Perinatal Care

Fertility/Preconception/Pregnancy/Postpartum

“The time to get pregnant is when you’re healthiest, both physically & psychologically.”

— Roger Hart, MD; NYT, 5/30/2019

There is an array of therapies that can help support fertility either prior to or in conjunction with conventional reproductive care. Consultation with an integrative specialist like myself, with 20 years of experience in western and eastern reproductive medicine, can provide evidence-based recommendations that will not interfere with traditional fertility care and are safe to use while trying to conceive. I am a member & current chair of American Society of Reproductive Medicine & a fellow of American Board of Acupuncture & Traditional Chinese Reproductive Medicine.

Infertility is diagnosed as no conception after trying to conceive for 12 months if under 35 and 6 months if over 35; if you meet this criteria it may be best for us to work in conjunction with a reproductive endocrinologist (RE). We can conduct initial testing and treatment, but consultation with an RE will let you know your full range of options. I can help you find one.

Diet & lifestyle assessment to remove barriers to conception, improve health prior to pregnancy, especially in women with polycystic ovarian syndrome (PCOS) or weight issues.
Hormone & nutrient testing and prescriptions as needed.
Herbal therapies & supplements to improve menstrual cycles & ovulation, decrease time to conception, improve egg quality, and decrease risk of miscarriage.
Conditions that may be related and can be successfully addressed:
- PCOS
- Endometriosis
- Menstrual irregularity
- Thyroid dysfunction
- Age-related ovarian decline
- Recurrent miscarriage

If you are struggling to get or stay pregnant or are working with a fertility clinic & would like to know how to improve your chances of conception, contact me for info on how I can help.

Conscientious Conception

Research has consistently found that changes to diet, lifestyle and starting prenatal supplements are most beneficial when started prior to conception, best up to one year before. In addition, when coming off hormone contraception or if you have a prior diagnosis of thyroid issues, PCOS, or endometriosis, it may take longer to conceive and acupuncture, herbs, or hormones may be helpful for successful conception. Knowledge about the physiology of conception, cycle/ovulation tracking and timing of intercourse can decrease time to conception. Finally, the uterine environment, as established by mom’s diet & lifestyle create lasting health effects on the fetus that can impact, either positively or negatively, the child’s lifelong health. We typically spend much more time planning for other things in our lives than we do planning for our future families. This process may require birth control to avoid pregnancy until ready to start a family, when spacing children, or when one has decided to be childless by choice. Set yourself and your baby up for success by planning for your pregnancy with a preconception visit.

Perinatal Evaluation & Interventions

I have continued my education with advanced certifications in caring for women through their reproductive years to help them achieve their goals, from fertility, healthy pregnancy and post-partum support to general health and wellbeing with a focus on healthy aging and prevention of chronic disease.

Individual evaluation and treatment planning will address history and physical, hormones, diet, and lifestyle. Special attention will focus on any issues encountered in previous pregnancies, such as prenatal/post-partum mood issues, blood sugar & blood pressure abnormalities, and nutritional & thyroid deficiencies. These problems can negatively impact a woman’s health and well-being long after the pregnancy & post-partum stages. Special attention is paid to choosing evidence-based therapies which are safe during pregnancy & lactation if needed.

By addressing issues related to the mind & body and integrating the best therapies from the Eastern & Western medical perspectives, my proactive approach seeks to prepare women for future pregnancy or re-establish the foundations of health after years of pregnancy and lactation. Women seeking pregnancy may find that their bodies have changed with age and previous pregnancies and require assistance getting and maintaining pregnancy that was not necessary at a younger age. For women who have finished childbearing, it is possible that she now finds herself in perimenopause, symptoms of which can start in excess of 15 years before the final menstrual period.

Therapies selected based on severity of symptoms, individual risk-factors, & patient preference and may include:

Social engagement & support
Counseling
Meditation & quiet time
Aerobic exercise & yoga
Hormone replacement
Pharmacological & non-pharmacological treatment options

SCHEDULE A POSTPARTUM CONSULTATION

The Fourth Trimester

The “Fourth Trimester” is broadened to include the weeks, months, and years after pregnancy, between pregnancies and following a woman’s last pregnancy. Referred to elsewhere as “postnatal depletion”, this is not an illness or disease that requires treatment in most cases. Instead, it falls into a nebulous category with other periods of normal hormonal flux that women experience throughout their lives, including PMS, pregnancy, and perimenopause. Like these issues, a given woman may experience a range of symptoms on a continuum, similar to a bell-shaped curve, with some women experiencing little to no distress, most women experiencing moderate distress, and some women, significant amounts of distress. The degree of distress will often inform the amount of intervention needed, with the goal of re-establishing the foundations of health & wellness post-childbearing.

It is important to acknowledge that in the US we often put more focus on pregnant women and then switch this focus to the baby immediately after delivery when mother-focused support is virtually non-existent. We as a culture ignore the needs of new mothers and make many demands on them that are prevented in other cultures out of respect for the postpartum period, a time recognized & honored as distinct from other times in a woman’s life. Curiously, these other cultures have virtually no post-partum disorders compared to 50-85% of new mothers in industrialized nations like the US. During this time, protective measures, so-called “mothering the mother”, help support and care for new mothers. Specifically, the practice of “lying in” relieves women of their normal workload and an implied duty to entertain visitors allows time for recuperation, rest, and family bonding. Not only does our culture minimize the significant change that occurs as a woman becomes a mother, but there is often an unspoken belief that any woman who needs post-partum support has somehow failed when in reality we as a culture have failed her.

Of course, having a children is hard work physically, emotionally, and mentally. Few women can honestly say they did not experience any of the symptoms listed below, but by drawing attention to these issues, I am hoping that women will address these concerns sooner, rather than later, not waiting for a crisis to occur to care for oneself; by taking the time to prioritize oneself to be healthier as an individual, mother, partner, colleague, & friend.

Symptoms may include, but are not limited to:

Fatigue
Sleep dysfunction
Poor motivation, concentration, memory
Mood swings
Menstrual irregularities
Inability to lose weight
Urinary & vaginal issues
Low libido
Hot flashes/night sweats

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Schedule a Fertility Consultation

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Certified Perinatal Mental Health Provider

I have made a commitment to furthering my post-graduate education in this ever-changing field in an effort to offer my patients the most up-to-date information and therapies. In addition, I am currently the co-Chair of PSI-Arizona Chapter Board and chair of the education committee.

~Dr. Leigh Lewis