like Fu Ling can be used to promote water metabolism, similar to those found in formulas like Kui Zi Fu Ling San.

These considerations pertain to the mother.

Regarding the fetus, since it is not yet securely established, it is susceptible to miscarriage. Because it has not fully formed, it is also vulnerable to injury.

Therefore, during the first three months, the focus is on preventing miscarriage and injury.

Preventing Miscarriage involves two aspects: external and internal.

• Externally, this refers to risks like falls and impacts.

• Internally, it refers to factors within the mother that might cause her Qi and blood to surge, potentially leading to the expulsion of the fetus.

The surging Qi and blood can result from two main causes: emotional factors and medication.

So, during the first three months, the mother should focus on maintaining calmness to prevent accidents, avoid major emotional upheavals that might disrupt Qi and blood flow, and refrain from using strong herbs that break Qi or promote blood flow excessively.

Preventing Injury also has two aspects: internal and external.

• Externally, environmental factors like radiation can lead to fetal malformations or developmental issues.

• Internally, the consumption of chemical medications, antibiotics, and certain vitamins may negatively impact fetal development.

These are important considerations for the first three months of pregnancy.

The Next Six Months

After the first three months, the fetus becomes fully formed, develops awareness of hunger and thirst, and starts to grow by drawing nourishment from the mother.

At this stage, the mother's body is supplying the essence the fetus needs. The central meridian opens, the Tai Chong meridian flourishes, and the vital energy descends, leading to increased vitality. As a result, the mother's body temperature may rise, but this is not a cause for concern. Additionally, the mother may find her appetite increasing, as she is now nourishing two beings.

It's important for the mother to eat well—what she enjoys and in amounts that feel right—without the need to force supplementation or restrict meals. The fetus grows significantly during this time, particularly from the fifth month onward, when it begins to move, indicating its vitality.

During these six months, the focus should be on nourishing the mother's Qi and blood. As long as the mother maintains sufficient Qi and blood, the organs will be nourished, and the fetus will grow strong enough to avoid premature birth.

Most modern individuals do not lack nutrition, so there is no need for excessive supplementation. A normal diet and regular activity are generally sufficient. If a mother feels weak or has insufficient Qi and blood, she can focus on nourishing the liver and blood using traditional remedies like Zhongjing's Danggui San or Baizhu San as needed.

I want to address two common misconceptions about nurturing the fetus in modern times: one is the idea of “fetal supplementation,” and the other is “fetal education.”

Both concepts can be seen as attempts to force growth. There's a saying: “right action without obstruction.” The natural way of the body aligns with the natural order of the universe. In the cosmos, one should simply act rightly and leave the rest to fate. The body has its own wisdom and will adjust as needed. Therefore, it's unnecessary to overly focus on what to eat or to supplement various nutrients. The mother should eat according to her body's needs and preferences.

The same applies to fetal education. The fetus grows naturally in the womb and should be allowed to do so with minimal interference. What's often referred to as “fetal education” is really about the mother's state of mind. A calm and positive emotional state fosters healthy fetal development.

How did ancient Chinese scholars approach fetal education? They advised that mothers should avoid negative sights and sounds and refrain from speaking arrogantly. This isn't about strict guidelines for mothers to be overly cautious; rather, it emphasizes maintaining a stable and peaceful state of mind, which is beneficial for the fetus's growth.

In contrast, modern interpretations of fetal education often directly stimulate the fetus, which can disrupt its natural rhythm. It's essential to understand that the fetus has its own needs and preferences, and imposing stimuli can be counterproductive.

In summary, during the middle six months of pregnancy, focus on nurturing Qi and blood and maintaining a natural balance—these eight words suffice. Mothers should keep a cheerful disposition, eat normally, and engage in regular activities.

Lastly, in the final month, the focus shifts to preparing for childbirth. This involves significantly boosting Qi and blood while also relaxing the muscles and bones to facilitate a smooth delivery.