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Bowman RL, Taylor J, Davis DL. Raspberry leaf (Rubus idaeus) use in pregnancy: a prospective observational study. BMC Complement Med Ther 2024; 24:169. [PMID: 38649906 PMCID: PMC11034164 DOI: 10.1186/s12906-024-04465-7] [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] [Received: 12/03/2023] [Accepted: 04/02/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Raspberry leaf use during pregnancy in Australia is widespread. There has been little research exploring the potential beneficial or harmful effects of raspberry leaf on pregnancy, labour, and birth. More research is needed to appropriately inform childbearing women and maternity healthcare professionals on the effects of raspberry leaf so that women can make informed choices. METHODS This study aimed to determine associations between raspberry leaf use in pregnancy and augmentation of labour and other secondary outcomes. Data was derived from questionnaires which captured demographic information and herbal use in pregnancy. Clinical outcomes were accessed from the maternity services' clinical database. Data analysis was conducted in R via package 'brms' an implementation for Bayesian regression models. RESULTS A total of 91 completed records were obtained, 44 exposed to raspberry leaf and 47, not exposed. A smaller proportion of women in the raspberry leaf cohort had augmentation of labour, epidural anaesthesia, instrumental births, caesarean section, and postpartum haemorrhage. A larger proportion had vaginal birth and length of all phases of labour were shorter. Under these conditions the use of raspberry leaf was strongly predictive of women not having their labours medically augmented. CONCLUSIONS While our study demonstrated that raspberry leaf was strongly predictive of women not having their labours medically augmented, the results cannot be relied on or generalised to the wider population of pregnant women. While there were no safety concerns observed in our study, this should not be taken as evidence that raspberry leaf is safe. A randomised controlled trial is urgently needed to provide women and healthcare providers with robust evidence on which to base practice.
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Affiliation(s)
| | - Jan Taylor
- University of Canberra, Canberra, Australia
| | - Deborah L Davis
- University of Canberra and ACT Government, Health Directorate, Canberra, Australia
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2
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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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3
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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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Veziari Y, Kumar S, Leach M. Barriers to the conduct and application of research among complementary and alternative medicine professions in Australia and New Zealand: A cross-sectional survey. Complement Ther Med 2021; 60:102752. [PMID: 34126172 DOI: 10.1016/j.ctim.2021.102752] [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: 03/11/2021] [Revised: 04/22/2021] [Accepted: 06/10/2021] [Indexed: 10/21/2022] Open
Abstract
INTRODUCTION Despite the growing international popularity and use of complementary and alternative medicine (CAM), the uptake of evidence-based practice (EBP) in CAM has been slow. This cross-sectional survey aimed to further our understanding of the factors impacting EBP uptake in CAM. METHODS The 32-item oBSTACLES instrument was administered online using the SurveyMonkey™platform. The survey evaluated barriers to both the conduct and application of research among CAM practitioners and researchers, from multiple CAM disciplines across Australia and New Zealand. Participants were recruited via practice-based research networks, professional associations, CAM educational institutions, CAM research centres, pertinent product manufacturers and social media platforms. Data were analysed using descriptive statistics. RESULTS Six hundred and eighty-two CAM stakeholders responded to the survey. Barrier items were divided into two interlinked constructs, "capacity" and "culture". Capacity related to issues regarding access, competency, bias, incentives, and time, whereas culture related to values and complex systems. Under capacity, the greatest proportion of participants (>70 %) agreed that access was a barrier to the conduct and application of research, including lack of funding, institutional support, research training and collaborations. In terms of culture, the majority of participants (>60 %) agreed that values were a barrier to research conduct and application, including limited undergraduate research opportunities and diverse views of evidence. CONCLUSION Findings from this research suggest a multitude of barriers negatively impact the conduct and application of research in CAM. Insights gained from this research will be instrumental in developing actionable strategies aimed at mitigating the impact of these barriers to improve research engagement in CAM.
