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Hesmert D, Klocke C, Stolz R, Huber R, Samstag Y, Hübner K, Simmet T, Syrovets T, Joos S, Valentini J. Exploring the gap: attitudes, knowledge, and training needs in complementary and integrative medicine among healthcare professionals at German university hospitals. Front Med (Lausanne) 2024; 11:1408653. [PMID: 38784234 PMCID: PMC11111851 DOI: 10.3389/fmed.2024.1408653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Accepted: 04/23/2024] [Indexed: 05/25/2024] Open
Abstract
Introduction The use of Complementary and Integrative Medicine (CIM) is very popular among the general population in Germany. However, international studies show that nurses, physicians, and other health care professionals (HCPs) at hospitals often do not feel sufficiently informed about different CIM approaches. Moreover, they do not feel trained enough to counsel their patients appropriately. In the German-speaking context, particularly within university hospitals, research on this subject is scarce. Therefore, the aim of this explorative study was to evaluate attitudes, subjective knowledge, and needs regarding CIM among HCPs with direct patient interaction across all four university hospitals in the federal state of Baden-Württemberg, Germany (Tübingen, Ulm, Freiburg, Heidelberg). Methods The multicenter, cross-sectional, anonymous full survey was conducted online using a self-developed, semi-structured, web-based questionnaire. Recruitment took place via all-inclusive e-mail distribution lists of all four university hospitals. Results A total of n = 2,026 participants (response rate varied by location from about 5 to 14%) fully answered the questionnaire. Nurses constituted the largest professional group (n = 1,196; 59%), followed by physicians (n = 567; 28%), physiotherapists (n = 54), psychologists (n = 48), midwives (n = 37), and other professions (n = 124). More than two-thirds (71%, n = 1,437) of the participants were female and 14% (n = 286) reported additional training in CIM. The overall attitude toward CIM (10-point Likert scale, 10 = "very favorable") was clearly positive (M ± SD: 7.43 ± 2.33), with notable differences between professional groups: midwives (9.05 ± 1.18), physiotherapists (8.44 ± 1.74), and nurses (8.08 ± 1.95) expressed the highest support, whereas physicians (5.80 ± 2.39) the lowest. 42% of the participants incorporated CIM in patient care (from 33% of physicians to 86% of midwives). Overall, relaxation therapy (n = 1,951; 96%), external applications (n = 1,911; 94%), massage (n = 1,836; 91%), and meditation/mindfulness (n = 1,812; 89%) were rated as useful or rather useful for patients. The average self-assessed knowledge level about CIM was moderate (M ± SD: 5.83 ± 2.03). Most of the participants found CIM training at university hospitals important and saw research about CIM as one of the tasks of university hospitals. The participants expressed the highest interest in education for acupuncture/acupressure, relaxation therapies, and manual medicine. Discussion This comprehensive survey of health care professionals (HCPs) at university hospitals in Germany reveals a clearly positive disposition toward CIM, aligning with findings from other hospital-based surveys and highlighting differences among professional groups. While most therapies deemed beneficial for patient care are supported by positive evidence, further research is required for others. Given the average self-reported knowledge of CIM, targeted education is essential to meet the needs of both HCPs and patients and to ensure the provision of evidence-based information on the risks and benefits of CIM.
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Affiliation(s)
- Daniela Hesmert
- Institute of General Practice and Interprofessional Care, University Hospital and Faculty of Medicine, Tübingen, Germany
| | - Carina Klocke
- Institute of General Practice and Interprofessional Care, University Hospital and Faculty of Medicine, Tübingen, Germany
| | - Regina Stolz
- Institute of General Practice and Interprofessional Care, University Hospital and Faculty of Medicine, Tübingen, Germany
| | - Roman Huber
- Center for Complementary Medicine, Department of Medicine II, Medical Center, Faculty of Medicine – University of Freiburg, Freiburg im Breisgau, Germany
| | - Yvonne Samstag
- Section of Molecular Immunology, Institute of Immunology, Heidelberg University Hospital, Heidelberg, Germany
| | - Katrin Hübner
- Section of Molecular Immunology, Institute of Immunology, Heidelberg University Hospital, Heidelberg, Germany
| | - Thomas Simmet
- Institute of Experimental and Clinical Pharmacology, Toxicology, and Pharmacology of Natural Products, Ulm University, Ulm, Germany
| | - Tatiana Syrovets
- Institute of Experimental and Clinical Pharmacology, Toxicology, and Pharmacology of Natural Products, Ulm University, Ulm, Germany
| | - Stefanie Joos
- Institute of General Practice and Interprofessional Care, University Hospital and Faculty of Medicine, Tübingen, Germany
| | - Jan Valentini
- Institute of General Practice and Interprofessional Care, University Hospital and Faculty of Medicine, Tübingen, Germany
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James KF, Klomhaus AM, Elliott T, Mensah M, Jeffers KS, Choi KR. Structural Factors in Health Care Associated With the Mental Health Needs of Black Women in California During the Perinatal Period. J Obstet Gynecol Neonatal Nurs 2023; 52:481-490. [PMID: 37634545 DOI: 10.1016/j.jogn.2023.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 08/07/2023] [Accepted: 08/08/2023] [Indexed: 08/29/2023] Open
Abstract
OBJECTIVE To identify structural factors associated with the receipt of mental health care treatment among Black women in California during pregnancy and after childbirth. DESIGN Secondary analysis of data from the population-based Listening to Mothers in California survey. PARTICIPANTS The sample included 194 non-Latina Black women in the postpartum period. METHODS We used descriptive statistics, including differences between means and logistic regression, to conduct a series of bivariate analyses. RESULTS Most respondents (84.4%, n = 163) reported symptoms of perinatal mood and anxiety disorders prenatally, and half (50% n = 97) reported symptoms of perinatal mood and anxiety disorders in the postpartum period. Only 12.3% to 14.6% of those who reported symptoms received mental health care treatment. Furthermore, 21.2% (n = 38) of respondents were not screened for postpartum depression. Respondents with private insurance coverage were more likely to report receipt of mental health care after childbirth (OR = 4.6; 95% confidence interval [1.5, 13.5]) compared to respondents with public insurance coverage. CONCLUSION Our results suggest a high prevalence of unmet mental health needs among non-Latina Black women who lived in California during the perinatal period. Practitioners in clinical settings may be more likely to make referrals to mental health care for women with private insurance coverage in the postpartum period.
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Buor D, Agyemang S, Awuku P. The Determinants of Utilisation of Herbal Medicine Among Pregnant Women in the Asante Akim North District, Ghana. Matern Child Health J 2023; 27:1886-1896. [PMID: 37209378 DOI: 10.1007/s10995-023-03676-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/10/2023] [Indexed: 05/22/2023]
Abstract
BACKGROUND Pregnant women especially in the developing countries resort to herbal medicines to manage their unpleasant conditions in pregnancy. The study examined the utilization of herbal medicine among pregnant women in Asante Akim North District of Ghana. METHODS Purposive, random and convenient sampling techniques were used to select pregnant women visiting antenatal clinics in the selected health institutions. The theoretical underpinning of the study was the theory of planned behaviour. The sequential mixed method approach was used to draw data from the respondents. The research was a cross-sectional study and instruments used for data collection were structured questionnaire and interview guide. Data were analysed using statistical tools such as frequencies, percentages and chi-square test of independence. RESULTS Results indicate that over 82% of respondents had ever used herbal medicine during pregnancy and they derived greater part of their medication from herbalists. Ginger and leaves of the neem tree were the herbs regularly used and the major health problems they faced during pregnancy were waist pains, malaria and anaemia. The factors that exhibited a statistically significant association with the use of herbal medicine were income (X2 =41.601; p=0.014) and religion (X2=9.422; p=0.045). CONCLUSIONS The rate of use of herbal medicine by pregnant women is high in the district. The theoretical underpinning of the study has been vindicated. The findings have implications for global health given that maternal health issues engage serious attention of international donor organisations. Recommendations have been made to improve the efficacy of herbal medicine and to integrate herbal medicine into orthodox medicine.
