Complementary And Alternative Therapies CATs For Female Infertility

Complementary And Alternative Therapies (CATs) For Female Infertility ( East Meets West ) § Dr Muhammad El Hennawy § Ob/gyn specialist § 59 Street - Rass el barr –dumyat - egypt § www. geocities. com/mmhennawy § www. geocities. com/abc_obgyn § Mobile 0122503011

The Cochrane Collaboration's Definition Of Complementary and Alternative Therapies (CATs) § It is "a broad domain of healing resources that encompasses all health systems, modalities, and practices and their accompanying theories and beliefs other than those intrinsic to the politically dominant health systems of a particular society or culture in a given historical period".

§ There are 105 reporting on different types of CAM § § for infertility But I try to explain few types of them Many women use complementary or alternative therapies (CATs) to resolve fertility problems, even though there is little evidence that they are effective. However, it is not clear whether people use these to reduce stress or to increase their chances of getting pregnant Recent research has found that complementary healing modalities can be important adjuncts to traditional infertility treatments including in-vitro fertilization. Eg : Acupuncture, massage, and hypnosis as well as nutrition and stress-reduction counseling may enhance treatment outcome.

HOW? § There is a list of how CATs specifically has been able to help § § § § § treat infertility: A healthy and happy organ is dependant on optimal circulation of blood , Qi , nervous function , lymph , as well as good nutrient and mineral balance a. Improve the function of ovaries (happy ovary) to produce better egg qualities (happy eggs) b. Regulate hormones to produce a larger number of follicles c. Increase blood flow to uterus and increase thickness of uterine lining (happy uterus ) d. Prevent uterus from contracting. e. Relax patient and decrease stress ( happy mind ) f. Lessen the side effects of drugs used in IVF g. Strengthen immune system h. Decrease chances of miscarriage

Complementary And Alternative Therapies (CATs) § They are divided into five categories: § v Mind-Body Interventions: Techniques used to enhance the § § mind’s ability to affect the body. Examples are patient support groups, prayer, yoga, support groups and cognitive-behavior therapy. v Alternative Medical Systems: Complete systems of theory and practice including homeopathic, naturopathic and Traditional Chinese Medicine. v Biologically Based Therapies: Vitamins, food and herbs. v Manipulative and Body-Based Methods: Massage, chiropractic and osteopathic treatment and manipulation. v Energy Therapies: Involves the use of energy fields by applying pressure to the body. Examples include therapeutic touch and electromagnetic fields

The Causes of Disease § They are divided into external and internal origins as well as other origins. § Internal Causes are the so called seven emotions, they are Anger, Joy, Worry, Pensiveness, Sadness, Fear and Shock. Each one of these emotions is normally healthy to our life, yet they effect our health when in excessive form. § External Causes are Wind, Cold, Heat, Dryness and Dampness which again in an extreme degree will provoke energetic imbalance within our body. § Other Causes are Weak Constitution, Over Exertion, Excessive Sexual Activity, Bad Diet, Trauma, Parasites and Poisons as well as wrong treatment.

Recognizing The Disease § The practitioner has the important task of analyzing the disease so that a right treatment could be applied. The methods of approaching any imbalance are by Observing, Listening, Asking and Feeling. § Observing the Spirit, Body, Demeanor, Head and Face, Skin, and Tongue. § Listening to the Voice, Breath and cough. § Asking is the conversation between the practitioner and the patient. Its aim is to find out how the problem arose, the living conditions of the patient, the environment, including the emotional environment and family environment. The goal of this investigation is, ultimately, to find the cause of disease, in order for the patient and practitioner to work together to try and eliminate it or minimize it. § Feeling is mainly the palpitation of the pulse, however palpitation of various points are also considered. Feeling the pulse is an extremely complex subject. It can give the practitioner a great deal of valuable information about the internal condition of the patient. The general consensus is that there are twenty-eight different kinds of pulse. Each of which can give the practitioner a great insight to the solution of the disease.

