1. Complementary and alternative medicine in pregnancy: a survey of North Carolina certified nurse-midwives.

Allaire AD, Moos MK, Wells SR.

Source

Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, USA. allaire@med.unc.edu

Abstract

OBJECTIVE:

To determine the prevalence and types of complementary and alternative medicine therapies used by certified nurse-midwives in North Carolina.

METHODS:

Surveys were sent to all 120 licensed certified nurse-midwives in North Carolina requesting information concerning their recommendations for use of complementary and alternative medicine for their pregnant or postpartum patients.

RESULTS:

Eighty-two responses were received (68.3%). Seventy-seven (93.9%) reported recommending complementary and alternative medicine to their pregnant patients in the past year. Forty-seven (57.3%) reported recommending complementary and alternative medicine to more than 10% of patients. The percentage of nurse-midwives who recommended each type of complementary and alternative medicine was as follows: herbal therapy (73.2%), massage therapy (67.1%), chiropractic (57.3%), acupressure (52.4%), mind-body interventions (48.8%), aromatherapy (32.9%), homeopathy (30.5%), spiritual healing (23.2%), acupuncture (19.5%), and bioelectric or magnetic applications (14.6%). The 60 respondents who reported prescribing herbal therapies gave them for the following indications: nausea and vomiting, labor stimulation, perineal discomfort, lactation disorders, postpartum depression, preterm labor, postpartum hemorrhage, labor analgesia, and malpresentation.

CONCLUSION:

Complementary and alternative medicine, especially herbal therapy, is commonly prescribed to pregnant women by nurse-midwives in North Carolina.

PMID: 10636495

[PubMed - indexed for MEDLINE]

 

2. Complementary and alternative therapies for pain management in labour.

Smith CA, Collins CT, Cyna AM, Crowther CA.

Source

The University of Adelaide, Discipline of Obstetrics and Gynaecology, Level 6, Medical School North, Frome Road, Adelaide, South Australia, Australia. caroline.a.smith@adelaide.edu.au

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 currently available evidence supporting the use of alternative and complementary therapies for pain management in labour.

OBJECTIVES:

To examine the effects of complementary and alternative therapies for pain management in labour on maternal and perinatal morbidity.

SEARCH STRATEGY:

We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (February 2006), the Cochrane Central Register of Controlled Trials (The Cochrane Library 2006, Issue 1), MEDLINE (1966 to February 2006), EMBASE (1980 to February 2006) and CINAHL (1980 to February 2006).

SELECTION CRITERIA:

The inclusion criteria included published and unpublished randomised controlled trials comparing complementary and alternative therapies (but not biofeedback) with placebo, no treatment or pharmacological forms of pain management in labour. All women whether primiparous or multiparous, and in spontaneous or induced labour, in the first and second stage of labour were included.

DATA COLLECTION AND ANALYSIS:

Meta-analysis was performed using relative risks for dichotomous outcomes and mean differences for continuous outcomes. The outcome measures were maternal satisfaction, use of pharmacological pain relief and maternal and neonatal adverse outcomes.

MAIN RESULTS:

Fourteen trials were included in the review with data reporting on 1537 women using different modalities of pain management; 1448 women were included in the meta-analysis. Three trials involved acupuncture (n = 496), one audio-analgesia (n = 24), two trials acupressure (n = 172), one aromatherapy (n = 22), five trials hypnosis (n = 729), one trial of massage (n = 60), and relaxation (n = 34). The trials of acupuncture showed a decreased need for pain relief (relative risk (RR) 0.70, 95% confidence interval (CI) 0.49 to 1.00, two trials 288 women). Women taught self-hypnosis had decreased requirements for pharmacological analgesia (RR 0.53, 95% CI 0.36 to 0.79, five trials 749 women) including epidural analgesia (RR 0.30, 95% CI 0.22 to 0.40) and were more satisfied with their pain management in labour compared with controls (RR 2.33, 95% CI 1.15 to 4.71, one trial). No differences were seen for women receiving aromatherapy, or audio analgesia.

AUTHORS' CONCLUSIONS:

Acupuncture and hypnosis may be beneficial for the management of pain during labour; however, the number of women studied has been small. Few other complementary therapies have been subjected to proper scientific study.