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Affiliation(s)
- D Buor
- Department of Geography and Rural Development, KNUST, Kumasi, Ghana.
| | - Seth Agyemang
- Department of Geography and Rural Development, KNUST, Kumasi, Ghana
| | - P Awuku
- Wesley Girls High School, P.O. Box KS8481, Kumasi, Ghana
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Lowe LA, Betts D. Midwifery Acupuncturists' Management of Antenatal Anxiety and Depression: Data from a Survey in Aotearoa (New Zealand). Med Acupunct 2023; 35:63-72. [PMID: 37095785 PMCID: PMC10122233 DOI: 10.1089/acu.2022.0062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023] Open
Abstract
Objective The goal of this research was to explore how New Zealand midwifery acupuncturists manage mild-to-moderate antenatal anxiety and depression (AAD). Materials and Methods A survey (Surveymonkey®) on midwives' perceptions of acupuncture for treating AAD was distributed late in 2019 to midwives who completed a Certificate in Midwifery Acupuncture. Data were collected on referrals and on acupuncture and complementary and alternative medicine use for AAD and associated symptoms of concern (SoC), such as low-back and pelvic pain (LBPP), sleep issues, stress, other pain, and pregnancy issues. Descriptive analysis was used to report data. Results Of 119 midwives, 66 responded (55.5%). For AAD and SoC, midwives mostly referred patients to general practitioners and counselors, and administered acupuncture themselves. Acupuncture was most accessed for LBPP (n = 38; 70.4%), sleep (n = 31; 57.4%), anxiety (n = 27; 50.0%); stress (n = 26; 48.1%), and other pain (n = 20, 37.0%). Massage was second most-accessed for LBPP (n = 36; 66.7%), sleep (n = 25; 46.3%), and stress (n = 24; 44.4%). For depression, treatments were herbs (n = 16; 29.6%), homeopathy (n = 14; 25.9%), and acupuncture and massage (both n = 13; 24.1%). Acupuncture was most used for other pregnancy issues: birth preparation (n = 44, 88.0%); assisted labor induction (n = 43; 86.0%): nausea and vomiting (n = 43; 86.0%); breech (n = 37; 74.0%); and headaches/migraines (n = 29; 58.0%). Conclusion Acupuncture is commonly used by midwife acupuncturists in New Zealand to treat a range of pregnancy issues, including anxiety, SoC for AAD, and other pregnancy issues. Further research would be beneficial.
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Affiliation(s)
- Lee-Ana Lowe
- Dunedin, Aotearoa (New Zealand)
- New Zealand School of acupuncture and Traditional Chinese Medicine, Auckland, Aotearoa (New Zealand)
| | - Debra Betts
- New Zealand School of acupuncture and Traditional Chinese Medicine, Auckland, Aotearoa (New Zealand)
- University Western Sydney, Sydney, Australia
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Nowak SA, Gidengil CA, Parker AM, Matthews LJ. Association among trust in health care providers, friends, and family, and vaccine hesitancy. Vaccine 2021; 39:5737-5740. [PMID: 34456072 DOI: 10.1016/j.vaccine.2021.08.035] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 08/04/2021] [Accepted: 08/10/2021] [Indexed: 10/20/2022]
Abstract
A health care provider's vaccination recommendation is one of the most important factors influencing parents' decisions about whether to vaccinate their children. Unfortunately, vaccine hesitancy is associated with mistrust of health care providers and the medical system. We conducted a survey of 2440 adults through the RAND American Life Panel in 2019. Respondents were asked to rate their trust in pediatricians, OB/GYNs, doulas, midwives, lactation consultants, friends and family for information about childhood vaccines. Respondents were also asked about willingness to vaccinate a hypothetical child as a measure of vaccine hesitancy. We used principal component analysis to characterize variance in responses on trust items and logistic regression to model the relationship between trust and vaccine hesitancy. Vaccine hesitancy was associated with: (1) lower overall trust; (2) reduced trust in OB/GYNs and pediatricians and greater trust in doulas, midwives, and lactation consultants; and (3) greater trust in friends and family.
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Affiliation(s)
- Sarah A Nowak
- Department of Pathology and Laboratory Medicine, Larner College of Medicine at the University of Vermont, Burlington, Vermont, USA; RAND Corporation, Boston, Massachusetts, USA.
| | - Courtney A Gidengil
- RAND Corporation, Boston, Massachusetts, USA; Boston Children's Hospital, Boston, Massachusetts, USA
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Ee C, Levett K, Smith C, Armour M, Dahlen HG, Chopra P, Maroun P, Rao VS, Avard N, Grant S, Keedle H, Armour S, Arentz S, Cave AE, Sutcliffe K, Templeman K. Complementary medicines and therapies in clinical guidelines on pregnancy care: A systematic review. Women Birth 2021; 35:e303-e317. [PMID: 34419374 DOI: 10.1016/j.wombi.2021.08.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 08/05/2021] [Accepted: 08/09/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND There is a need for evidence-based guidance on complementary medicines and therapies (CMT) use during pregnancy due to high prevalence of use and lack of guidance on the balance of benefit and harms. AIM Evaluate the extent to which current clinical practice guidelines relevant to Australian healthcare professionals make clear and unambiguous recommendations about CMT use in pregnancy, and synthesise these recommendations. METHODS The search included EMBASE, PubMed, the National Health and Medical Research Council's Clinical Practice Guidelines Portal, and websites of Australian maternity hospitals and professional/not-for-profit organisations for published guidelines on pregnancy care. Data were synthesised narratively. Guidelines were appraised by two independent reviewers using the Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument. FINDINGS A total of 48 guidelines were found, of which 41% provided recommendations that were not limited to routine vitamin and mineral supplementation. There were wide variations in recommendations, particularly for vitamin D and calcium. There was some consensus on recommending ginger and vitamin B6 for nausea and vomiting, and additional supplementation for women with obesity. Guidelines generally scored poorly in the domains of editorial independence and rigour of development. DISCUSSION There is a lack of guidance with regard to appropriate CMT use during pregnancy, which may result in less-than-optimal care. Inconsistency between guidelines may lead to variations in care. CONCLUSION Guidelines should include clear and unambiguous guidance on appropriate CMT use during pregnancy, be based on a structured search of the evidence and informed by stakeholder engagement.
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Affiliation(s)
- Carolyn Ee
- NICM Health Research Institute, Western Sydney University, Penrith, NSW, Australia.
| | - Kate Levett
- School of Medicine, The University of Notre Dame Australia, Broadway, NSW, Australia.
| | - Caroline Smith
- NICM Health Research Institute, Western Sydney University, Penrith, NSW, Australia.
| | - Mike Armour
- NICM Health Research Institute, Western Sydney University, Penrith, NSW, Australia.
| | - Hannah G Dahlen
- School of Nursing and Midwifery, Western Sydney University, Penrith, NSW, Australia.
| | - Prakshi Chopra
- Obstetrics and Gynaecology Department, Canberra Hospital, Canberra, ACT, Australia.
| | - Paulette Maroun
- Royal Australian and New Zealand College of Obstetricians and Gynaecologists, East Melbourne, VIC, Australia.
| | - Vibhuti S Rao
- NICM Health Research Institute, Western Sydney University, Penrith, NSW, Australia.
| | - Nicole Avard
- Next Practice Health, Erina, Sydney, NSW, Australia.
| | - Suzanne Grant
- NICM Health Research Institute, Western Sydney University, Penrith, NSW, Australia.
| | - Hazel Keedle
- School of Nursing and Midwifery, Western Sydney University, Penrith, NSW, Australia.
| | - Susanne Armour
- Maternity Service, Wollongong Hospital, Wollongong, NSW, Australia.
| | - Susan Arentz
- NICM Health Research Institute, Western Sydney University, Penrith, NSW, Australia.
| | - Adele E Cave
- NICM Health Research Institute, Western Sydney University, Penrith, NSW, Australia.
| | - Kerry Sutcliffe
- School of Medicine, The University of Notre Dame Australia, Broadway, NSW, Australia.
| | - Kate Templeman
- NICM Health Research Institute, Western Sydney University, Penrith, NSW, Australia.
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Mollart L, Stulz V, Foureur M. Midwives knowledge and education/training in complementary and alternative medicine (CAM): A national survey. Complement Ther Clin Pract 2021; 45:101473. [PMID: 34385048 DOI: 10.1016/j.ctcp.2021.101473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 07/29/2021] [Accepted: 08/06/2021] [Indexed: 10/20/2022]
Abstract
Despite the proliferation of research exploring complementary and alternative medicine (CAM) use in maternity care and midwifery practice, there is a gap on midwives' level of CAM knowledge and education/training. This national survey investigated Australian midwives' knowledge and education/training in CAM. A total of 571 midwives completed the survey (16%). Over half (54.3%) had some level of CAM education/training (self-learning to diploma) and with multiple CAM modalities. The top four modalities that midwives had received education/training were acupressure (66.5%), aromatherapy (60.3%), massage (45.5%), and reflexology (37.7%). There was a significant correlation between midwives attending a CAM workshop with competency-assessment (p < 0.000) and confidence to discuss CAM options with pregnant women compared with participants who have not. There are no other health-related therapies used by women consumers with such frequency where clinicians are not expected to have baseline knowledge and understanding. Midwifery education programs need to include evidence-based information on CAM modalities.
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Affiliation(s)
- Lyndall Mollart
- Centre for Midwifery and Child and Family Health, Faculty of Health, University of Technology, Sydney, City Campus, PO Box 123 Broadway, NSW, 2007, Australia; School of Nursing and Midwifery, Faculty of Health and Medicine, University of Newcastle, Callaghan NSW Australia, University Dr, Callaghan, NSW, 2308, Australia.
| | - Virginia Stulz
- School of Nursing and Midwifery, Western Sydney University, Penrith NSW, Locked Bag, 1797, Penrith, NSW, 2751, Australia.
| | - Maralyn Foureur
- School of Nursing and Midwifery, Faculty of Health and Medicine, University of Newcastle, Callaghan NSW Australia, University Dr, Callaghan, NSW, 2308, Australia; Nursing and Midwifery Research Centre & University of Newcastle, James Fletcher Campus, Hunter New England Health, Newcastle NSW, Gate Cottage, 72 Watt Street, Newcastle, NSW, 2300, Australia.
