BEING PREGNANT

• Pregnancy Precautions
• Practitioner’s Corner: A Whole Pregnancy

Evans is one of a handful of physicians in the United States who is board certified in both holistic medicine and obstetrics/gynecology and he brings the wisdom of both conventional Western medicine and complementary approaches to his practice and to his book.

Knowing that he wanted to be a doctor from the time he was in high school, Evans attended medical school at Mt. Sinai School of Medicine and trained at Albert Einstein College of Medicine. He began practicing obstetrics and gynecology in Stamford, CT in 1988, but it wasn't until 1993 that he says he truly became a healer. That's when two patients—one, a young woman in her twenties who was diagnosed with breast cancer; the other, a nurse who had ovarian cancer—began asking him what they could do, apart from their oncology treatments, to help heal themselves. They challenged him with questions about life and death and about healing that went beyond the boundaries of conventional Western medicine.

Evans' experiences with these patients inspired him to embark on an intensive exploration of the healing process. He began studying about herbs, mind-body medicine, nutrition, energy medicine, and relaxation techniques. In 1996 he founded the Center for Women's Health, an integrative health center in Darien, Connecticut, that combines holistic healing approaches with conventional Western medicine to address women's health issues, from fertility problems to pregnancy to menopause.

Evans recently shared his thoughts about holistic medicine and creating the optimal pregnancy experience with Lime.

LIME: You use the terms "whole pregnancy" and "holistic prenatal care" in your book. How would you define those terms?

JOEL EVANS: Too often medicine can be super-specialized. When I talk about a whole pregnancy or holistic pregnancy care, I'm not just talking about the medical things that can go wrong. Number one, I look at pregnancy as a process from the preconception period (what you can do to enhance conception) through the pregnancy to after the pregnancy. Number two, I'm talking about what you can do to have as healthy a pregnancy as possible and reduce the likelihood of complications. That means what you can do to enjoy the pregnancy and have a better experience. I include nutrition, herbs, the role of emotions, the beneficial effects of meditation and stress reduction, mind-body skills, the importance of healthy relationships and healthy families. That's what I mean by whole pregnancy.

LIME: A lot of women today use acupuncture, homeopathy, herbal medicine and other complementary medicine practices to manage their health. Are there things they should be especially wary of when they are pregnant?

JOEL EVANS: There are. In terms of herbs, you should never take goldenseal when pregnant. It's good for the immune system at other times but not when a woman is pregnant. There are other herbs contraindicated in pregnancy, too. If you want to use acupuncture, you need to go to an acupuncturist who is experienced with treating pregnant women. There are acupuncture points that can stop contractions and points that can put you into labor. Also, the acupuncturist should know to not have you lie flat on your back. You should have a pillow put under one hip.

By and large most things are safe as long as they're done by an experienced, knowledgeable practitioner.

LIME: Many women suffer from a variety of health problems during pregnancy—low back pain, swollen feet, nausea, heartburn. And often conventional medicine doesn't have good treatments for these conditions. What does the alternative medicine world have to offer for the common complaints of pregnancy?

JOEL EVANS: I have a whole chapter on that in my book. Red raspberry tea is great during pregnancy and chamomile tea is useful for stomach issues. You can throw in some ginger for nausea and vomiting. Acupuncture has been helpful for back pain as well as nausea and vomiting. Omega 3 essential fatty acids are helpful for dry skin and can prevent premature rupture of the membrane. Fish oil capsules can also help prevent preterm labor.

LIME: Women today have so many choices when it comes to childbirth: midwife, doula, home birth, birth with an obstetrician in a hospital, various kinds of treatment to relieve pain. What advice do you have for women about making these choices?

JOEL EVANS: I'm very much a believer in doing what you think is right for you. There's no one way to have a baby. The more plans you make, the more likely it is some of them won't happen. The important thing is that you try to educate yourself about what the options are. Look on the Internet. Read my book. Talk to friends. Visit a birthing center. Talk to midwife. See what the hospital is like. You have to be comfortable not only with the "category" but with the individual provider. Do your research. These are important decisions.

LIME: Women today are very aware of the toxins in the environment and the potential harm they could pose to their babies. What do you say to women who are anxious about these toxins and what can they do to reduce the risks?

JOEL EVANS: The big picture message is to do the best you can and not make yourself crazy. The simplest and easiest thing to do is to eat the healthiest diet you can, avoiding processed food and eating whole foods. By processed food I mean food with a lot of chemicals that help preserve shelf life. Anything that doesn't spoil isn't a whole food. A cookie that can stay on the shelf for 10 months and still taste good is not a whole food, whereas a freshly baked cookie that spoils after a couple of days is a whole food. You want to eat foods that can spoil. Then you want to drink a fair amount of water. Water helps the body eliminate toxins.

LIME: Is it important to drink bottled water?

JOEL EVANS: If you're in an area where your tap water is safe then tap water is O.K. You should have your water tested. We just founded out in the Ohio River Valley that the tap water is contaminated with Teflon. That would be tap water I wouldn't want. Go to the department of health and bring a water sample in and or call your local water company. Private companies test water as well.

LIME: Anything else women can do to reduce the baby's exposure to toxins?

JOEL EVANS: The other general principle is to decrease the amount of toxins the body is exposed to, to decrease environmental toxins. What you want to do is stay away from pesticides, don't have exterminators, don't spray your lawn or garden, don't paint or get new carpeting that will produce off gasses. Wherever there's a strange smell, stay away.

The food you eat should be as free from toxic chemicals as possible. If you can afford to buy organic, that will decrease the amount of pesticides in the food.

Some people would consider alcohol and caffeine toxins, too. You want to limit exposure to, say, 200 mg of caffeine per day. You shouldn't drink alcohol at all in the first trimester. Some doctors say you shouldn't drink at all during pregnancy. I'm a little more liberal. I say a drink or two every couple of weeks after the first trimester is O.K.

Then the next step is help the body get rid of toxins. Sixty-four ounces a day of water helps your body get rid of toxins. Certain foods also help. Artichokes, watercress, pomegranate and green tea help your liver get rid of unhealthy chemicals. Having 10 servings of fruits and vegetables a day also helps your body eliminate toxins.

LIME: Any other advice for pregnant women?

JOEL EVANS: They should be cognizant of what they're thinking and feeling. They need to spend time focusing on and communicating with and talking to their baby. I can't tell you the number of patients I have -- busy career women -- who never spend time focusing on the baby until six weeks before they're due to give birth. They get caught up in externally oriented thoughts, whether it's planning the nursery or this or that, and they never consciously realize there's a little person inside of them.

LIME: How can a pregnant woman get in touch with that baby?

JOEL EVANS: You close your eves, put your hands on your belly and breathe quietly, sending loving thoughts to the baby. Tell the baby you're excited about it coming into this world, that you're going to create a nice life for it. Bonding is important.

It's also important to address all of your fears. Eliminating fear is the most important thing you can do to prepare for birth, whether it's fear of the pregnancy, fear about labor, fear of whether you'll be a good mother, fear of whether your marriage will survive. Figure out what those fears are and talk about them to someone you feel close to—your significant other, a doctor, a therapist, a midwife, a doula. If you do that, you can go into your labor with excitement and anticipation rather than fear.