Update of

PMID: 17054175

[PubMed - indexed for MEDLINE

 

3. Use of complementary therapies by mothers in their children: study at an university hospital.

[Article in Portuguese]

Gentil LB, Robles AC, Grosseman S.

http://www.ncbi.nlm.nih.gov/pubmed/20640288

 

Source

Prefeitura Municipal de Santo Amaro da Imperatriz, SC, Brazil. luizagentil@gmail.com

Abstract

The objective of this article is to evaluate the use of complementary therapies by mothers in their children. A cross-sectional and descriptive study with 202 mothers of children that attended an University Hospital were interviewed. The variables analyzed were: use of complementary therapies/reasons, therapies used its purpose, effects, doctor's revelation/reasons and doctor's reaction. The prevalence of complementary therapies use was of 87.6%. Among the 177 mothers that used complementary therapies, many mentioned more than one kind, as follow: teas (72.8%), blessings (41%), sympathies (12.9%), homemade remedies/syrups (8.4%), prayer/promises (7.4%), homeopathy (4.0%), spiritual/parapsychological treatment (4.0%), mixture of unknown substances/"garrafada" (bottled) (3%), massage (2%) and reiki/floral (1.5%). The most used herbs were anise (16.7%), chamomile (14.8%) and mint (10.9%); 57.6% of the mothers did not inform its use to the doctor. Out of 499 treatments employed, there was a perception of improvement in 429 (86%) and 2 reports of adverse effects. The prevalence of complementary therapies utilization was high, being teas the most utilized therapy and anise, chamomile and mint the most used herbs. There was perception of improvement in most of the used therapies.

PMID: 20640288

[PubMed - indexed for MEDLINE]

 

4. Effectiveness of non-pharmacological strategies in relieving labor pain.

[Article in Portuguese]

Davim RM, Torres Gde V, Dantas Jda C.

http://www.ncbi.nlm.nih.gov/pubmed/19655687

 

Source

Departamento de Enfermagem da Universidade Federal do Rio Grande do Norte, Natal, RN, Brasil. rejanemb@uol.com.br

Abstract

The study objective was to evaluate the effectiveness of non-pharmacological strategies to relieve pain in parturients in labor. This is a before and after therapeutic intervention clinical trial, performed at a public maternity in the city of Natal, in the state of Rio Grande do Norte, Brazil, with 100 parturients applying breathing exercises, muscle relaxation, lumbosacral massage, and showers. A visual analogue scale was used for data collection. Most parturients were between 20- and 30-years-old (60%), had incomplete primary-level education (85%), family income of up to 2 minimum salaries (74%), and 78% had a companion with them at the hospital. Oxytocine was administered in 81% of cases, but 15% did not receive any medication. A significant difference was observed in pain relief after using non-pharmacological strategies, showing reduced pain as cervix dilation increased. It was concluded that the strategies were effective in reducing the intensity of pain in the studied parturients in labor.

PMID: 19655687

[PubMed - indexed for MEDLINE]

 

5. Research on Tuina treatment for postpartum hypolactation].

[Article in Chinese]

Zheng JJ, Lu P, Zhao Y.

http://www.ncbi.nlm.nih.gov/pubmed/19563202

 

Source

College of Acupuncture and Massage, Shanghai University of TCM, Shanghai 201203, China.

Abstract

In this paper, the TCM typing of postpartum hypolactation is introduced and the manipulation and duration of Tuina treatment for postpartum hypolactation are summarized, and the effectiveness index used in Tuina treatment is proposed. It is held that the Tuina therapy will be widely used for treatment of the postpartum hypolactation, and the convenient and effective Tuina manipulation will promote the development of postpartum nursing and will be used in gynecology department and enlarge the therapeutic range of the Tuina therapy.

PMID: 19563202

[PubMed - indexed for MEDLINE]

 

6. Postnatal depression.

Craig M, Howard L.

Source

Health Services Research Department, Institute of Psychiatry, London, UK.

Abstract

INTRODUCTION:

The differentiation between postnatal depression and other types of depression is often unclear, but there are treatment issues in nursing mothers that do not apply in other situations. Overall, the prevalence of depression in postpartum women is the same as the prevalence in women generally, at about 12-13%. Suicide is a major cause of maternal mortality in resource-rich countries, but rates are lower in women postpartum than in women who have not had a baby. METHODS AND OUTCOMES: We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of drug treatments, and of non-drug treatments, for postnatal depression? We searched: Medline, Embase, The Cochrane Library, and other important databases up to May 2008 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).

RESULTS:

We found 34 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.

CONCLUSIONS:

In this systematic review we present information relating to the effectiveness and safety of the following interventions: group cognitive behavioural therapy, hormones, individual cognitive behavioural therapy (CBT), infant massage by mother, interpersonal psychotherapy, light therapy, mother-infant interaction coaching, non-directive counselling, other antidepressants, physical exercise, psychodynamic therapy, psychoeducation with partner, selective serotonin reuptake inhibitors (SSRIs), St John's Wort, telephone-based peer support.