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Efeitos da auriculoterapia na ansiedade de gestantes no pré-natal de baixo risco. ACTA PAUL ENFERM 2020. [DOI: 10.37689/acta-ape/2020ao0016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Abdollahi F, Yazdani Charati J, Lye MS. Midwives' perceptions of Complementary and Alternative Medicines' during pregnancy. Complement Ther Med 2020; 49:102323. [PMID: 32147049 DOI: 10.1016/j.ctim.2020.102323] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 01/19/2020] [Accepted: 01/20/2020] [Indexed: 11/30/2022] Open
Abstract
Using Complementary and Alternative Medicine (CAMs) is growing worldwide. This study determined the midwives' attitude toward CAMs in general and their view on its safety and efficacy during pregnancy. Via a random sampling method, 344 midwives working in Mazandaran primary health centers (PHC) were recruited from March to November 2017. The data were analyzed using descriptive statistics. The majority of the midwives had positive view on the usefulness of CAMs in general (74.3 %) and thought they should have more knowledge about it (76.7 %). While 50-83 % of the midwives considered some CAM-therapies safe and beneficial, a small number of them referred the patients for CAM-therapy during pregnancy (1.2-5.4 %). A minority of the midwives stated that CAM may be a threat to public health (12.7 %). The midwives' perception toward the usefulness of CAM in general was positive; although, they approved the benefit of few CAMs during pregnancy. A small minority of the midwives considered CAMs as a threat to public health, and few of them advised the patients to use CAMs during pregnancy. As most midwives are interested in learning in this field, it is recommended to run some training programs on the benefit and side effects of CAMs.
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Affiliation(s)
- Fatemeh Abdollahi
- Department of Public Health, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran; Health Science Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran.
| | - Jamshid Yazdani Charati
- Health Science Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran; Department of Biostatistics, Faculty of Health, Mazandaran University of Medical Science, Sari, Iran.
| | - Munn-Sann Lye
- Department of Community Health, Faculty of Medicine and Health Sciences, University Putra Malaysia, Serdang, Malaysia.
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Abstract
Synthesis of pooled data on herbal medicinal products used during and after pregnancy highlights the need for robust safety studies. OBJECTIVE: To report the incidence and nature of herbal medicinal products' adverse events and herb–drug interactions used by some pregnant and postnatal women. DATA SOURCES: The Allied and Complementary Medicine Database, the Cumulative Index to Nursing and Allied Health Literature, EMBASE, the Cochrane Library, MEDLINE, Scopus, Web of Science, and ClinicalTrials.gov were searched from inception until August 2018. METHODS OF STUDY SELECTION: Any studies reporting adverse events, herb–drug interactions or absence thereof associated with herbal medicinal products used during pregnancy or the postnatal period were included. Conference abstracts, pilot studies, and nonhuman studies were excluded. All included studies were critically appraised by two independent reviewers. TABULATION, INTEGRATION AND RESULTS: Database searches retrieved 3,487 citations. After duplicate removal and review of titles, abstracts, and full-text, 115 articles were critically appraised. After excluding irrelevant and low-quality articles, 74 articles were included for data extraction and synthesis. Adverse drug reactions, congenital malformations, fetal growth retardation or herb–drug interactions were the primary study objective reported by 19 of the 74 included studies, 16 cohort studies, one cross-sectional survey, and two randomized controlled trials. A total of 47 herbal medicinal products and 1,067,071 women were included in this review. Use of almond oil was associated with preterm birth (odds ratio 2.09, 95% CI 1.07–4.08), oral raspberry leaf was associated with cesarean delivery (adjusted odds ratio [AOR] 3.47, 95% CI 1.45–8.28); heavy licorice use was associated with early preterm birth by 3.07-fold (95% CI 1.17–8.05). African herbal medicine mwanaphepo was associated with maternal morbidity (AOR 1.28; 95% CI 1.09–1.50), and neonatal death or morbidity. Fourteen studies reported absence of adverse events. Four studies reported herb–drug interactions, but none studied adverse events arising from them. CONCLUSION: The use of herbal medicinal products during pregnancy and the postnatal period should be discouraged until robust evidence of safety is available. SYSTEMATIC REVIEW REGISTRATION: PROSPERO, CRD42017081058.
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Barnes LA, Barclay L, McCaffery K, Aslani P. Complementary medicine products: Information sources, perceived benefits and maternal health literacy. Women Birth 2019; 32:493-520. [DOI: 10.1016/j.wombi.2018.11.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 11/15/2018] [Accepted: 11/26/2018] [Indexed: 10/27/2022]
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Barnes LAJ, Barclay L, McCaffery K, Aslani P. Complementary medicine products information-seeking by pregnant and breastfeeding women in Australia. Midwifery 2019; 77:60-70. [PMID: 31255910 DOI: 10.1016/j.midw.2019.06.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2019] [Revised: 06/04/2019] [Accepted: 06/20/2019] [Indexed: 12/27/2022]
Abstract
OBJECTIVE Complementary medicine product use in pregnancy and lactation is common but little is known about women's health literacy and information-seeking regarding this. The objectives of this study were to identify and explore pregnant or breastfeeding women's sources of, and rationale for seeking complementary medicine products information, the types of information sought, and how women felt their health care practitioners can help them receive information that meets their needs. DESIGN A qualitative research design consisting of in-depth interviews and focus group discussions was conducted. Data were thematically analysed. Participants also completed two validated health literacy screening tools. SETTING Communities in regional and metropolitan settings in Sydney and Northern New South Wales, and South-East Queensland, Australia. PARTICIPANTS Twenty-five women (n = 7 pregnant, n = 17 breastfeeding, n = 1 both pregnant and breastfeeding) who currently used complementary medicine products participated. Eleven women were pregnant with or breastfeeding their first child; 14 had between one and four older children. FINDINGS Twenty-four participants had high health literacy according to the validated screening tools. Around half of the participants had used complementary medicine products for most of their lives and 17 had used complementary medicine products to resolve or manage complex health conditions in adulthood or childhood. Women sought complementary medicine products information from three main sources. 1) Practical and safety information on complementary medicine products was sought from health care practitioners and published research; 2) health care practitioners were also sources of information on reasons for complementary medicine products recommendations and physiological actions; and 3) sharing experiences of complementary medicine products use with other mothers appeared to help women understand what to expect when taking complementary medicine products, support social-emotional wellbeing and encourage participants to look after their own health. Participants strongly expressed the desire for their mainstream biomedical health care practitioners to be more informed in, and open to, complementary medicine product use in pregnancy and breastfeeding. KEY CONCLUSIONS Participants' high health literacy skills may have influenced them to seek comprehensive information on complementary medicine products from a variety of professional and lay sources. Their use of complementary medicine products in pregnancy and breastfeeding was a natural consequence from previous positive experiences with complementary medicine products and/or therapies. IMPLICATIONS FOR PRACTICE Maternity care practitioners can positively enhance their interactions with pregnant or breastfeeding women who use complementary medicine products by respectfully discussing use within the context of these women's values and health goals, and by furthering their own education in complementary medicine products' safety, efficacy and indications in pregnancy and breastfeeding.
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Affiliation(s)
- Larisa A J Barnes
- Faculty of Medicine and Health, The University of Sydney School of Pharmacy, Pharmacy & Bank Building (A15), Science Rd, The University of Sydney NSW 2006, Australia; The University of Sydney, University Centre for Rural Health, 61 Uralba Street, Lismore NSW 2480, Australia.
| | - Lesley Barclay
- The University of Sydney, University Centre for Rural Health, 61 Uralba Street, Lismore NSW 2480, Australia; Faculty of Medicine and Health, The University of Sydney School of Public Health, Edward Ford Building (A27), NSW 2006, Australia.
| | - Kirsten McCaffery
- Sydney Health Literacy Lab, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Edward Ford Building (A27), NSW 2006, Australia.
| | - Parisa Aslani
- Faculty of Medicine and Health, The University of Sydney School of Pharmacy, Pharmacy & Bank Building (A15), Science Rd, The University of Sydney NSW 2006, Australia.
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Peprah P, Agyemang-Duah W, Arthur-Holmes F, Budu HI, Abalo EM, Okwei R, Nyonyo J. 'We are nothing without herbs': a story of herbal remedies use during pregnancy in rural Ghana. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2019; 19:65. [PMID: 30876425 PMCID: PMC6419816 DOI: 10.1186/s12906-019-2476-x] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Accepted: 03/06/2019] [Indexed: 02/08/2023]
Abstract
BACKGROUND Herbal medicine has become the panacea for many rural pregnant women in Ghana despite the modern western antenatal care which has developed in most parts of the country. To our knowledge, previous studies investigating herbal medicine use have primarily reported general attitudes and perceptions of use, overlooking the standpoint of pregnant women and their attitudes, and utilisation of herbal medicine in Ghana. Knowledge of herbal medicine use among rural pregnant women and the potential side effects of many herbs in pregnancy are therefore limited in the country; this qualitative study attempts to address this gap by exploring the perceptions of herbal medicine usage among pregnant women in rural Ghana. METHODS A sample of 30, conveniently selected pregnant women, were involved in this study from April 11 to June 22, 2017. Data from three different focus group discussions were thematically analysed and presented based on an a posteriori inductive reduction approach. RESULTS The main findings were that pregnant women used herbal medicine, most commonly ginger, peppermint, thyme, chamomile, aniseeds, green tea, tealeaf, raspberry, and echinacea leaf consistently throughout the three trimesters of pregnancy. Cultural norms and health beliefs in the form of personal philosophies, desire to manage one's own health, illness perceptions, and a holistic healing approach were ascribed to the widespread use of herbs. CONCLUSION We recommend public education and awareness on disclosure of herbal medicine use to medical practitioners among pregnant women.
