I have always had an interest in cooking wholesome food for both enjoyment and health and am guided away from processed foods by choosing ingredients that ‘ran, swam, flew or grew’ in their most natural state. Like many people I have in recent years leant towards a more heavily plant-based diet with an emphasis on a wide variety of colourful fruit and veg, wholegrains and plant-based protein like lentils, pulses, beans and tofu. However, I do still eat fish and meat, buying far less but of higher quality, higher welfare - by trying to choose largely wild fish and meat that is free-range, grass fed, preferably organic - and using every last bit which brings me to the wonders of bone broth.
 
It has been revered for its potent nutritional and medicinal properties by various cultures across the globe for thousands of years from ancient Greece, throughout Africa and Asia, to the infamous recuperative ‘Jewish Penicillin’.  A South American proverb states ‘Bone Broth will resurrect the dead’. It had a reputation within Chinese Medicine stretching back over 2,500 years for its ability to support digestion and reproductive health – pre-conceptually for both men and women to support egg and sperm health, during pregnancy for mum and baby, and post birth to help mum rebuild her strength.
 
Bone broth is packed with easy to digest gelantinous protein and amino acids from the collagen in cartilage, and minerals such as magnesium, calcium, phosphorus and potassium from the bones, extracted by long slow cooking. Wide ranging potential health benefits include helping to support skin, bone and joint health, soothing gut issues like ulcerative colitis and leaky gut, supporting immune function, helping recovery from upper respiratory infections and it may also help to promote good sleep. The combination of skin, joint and sleep effects likely make it beneficial for women post menopause, a time when increasing protein and reducing carbs can be helpful.
 
We can get a bit caught up about what’s in food and what it is good for. Sometimes it is good just to let go of that and enjoy the wholesomeness because you know in another more intuitive way that it is nourishing. For me bone broth is one of those things. A warm soothing elixir!  It is delicious drunk on its own, makes a great base for soups and stews.
 
For convenience you can buy bone broth ready-made, conveniently packaged and delivered frozen direct from the farm to your door but it is far cheaper and satisfying to make your own.  It cooks for so long that it is more economical on fuel to cook up a big batch so I collect any chicken bones both raw and cooked in the freezer until I have a good supply, supplementing them with some chicken carcass bones from the butchers to fill a stock pot.
 
Chicken Bone Stock Recipe
 
This recipe uses chicken bones and cooks for 4-6 hours.  You could make a fish version substituting the chicken for fish heads and bones usually discarded by the fishmonger so very cheap – use about 1kg per litre of water - and simmer for one hour. Strain through muslin to remove all bones.

You’ll need a large stock pot with a tight fitting lid.
 
Ingredients:

• Good Quality Chicken bones (legs but especially wings and whole carcass are good, preferably organic). Equivalent of 4-5 carcasses.
• Spices for flavour: Your choice of whole peppercorns, fennel seeds, coriander seeds. About 1-2 tsp of each for a large stockpot.
• Vegetables and herbs for flavour: Your choice of celery, carrot, leeks, onion, garlic, parsley and coriander stalks, a few bay leaves and fresh ginger. Peelings and ends are fine.
• Cider vinegar. About 4 tablespoons for a large stock pot.

 
Method:
Optional: Before making the stock you can roast the bones for an hour in the oven until they are golden for a richer flavour.
 

• Place the bones in the stock pot.
• Add spices and vegetables. Veg can just be added for the final hour if you prefer.
• Cover with water (boiling from the kettle is quicker than heating on the hob).
• Add cider vinegar to help extract the minerals from the bones.
• Cover with a tight fitting lid and simmer gently for 4-10 hours (with the extractor fan on unless you like to live in a soup scented sauna!) checking and stirring every now and then to ensure it is still covered with water and not sticking.
• I cook it until the cartilage on the ends of the bones softens and dissolves which usually takes 4 – 5 hours but some people cook it for much longer which will extract more minerals from the bones.
• Strain off all the liquid, discard bones and veg and then reduce it to a manageable quantity.  For 5 carcasses I end up with about 1.5 litres of concentrated broth. You could concentrate is down even more and freeze in ice cube trays.
• Pour into portion sized pots (I use metal Indian thali bowls) and allow to cool. It should have a thick jelly consistency when cold. The fat will rise to the surface which you can then scrape off if you wish, I usually scrape off some but leave some for flavour. Freeze in a suitable container or bag and use as needed. As it is so concentrated you can dilute it as needed.

