If you are a Traditional Chinese Medicine (TCM) practitioner trained in North America. you know that beginner TCM texts forbid treating pregnant women with blood quickeners or using “forbidden” acupuncture points.
What you may not know is that Chinese medicine has a long tradition of and extensive literature on the subject of gynecology and obstetrics. Advanced Chinese medicine literatures contain descriptions on how and when pregnant woman can be treated. According to Dr. Bob Flaws, one of North America’s foremost experts on Chinese Medicine GYN OB, the prohibition against treating pregnant women is to prevent unqualified and inexperienced practitioners from intervening and potentially doing harm. Dr. Flaws states, however, that practitioners who receive professional training from a TCM specialist who is knowledgeable and experienced in Chinese Medicine GYN OB can learn to treat problems in pregnancy safely, effectively, and with confidence.
For trained practitioners there are certain conditions in pregnancy where treatment using some of the forbidden points and/or herbs is warranted and even necessary. In particular, bleeding during pregnancy is always serious and may indicate that the woman is at risk of losing the fetus. But to safely treat a woman in this condition, the practitioner must be able to make the correct pattern diagnosis and know the appropriate treatment.
Dr. Flaws gives the example of diagnosing and treating blood stasis with blood quickeners.
According to Chinese OB texts, blood stasis is one of the four basic causes of bleeding. If the total pattern (i.e., all the corroborating signs and symptoms) indicates blood stasis, and blood stasis threatens the viability of the fetus, then blood quickeners may be indicated. In this case blood-quickeners are not toxic to the fetus and are in fact necessary to protect and preserve the pregnancy. Blood quickening, according to the meaning of the Chinese character "sheng," refers to “bringing the blood back to life” and so can preserve and promote life and birth.
It is critical, however, that the correct pattern differential is determined. Conditions like myomas during pregnancy may or may not indicate blood stasis or threaten the pregnancy. Simply the presence of a myoma on an ultrasound does not equal blood stasis. The collaborating signs and symptoms must be present to arrive at the diagnosis of Blood stasis and to warrant the use of certain points and herbs.
Thus in order to treat a pregnant patient, you must ensure that you are capable of making a thorough and accurate diagnosis of symptom patterns and that you have the knowledge to prescribe the safest most effective treatment. If you do not feel fully confident treating a patient then do both you and her a favor and refer her to someone who does have the proper skill and experience. As a practitioner you are obliged, above all, to “do no harm.” However, with adequate training and experience, you can develop the knowledge and skill to treat conditions in pregnancy with confidence and success.