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Affiliation(s)
- Prince Peprah
- Department of Natural and Built Environment, Sheffield Hallam University, Sheffield, UK
| | - Williams Agyemang-Duah
- Department of Planning, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | - Hayford Isaac Budu
- Department of Nursing, Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Emmanuel Mawuli Abalo
- School of Geography and the Environment, University of Oxford, South-Parks Road, Oxford, GB OX1 3QY UK
| | - Reforce Okwei
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Julius Nyonyo
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Shahvisi A. Medicine is Patriarchal, But Alternative Medicine is Not the Answer. JOURNAL OF BIOETHICAL INQUIRY 2019; 16:99-112. [PMID: 30570716 PMCID: PMC6474852 DOI: 10.1007/s11673-018-9890-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Accepted: 12/05/2018] [Indexed: 06/09/2023]
Abstract
Women are over-represented within alternative medicine, both as consumers and as service providers. In this paper, I show that the appeal of alternative medicine to women relates to the neglect of women's health needs within scientific medicine. This is concerning because alternative medicine is severely limited in its therapeutic effects; therefore, those who choose alternative therapies are liable to experience inadequate healthcare. I argue that while many patients seek greater autonomy in alternative medicine, the absence of an evidence base and plausible mechanisms of action leaves patients unable to realize meaningful autonomy. This seems morally troubling, especially given that the neglect of women's needs within scientific medicine seems to contribute to preferences for alternative medicine. I conclude that the liberatory credentials of alternative medicine should be questioned and make recommendations to render scientific medicine better able to meet the needs of typical alternative medicine consumers.
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Affiliation(s)
- Arianne Shahvisi
- Lecturer in Ethics and Medical Humanities, Brighton & Sussex Medical School, University of Sussex, Falmer, BN1 9PX, UK.
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Steel A, Hall H, Diezel H, Wardle J, Adams J. Filling the gaps in contemporary maternity care: The perceptions of complementary medicine practitioners providing care to women during pregnancy. Complement Ther Clin Pract 2019; 34:174-178. [DOI: 10.1016/j.ctcp.2018.11.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 11/29/2018] [Accepted: 11/29/2018] [Indexed: 12/23/2022]
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Vakili F, Mirmohammadaliei M, Montazeri A, Farokhi M, Minaee MB. Impact of Hypericum Perforatum Ointment on Perineal Pain Intensity Following Episiotomy: a Randomized Placebo-Controlled Trial. J Caring Sci 2019; 7:205-211. [PMID: 30607361 PMCID: PMC6311625 DOI: 10.15171/jcs.2018.031] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Accepted: 10/22/2018] [Indexed: 12/23/2022] Open
Abstract
Introduction:The present study was conducted to evaluate
the effects of Hypericum Perforatum ointment on perineal pain intensity following
episiotomy among primiparous women. Methods This triple-blind clinical trial was performed on 98
eligible primiparous women referring to selected educational hospital of Tehran University
of Medical Sciences for normal vaginal delivery. Block Randomization (in 1; 1 ratio) was
used to categorize the participants continuously into two groups: intervention (using
Hypericum Perforatum ointment) and control (using placebo ointment). Participants in each
group used ointments (about 3 grams each time) on episiotomy site, twice a day and for a
period of ten days. Our primary outcome was the pain intensity in different intervals
following episiotomy. The data were analyzed by SPSS software (version 13) using student's
t test, Mann-Whitney U test and chi-square test. Results: We missed 14 participants during the study and
analyzed the data from 42 participants in each group. The mean of pain scores revealed no
significant differences before (mean difference=-0.33; P=0.46) and four hours (mean
difference=0.57; P=0.13) after ointments use, between the intervention and control groups,
while these differences were significant after eight hours (mean difference=2.17;
P<0.001), five days (mean difference=2.20; P<0.001) and ten days (mean
difference=2.21; P<0.001) following the intervention. Conclusion: Using Hypericum Perforatum ointment as a
noninvasive, simple and effective topical formulation, can significantly reduce pain
intensity of episiotomy site.
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Affiliation(s)
- Farzaneh Vakili
- Department of Midwifery, Faculty of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Mandana Mirmohammadaliei
- Department of Midwifery, Faculty of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Montazeri
- Department of Mental Health, Institute of Health Sciences, Tehran, Iran
| | - Mina Farokhi
- Department of Midwifery, Faculty of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Bagher Minaee
- Department of Histology, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
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Knowledge and Opinion of Obstetrician-Gynecologists and Midwives Regarding Complementary and Alternative Medicine in Spain. Holist Nurs Pract 2018; 33:52-59. [PMID: 30422925 DOI: 10.1097/hnp.0000000000000306] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The objective of this article is to present the results from a cross-sectional survey carried out to assess and compare knowledge, attitudes, and beliefs of the obstetrician-gynecologists and midwives, regarding a set of complementary and alternative therapies in the area of the Corredor del Henares in Spain. The results show a high percentage of acceptance regarding complementary and alternative therapies in the field of obstetrics and gynecology, and more than half of the Spanish professionals of reproductive health would like to learn more about these therapies.
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Bean SJ, Catania JA. Immunology beliefs as a factor in vaccine opposition among complementary and alternative medical providers. SAGE Open Med 2018; 6:2050312118807625. [PMID: 30455945 PMCID: PMC6236863 DOI: 10.1177/2050312118807625] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Accepted: 09/25/2018] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVES Parental pediatric vaccine decisions are influenced by parents' health provider networks. Complementary and alternative medical providers may be key influences in the networks of those parents who do not vaccinate their children. METHODS From March to July 2013, we conducted semi-structured interviews of Oregon complementary and alternative medical providers (N = 36) in five disciplines likely to treat parents or children, or both, and whose practitioners are known to express opinions about vaccines and vaccination. We interviewed them concerning their immunology beliefs, vaccine positions, and what these providers recommend to their patients concerning vaccines. We conducted face-to-face interviews and analyzed the interview data using thematic analysis methodology. RESULTS This article identifies the range and type of immunological beliefs of complementary and alternative medical providers concerning pediatric vaccine recommendations. From repeated readings of the data, we identified three areas of alternative immunological beliefs among complementary and alternative medical providers (i.e. "natural is best," "innate intelligence," and "the fragile immune system"). In addition, complementary and alternative medical providers who embraced mainstream medicine were likely to be vaccine accepters and to mention vaccines as a positive health measure to their patients-these themes were "vaccines prevent illness" and "herd immunity." CONCLUSION Complementary and alternative medical providers influence their patients' vaccination decisions, particularly urging caution or complete vaccine avoidance, and may be a major influence in states like Oregon with high non-medical exemption rates. Complementary and alternative medical providers come to their anti-vaccine positions largely through post-graduation continuing education courses and seminars. In Oregon, such courses are unregulated and not vetted.
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Affiliation(s)
- Sandra J Bean
- College of Public Health and Human Sciences, Oregon
State University, Corvallis, OR, USA
| | - Joseph A Catania
- College of Public Health and Human Sciences, Oregon
State University, Corvallis, OR, USA
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Heidari-fard S, Mohammadi M, Fallah S. The effect of chamomile odor on contractions of the first stage of delivery in primpara women: A clinical trial. Complement Ther Clin Pract 2018; 32:61-64. [DOI: 10.1016/j.ctcp.2018.04.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Revised: 04/21/2018] [Accepted: 04/26/2018] [Indexed: 10/17/2022]
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Teaching midwives homeopathy—A Belgian pilot project. Eur J Integr Med 2018. [DOI: 10.1016/j.eujim.2018.05.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Lans C, Taylor-Swanson L, Westfall R. Herbal fertility treatments used in North America from colonial times to 1900, and their potential for improving the success rate of assisted reproductive technology. REPRODUCTIVE BIOMEDICINE & SOCIETY ONLINE 2018; 5:60-81. [PMID: 30023440 PMCID: PMC6047296 DOI: 10.1016/j.rbms.2018.03.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Revised: 09/19/2016] [Accepted: 03/12/2018] [Indexed: 06/08/2023]
Abstract
This paper serves to fill a gap in the literature regarding evidence for the use of botanical remedies in the promotion of fertility. It examines the botanical remedies that were used in North America (1492-1900) for all stages of reproduction from preconception to birth, and discusses their potential for future use with present-day infertility treatments. Each medicinal plant discussed in this paper is assessed using an ethnomedicinal methodology that entails examining the published ethnobotanical, phytochemical and pharmacological data. A few clinical trials have shown that there is potential for medicinal plants to improve the success rate of assisted reproductive technology (ART) treatment if used in an integrated manner, similar to the integrated use of traditional Chinese medicine with ART treatment. For example, research has shown that older women who become pregnant have a high miscarriage rate, and this is one area that complementary and alternative medicines can address.