Body Acupuncture Therapy § Chinese medicine views most diseases as a § § process of energy imbalance. Acupuncture is a therapy that applies fine needles on acupoints on the body's surface to achieve an activated energy flow (qi) in invisible lines of energy (the meridians). There are 14 main meridians Physicians will insert six to 20 needles and leave them for about 15 to 30 minutes depending on the condition and the treatment required. 1 cun = width of the thumb, in the middle, at the crease

§ There are 14 main meridians, 12 of which are named after the organs § § through which they pass, such as Liver, Spleen or Kidney, and about 500 acupuncture points. (The names of organs in traditional Chinese medicine are given capitals because the concept is different and more diffuse than that in Western medicine. ) Meridians: Connective tissue planes. Points: Convergence of connective tissue planes Blockage of qi: Altered connective tissue matrix composition leading to altered signal transduction Stimulating points on or beneath the skin affects the function of organs elsewhere in the body that are on the same meridian. For example, needles may be inserted in the foot or hand to relieve headaches.

How does acupuncture work? § There are probably several mechanisms of action of acupuncture. Three basic concepts are commonly used today to explain acupuncture's benefits: § Acupuncture alters body chemicals, including stimulating natural painkillers. § Acupuncture sensations affect nerves and cause beneficial reflex responses, and possibly repatterning of the nervous system. § Acupuncture affects the body's natural electromagnetic fields.

Body Acupuncture for Female Infertility § Reproductive Cerebral zone: This is a zone (not an acupoint), which is one inch in length beginning at the front natural hairline and in line with an imaginary line drawn caudally/posterobilateral from the lateral canthus of the eye. • “Sperm or Ovum Palace”: This point is three fingerbreadths bilateral to GV 4, which is directly below the spinous of the second lumbar vertebrae. • “Palace of the Child”: This point is three inches (four fingerbreadths) bilateral to CV 3, which is one inch superior to the symphysis pubes. • CV 1: From a medico/legal standpoint, this point, because of its critical location, has fallen out of favor with Western practitioners. This point lies directly in the perineum. .

Induction Of Ovulation § For Induction Of Ovulation (as § § § § clomid) use st 28 or st 30 or k 13 or Zi Gong + or- sp 6 3 times in follicular phase (around day 5 of the cycle until day 11 ) eg At day 5, 7, 9 For Ovarian Hyperstimulation (augmentation of ovulation as h. Mg) Some use st 28 or st 30 or k 13 or Zi Gong + or- sp 6 Plus Bl 23 or Gv 4 Every 2 day till day of retrival of ova In PCOS decrease points to avoid OHSS

IVF, ICSI Acupuncture and assisted conception § Acupuncture in conjunction with modern assisted reproduction techniques because of the relaxation effects. § Before embryo transfer ----- PC 6 (Neiguan), Sp 8 (Diji), Liv 3 (Taichong), Gv 20 (Baihui) and S 29 ( Guilai). § After embryo transfer----- S 36 (Zusanli), Sp 10 (Xuehai) , Sp 6 (Sanyinjiao), and Li 4 (Hegu).

Female Infertility and Acupressure § Magic or Science? § Acupressure is an ancient Chinese healing art that calls for stimulating definite pressure points on the body to promote healing. § Acupressure is static pressure, applied to acupoints § Tui Na therapy is to focus pressure with movement both along the meridians and into the qi points which may be "gun fa“method or the rolling style or The Nei Gung method § Acupressure involves pressing specific points on the body with the fingers, knuckles, and palms as well as the elbows and feet or Using pencil eraser or using a fingernail or little balls and tape to relieve pain, reduce stress, and promote general good health for 2 -3 minutes § According to 1 -The pressure applied to specific points on the hands and feet can help motivate the ovaries, uterus and adrenal, pituitary, thyroid and parathyroid glands to balance hormone production. 2 -According to five-element theory infertility is influenced by the water element that is inside the bladder and kidney areas and the earth element. 3 -The specific acupressure points that may be used to help during the preconception period include spleen 3, large Intestine 11, Triple warmer 7, Conception vessel 3. Liver 3 point is also helpful as it relaxes the nervous system. , Spleen 6 and Stomach 36 improve circulation. . By simply pressing a point, you are reinforcing it you can reduce a point by continually moving a finger counterclockwise over it

Cupping Therapy § Cupping is an ancient method of causing § § § local congestion. A partial vacuum is created in cups placed on the skin either by means of heat (old) or suction(recent). This draws up the underlying tissues. When the cup is left in place on the skin for a few minutes, blood stasis is formed and localized healing takes place. Cupping therapy was originally used in Egypt and China dating back some 3, 500 years Cupping is applied by acupuncturists to certain Acupuncture points, as well as to region of the organ or the area of dysfunction as well as to regions of the body that are affected by pain (where the pain is deeper than the tissues to be pulled)

Moxibustion § Moxibustion is the application of heat to acupuncture points or areas of the body using moxa to treat and prevent health conditions.