 
The effort will more than pay off for the ease with which you can prepare a tasty meal or quick warming drink that nourishes you deep to the bone.  Enjoy!

Trying to have babies when it doesn’t just happen easily can be a heart wrenchingly difficult time.  There can be months even years of trying, balancing hope with uncertainty, even at times despair.   Another cycle starts.  Is this going to be your lucky month?
 
When supporting women with fertility I tend to focus treatment on the follicular phase leading up to ovulation, or in the case of IVF through the stimulation phase until egg collection and at embryo transfer.  These are the times that research has shown acupuncture can have a significant influence on live birth rates (Zheng, 2012). Treatments around embryo transfer, when they can be scheduled in without adding extra stress, are also shown to have a beneficial effect on outcomes (Smith, 2019).
 
Ideally, men and women would also have received some preconceptual lifestyle advice during the preceding months, not least of all to support egg and sperm quality as they develop and mature.  Treatment can be aimed at regulating the menstrual cycle, supporting endometrial development and addressing other issues impacting on fertility.  Treatment during the follicular phase will be aimed at supporting the processes that take place throughout the menstrual cycle including the luteal phase but what about treatment during the actual luteal phase or the two-week wait as it is commonly known, which follows ovulation or embryo transfer?
 
How can Acupuncture help?
As I have said, I tend to focus most treatment during the follicular phase but that does not exclude treatment during the luteal phase. It is a time to be cautious with any treatments that could disturb the delicate interplay between the embryo and uterine lining around the time of implantation, but treatments aimed at relaxation and good sleep can be positively beneficial.   It is often an anxious time when every little twinge seems to take on some significance.  An acupuncture treatment can offer a gentle wind down from the intensity of IVF or the pressures of trying naturally, at a time when sound sleep and a feeling of calm may be quite elusive.
 
How can you support yourself during the two week wait?
The preparations you have taken in the preceding months, weeks and days will help to lay the foundations but here are 10 tips to support implantation and help through these two weeks:
 

1. Get plenty of rest and sleep. Try one of these Yoga Nidra exercises for sleep.
2. Eat nourishing anti-inflammatory food. Lots of fresh fruit and veg, good quality protein, nuts and seeds, healthy fats and wholegrains.  
3. Avoid sugar, processed and junk food as much as possible.
4. Include some live fermented foods – yoghurt, sauerkraut, kimchi, kombucha, kefir etc - or take a probiotic.
5. Ease up on strenuous workouts, moderate exercise is fine even beneficial.
6. Avoid excess heat on the abdomen (no hot baths, saunas or hot water bottles on the belly).
7. Avoid googling and trying to second guess the meaning of everything you feel.
8. Take time to sit quietly, and just notice how you feel. Take a few breaths into your belly to help your thoughts settle – longer on the out breath. Notice any sensations you feel in your body, without attaching any significance.  Just notice and let them go.
9. Distract yourself with a few things to look forward to. A catch up with friends, a film, a creative project, a good book.
10. Don’t be tempted to test too early. Wait until the first day of your missed period or until advised by your fertility clinic.

 
Good luck. Remember that even under perfect conditions there is only a 1 in 4 chance of conceiving each month, so it can take a while. Please contact me if you think I may be able to help you.

I love being a mother. I love having that relationship with my son. I love being around him, I love watching him grow, I love sharing his important moments and hearing him find himself and his passions. I love snuggling him to sleep and being woken by him in the morning (less so at 4am). I love the richness he brings to my life and the ways that relationship pushes me to grow and be a better person.
 
It is also challenging, in particular the expectations I realise I have of myself around what it means to be a mum and who else I am ‘allowed’ to be at the same time. I find the juggling is difficult and varied and I have had to work to create self care time as I wrote about in a Shame and Self Care blog. I am still working hard to hold onto myself as a broad, multifaceted creature and realise how easy it is to slip back into the assumption that being a ‘good’ mother is synonymous with total self sacrifice. These are my expectations on myself and that I see in mothers around me, which must come from the world and society in which we were raised.
 