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Affiliation(s)
- Cheryl Lans
- Institute for Ethnobotany and Zoopharmacognosy, Beek, The Netherlands
| | - Lisa Taylor-Swanson
- College of Nursing University of Utah, Annette Cummings Building, 10 South 2000 East Salt Lake City, UT, USA
| | - Rachel Westfall
- Yukon Bureau of Statistics, Government of Yukon, Yukon, Canada
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Smith CA, Levett KM, Collins CT, Dahlen HG, Ee CC, Suganuma M. Massage, reflexology and other manual methods for pain management in labour. Cochrane Database Syst Rev 2018; 3:CD009290. [PMID: 29589380 PMCID: PMC6494169 DOI: 10.1002/14651858.cd009290.pub3] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
BACKGROUND Many women would like to avoid pharmacological or invasive methods of pain management in labour, and this may contribute towards the popularity of complementary methods of pain management. This review examined the evidence currently available on manual methods, including massage and reflexology, for pain management in labour. This review is an update of the review first published in 2012. OBJECTIVES To assess the effect, safety and acceptability of massage, reflexology and other manual methods to manage pain in labour. SEARCH METHODS For this update, we searched Cochrane Pregnancy and Childbirth's Trials Register (30 June 2017), the Cochrane Central Register of Controlled Trials (CENTRAL; 2017, Issue 6), MEDLINE (1966 to 30 June 2017, CINAHL (1980 to 30 June 2017), the Australian New Zealand Clinical Trials Registry (4 August 2017), Chinese Clinical Trial Registry (4 August 2017), ClinicalTrials.gov, (4 August 2017), the National Center for Complementary and Integrative Health (4 August 2017), the WHO International Clinical Trials Registry Platform (ICTRP) (4 August 2017) and reference lists of retrieved trials. SELECTION CRITERIA We included randomised controlled trials comparing manual methods with standard care, other non-pharmacological forms of pain management in labour, no treatment or placebo. We searched for trials of the following modalities: massage, warm packs, thermal manual methods, reflexology, chiropractic, osteopathy, musculo-skeletal manipulation, deep tissue massage, neuro-muscular therapy, shiatsu, tuina, trigger point therapy, myotherapy and zero balancing. We excluded trials for pain management relating to hypnosis, aromatherapy, acupuncture and acupressure; these are included in other Cochrane reviews. DATA COLLECTION AND ANALYSIS Two review authors independently assessed trial quality, extracted data and checked data for accuracy. We contacted trial authors for additional information. We assessed the quality of the evidence using the GRADE approach. MAIN RESULTS We included a total of 14 trials; 10 of these (1055 women) contributed data to meta-analysis. Four trials, involving 274 women, met our inclusion criteria but did not contribute data to the review. Over half the trials had a low risk of bias for random sequence generation and attrition bias. The majority of trials had a high risk of performance bias and detection bias, and an unclear risk of reporting bias. We found no trials examining the effectiveness of reflexology.MassageWe found low-quality evidence that massage provided a greater reduction in pain intensity (measured using self-reported pain scales) than usual care during the first stage of labour (standardised mean difference (SMD) -0.81, 95% confidence interval (CI) -1.06 to -0.56, six trials, 362 women). Two trials reported on pain intensity during the second and third stages of labour, and there was evidence of a reduction in pain scores in favour of massage (SMD -0.98, 95% CI -2.23 to 0.26, 124 women; and SMD -1.03, 95% CI -2.17 to 0.11, 122 women). There was very low-quality evidence showing no clear benefit of massage over usual care for the length of labour (in minutes) (mean difference (MD) 20.64, 95% CI -58.24 to 99.52, six trials, 514 women), and pharmacological pain relief (average risk ratio (RR) 0.81, 95% CI 0.37 to 1.74, four trials, 105 women). There was very low-quality evidence showing no clear benefit of massage for assisted vaginal birth (average RR 0.71, 95% CI 0.44 to 1.13, four trials, 368 women) and caesarean section (RR 0.75, 95% CI 0.51 to 1.09, six trials, 514 women). One trial reported less anxiety during the first stage of labour for women receiving massage (MD -16.27, 95% CI -27.03 to -5.51, 60 women). One trial found an increased sense of control from massage (MD 14.05, 95% CI 3.77 to 24.33, 124 women, low-quality evidence). Two trials examining satisfaction with the childbirth experience reported data on different scales; both found more satisfaction with massage, although the evidence was low quality in one study and very low in the other.Warm packsWe found very low-quality evidence for reduced pain (Visual Analogue Scale/VAS) in the first stage of labour (SMD -0.59, 95% CI -1.18 to -0.00, three trials, 191 women), and the second stage of labour (SMD -1.49, 95% CI -2.85 to -0.13, two trials, 128 women). Very low-quality evidence showed reduced length of labour (minutes) in the warm-pack group (MD -66.15, 95% CI -91.83 to -40.47; two trials; 128 women).Thermal manual methodsOne trial evaluated thermal manual methods versus usual care and found very low-quality evidence of reduced pain intensity during the first phase of labour for women receiving thermal methods (MD -1.44, 95% CI -2.24 to -0.65, one trial, 96 women). There was a reduction in the length of labour (minutes) (MD -78.24, 95% CI -118.75 to -37.73, one trial, 96 women, very low-quality evidence). There was no clear difference for assisted vaginal birth (very low-quality evidence). Results were similar for cold packs versus usual care, and intermittent hot and cold packs versus usual care, for pain intensity, length of labour and assisted vaginal birth.Music One trial that compared manual methods with music found very low-quality evidence of reduced pain intensity during labour in the massage group (RR 0.40, 95% CI 0.18 to 0.89, 101 women). There was no evidence of benefit for reduced use of pharmacological pain relief (RR 0.41, 95% CI 0.16 to 1.08, very low-quality evidence).Of the seven outcomes we assessed using GRADE, only pain intensity was reported in all comparisons. Satisfaction with the childbirth experience, sense of control, and caesarean section were rarely reported in any of the comparisons. AUTHORS' CONCLUSIONS Massage, warm pack and thermal manual methods may have a role in reducing pain, reducing length of labour and improving women's sense of control and emotional experience of labour, although the quality of evidence varies from low to very low and few trials reported on the key GRADE outcomes. Few trials reported on safety as an outcome. There is a need for further research to address these outcomes and to examine the effectiveness and efficacy of these manual methods for pain management.
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Affiliation(s)
- Caroline A Smith
- Western Sydney UniversityNational Institute of Complementary Medicine (NICM)Locked Bag 1797PenrithNew South WalesAustralia2751
| | - Kate M Levett
- The University of Notre DameSchool of MedicineSydneyAustralia
| | - Carmel T Collins
- South Australian Health and Medical Research InstituteHealthy Mothers, Babies and Children72 King William RoadNorth AdelaideSouth AustraliaAustralia5006
| | - Hannah G Dahlen
- Western Sydney UniversitySchool of Nursing and MidwiferyLocked Bag 1797PenrithNSWAustralia2751
| | - Carolyn C Ee
- Western Sydney UniversityNational Institute of Complementary Medicine (NICM)Locked Bag 1797PenrithNew South WalesAustralia2751
| | - Machiko Suganuma
- South Australian Health and Medical Research InstituteHealthy Mothers, Babies and Children72 King William RoadNorth AdelaideSouth AustraliaAustralia5006
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Bruno LO, Simoes RS, de Jesus Simoes M, Girão MJBC, Grundmann O. Pregnancy and herbal medicines: An unnecessary risk for women's health-A narrative review. Phytother Res 2018; 32:796-810. [PMID: 29417644 DOI: 10.1002/ptr.6020] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Revised: 12/11/2017] [Accepted: 12/11/2017] [Indexed: 12/11/2022]
Abstract
The indiscriminate use of herbal medicines to prevent or to heal diseases or even the use for questionable purposes such as weight loss has received both interest and scrutiny from the scientific community and general public alike. An increasing number of women put their own and the unborn child's health at risk due to a lack of knowledge about the phytochemical properties and adequate use of herbal medicine (phytomedicines or herbal supplements) and lack of communication with their healthcare provider. The purpose of this narrative review was to summarize the use of herbal medicines during pregnancy and their potential toxic effects to highlight the importance of caution when prescribing herbal medicines or supplements for women, because, in addition to suffering interactions and a great amount of information obtained in preclinical predictive studies, assessment of nephrotoxicity, neurotoxicity, hepatotoxicity, genotoxicity, and teratogenicity of traditional medicinal herbs still remains scarce in the clinical setting.