Micro-system Acupuncture § The idea of all micro-systems acupuncture is that there is a map of the entire body on small, selected areas of the body, and, by stimulating these points, one can promote healing and pain relief in the corresponding body parts § Eg : Hand , Foot , Scalp. Nose , Tongue, Face, Ear , abdominal Acupuncture

Sujok § Sujok (Su meaning "hand" and Jok meaning "foot" in Korean) § It is a form of acupuncture in which all acupuncture points are located on the hands and feet and which is designed to treat people.

Hand Acupuncture, Acupressure Korean Hand Therapy (KHT) § It was discovered in 1971 by Dr. YU Tae Woo, a korean specialist on traditional healing methods. § The traditional meridians and acupuncture points are duplicated in the micromeridians and points of the Korean Hand Therapy 1. Palm of the hand is the ventral side of body and the abdominal region. 2. The dorsal side of the hand is the back side of body and the waist region. Hand Acupuncture for Female Infertility The points on the base of the palmar hand, just distal to the wrist

Foot Acupuncture § Foot Acupuncture for Female Infertility § The points on the base of the ventral half of foot

Scalp acupuncture § It is a specialized form of acupuncture that has helped many people § the scalp acupuncture microsystem can treat most of the same disorders as traditional acupuncture, it is especially effective in treating nervous-system disorders and pain § Reproductive Cerebral zone: This is a zone (not an acupoint), which is one inch in length beginning at the front natural hairline and in line with an imaginary line drawn caudally/posterobilateral from the lateral canthus of the eye

Face Acupuncture

Tongue Acupuncture § Tongue acupuncture is just a couple of decades old but is becoming increasingly popular in Hong Kong § Tongue acupuncture is a new treatment that appears immature and undeveloped when compared with its long-standing counterparts. Much remains to be discovered, explored and refined through modern research before it will better serve mankind

Nose Acupuncture § It is one of the styles of microsystems acupuncture. § The idea of all micro-systems acupuncture is that there is a map of the entire body on small, selected areas of the body, and, by stimulating these points, one can promote healing and pain relief in the corresponding body parts

Auriculotherapy § § § It is the stimulation of the auricle part of the external ear for the diagnosis and treatment of health conditions in other parts of the body. The stimulation can be done with acupuncture needles, often referred to as ear acupuncture. Ear acupuncture is only about 50 years old. By Paul Nogiers a neurlogist from France The stimulation can also be done by manual pressure, referred to as auricular acupressure In Egypt the ear was used to treat impotence and sterility, both to cause it and prevent it. There are hieroglyphs to support this according to Alexandre Varille These points on the ear can also be stimulated with lasers, magnets, and ear pellets § Before ET § the use of the following auricular points: 55 (Shenmen), 58 (Zhigong) uterus § After ET § the use of the following auricular points: , 22 (Neifenmi) relaxing point, 29 ovary and 34 (Naodian) endocrine,

Iridology § Iridology is the study of the iris to determine potential health problems. § Iridologists believe that changing patterns and markings in the iris can be used to reveal emerging conditions in every part of the body and to identify inherited weaknesses that may lead to physical and emotional disorders. • 1. Stomach • 2. Cardiac spincture • 3. Pylorus • 4. Duodenum • 5. Peyers patches • 6. Villi of small intestine • 7. Ileocecal valve • 8. Appendix • 9. Ascending colon • 10. Transverse colon • 11. Liver • 12. Gall bladder • 13. Sigmoid colon • 14. Pancreas • 29. Cervical/neck • 30. Scapula • 31. Spine • 32. Lungs • 33. Bronchioles • 34. Bronchus • 35. Sinus • 36. Trachea • 37. Esophagus • 38. Heart • 39. Arteries • 40. Lymphatics • 41. Veins • 42. Skin • 15. Adrenal glands • 16. Pituitary gland • 17. Thyroid • 18. Testes • 19. Ovary • 20. Uterus • 21. Vagina • 22. Prostate • 23. Penis • 24. Kidney • 25. Bladder • 26. Fallopian tube • 27. Pelvis • 28. Clavicle • 43. Autonomic N. S. • 44. T. M. J. • 45. Solar plexus • 46. Cerebrum • 47. Occipital lobe • 48. Cerebrum • 49. Brain stem • 50 Breast • 51. Mastoid • 52. Ear • 53. Sm. Intestine • 54. Spleen •

