Treating Asthma When Women Can't Take Medications: Asthma During Pregnancy

In the USA, about one in 12 women who gets pregnant has to deal with asthma during pregnancy. In Australia, asthma is the most common complicating health condition during pregnancy. All around the world, hundreds of millions of women have asthma that continues during pregnancy.

In a study of 366 pregnancies in 330 women who had asthma, symptoms go worse during pregnancy in about a quarter (28%) of women who have it, and  symptoms of asthma get better during pregnancy for about another third (35%) of pregnant asthmatics, and symptoms were unchanged in the rest (about 37%). Many women, however, don't use inhalers or take asthma medications when they are pregnant.

Controlling asthma during pregnancy is important for a number of reasons, including:

• Untreated asthma increases the need for Caesarian sections to deliver the child.
• Death rates during pregnancy are higher for women who don't treat their asthma.
• Pre-eclampsia, a condition of sudden, severe, life-threatening high blood pressure, is more common in women who have asthma than in women who do not.
• Babies born at full term to mothers who had asthma attacks during pregnancy are more likely to be born with low birth weight.
• Babies born to mothers who have asthma attacks during pregnancy are more likely to be born prematurely.

Obstetricians usually have a good understanding of the potential complications of asthma medications during pregnancy, but they usually do not know how to handle deteriorating asthma during pregnancy. And if a woman develops high blood pressure, or gestational diabetes, so that she cannot take steroid medications or use inhalers, most doctors are not aware of non-pharmacological interventions that work. So what are the interventions doctors can try to manage asthma during pregnancy without medication?

Education programs are of dubious value. Most "packaged" health education for managing asthma consists of educating asthmatics in how to use their inhalers more effectively, not using them so often that they become resistant to the medication. But when women can't use inhaler at all because of blood pressure or diabetes, these educational programs are useless. Of course, in women who can still use inhalers or steroid medications, education programs may sometimes be genuinely helpful.

See Also: The Growing Problem Of Asthma

The technique of progressive relaxation is not hard to master. The first thing to do is to lie down in a comfortable position.

Then the toes are flexed, as if you were trying to pick up something with them, hard enough to be felt but not hard to enough to hurt, and released. Then the ankles are flexed by moving the feet sideways, hard enough to be felt but not hard enough hurt. The knees are pressed against the bed or couch, and released. Then the thighs, followed by the hips, pushed down and released. You make an effort to lift your midsection off the mattress. If that's not possible, that's not a problem.

Non-Drug Treatments for Asthma During Pregnancy, Continued

After the core exercise, then one flexes the fingers and releases them, pushes the elbows into the bed and releases them, pushes the back of the head into the bed and release it, grimaces and then relaxes with a smile.

Each isometric position should be held for a few seconds, no more than 10 seconds. How long to put tension on the muscles depends on the "feel" of the exercise. If you can feel tension, you have flexed that muscle long enough. It is never beneficial to feel pain, in this exercise. After tensing and relaxing muscles from toe to head, there should be a feeling of relaxation with slower pulse.

The "catch" with progressive relaxation training is that it usually is something one needs to learn in one-to-one training sessions with a trusted psychologist or trainer.

Listening to relaxing music may be pleasant, but it doesn't usually cut back the number of asthma attacks. Hypnosis usually results in less wheezing and greater compliance with prescribed medication, but usually does not result in lower rates of asthma attacks. Biofeedback devices, such as HeartMath and the LIFE system (used by naturopaths in some states of the United States and some provinces in Canada), do reduce the frequency of asthma attacks but do not usually increase lung capacity.

A method that many people who have asthma say works for them but that has never been especially popular in the medical community is the Buteyko method, invented by Ukrainian psychologist Dr. Konstantin Pavlovich Buteyko. This method of treatment is based on the idea that asthma and many other chronic conditions are caused by "hidden hyperventilation." To correct overbreathing, users of the Buteyko method:

• Breathe through the nose, not through the mouth. Breathing through the nose warms and humidifies air so that the linings of the air passages are more flexible and relaxed. Keeping the nose clear and breathing through the nose is especially helpful for controlling nighttime symptoms.
• Breathe slowly and breathe only a small volume of air. This "retrains" the lungs to avoid spasmodic asthma attacks. The ability to breathe a small amount of air dependably is more important than the ability to breathe deeply and excessively. If the lungs try too hard to fill with air, asthma may result.
• Relax when they feel like they are about to have an asthma attack. Fearing an asthma attack and breathing too hard can trigger the attack. Keeping calm reduces this risk.

See Also: What's New In Asthma Treatment?

Dr. Buteyko used to say that once you learned his method, it was like riding a bicycle, you could just do it anytime. That's true if you spend enough time with the Buteyko method to get results you can feel, but just one or two practice sessions will not be enough. Chances are you will have to practice once a day for about a month before this method of controlling asthma becomes second nature.

For more information about progressive relaxation and the Buteyko method, see the links below.