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Affiliation(s)
- Luciana O Bruno
- Department of Gynecology, Federal University of São Paulo (UNIFESP), São Paulo, 04021-001, Brazil
| | - Ricardo Santos Simoes
- Department of Obstetrics and Gynecology, University of São Paulo (USP), São Paulo, 05508-010, Brazil
| | - Manuel de Jesus Simoes
- Department of Morphology and Genetics, Federal University of Sao Paulo (UNIFESP), São Paulo, 04021-001, Brazil
| | | | - Oliver Grundmann
- Department of Medicinal Chemistry, College of Pharmacy, University of Florida (UFL), Gainesville, 32611, FL, USA.,Department of Biobehavioral Nursing Science, College of Nursing, University of Florida (UFL), Gainesville, 32611, FL, USA
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Tanvisut R, Traisrisilp K, Tongsong T. Efficacy of aromatherapy for reducing pain during labor: a randomized controlled trial. Arch Gynecol Obstet 2018; 297:1145-1150. [DOI: 10.1007/s00404-018-4700-1] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Accepted: 01/30/2018] [Indexed: 11/27/2022]
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Mirzaie P, Mohammad-Alizadeh-Charandabi S, Goljarian S, Mirghafourvand M, Hoseinie MB. The effect of foot reflexology massage on breast milk volume of mothers with premature infants: A randomized controlled trial. Eur J Integr Med 2018. [DOI: 10.1016/j.eujim.2017.11.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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McLay JS, Izzati N, Pallivalapila AR, Shetty A, Pande B, Rore C, Al Hail M, Stewart D. Pregnancy, prescription medicines and the potential risk of herb-drug interactions: a cross-sectional survey. Altern Ther Health Med 2017; 17:543. [PMID: 29258478 PMCID: PMC5738179 DOI: 10.1186/s12906-017-2052-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Accepted: 12/07/2017] [Indexed: 12/27/2022]
Abstract
Background Pregnant women are routinely prescribed medicines while self-medicating with herbal natural products to treat predominantly pregnancy related conditions. The aim of this study was to assess the potential for herb-drug interactions (HDIs) in pregnant women and to explore possible herb-drug interactions and their potential clinical significance. Methods A cross-sectional survey of women during early pregnancy or immediately postpartum in North-East Scotland. Outcome measures included; Prescription medicines use excluding vitamins and potential HDIs assessed using Natural Medicines Comprehensive Database. Results The survey was completed by 889 respondents (73% response rate). 45.3% (403) reported the use of at least one prescription medicine, excluding vitamins. Of those taking prescription medicines, 44.9% (181) also reported concurrent use of at least one HNP (Range 1–12). A total of 91 different prescription medicines were reported by respondents using HNPs. Of those taking prescription medicines, 44.9% (181) also reported concurrent use of at least one HNP (Range 1–12). Thirty-four herb-drug interactions were identified in 23 (12.7%) women with the potential to increase the risk of postpartum haemorrhage, alter maternal haemodynamics, and enhance maternal/fetal CNS depression. Almost all were rated as moderate (93.9%), one as a potentially major (ginger and nifedipine) and only one minor (ondansetron and chamomile). Conclusion Almost half of pregnant women in this study were prescribed medicines excluding vitamins and minerals and almost half of these used HNPs. Potential moderate to severe HDIs were identified in an eighth of the study cohort. Healthcare professionals should be aware that the concurrent use of HNPs and prescription medicines during pregnancy is common and carries potential risks.
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Does nurses’ role, health or symptoms influence their personal use of ingestible complementary and alternative medicines? Complement Ther Med 2017; 35:39-46. [DOI: 10.1016/j.ctim.2017.08.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Revised: 07/11/2017] [Accepted: 08/28/2017] [Indexed: 11/30/2022] Open
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Isabella N, Maria CG, Alba R, Elisabetta R. Italian midwives attitude toward complementary and alternative medicine. ACTA ACUST UNITED AC 2017. [DOI: 10.5897/ijnm2016.0219] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Yazdkhasti M, Pirak A. The effect of aromatherapy with lavender essence on severity of labor pain and duration of labor in primiparous women. Complement Ther Clin Pract 2016; 25:81-86. [DOI: 10.1016/j.ctcp.2016.08.008] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2016] [Revised: 08/14/2016] [Accepted: 08/15/2016] [Indexed: 10/21/2022]
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Hall H, Cramer H, Sundberg T, Ward L, Adams J, Moore C, Sibbritt D, Lauche R. The effectiveness of complementary manual therapies for pregnancy-related back and pelvic pain: A systematic review with meta-analysis. Medicine (Baltimore) 2016; 95:e4723. [PMID: 27661020 PMCID: PMC5044890 DOI: 10.1097/md.0000000000004723] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Low back pain and pelvic girth pain are common in pregnancy and women commonly utilize complementary manual therapies such as massage, spinal manipulation, chiropractic, and osteopathy to manage their symptoms. OBJECTIVE The aim of this systematically review was to critically appraise and synthesize the best available evidence regarding the effectiveness of manual therapies for managing pregnancy-related low back and pelvic pain. METHODS Seven databases were searched from their inception until April 2015 for randomized controlled trials. Studies investigating the effectiveness of massage and chiropractic and osteopathic therapies were included. The study population was pregnant women of any age and at any time during the antenatal period. Study selection, data extraction, and assessment of risk of bias were conducted by 2 reviewers independently, using the Cochrane tool. Separate meta-analyses were conducted to compare manual therapies to different control interventions. RESULTS Out of 348 nonduplicate records, 11 articles reporting on 10 studies on a total of 1198 pregnant women were included in this meta-analysis. The therapeutic interventions predominantly involved massage and osteopathic manipulative therapy. Meta-analyses found positive effects for manual therapy on pain intensity when compared to usual care and relaxation but not when compared to sham interventions. Acceptability did not differ between manual therapy and usual care or sham interventions. CONCLUSIONS There is currently limited evidence to support the use of complementary manual therapies as an option for managing low back and pelvic pain during pregnancy. Considering the lack of effect compared to sham interventions, further high-quality research is needed to determine causal effects, the influence of the therapist on the perceived effectiveness of treatments, and adequate dose-response of complementary manual therapies on low back and pelvic pain outcomes during pregnancy.
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Affiliation(s)
- Helen Hall
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), University of Technology Sydney, Sydney Faculty of Medicine, Nursing and Health Sciences, School of Nursing & Midwifery Monash University, Frankston, Australia Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany Department of Neurobiolgy, Care Sciences and Society, Karolinska Institutet The Integrative Care Science Centre, Stockholm, Sweden Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, UK
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Mollart L, Adams J, Foureur M. Pregnant women and health professional's perceptions of complementary alternative medicine, and participation in a randomised controlled trial of acupressure for labour onset. Complement Ther Clin Pract 2016; 24:167-73. [DOI: 10.1016/j.ctcp.2016.06.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Revised: 06/20/2016] [Accepted: 06/22/2016] [Indexed: 11/29/2022]
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Women and complementary medicine: Eleven years of experience at a homeopathic clinic for women in a public hospital. Eur J Integr Med 2016. [DOI: 10.1016/j.eujim.2016.03.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Abstract
Childbirth is a fundamental component of a woman’s sexual cycle. The sexuality of childbirth is not well recognized in Western society despite research showing that some women experience orgasm(s) during labor and childbirth. Current thinking supports the view that labor and childbirth are perceived to be physically painful events, and more women are relying on medical interventions for pain relief in labor. This review explores the potential of orgasm as a mode of pain relief in childbirth and outlines the physiological explanations for its occurrence. Potential barriers to sexual expression during childbirth and labor, including the influence of deeply held cultural beliefs about sexuality, the importance of privacy and intimacy in facilitating orgasmic birth experiences, and the value of including prospective fathers in the birthing experience, are discussed. The role of midwives and their perceptions of the use of complementary and alternative therapies for pain relief in labor are examined. While there are indications of widespread use of complementary and alternative therapies such as hydrotherapy, herbal remedies, and breathing techniques for pain relief in childbirth, orgasm was not among those mentioned. Lack of recognition of the sexuality of childbirth, despite findings that orgasm can attenuate the effects of labor pain, suggests the need for greater awareness among expectant parents, educators, and health professionals of the potential of orgasm as a means of pain relief in childbirth.
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Dubé E, Vivion M, Sauvageau C, Gagneur A, Gagnon R, Guay M. "Nature Does Things Well, Why Should We Interfere?": Vaccine Hesitancy Among Mothers. QUALITATIVE HEALTH RESEARCH 2016; 26:411-25. [PMID: 25711847 DOI: 10.1177/1049732315573207] [Citation(s) in RCA: 88] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
Parents' decision to use vaccination services is complex and multi-factorial. Of particular interest are "vaccine-hesitant" parents who are in the middle of the continuum between vaccine acceptance and refusal. The objective of this qualitative longitudinal study was to better understand why mothers choose to vaccinate-or not-their newborns. Fifty-six pregnant mothers living in different areas of Quebec (Canada) were interviewed. These interviews gathered information on mothers' views about health and vaccination. Almost half of the mothers were categorized as vaccine-hesitant. A second interview was conducted with these mothers 3 to 11 months after birth to look at their actual decision and behavior concerning vaccination. Our results show the heterogeneity of factors influencing vaccine decision making. Although the majority of vaccine-hesitant mothers finally chose to follow the recommended vaccine schedule for their child, they were still ambivalent and they continued to question their decision.