Abdominal Acupuncture § It was developed in China over the last two decades and is § § § § becoming increasingly popular throughout the world Similar to Auricular Acupuncture, this new theory believes that the abdomen and navel area also possess points related to the whole body. It only requires a small number of needles to be placed in the abdomen at a very shallow depths, greatly reducing any discomfort patients may experience. This has made it very popular with patients and practitioners alike. Acupuncture needles are applied to the AMS, with the acupoint Shénquè (CV 8) at its centre. There are three different levels of puncturing depth. The superficial level is located on the congenital AMS, which develops together with the embryo and involves the areas of the head, torso and the upper and lower limbs The intermediate level is located on the standard classical meridian system known as the Jing Luo The deep level is located on the acquired AMS, which develops together with the organogenesis and involves all of the visceral organs

Reflexology § The art of reflexology dates back to Ancient Egypt, India § § and China. However, it was not until the twentieth century when Fitzgerald introduced this therapy to the West as ‘zone therapy’. He discovered that reflex areas on hands and feet were linked to other areas and organs of the body within the same zone. massage of the corresponding area on the foot is intended to positively influence the energy balance within the particular organ. Similar responses apparently result from working on the hands. § Gentle pressure to reflex points balances the hormonal system and stimulates the reproductive organs. Both women and men can benefit from treatments for individual reasons, such as regulation of menstruation and stimulation of sperm production § Eg : Hand , Foot , Face

Hand Reflexology § There are reflexes on the hand which relate to organs, glands and parts of the half side of body. Pitutary , Ovary , uterus § The wrist area from the base of palm down to watch area and around wrist joint These are ovary(medial ) and uterus ( lateral )

Foot Reflexology § There are reflexes on the Foot which relate to all organs, glands and parts of the half side of body. § Ovary - below and behind lateral malleolus § uterus - below and behind medial malleolus

Face Reflexology § Face reflexology is a modern treatment that § § § has its roots in oriental medicine combined with techniques used by South American Indians and up-to-date neuro-anatomy. This deeply relaxing therapy is designed to assess the underlying causes of our health discomforts as well as treating the symptoms. Our health is influenced by our physical, hormonal and emotional state. Face Reflexology has undergone long trials which show that the treatment addresses these imbalances with positive influences on our physical wellbeing. How? Using only hands and a light cream, the treatment incorporates precise stimulation of acupressure points, neurological points and body maps on the face. .

Aromatherapy § The is a great deal of evidence pointing to the extra strain infertility can § § § § place on individuals and subsequently on the marital relationship itself. Aromatherapy can help alleviate these stresses. In aromatherapy, The aromas of some essential oils are used in order to stimulate relaxation in the muscles and to relieve tension. Essential oils are highly concentrated plant substances, distilled from roots, seeds, barks and leaves. Because essential oils are so concentrated, they should not be applied directly to the skin. Instead, try the following methods 1 Massage: dilute the essential oil in a base such as grapeseed oil, wheatgerm or almond oil 2 Oil Burner: add 3 to 4 drops of essential oils to a container holding water that is heated by a small candle, allowing the aromas to gently fill the air to smell 3 Baths: add 5 to 10 drops of essential oil to a warm bath The following essential oils are particularly beneficial to the reproductive system of women trying to get pregnant : Rose, Chamomile, Geranium Melissa , Basil:

Homeopathy § This involves treating the disease with very, very small quantities of § § § natural substances that are derived from plants, minerals and animals that might give the same symptoms to a healthy person. The more dilute the active ingredient is the more potent it is felt to be Eg : sepia 6 c: used to treat irregular or absent ovulation aurum: used when lack of sex drive and depression are thought to be the cause of infertility silica: this remedy is used to boost a woman’s weakened immune system phosphorus: used to treat stress as well as emotional anxiety that can accompany infertility