Maternal mental health is important for our children’s mental health and for our society at large. And I believe it is a challenge to all mothers to maintain mental health. We have a constant need to juggle and our brains and bodies are expected to jump in all directions often simultaneously. We are often tired and overstretched and I think our society has a long way to go to accommodate flourishing mental health for us. 
 
I love Caitlin Moran’s insight into how we are forever changed on a chemical level by motherhood: 
“No one really talks about the chemical elements of parenting but when you think about it, this is what underpins everything. Humans are essentially bags of chemicals We choose our mate on their smell, their hormones subliminally whispering to us in a neanderthal grunt ‘this man make good baby with you’ then when a woman gets pregnant, what is created in her uterus is essentially a living hormonal implant emitting random amounts of fuck knows what into her system and rewiring her entire body and brain in a massive hormonal pyroclustic blast that she never fully recovers from” (Caitlin Moran in More Than a Woman)
 
Here are my fantasies of how a shift in our expectations could come about that might better support maternal mental health:
What if…
...It was widely understood and accepted by society that pregnant women are going through an immense change that involves so much loss as well as gain. That there is much to be grieved in becoming a mother - a sense of self, alone time, sleep, some friendships, an ability to wholly commit to something else, our bodies as they were, our attitudes as they were - everything as it was!
 
...we recognised openly that ‘tired and hormonal’ can really mean ‘can barely lift myself off the chair and feel like my brain is exploding’ and realised that those things shouldn’t be ignored just because they are common, that in fact this is womanhood in all its glorious colours, a rainbow to be celebrated and supported.
 
...our society recognised the value in rest and supporting mothers to get rest that they need from the early weeks of pregnancy through to their children leaving home, that work breaks for naps were a given and it was built into our expectations that we are all healthier and happier when well rested.
 
…our government understood ’supporting childcare needs’ less as simply making the age for group child care lower and more the benefits to our future society of child care with a much lower adult to child ratio
 
...we gave more space to the fact that bringing a child into a relationship utterly changes the relationship and can often leave the person who didn’t give birth feeling left out so that couples finding themselves in this difficult place don’t feel bad or wrong and instead know this is their rites of passage to get through.
 
...we allowed women to work and be a primary carer by helping support the caring part better, that the person paid to look after the child can feasibly be the one who loves them best and that we didn’t feel it was a constant sacrifice between our work passions and our family as to who gets more of our time and energy.
 
...we celebrated the changes in women’s bodies that come with pregnancy, birth, breastfeeding, getting older and the menopause and let go of any expectation or idealisation of ‘back to a pre-pregnancy body’ - what if we could celebrate every stage of women’s bodies....
 
...it was widely understood that Feminism doesn't mean ignoring biology but restructuring society so that we can accommodate everyone fairly rather than simply ‘letting’ women do more and more things.
 
...things that strengthen our bodies, minds and spirits like yoga, mediation, therapies and walking were valued to such a degree that we assumed it was part of our every day like eating and washing.
 
...we understood that you cannot separate the physical from the mental or emotional and that our mental health is always going to be affected by things that affect our bodies, like pregnancy and motherhood.
 
The optimist in me sees some steps in some of these directions and is hopeful that society is changing, however incrementally. At the heart of any of this change is kindness and compassion - things that we so value in the act of mothering that surely should be so highly valued in how we treat our mothers in society.
 

Acupuncturist Philippa Summers, who has a special interest in fertility, shares some helpful resources around supporting the often overlooked area of male fertility.

here is a growing movement among men and male fertility specialists to encourage the issue of male fertility into the open, improve awareness and access to help, both specialist and peer support. Prompted by watching a BBC program on male fertility with comedian Rhod Gilbert aimed at opening up the conversation and garnering more support, I have put together some resources. I hope they will be useful to men facing fertility issues, especially if they are feeling isolated and unsure of where to turn. It is also National Infertility Awareness Week.
 
In couples struggling to conceive male factors contribute almost 50% of the time and are often overlooked, especially so when an identifiable contributing issue has been identified in the woman, and this can leave many male issues underdiagnosed and undertreated. It can leave couples struggling often with an over reliance on IVF, which may give you a chance of navigating around a problem but will not rectify an issue, and the emotional, physical and financial burden IVF imposes is comparatively very high.
 