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Affiliation(s)
- Eve Dubé
- Centre de recherche du CHU de Québec, Québec City, Québec, Canada
| | - Maryline Vivion
- Institut national de santé publique du Québec, Québec City, Québec, Canada
| | - Chantal Sauvageau
- Institut national de santé publique du Québec, Québec City, Québec, Canada
| | | | - Raymonde Gagnon
- Université du Québec à Trois-Rivières, Trois-Rivières, Québec, Canada
| | - Maryse Guay
- Université de Sherbrooke, Sherbrooke, Québec, Canada
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Frawley J, Sibbritt D, Broom A, Gallois C, Steel A, Adams J. Complementary and alternative medicine practitioner use prior to pregnancy predicts use during pregnancy. Women Health 2016; 56:926-39. [DOI: 10.1080/03630242.2016.1145170] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Frawley J, Sundberg T, Steel A, Sibbritt D, Broom A, Adams J. Prevalence and characteristics of women who consult with osteopathic practitioners during pregnancy; a report from the Australian Longitudinal Study on Women's Health (ALSWH). J Bodyw Mov Ther 2016; 20:168-172. [DOI: 10.1016/j.jbmt.2015.03.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Revised: 03/02/2015] [Accepted: 03/13/2015] [Indexed: 10/23/2022]
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Kuo SY, Tsai SH, Chen SL, Tzeng YL. Auricular acupressure relieves anxiety and fatigue, and reduces cortisol levels in post-caesarean section women: A single-blind, randomised controlled study. Int J Nurs Stud 2015; 53:17-26. [PMID: 26525188 DOI: 10.1016/j.ijnurstu.2015.10.006] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Revised: 10/02/2015] [Accepted: 10/06/2015] [Indexed: 01/16/2023]
Abstract
BACKGROUND Anxiety and fatigue adversely affect women's postpartum recovery, but few effective non-pharmacological interventions are known to relieve these two common and unpleasant symptoms. OBJECTIVES To examine the efficacy of an auricular acupressure intervention provided during early postpartum in reducing anxiety, fatigue levels, cortisol levels, blood pressure, and heart rate. DESIGN A single-blind, randomised controlled trial. SETTING A 40-bed postpartum unit. PARTICIPANTS Women who underwent caesarean section were randomly allocated to two groups: intervention (auricular pressure, n=40), and control (usual care, n=40). METHODS The intervention group received auricular acupressure on the shenmen acupoint twice a day (9 AM and 5 PM), and the control group received usual postpartum care. Serum cortisol levels were assessed by immunochemiluminescence, with blood pressure and heart rate assessed by electric sphygmomanometer. Anxiety and fatigue symptoms were assessed using the State Anxiety subscale of the State-Trait Anxiety Inventory and the Fatigue Continuum Form, respectively. RESULTS Of the 76 women who completed the study, those who received auricular acupressure had significantly lower mean cortisol levels (mean difference=4μg/dl, p<0.05), heart rate (mean difference=9.2 beats/min, p<0.001), anxiety symptoms (mean difference=3.8, p<0.01), and fatigue symptoms (mean difference=7.1, p<0.01) than women in the control group at 5 days postpartum. CONCLUSIONS Auricular acupressure is an effective non-pharmacological method for reducing cortisol levels, heart rate, anxiety, and fatigue in early postpartum after caesarean section.
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Affiliation(s)
- Shu-Yu Kuo
- School of Nursing, College of Nursing, Taipei Medical University, 250 Wuxing Street, Taipei, Taiwan.
| | - Su-Hua Tsai
- School of Nursing, China Medical University, 91 Hsueh-Shih Road, Taichung, Taiwan; Department of Nursing, China Medical University Hospital, 2 Yu-Der Road, Taichung, Taiwan.
| | - Shu-Ling Chen
- Department of Nursing, Hungkuang University, No. 1018, Sec. 6, Taiwan Boulevard, Shalu District, Taichung, Taiwan.
| | - Ya-Ling Tzeng
- School of Nursing, China Medical University, 91 Hsueh-Shih Road, Taichung, Taiwan; Department of Nursing, China Medical University Hospital, 2 Yu-Der Road, Taichung, Taiwan.
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Feijen-de Jong EI, Jansen DEMC, Baarveld F, Spelten E, Schellevis F, Reijneveld SA. Determinants of use of care provided by complementary and alternative health care practitioners to pregnant women in primary midwifery care: a prospective cohort study. BMC Pregnancy Childbirth 2015; 15:140. [PMID: 26104413 PMCID: PMC4479252 DOI: 10.1186/s12884-015-0555-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Accepted: 05/12/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Pregnant women visit complementary/alternative health care practitioners in addition to regular maternal health care practitioners. A wide variation has been reported with regard to rates and determinants of use of complementary/alternative medicine (CAM), which may be due to heterogeneous populations. The aim of this study was to examine the prevalence and determinants of use of CAM practitioners by a homogeneous population of low-risk pregnant women in the Netherlands. METHODS Data from the population-based DELIVER study was used, concerning 1500 clients from twenty midwifery practices across the Netherlands in 2009 and 2010. CAM use was measured based on patient reports. Potential determinants were derived from Andersen's behavioural model of health care utilization. RESULTS The prevalence of CAM practitioner use by low-risk pregnant women was 9.4 %. Women were more likely to use CAM if they had supplementary health care insurance (OR 3.11; CI 1.41-6.85), rated their health as 'bad/fair' (OR 2.63; CI 1.65-4.21), reported a chronic illness or handicap (OR 1.93; CI 1.14-3.27), smoked during pregnancy (OR 1.88; CI 1.06-3.33), or used alcohol during pregnancy (OR 2.30; CI 1.46-3.63). CONCLUSIONS CAM is relatively frequently used by low-risk pregnant women. Determinants revealed in this study diverge from other studies using heterogeneous populations. Maternal health care practitioners must be aware of CAM use by low-risk pregnant women and incorporate this knowledge into daily practice by actively discussing this subject with pregnant women.
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Affiliation(s)
- Esther I Feijen-de Jong
- Department of Midwifery Science, AVAG, and the EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands. .,Academy of Midwifery Amsterdam-Groningen, Dirk Huizingastraat 3-5, 9713 GL, Groningen, The Netherlands.
| | - Danielle E M C Jansen
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. .,Department of Sociology, Interuniversity Center for Social Science Theory and Methodology (ICS), University of Groningen, Groningen, The Netherlands. .,, PO Box 196, 9700 AD, Groningen, The Netherlands.
| | - Frank Baarveld
- National Association for Specialty Training for General Practice and GP Trainers, Utrecht, The Netherlands. .,, PO Box 20072, 3502 LB, Utrecht, The Netherlands.
| | - Evelien Spelten
- Department of Midwifery Science, AVAG, and the EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands. .,Faculty of Medicine, Nursing, and Health Science, Monash University, Melbourne, Australia. .,Academy of Midwifery Amsterdam-Groningen, Dirk Huizingastraat 3-5, 9713 GL, Groningen, The Netherlands.
| | - François Schellevis
- Department of General Practice, Elderly Care Medicine/EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands. .,Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands. .,, PO Box 1568, 3500 BN, Utrecht, The Netherlands.
| | - Sijmen A Reijneveld
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. .,, PO Box 196, 9700 AD, Groningen, The Netherlands.
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Charaf S, Wardle JL, Sibbritt DW, Lal S, Callaway LK. Women's use of herbal and alternative medicines for preconception care. Aust N Z J Obstet Gynaecol 2015; 55:222-6. [DOI: 10.1111/ajo.12324] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Accepted: 01/10/2015] [Indexed: 01/24/2023]
Affiliation(s)
- Safa Charaf
- School of Medical and Molecular Biosciences; University of Technology Sydney; Ultimo New South Wales Australia
| | - Jonathan L. Wardle
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM); Faculty of Health; University of Technology Sydney; Ultimo New South Wales Australia
| | - David W. Sibbritt
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM); Faculty of Health; University of Technology Sydney; Ultimo New South Wales Australia
| | - Sara Lal
- School of Medical and Molecular Biosciences; University of Technology Sydney; Ultimo New South Wales Australia
| | - Leonie K. Callaway
- School of Medicine; University of Queensland; Herston Queensland Australia
- UQ Centre for Clinical Research; University of Queensland; Herston Queensland Australia
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Hall HG, Griffiths D, McKenna LG. Complementary and alternative medicine: Interaction and communication between midwives and women. Women Birth 2015; 28:137-42. [DOI: 10.1016/j.wombi.2014.12.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2014] [Revised: 11/26/2014] [Accepted: 12/16/2014] [Indexed: 11/26/2022]
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Berger B, Schwarz C, Heusser P. Watchful waiting or induction of labour--a matter of informed choice: identification, analysis and critical appraisal of decision aids and patient information regarding care options for women with uncomplicated singleton late and post term pregnancies: a review. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2015; 15:143. [PMID: 25947100 PMCID: PMC4480447 DOI: 10.1186/s12906-015-0663-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 04/22/2015] [Indexed: 11/10/2022]
Abstract
BACKGROUND Decision-making during pregnancy regarding different options of care can be difficult, particularly when risks of intervention versus no intervention for mother and baby are unclear. Unbiased information and support for decision making may be beneficial in these situations. The management of normal pregnancies at and beyond term is an example of such a situation. In order to determine the need to develop an evidence-based decision aid this paper searches, analyses and appraises patient decision aids and patient information leaflets regarding care options in cases of late term and post-term pregnancies, including complementary and alternative medicine (CAM). METHODS A literature search was carried out in a variety of lay and medical databases. INCLUSION CRITERIA written information related to uncomplicated singleton pregnancies and targeted at lay people. Analysis and appraisal of included material by means of quality criteria was set up based on the International Patient Decision Aid Standards accounting for evidence-basing of CAM options. RESULTS Inclusion of two decision aids and eleven leaflets from four decision aids and sixteen leaflets. One decision aid met the quality criteria almost completely, the other one only insufficiently despite providing some helpful information. Only one leaflet is of good quality, but cannot substitute a decision aid. CONCLUSIONS There is an urgent need for the design of an evidence-based decision aid of good quality for late-term or post-term pregnancy, particularly in German language.