Massage § Abdominal Uterine Massage § It is a non-invasive external massage § § technique to the abdomen and pelvis that helps to guide to the internal reproductive organs into their proper position, that uses only the hands to reposition reproductive organs that have shifted. This massage technique can be taught to women that they can perform on themselves daily (except during the menstrual cycle) actually repositioning the uterus correctly. allowing a 30% increase in fertility. The massage creates a healthy uterine wall with complete sluffing off during subsequent periods When the uterus is out of position the vital flow of blood, lymph, nerve impulse and chi to the pelvic area is compromised § Body Massage § Step 1 Bao Huang point § § In the sacral region, 3 finger's breadth lateral to the posterior midline, at the level of the second sacral foramen. Press the buttocks and wrap the low back with hand, Massage the point by thumb for 1 -3 minutes. Step 2 San Yin Jiao point On the medial leg, 3 finger's breadth superior to the medial malleolus, on the posterior border of the tibia. Wrap up leg with the hands and massage it by thumb for 1 -3 minutes. Step 3 Fu Liu point On the medial leg, 2 finger's breadth superior to frim on the anterior border of the Achille's tendon. Wrap the ankle with hand, Massage the point by thumb for 1 -3 minutes.

Hypnosis § Hypnosis is a natural state of mind which we enter into and out of every single day! § It is the same basic state you enter into when you daydream, get lost in an interesting task or § § lose yourself in a vigourous workout. While you are in this state, the conscious mind is occupied or distracted and you run on auto pilot, often not paying attention to the activities going on around you. Curiously while you are in this altered state, your suggestability significantly increases, and time can appear to slow down or speed up, the same as when undergoing hypnosis. What we do in Hypnotherapy is induce this altered state and use it to make positive suggestions to improve your life. A hypnotic trance can be induced in a number of ways using physical relaxation and focussed concentration. Hypnosis activates the limbic system and may have effects on the autonomic nervous system via the thalamus. Suggestions are accepted at an unconscious level including the induction of relaxation Modern studies have now confirmed that psychological and emotional blocks can create infertility issues. There may be subconscious fears around pregnancy, labor, childbirth, hospitals, medical treatments, motherhood, loss of independence or individuality, questions about their husband's ability to be a good father, unresolved dysfunctional patterns from a woman’s own childhood or even the fear that a new baby might be a threat to the relationship with her spouse.

Meditation Music § Therapy through music—listening to a CD or attending a live concert, playing an instrument, singing alone or in a group—can be a powerful healer. § Music is often used as a technique to aid visualization or meditation

Visualization § The use of imagery, or visualization, aims to focus the § § § mind to enhance body functions and processes. It can sometimes ease nausea, pain, and anxiety. You can do it on your own or with the help of a trained therapist. Visualization may involve: mentally picturing a state of being healthy; imagining yourself at a beautiful, restful place, like a beach or waterfall; or seeing yourself doing something active and enjoyable, such as swimming or running

Osteopathy § § § § § Osteopathy is a way of detecting and treating damaged parts of the body such as muscles, ligaments, nerves and joints proper manual manipulation releases the body’s own healing powers which then are able to restore the joints or tissue being treated to normal functioning. skilled osteopath uses therapeutic touch alone to locate the malfunctioning body part, then gently manipulates that body part using the right amount of pressure in the right place at the right time in the right way. Osteopathy specialises in the manipulation of the fascia thatpermeates, divides and subdivides all parts of the body surrounding muscles, arteries, veins and lymphatics, and supports a network of nerves around those body tissues Cranial osteopathy is based on the subtle involuntary mechanisms or rhythms which can be felt with a very finely developed sense of touch and, generally, through the use of an elaborate adjustable "lift" massage table which allows the practitioner to position the hands, arms and shoulders of the practitioner with a sufficiently relaxed angle (attitude) that the rhythms can be felt. From the experienced cranial osteopath, pulses in hydrostatic pressure can be initiated by pulsing the pressure of the practitioner's palms and fingers on the head and neck of the patient. The practitioner's own neurotransmitters are said by many practitioners to be somehow "activated" as the practitioner's fingers and palms find and settle in on locations on the patient's head which have an electrostatic presence. Treatments are generally weekly and continue until cranial osteopathy has re-established the rhythmic movement of the plates which together form the skull. Visceral osteopathy the mobility and motility of the organs and structures within the pelvis including the reproductive organs Factors such as surgery, hormonal disorders, and fibroids can all influence the mobility of the tissues, particularly in the uterus The resulting congestion and mechanical problems can in turn, lead to infertility The idea is that both somato-visceral and viscero-somatic connections exist between internal organs, and manipulation of the somatic system can affect the visceral system (and vice-versa). It rely on the interconnection synchronicity between the motion of all the organs and structures of the body, and that at optimal health this harmonious relationship remains stable despite the body's endless varieties of motion.