PMID: 19445768

[PubMed - in process]

PMCID: PMC2907780

Free PMC Article

 

7. Interventions (other than pharmacological, psychosocial or psychological) for treating antenatal depression.

Dennis CL, Allen K.

http://www.ncbi.nlm.nih.gov/pubmed/18843730

 

Source

Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College Street, Toronto, Ontario, Canada, M5T 1P8. cindylee.dennis@utoronto.ca

Abstract

BACKGROUND:

Although pregnancy was once thought of as a time of emotional well-being for many women, conferring 'protection' against psychiatric disorders, a recent meta-analysis of 21 studies suggests the mean prevalence rate for depression across the antenatal period is 10.7%, ranging from 7.4% in the first trimester to a high of 12.8% in the second trimester. Due to maternal treatment preferences and potential concerns about fetal and infant health outcomes, non-pharmacological treatment options are needed.

OBJECTIVES:

To assess the effects, on mothers and their families, of non-pharmacological/psychosocial/psychological interventions compared with usual antepartum care in the treatment of antenatal depression.

SEARCH STRATEGY:

We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (August 2007), the Cochrane Collaboration Depression Anxiety and Neurosis Group's Trials Registers (CCDANCTR-Studies and CCDANCTR-References) (January 2007), the Cochrane Central Register of Controlled Trials (The Cochrane Library 2006, Issue 3), MEDLINE (1966 to January 2007), EMBASE (1980 to January 2007) and CINAHL (1982 to January 2007). We scanned secondary references and contacted experts in the field to identify other published or unpublished trials.

SELECTION CRITERIA:

All published, unpublished and ongoing randomised controlled trials of non-pharmacological/psychosocial/psychological interventions to treat antenatal depression.

DATA COLLECTION AND ANALYSIS:

All review authors independently participated in the evaluation of methodological quality and data extraction. .

MAIN RESULTS:

We included one US three-armed randomised controlled trial in this review, incorporating 61 outpatient antenatal women who met Diagnostic and Statistical Manual for Mental Disorders-IV criteria for major depression. Maternal massage, compared to non-specific acupuncture (control group), did not significantly decrease the number of women diagnosed with clinical depression immediately post-treatment (one trial, n = 38; risk ratio (RR) 0.80, 95% confidence interval (CI) 0.25 to 2.53) or at final assessment at 10 weeks' postpartum (one trial, n = 32; RR 1.93, 95% CI 0.37 to 10.01). Acupuncture specifically treating symptoms of depression, compared to non-specific acupuncture, did not significantly decrease the number of women diagnosed with clinical depression immediately post-treatment (one trial, n = 35; RR 0.48, 95% CI 0.11 to 2.13) or at final assessment at 10 weeks' postpartum (one trial, n = 32; RR 0.64, 95% CI 0.06 to 6.39).

AUTHORS' CONCLUSIONS:

The evidence is inconclusive to allow us to make any recommendations for massage therapy or depression-specific acupuncture for the treatment of antenatal depression. The included trial was too small with a non-generalisable sample, to make any recommendations.

PMID: 18843730

[PubMed - indexed for MEDLINE]

 

8. Pregnancy and labor alternative therapy research.

Field T.

http://www.ncbi.nlm.nih.gov/pubmed/18780582

 

Source

Touch Research Institute, University of Miami Medical School, USA.

Abstract

This review covers research from the last 5 years on the most popular complementary and alternative therapies used during pregnancy and labor and potential underlying biological bases for their effects. MEDLINE was searched and papers were reviewed for the most popular complementary and alternative therapies used during pregnancy and labor, including massage therapy, acupuncture, relaxation, yoga, and exercise. The pregnancy research generally suggests that alternative therapies have been effective for reducing pregnancy-related back and leg pain and nausea and for reducing depression and cortisol levels and the associated prematurity rate. The labor research generally shows that alternative therapies reduce pain and thereby the need for medication. Although the literature suggests positive effects of alternative therapies for pregnancy and labor and some potential biological mechanisms, the research has several methodological limitations.

Comment in

PMID: 18780582

[PubMed - indexed for MEDLINE]

 

9. Non-pharmacological strategies on pain relief during labor: pre-testing of an instrument.

Davim RM, Torres Gde V, Melo ES.

http://www.ncbi.nlm.nih.gov/pubmed/18235958

 

Source

Rio Grande do Norte Federal University, Brazil. rejanemb@uol.com.br

Abstract

This descriptive study aimed to evaluate the effectiveness of Non-Pharmacological Strategies (NFS) on pain relief of parturients as part of a research instrument to be utilized in a Doctoral Dissertation. In order to evaluate the NFS, the Analogous Visual Scale (AVS) was used on 30 parturients attended at the Humanized Labor Unit of a school-maternity hospital in Natal, RN, Brazil. Of the six NFS (respiratory exercises, muscular relaxation, lumbossacral massage, shower washing, deambulation and pelvic swing), two were excluded post-test (deambulation and pelvic swing) for not being accepted by the parturients. The remaining NFS (respiratory exercises, muscular relaxation, lumbossacral massage, and shower washing) which reached satisfactory acceptation and applicability rates, were found to be effective in relieving pain of these parturients, and thus deemed adequate for use in the Doctoral Dissertation data collection process.