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Affiliation(s)
- Yasamin Veziari
- University of South Australia, North Terrace, Adelaide, SA, 5000, Australia.
| | - Saravana Kumar
- University of South Australia, North Terrace, Adelaide, SA, 5000, Australia.
| | - Matthew Leach
- Southern Cross University, Military Road, East Lismore, NSW, 2480, Australia.
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Bowman R, Taylor J, Muggleton S, Davis D. Biophysical effects, safety and efficacy of raspberry leaf use in pregnancy: a systematic integrative review. BMC Complement Med Ther 2021; 21:56. [PMID: 33563275 PMCID: PMC7871383 DOI: 10.1186/s12906-021-03230-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Accepted: 01/28/2021] [Indexed: 12/25/2022] Open
Abstract
Background Childbearing women have been using various herbs to assist with pregnancy, labour and birth for centuries. One of the most common is raspberry leaf. The evidence base for the use of raspberry leaf is however under-developed. It is incumbent on midwives and other maternity care providers to provide women with evidence-based information so they can make informed choices. The aim of this study was to review the research literature to identify the evidence base on the biophysical effects, safety and efficacy of raspberry leaf in pregnancy. Methods A systematic, integrative review was undertaken. Six databases were searched to identify empirical research papers published in peer reviewed journals including in vitro, in vivo, human and animal studies. The search included the databases CINAHL, MEDLINE, Cochrane Library, Scopus and Web of Science Core Collection and AMED. Identified studies were appraised independently by two reviewers using the MMAT appraisal instrument. An integrative approach was taken to analysis. Results Thirteen studies were included. Five were laboratory studies using animal and human tissue, two were experiments using animals, and six were human studies. Included studies were published between 1941 and 2016. Raspberry leaf has been shown to have biophysical effects on animal and human smooth muscle including the uterus. Toxity was demonstrated when high doses were administered intravenously or intaperitoneally in animal studies. Human studies have not shown any harm or benefit though one study demonstrated a clinically meaningful (though non-statistically significant) reduction in length of second stage and augmentation of labour in women taking raspberry leaf. Conclusions Many women use raspberry leaf in pregnancy to facilitate labour and birth. The evidence base supporting the use of raspeberry leaf in pregnancy is weak and further research is needed to address the question of raspberry leaf’s effectiveness.
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Affiliation(s)
- Rebekah Bowman
- University of Canberra, 11 Kirinari St, Bruce ACT, 2617, Australia
| | - Jan Taylor
- University of Canberra, 11 Kirinari St, Bruce ACT, 2617, Australia
| | - Sally Muggleton
- University of Canberra, 11 Kirinari St, Bruce ACT, 2617, Australia
| | - Deborah Davis
- University of Canberra, 11 Kirinari St, Bruce ACT, 2617, Australia. .,ACT Government, Health Directorate, 4 Bowes St, Phillip ACT, 2606, Australia.
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Grigoriu C, Varlas V, Călinescu G, Bălan AM, Bacalbașa N, Gheorghe CM, Salmen T, Zugravu CA, Bohîlțea RE. Phytotherapy in obstetrics - therapeutic indications, limits, and dangers. J Med Life 2021; 14:748-755. [PMID: 35126743 PMCID: PMC8811673 DOI: 10.25122/jml-2021-0353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 11/23/2021] [Indexed: 11/17/2022] Open
Abstract
The wide access to varied, attractive, and aggressively promoted information can induce pregnant women to think that any form of complementary therapy can be a saving solution for a medical problem because these therapies are natural, therefore, harmless. Updated information from literature about indications, benefits, limits, and risks of phytotherapy in pregnancy was presented. Valuable therapeutic resources with proven clinical efficacy (evidence-based medicine) were presented for each trimester of pregnancy, during labor, postpartum, but also during breastfeeding. For some phytotherapeutics, there are scientific studies. There is also a detailed presentation about some possibilities for therapeutic errors, which should be avoided during pregnancy. Positive results of phytotherapy deserve to be known and applied by the obstetrician for the certain benefit of future mothers.