Chiropractic § The term "chiropractic" combines the Greek words cheir (hand) § § § § and praxis (action) to describe a treatment done by hand. The brain "talks" to the body via the nerve supply, much as we communicate over a telephone line. It emphasizes manual therapy including spinal adjustment and other joint and soft-tissue manipulation While some procedures associated with chiropractic care can be traced back to ancient times, the modern profession of chiropractic was founded by Daniel David Palmer in 1895 in Davenport, Iowa. Palmer vertebral subluxations caused pinched nerves in the intervertebral spaces in favor of subluxations causing altered nerve vibration, either too tense or too slack, affecting the tone (health) of the end organ It involves using the hands or a device to apply a controlled, sudden force to a joint, moving it beyond its passive range of motion. The goal is to increase the range and quality of motion in the area being treated and to aid in restoring health. Other handson therapies such as mobilization (movement of a joint within its usual range of motion) also may be used. Therapy aims to normalize this relationship between structure and function and assist the body as it heals Although chiropractic care is not a treatment for infertility, it is postulated that improvement of spinal neural integrity through specific chiropractic adjustments may have contributed to improved homeostasis and physiological adaptation thus allowing the body to express a greater level of health as an outcome

Herbalism § Herbal remedies are used in the treatment of many different conditions and ailments. § This ancient branch of medicine uses plant roots, stems, leaves, flowers, fruits or bark § It is a very popular alternative therapy

Fertility Yoga § Yoga is a centuries-old system of exercise and relaxation § a series of different postures designed to tone and strengthen all areas of the body, § The most powerful effect of regular yoga practice on a person's fertility is through the calming, restorative effects on the mind and body. A quiet, stable mind and body promote fertility § Fertility yoga is a specific branch of yoga that has been designed for men and women who are trying to conceive. Fertility yoga follows the basic principles of yoga but combines them with specific postures designed to aid the reproductive organs, thereby increasing chances of pregnancy , also focuses on providing stress relief and relaxation in order to balance the body’s hormones and emotions in an effort to make the body more conducive to conception by increasing energetic flow in the body, particularly in the area of the second chakra or seat of creation where the reproductive organs are located

Naturopathy A naturopath may suggest the following as treatment for infertility: improving the nutrition of both partners; hot and cold water splashes on the genitals to stimulate circulation locally; avoiding alcohol and smoking for a while, and also getting enough rest. Dietary and Lifestyle Recommendations Consume a diet that focuses on whole, unprocessed foods (whole grains, legumes, vegetables, fruits, nuts, and seeds). Eat 1/4 cup of raw sunflower seeds or pumpkin seeds each day. Eliminate alcohol, caffeine, and sugar. Identify and control food allergies. Get regular exercise. (Avoid excessive exercise. ) Perform a relaxation exercise (deep breathing, meditation, prayer, visualization, etc. ) 10 to 15 minutes each day. Drink at least 48 ounces of water daily.

Qi Gong (energy building exercises) § It's actually an ancient Chinese way of greeting each day § § § with increased vitality. Qi Gong is an exercise process of gathering and storing energy from nature. The exercises aim to raise energy flow, enhance flexibility, improve circulation and reduce stress. It's based on slow, graceful, dance-like movements. The following types of Qigong may help: Static Qigong: Relaxation Qigong Inner-Nourishing Qigong Relaxing Quiescent Qigong Dynamic Qigong: Fifteen Sets of Taiji-Qigong Exercise Baduanjing of Internal Exercise

“One Size Fits All” Does Not Apply To Infertility § Many treatments and therapies, both Western and Eastern based, are utilized to enhance fertility. “One size fits all” does not apply to infertility treatment. § It is important to alert physician to alternative therapies that patient are using, so that treatment plan can be tailored to her needs, and optimal care can be achieved. § Communication between patient and her physician is essential to help her achieve her dream of a having a healthy baby! § A Needle , A Cup or A Pressure Here ………… A Baby Here!