The Integrative Approach
Adapted from: "The Integrative Approach to Pregnancy" by Tracy Gaudet:
Three distinguishing elements of an integrative approach to pregnancy are:
A recognition of the whole person; mind, body, spirit and community
A health orientation, rather than a disease orientation
The use of complementary and alternative therapies (CAM) when appropriate
The majority of patients that you encounter as family physicians will not experience complications.
Pregnancy is not a disease state. An "integrative approach" in this context is an approach to the care of pregnant women recognizing that pregnancy is a significant life transition, and that all aspects of the individual are affected: mind, body, spirit and community (Gaudet). All aspects of the woman's life, regardless of the outcome of the pregnancy, will be changed forever.
An integrative approach to prenatal care utilizes the best aspects of conventional prenatal care, combined with alternative and complementary remedies that have been shown to be safe and effective at improving the experience and outcomes of pregnancy. Overall, the goal is to be as minimally invasive as possible during
Pregnancy has benefited enormously from advances in modern medicine. Maternal morbidity and mortality have drastically declined. When complications occur, it is your job as a prenatal care provider to identify them. The screening tests you do, and the regular follow up you offer is very important.
Many symptoms that patients experience during pregnancy are not signs of serious problems, but nevertheless negatively impact the pregnancy experience and create morbidity. In such cases, the judicious use of selected Complementary and alternative (CAM) therapies may be appropriate.
Ideally, the integrative approach to prenatal care can start before conception. You can discuss with your patients strategies to optimize the physical, emotional, spiritual preparation for conception, relaxation techniques, discuss effects of environmental toxins, emotional (relationships, single parenthood, anxieties, dreams, mothering issues), spiritual and practical issues (work, finance) that might affect pregnancy and parenthood, and discuss diet, nutrition, appropriate weight gain.
Once your patient is pregnant, it is your job to help her be as healthy as possible for the new life developing within her. This requires attention to all aspects of her life - her environmental exposures, ingestions (tobacco, alcohol), nutrition, physical fitness, emotional and spiritual health, and the strength of her community.
See the PDF attached below for the University of Michigan's prenatal care guideline. This should still be your standard of care.
Although this web module discusses some specific CAM therapies, an integrative approach to prenatal care is more than conventional care + CAM. Your patients may not need any "alternative" therapies, but will still benefit from an "Integrative" approach, one that embraces the whole person, mind-body-spirit-community, and in doing so optimizes their health and well being.