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Affiliation(s)
- Corina Grigoriu
- Department of Obstetrics and Gynecology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania,Department of Obstetrics and Gynecology, University Emergency Hospital, Bucharest, Romania
| | - Valentin Varlas
- Department of Obstetrics and Gynecology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania,Department of Obstetrics and Gynecology, Filantropia Clinical Hospital, Bucharest, Romania
| | - Gina Călinescu
- Department of Obstetrics and Gynecology, University Emergency Hospital, Bucharest, Romania
| | - Andra Magdalena Bălan
- Department of Obstetrics and Gynecology, University Emergency Hospital, Bucharest, Romania
| | - Nicolae Bacalbașa
- Department of Obstetrics and Gynecology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Consuela-Mădălina Gheorghe
- Department of Marketing and Medical Technology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania,Corresponding Author: Consuela-Mădălina Gheorghe, Department of Marketing and Medical Technology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania. E-mail:
| | - Teodor Salmen
- Doctoral School of Carol Davila University of Medicine and Pharmacy Bucharest, National Institute of Diabetes, Nutrition and Metabolic Diseases N. C. Paulescu, Bucharest, Romania
| | - Corina Aurelia Zugravu
- Department of Hygiene and Ecology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Roxana Elena Bohîlțea
- Department of Obstetrics and Gynecology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania,Department of Obstetrics and Gynecology, University Emergency Hospital, Bucharest, Romania, Roxana Elena Bohîlțea, Department of Obstetrics and Gynecology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania. E-mail:
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Fogarty S, Steel A, Hall H, Hay P. Australian massage therapists' views and practices related to preconception, pregnancy and the early postpartum period. Complement Ther Clin Pract 2020; 40:101222. [PMID: 32891296 DOI: 10.1016/j.ctcp.2020.101222] [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: 03/17/2020] [Revised: 07/06/2020] [Accepted: 07/07/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND PURPOSE Massage is commonly used by the Australian public and is often sought by expectant mothers. Despite its popularity there is no regulatory body to enforce minimum educational standards, guidelines or evidence-based best practice for massage therapists. The aim of this paper is to critically examine the views and practices of massage therapists who offer preconception, antenatal or postnatal massage. MATERIALS AND METHODS An online survey was administered to Australian massage therapists who provide massage in the preconception, antenatal or postnatal periods. RESULTS Ninety-nine therapists completed the survey. The majority of respondents had received training in pregnancy massage (n = 72; 72.7%) only. The most confident respondents were those that had both training and experience. CONCLUSION There are potential gaps in training for massage therapists including up-to-date curriculum and a fragmentation around industry training requirements for pregnancy massage, which may impact on the safety and benefits of pregnancy massage.
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Affiliation(s)
- Sarah Fogarty
- School of Medicine, Western Sydney University, Australia.
| | - Amie Steel
- Faculty of Health University of Technology Sydney, Australia
| | - Helen Hall
- School of Nursing and Midwifery, Monash University, Australia
| | - Phillipa Hay
- School of Medicine, Western Sydney University, Australia
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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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Mollart L, Stulz V, Foureur M. Midwives’ personal views and beliefs about complementary and alternative medicine (CAM): A national survey. Complement Ther Clin Pract 2019; 34:235-239. [DOI: 10.1016/j.ctcp.2018.12.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 12/07/2018] [Accepted: 12/15/2018] [Indexed: 11/17/2022]
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Braillon A, Maclennan A, Marron L, Dervaux A. Teaching midwives to poke with needles on non-existing meridians. Women Birth 2018; 32:e284-e285. [PMID: 29914849 DOI: 10.1016/j.wombi.2018.06.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Revised: 05/30/2018] [Accepted: 06/05/2018] [Indexed: 10/28/2022]
Affiliation(s)
| | - Alastair Maclennan
- Obstetrics & Gynaecology, The University of Adelaide, Friends of Science in Medicine, Australia.
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