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Affiliation(s)
- Bettina Berger
- Institute of Integrative Medicine, Chair for Theory of Medicine, Integrative and Anthroposophic Medicine, Witten/Herdecke University, Gerhard-Kienle-Weg 4, 58313, Herdecke, Germany.
| | | | - Peter Heusser
- Institute of Integrative Medicine, Chair for Theory of Medicine, Integrative and Anthroposophic Medicine, Witten/Herdecke University, Gerhard-Kienle-Weg 4, 58313, Herdecke, Germany.
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Kataoka Y, Yaju Y, Hiruta A, Horiuchi S, Mori R. Homeopathy for reducing blood loss in the third stage of labour. Hippokratia 2015. [DOI: 10.1002/14651858.cd011635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Yaeko Kataoka
- St. Luke's College of Nursing; Maternal Infant Nursing and Midwifery; 10-1 Akashi-cho, Chuo-ku Tokyo Japan 104-0044
| | - Yukari Yaju
- St. Luke's International University; Statistics in Nursing Research; 10-1 Akashi-cho, Chuo-ku Tokyo Japan 104-0044
| | - Akiko Hiruta
- St. Luke's College of Nursing; Maternal Infant Nursing and Midwifery; 10-1 Akashi-cho, Chuo-ku Tokyo Japan 104-0044
| | - Shigeko Horiuchi
- St. Luke's College of Nursing; Maternal Infant Nursing and Midwifery; 10-1 Akashi-cho, Chuo-ku Tokyo Japan 104-0044
| | - Rintaro Mori
- National Center for Child Health and Development; Department of Health Policy; 2-10-1 Okura Setagaya-ku Tokyo Tokyo Japan 157-0074
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López-Garrido B, García-Gonzalo J, Patrón-Rodriguez C, Marlasca-Gutiérrez MJ, Gil-Pita R, Toro-Flores R. Influence of acupuncture on the third stage of labor: a randomized controlled trial. J Midwifery Womens Health 2015; 60:199-205. [PMID: 25782852 DOI: 10.1111/jmwh.12262] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
INTRODUCTION A prolonged third stage of labor is considered to be a risk factor for postpartum hemorrhage. The objective of this study was to determine the ability of acupuncture to reduce the length of the third stage of labor. METHODS Seventy-six puerperal women who had a normal spontaneous birth at the Hospital Universitario Principe de Asturias, Alcalá de Henares, Spain, were included in a single-blind randomized trial and evaluated by a third party. Women were randomly assigned to receive true acupuncture or placebo acupuncture (also known as sham acupuncture). In the first group, a sterilized steel needle was inserted at the Ren Mai 6 point, which is located on the anterior midline between the umbilicus and the upper part of the pubic symphysis. In the second group, the insertion site was located at the same horizontal level as the Ren Mai 6 point but shifted slightly to the left of the anterior midline. The management of the third stage of labor was the same in both groups. RESULTS Statistically significant differences were found, with an average time to placental expulsion of 15.2 minutes in the placebo group and 5.2 minutes in the acupuncture group. No major complications occurred in either group. DISCUSSION These results confirm that acupuncture at the Ren Mai 6 point can decrease the time to placental expulsion. This treatment represents a simple, safe, and inexpensive way of decreasing the duration of the third stage of labor.
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Fahy K. Women and Birth gets its first Impact Factor: A time to reflect. Women Birth 2014; 27:231-2. [PMID: 25484343 DOI: 10.1016/s1871-5192(14)00119-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Women's use of complementary and alternative medicine in pregnancy: A search for holistic wellbeing. Women Birth 2014; 27:276-80. [DOI: 10.1016/j.wombi.2014.06.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Revised: 06/11/2014] [Accepted: 06/28/2014] [Indexed: 11/18/2022]
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Abedzadeh Kalahroudi M. Complementary and Alternative Medicine in Midwifery. Nurs Midwifery Stud 2014. [DOI: 10.17795/nmsjournal19449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Abedzadeh Kalahroudi M. Complementary and alternative medicine in midwifery. Nurs Midwifery Stud 2014; 3:e19449. [PMID: 25414903 PMCID: PMC4228532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2014] [Revised: 04/16/2014] [Accepted: 04/23/2014] [Indexed: 12/03/2022] Open
Affiliation(s)
- Masoumeh Abedzadeh Kalahroudi
- Trauma Nursing Research Center, Kashan University of Medical Science, Kashan, IR Iran,Corresponding author: Masoumeh Abedzadeh Kalahroudi, Trauma Nursing Research Center, Kashan University of Medical Science, Kashan, IR Iran. Tel: +98-3615550021-5, Fax: +98-3615556633, E-mail:
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Levett KM, Smith CA, Dahlen HG, Bensoussan A. Acupuncture and acupressure for pain management in labour and birth: a critical narrative review of current systematic review evidence. Complement Ther Med 2014; 22:523-40. [PMID: 24906592 DOI: 10.1016/j.ctim.2014.03.011] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2013] [Revised: 02/27/2014] [Accepted: 03/30/2014] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Reviews of maternity services highlight the need for a reduction of medical interventions for women with low risk pregnancies and births to prevent the potential cascade of interventions and their associated risks. Complementary medicines (CM) such as acupuncture and acupressure have claimed to be effective in reducing interventions in labour; however, systematic reviews of evidence to date are conflicting. AIMS To examine current evidence from systematic reviews on the topic of acupuncture and acupressure for pain management in labour and birth, and to evaluate the methodological and treatment frameworks applied to this evidence. METHODS A search limited to systematic reviews of the MEDLINE, CINAHL, PUBMED, EMBASE and Cochrane databases was performed in December 2013 using the keywords 'CAM', 'alternative medicine', 'complementary medicine', 'complementary therapies', 'traditional medicine', 'Chinese Medicine', 'Traditional Chinese Medicine', 'acupuncture', 'acupressure', cross-referenced with 'childbirth', 'birth', labo*r', and 'delivery'. The quality of the evidence is also evaluated in the context of study design. RESULTS The RCTs included in these systematic reviews differed in terms of study designs, research questions, treatment protocols and outcome measures, and yielded some conflicting results. It may be inappropriate to include these together in a systematic review, or pooled analysis, of acupuncture for labour with an expectation of an overall conclusion for efficacy. Trials of acupuncture and acupressure in labour show promise, but further studies are required. CONCLUSION The use of current systematic reviews of the evidence for acupuncture and acupressure for labour and birth may be misleading. Appropriate methods and outcome measures for investigation of acupuncture and acupressure treatment should more carefully reflect the research question being asked. The use of pragmatic trials designs with woman-centred outcomes may be appropriate for evaluating the effectiveness of these therapies.
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Affiliation(s)
- K M Levett
- National Institute for Complementary Medicine, University of Western Sydney, Penrith, New South Wales, Australia.
| | - C A Smith
- National Institute for Complementary Medicine, University of Western Sydney, Penrith, New South Wales, Australia.
| | - H G Dahlen
- School of Nursing and Midwifery, University of Western Sydney, Penrith, New South Wales, Australia.
| | - A Bensoussan
- National Institute for Complementary Medicine, University of Western Sydney, Penrith, New South Wales, Australia.
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Abstract
PURPOSE OF REVIEW The aim of this article is two-fold: to report the prevalence of herbal products used by pregnant women and to evaluate the evidence of efficacy and safety of the most popular remedies. RECENT FINDINGS Of the 671 articles identified, 15 randomized controlled trials (RCTs) and 16 non-RCTs were eligible. Ginger was the most investigated remedy and it was consistently reported to ameliorate nausea and vomiting in pregnancy. Although raspberry, blue cohosh, castor oil, and evening primrose oil are believed to facilitate labor in traditional medicine, very few scientific data support such indication. Moreover, they have been associated with severe adverse events. Data on the safety of Hypericum perforatum in pregnancy or lactation are reassuring, whereas efficacy was demonstrated only in nonpregnant individuals. There is still insufficient evidence regarding the efficacy and safety of Echinacea, garlic, and cranberry in pregnancy. SUMMARY Epidemiological studies reported a wide range of use of herbal remedies in pregnancy. Too few studies have been devoted to the safety and efficacy of singular herbs. With the exception of ginger, there are no consistent data to support the use of any other herbal supplement during pregnancy. Severe adverse events have been reported using blue cohosh and evening primrose oil.
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Affiliation(s)
- Giulia Dante
- Mother-Infant Department, University of Modena and Reggio Emilia, Modena, Italy
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