The Tao of Snacking: Medicinal Foods in Winter

Choices in Childbirth welcomes Zoe Kogan, our first guest blogger for our monthly Provider Blog. We also want to give a big thank you to Milon Nagi, our blog editor and long-time supporter and volunteer.

By Zoe Kogan, L.Ac.
Brooklynacupuncture.com

In Chinese medicine food may be used therapeutically.  Pregnancy is an especially beneficial time to make use of some of these basic principles. According to the Taoist and Buddhist foundations of Chinese medicine there is no separation between the individual and their environment.  We are all impacted by our surroundings, including animals, plants, geography and the seasons.  When we are pregnant it is a particularly interesting time to pay closer attention to both our internal and external environments.

Eating According To The Seasons
Each season is associated with the energetic balance of an organ in the body.  Winter is associated with the kidneys.  In Chinese medicine the Kidney energy is our deepest, most yin source of energy. During pregnancy we are using a great deal of this Kidney qi to create and sustain the new being inside of us.  As it is also winter time, a season where it is especially important to boost the kidney, it becomes twice as necessary to support the kidney energy during pregnancy.  This is not hard to do.

Tea for Two
First of all, rest.  Don’t disperse your energy on unimportant matters or stay up extra late to watch mediocre entertainment on TV.  The kidneys are replenished by proper amounts of sleep. When we drink caffeine to feel more awake and to accomplish a longer list of tasks we are chipping away at our ming meng huo or pre-natal qi.  This is the kidney qi we are born with, comparable to the western version of our innate constitution.  When we drink stimulants we are depleting our constitutional energy by using false qi to keep moving.  This short energy burst supplied by coffee steals from the essential qi and masks the true fatigue that requires rest for true replenishment.  Instead of coffee try opting for green tea or rooibus tea for gentle stimulation with other benefits that won’t harm the essential qi.

Make Life Easy on Your Digestive System
In Chinese medicine the spleen controls the stomach.  The spleen controls digestion, builds blood and regulates the fluids in the body.  When we are pregnant the spleen is already working overtime building life in the body so it is important to eat in a way that strengthens the spleen.  The spleen is taxed by greasy and fatty foods.  I’m not saying the occasional French fry, burger or deep fried delight is completely off limits but they should be very limited.  During the winter the spleen flourishes from cooked vegetables and warm liquids.

Eat more fruit and vegetables than meat.  Whenever possible use whole grains in place of refined grains.  Eat brown rice instead of white and whole grain breads.  Eating whole grains helps to lessen the craving for meat and sugar.  Make vegetables your main course and use smaller amounts of meat, or substitute animal protein with fish or tofu.  In Chinese medicine meat is considered a tonic.  To overindulge in meat wastes the medicinal properties of the animal. During winter it is better to eat vegetables cooked instead of raw. As it is cold outside we want to eat neutral or warming foods such as soup or cooked greens. Vegetables such as cucumber and lettuce, although beneficial in general, are more cooling in nature. During pregnancy it is helpful to tonify the kidneys with foods such as walnuts, chicken broth and eggs in moderation.

Snack for the Season
Try these seasonally appropriate suggestions for winter snacks and nutrition:

• Pumpkin seeds or walnuts are slightly warming and aid digestion.
• Berries are one of the few fruits considered slightly warming.  Fresh or dried works.
• Throw sesame seeds on your veggies.  Sesame seeds are good for boosting qi that benefits the immune system.
• If you use sugar, switch to brown sugar which is energetically warmer than white.
• Drink room temperature or hot beverages only.  Winter is a great time for ginger tea.

Zoe Kogan, L.Ac. is a nationally board certified and licensed acupuncturist and the co-founder of Brooklyn Acupuncture.   She attended the Midwest College of Oriental Medicine in Wisconsin for acupuncture and Tri-State College of Acupuncture for certification in Chinese Herbology.  She has completed additional training in Beijing, China, as well as certification as an Acupuncture Detoxification Specialist Trainer from the Lincoln Recover Center in the Bronx.  In 2002, Zoe initiated the Acupuncture Detoxification Training Program at Beth Israel Medical Center, where she trained and certified hospital staff in acupuncture detoxification.

Recommendations from the Home Birth Consensus Summit Released This Week:

By Elan McAllister

I recently had the great good fortune to travel to Virginia and participate in the Home Birth Consensus Summit. The Summit brought together multidisciplinary stakeholders from across the maternity care system including midwives, consumers, obstetricians, insurers, policy makers, consumer advocates, pediatricians, family practice doctors, nurses, researchers, neonatologists, ethicists and hospital administrators. I have to say that the Summit far surpassed my expectations. I was so impressed by the dedication of all in attendance to work together toward finding common ground over an issue that has traditionally been deeply contentious. We all shared an understanding that, like it or not, home birth is a reality and we collectively share the responsibility to make it as safe as possible for the families who choose it. By the end of the three days we were able to find consensus over 9 common ground beliefs. Action plans for shifting these beliefs into practical reality are in development. We have a long way to go, there are still deep divides over this issue, but this was a beautiful, hope-inspiring first step toward change. I am deeply grateful to the organizers who made this happen and encourage you to support this work in anyway that you can.