Where male factors have been identified men often bear it alone, harbour their feelings and find it difficult to discuss these very private issues with anyone, including their partner, friends or family.  It can be very isolating, impacting on almost every aspect of their life. It can also be a source of conflict within couples, allowing resentments to build up and adding to the already considerable strain.
 
 
So where can you find support, advice and treatment?
 
Here are some resources that you may find helpful regardless of where you are on your fertility journey, be it starting out and looking for lifestyle advice to help improve sperm and semen, or somewhere down the road and looking at getting investigations, treatment or support. Maybe to begin with you just want to find out that you are not alone and have a chance to listen to other men’s experiences and how they are coping. Be selective so that you are not overwhelmed with information. Included are resources that you can access anonymously or listen to on your own where your privacy is important.
 
Acupuncture
 
A quick mention of the benefits of acupuncture. For men with suboptimal semen parameters acupuncture has been shown to improve the number of normal sperm by improving sperm count, movement and shape – all important factors for improving fertility. Typically the needles are placed in the arms, legs, back and abdomen – never locally!  It is also extremely relaxing and helpful for coping with stress and low mood.
 
Information
 
Fertility Network UK have plenty of good up to date information on all aspects of fertility including male fertility. This is a good starting point for information.
 
The Fertility Podcast website has several episodes that focus on male fertility.  Each podcast is accompanied by notes to help you find those that are likely to be of most interest and relevance to you. They include personal stories, which can help to break down the stigma and isolation, and interviews with male fertility specialists to help understand where different tests and treatments fit in as well, as providing tips for improving your fertility.
 
Specialist Consultations and info
Your GP is usually the first port of call for accessing specialist help. Ask to see a GP in the practice with particular knowledge of male fertility. They should offer you a comprehensive semen analysis and a physical examination with NHS referral to a specialist Andrologist (men’s equivalent of a gynaecologist) where appropriate. This is something you can request giving you the same level of investigation as is routinely offered to women.
 
Prof Sheryl Homa and her team at Andrology Solutions , an HFEA licensed male fertility clinic, have exceptional knowledge of male fertility and provide diagnosis and support for men who are trying to conceive. They are a private clinic and you can self refer. They also have some very useful information on their website.
 
Consultant urologist Jonathan Ramsay is one of the leading experts in male fertility. His website has a wealth of information including the latest advances in research and guidelines. He is available for private consultation.
 
Nutritionist Melanie Brown specialises in helping men and women with fertility, IVF and pregnancy. The right nutrition and supplements provide a solid foundation for overall good health as well as fertility and can make all the difference.
 
Men Only Support Groups
Here are a couple of groups where you can connect with other men going through similar problems.
 
Men’s Fertility Support – a men only Facebook group where men can discuss male fertility issues anonymously. It says IVF/IUI/ICSI but may be broader than this.
 
Fertility Network Uk run a regular Zoom support group for men only (which you can join with your camera off if you wish to remain anonymous). On the linked page it mentions an April date but as of Feb 2021 it is still running.
 
Film, TV and radio programmes
Comedian Rhod Gilbert ‘Stand Up To Fertility’ on BBC2. While undergoing treatment himself comedian Rod Gilbert goes on a frank, revealing and frequently funny journey into the world of male infertility.
 
BBC Radio 4 Benjamin Zephaniah discusses his experience of male infertility with urologist Kevin McEleny, and also talks separately to a couple, Richard and Terri, about their experiences of male fertility issues.
 
Also BBC Radio 4 My Life as a Childless Man.  Writer and actor Rod Silvers talks about his experience and the isolation that it can cause.  He encourages men to find ways to speak about it, something he still finds difficult.
 
LGBTQ+ Community
The Agora Journals podcasts – from The Agora Clinic in Hove. They treat heterosexual couples and solo parents but also have a deeper awareness than many clinics of the needs of the LGBTQ+ community, including people who are transitioning for whom egg and sperm preservation before transition is important.
 
I hope that among this selection you find something that helps you, whatever your circumstances.
 
Very best wishes,
Philippa