Acupuncture and Pregnancy Special Issue: Part II.

When I started this project, I did not imagine having enough articles for a second special issue dealing with pregnancy. Nevertheless, we had an enthusiastic response from our readership that provided articles to produce Part II. I trust these two issues will build confidence and a better understanding of using acupuncture for better patient care during pregnancy. The periods pre- and postpregnancy are just as important as we embrace women's health and, of course, the value of acupuncture. Each generation of health care providers refines and modernizes the medical knowledge of the previous generation and concludes that it is up to date. The two special issues of acupuncture and pregnancy cannot be construed as a major update, but instead, as a “refresher” on how best to use acupuncture during pregnancy. Pump your reading effort into these two pregnancy special issues if you wish to tune your skills and improve your advice for your patients. Pause your day for a few minutes and challenge yourself with Medical Acupuncture. There is a lot going on in the field, and we will help you keep up to-date. What did I learn in Part II? It was another eye opener for me. Medical knowledge is in constant flux. It is important to avoid stagnation, so plan to jump ahead and acquire new wisdom. Continue to build a solid foundation, but be aware of new trends and have the curiosity to evaluate them. Work smarter with Medical Acupuncture. Claudia Citkovitz, PhD, MS, LAc, and Debra Betts, PhD, LAc, discuss “Obstetrical Acupuncture: Reflections on a Much-Needed Special Issue.” This is an inspiring Guest Editorial that reinforces the value of these 2 special issues on pregnancy. Disbelief comes frequently in medicine, and we try to make the value of observation substantial versus the needed clinical trial. This was seen during the 1940s when antibiotics were introduced. Despite the benefits of observation by very astute physicians, it took some convincing to accept these drugs into practice. If anything, these special issues will open our curiosity to explore the technology that acupuncture brings to the patient. Until clinical trials offer the final “proof,” we need to utilize our clinical judgement as to what is best for our patients. Good judgement can be very powerful when decisions are needed. Lee's “Point of influence: What is the Role of Acupuncture in In Vitro Fertilization Outcomes?” offers more information on augmenting in vitro fertilization (IVF) with acupuncture. Is acupuncture effective or is this result still ambiguous? Read further to understand what is recommended. Aung's “Pediatric Acupuncture: A Spiritual Perspective” concentrates on the endpoint of pregnancy, which is childbirth. However, his advice on the prenatal period suggests that acupuncture could ensure a normal delivery of a heathy child. It is interesting to learn that, by treating KI 6, you may lessen genetic factors that would be detrimental to the development of the fetus. There is a wealth of information in his article He also emphasizes the importance of the spiritual connection between the mother and child. This is often overlooked by all of us. Levett et al., discuss “Using Forbidden Points in Pregnancy: Adverse Outcomes and Quality of Evidence in Randomized Controlled Trials—A Systematic Narrative Review.” We are cautioned to understand the forbidden points in pregnancy better. This is certainly a must-read article that will keep us practicing safely. Avoid these points! Djaali et al.'s literature review of the “Management of Acupuncture as Adjuvant Therapy for In Vitro Fertilization,” analyzes a large spectrum of convincing data encouraging acupuncturists to play a vital role in IVF. I always thought that what I was doing was helpful, but here is the proof. However, there are different views on this subject. Most readers will not be surprised about what they learn from Madsen et al.'s “Trends in Use of Acupuncture During Pregnancy for the Military Health System, 2006–2016.” There has been considerable use of acupuncture in the United States military over the last decade, which has been greatly influenced by Battlefield Acupuncture. The military is well-known for its innovations in medicine, and it is not surprising that acupuncture is being applied increasingly in the Department of Defense and in the field of pregnancy. Is laser better than needles? According to “Acupuncture and Laser Acupuncture as Treatments for Emotional Distress in Infertile Woman in Japan,” by Taguchi et al., better results are obtained with needles than laser. I like the use of lasers especially if a patient has repeated auriculotherapy treatments. It does not irritate or hurt the ear. I was always under the impression that 1 minute of a laser treatment equals 10 minutes of needling. Budihastuti et al. affirm that the “Electroacupuncture Effect on Polycystic Ovary Syndrome to Improve Oocytes' Growth” is feasible. This is a fascinating study, demonstrating electroacupuncture repair of PCOS involves a multitude of many complex mechanisms. Cruz et al.'s “A Feasibility Study on Treatment of Uterine Fibroids with Tung's Acupuncture” is an excellent example of research challenges. It is unfortunate that the ultrasound measurements were very problematic for measuring fibroid regression, but I am sure that the next attempt will be very successful. I was very impressed to receive the Case Reports for this issue. There is a wide spectrum of subjects dealing with endometriosis, assisted reproduction technology, preeclampsia, and high-risk antepartum. The Clinical Pearls are equally informative, dealing with morning sickness, back pain treatment, induction of labor, cesarean-scar pain, preeclampsia, nausea and vomiting, sacroiliac dysfunction, and infertility. If you want to read about the virtues of treating anemia during pregnancy with moxa, Hayes expands on the subject and more in her paradigm article, “Blood Support for Pregnancy and Postpartum Using Acupuncture from Ancient Medical Texts' Theory.” Once more I wish to thank our guest editors and editorial staff for helping with this second issue. Dr. Yael Ben-Porat did a fabulous job moving this publication forward. To each of you, I am very grateful that we were able to publish two special issues dealing with pregnancy and acupuncture. Most importantly, my very deep thanks to all the authors who took time out from their busy lives to support Medical Acupuncture and to enrich us with their profound knowledge. A very special thanks to our guest editors who did more than write editorials. They served as very important subject-matter experts. Without their specialized and knowledgeable input, I doubt we would have succeeded in producing these two special issues. My profound thanks and respect for their hard work and encouragement. —Richard C. Niemtzow, MD, PhD, MPH, Editor-in-Chief