Here are the 9 Statements from the Home BIrth Consensus Summit

The following statements reflect the areas of consensus that were achieved by the individuals who participated in the Home Birth Consensus Summit at Airlie Center in Warrenton, Virginia from October 20-22, 2011. These statements do not represent the position of any organization or institution affiliated with those individuals.

STATEMENT 1
We uphold the autonomy of all childbearing women.

All childbearing women, in all maternity care settings, should receive respectful, woman-centered care. This care should include opportunities for a shared decision-making process to help each woman make the choices that are right for her. Shared decision making includes mutual sharing of information about benefits and harms of the range of care options, respect for the woman’s autonomy to make decisions in accordance with her values and preferences, and freedom from
coercion or punishment for her choices.

STATEMENT 2

We believe that collaboration within an integrated maternity care system is essential for optimal mother-baby outcomes. All women and families planning a home or birth center birth have a right to respectful, safe, and seamless consultation, referral, transport and transfer of care when necessary. When ongoing inter-professional dialogue and cooperation occur, everyone benefits.

STATEMENT 3

We are committed to an equitable maternity care system without disparities in access, delivery of care, or outcomes. This system provides culturally appropriate and affordable care in all settings, in a manner that is acceptable to all communities.

We are committed to an equitable educational system without disparities in access to affordable, culturally appropriate, and acceptable maternity care provider education for all communities.

STATEMENT 4

It is our goal that all health professionals who provide maternity care in home and birth center settings have a license that is based on national certification that includes defined competencies and standards for education and practice.

We believe that guidelines should:

- allow for independent practice,
- facilitate communication between providers and across care settings,
- encourage professional responsibility and accountability, and
- include mechanisms for risk assessment.

STATEMENT 5

We believe that increased participation by consumers in multi-stakeholder initiatives is essential to improving maternity care, including the development of high quality home birth services within an integrated maternity care system.

STATEMENT 6

Effective communication and collaboration across all disciplines caring for mothers and babies are essential for optimal outcomes across all settings.

To achieve this, we believe that all health professional students and practitioners who are involved in maternity and newborn care must learn about each other’s disciplines, and about maternity and health care in all settings.

STATEMENT 7

We are committed to improving the current medical liability system, which fails to justly serve society, families, and health care providers and contributes to:
- inadequate resources to support birth injured children and mothers;
- unsustainable health care and litigation costs paid by all;
- a hostile health care work environment;
- inadequate access to home birth and birth center birth within an integrated health care system;
and,
- restricted choices in pregnancy and birth.

STATEMENT 8

We envision a compulsory process for the collection of patient (individual) level data on key process and outcome measures in all birth settings. These data would be linked to other data systems, used to inform quality improvement, and would thus enhance the evidence basis for care.

STATEMENT 9

We recognize and affirm the value of physiologic birth for women, babies, families and society and the value of appropriate interventions based on the best available evidence to achieve optimal outcomes for mothers and babies.

The Power of Choice

Where is the line between feeling powerless and feeling empowered in birth? Is it even something over which we have any choice?

At CIC’s most recent Healthy Birth Choices workshop we heard three moms describe how consciously choosing where and with whom to give birth made it possible for them to birth their babies the way they envisaged – and to feel happy, even triumphant, about their experience.

During Roisin’s first birth, with her regular OB/GYN, she found herself being induced and given routine interventions she had hoped to avoid, such as episiotomy. Her pitocin level was increased every 15 minutes and she was repeatedly told to “hurry up” or face a cesarean section. Nurses and residents were in and out of the room and her OB didn’t even look her in the eye. “I felt powerless”, she told us.

Pregnant again, Roisin realized her new, female OB had the same approach. Inspired by her reading and by a friend’s experience, at six months she switched to a home birth midwife’s care. Being comfortable in her own home helped her let go and she credits it with the speed and ease of her birth. Most importantly, surrounded only by people she had handpicked and free to choose how to labor, she felt powerful instead of powerless. The decision-making was back in her hands. With her midwife and doula she could do what felt right and birth her baby her own way.

Andrea had always dreamed of giving birth in water. So, when her OB was dismissive (describing birthing pools as “a kind of soup”), she did some digging.  She learned she could give birth – rather than labor only – in water either at home, at one local hospital or at an independent birth center. She chose the birth center’s relaxed, home-like atmosphere and ultimately had a beautiful water birth with a midwife.

Sarah visited a birth center and interviewed home birth midwives but felt more comfortable being in hospital for her first birth. Quizzing her family doctor in detail, Sarah realized their practices were well aligned with her wishes. In hospital, she was largely left with her partner and doula to labor as she wished and birth naturally. She left with the confidence to potentially birth her next baby at home.

Birth is a time we need to believe in – and need those around us to trust and encourage – our bodies, our power. There is no “right” way or place to give birth. We each need to decide for ourselves what feels safe, comfortable and right for our own situation. Birth can be unpredictable, but we can educate ourselves about our options, ask a ton of questions and gather a birth team that can support our wishes as well as ensuring the safety and health of mother and baby.

CIC’s Online Provider Network can help you find mother-friendly practitioners.  Interview as many as you need to until you find the person who feels “right”. 10 Questions to Ask Your Care Provider is a good place to start. Don’t be shy about asking how they practice – after all, as one of our speakers pointed out, if they go bright red in the face when you ask questions, they may not be the person for you!

Be informed. Be powerful!