PMID: 18235958

[PubMed - indexed for MEDLINE]

Free full text

 

10. Prophylactic role for complementary and alternative medicine in perinatal programming of adult health.

Hodgson DM, Nakamura T, Walker AK.’

http://www.ncbi.nlm.nih.gov/pubmed/17464160

 

Source

Laboratory of Neuroimmunology, School of Psychology, The University of Newcastle, Callaghan, Australia. Deborah.Hodgson@newcastle.edu.au

Abstract

BACKGROUND: The health status of an individual in adulthood is proposed to be determined by events occurring in the prenatal and early postnatal period. A common early life event proven to have long lasting effects on the developing fetus is stress, including pain. Exposure of fetal and neonatal infants to repetitive psychological (e.g., maternal stress) or physiological (e.g., pain, infection, and noise) stress during this period is proposed to alter mechanisms involved in the regulation of stress, immunological maturation, pain perception, and cognition. Such changes, which persist into adulthood, may occur via alterations in the development of the hypothalamic-pituitary-adrenal (HPA) axis. This process is typically referred to as 'perinatal programming'. Ontogenic alterations in the development of the HPA-axis have been related to a number of adult pathologies such as cardiovascular disease, type 2 diabetes, asthma, as well as psychopathologies such as anxiety and depression. OBJECTIVE: In this review, the effectiveness of complementary and alternative medicine (CAM), such as music, dietary supplements, massage and aromatherapy, in reducing perinatal stress in mothers and infants is examined. An emphasis is placed on these therapies as preventative measures which may be of value to individuals at risk of developing disease profiles associated with the consequences of adverse perinatal programming. The widening interest in perinatal programming and CAM suggests the potential for CAM to become a valuable tool in offsetting negative adult health outcomes resulting from perinatal programming associated with adverse gestational early life environments.

PMID: 17464160

[PubMed - indexed for MEDLINE]

 

11. Women's Evaluation of Intrapartum Nonpharmacological Pain Relief Methods Used during Labor.

Brown ST, Douglas C, Flood LP.

http://www.ncbi.nlm.nih.gov/pubmed/17273260

 

Source

S ylvia B rown is a professor in the School of Nursing at East Carolina University in Greenville, North Carolina.

Abstract

A wide variety of pain relief measures are available to women in labor. This retrospective, descriptive survey design study examined which nonpharmacologic pain-relief techniques laboring women use most often and the effectiveness of the chosen techniques. Of the 10 nonpharmacological strategies rated by the sample (N = 46), breathing techniques, relaxation, acupressure, and massage were found to be the most effective. However, no specific technique or techniques were helpful for all participants. The results provide directions for childbirth educators in designing and implementing an effective childbirth education curriculum that assists women to have empowered birth experiences.

PMID: 17273260

[PubMed - in process]

PMCID: PMC1595076

Free PMC Article

 

12. How to implement complementary therapies for laboring women.

Zwelling E, Johnson K, Allen J.

http://www.ncbi.nlm.nih.gov/pubmed/17149111

 

Source

Hill-Rom Company, Sarasota, FL, USA. ezwelling@verizon.net

Abstract

Complementary therapies have been a part of nursing practice for centuries and are supported today as a part of nursing practice by many state boards of nursing. Some of these modalities can be used by nurses as a part of their comprehensive plan of labor support for women during the childbirth experience. This article describes five complementary therapies (aromatherapy, massage, use of birth balls, music therapy, and hydrotherapy), and how one large Midwestern hospital system implemented an educational program for nurses that helped them integrate complementary therapies into their nursing care for laboring women.

Comment in

PMID: 17149111

[PubMed - indexed for MEDLINE]

 

13. The psychological effects of aromatherapy-massage in healthy postpartum mothers.

Imura M, Misao H, Ushijima H.

http://www.ncbi.nlm.nih.gov/pubmed/16504900

 

Source

Department of Developmental Medical Sciences, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongoh, Bunkyo-ku, Tokyo 113-0033, Japan.

Abstract

This study examined the effect of aromatherapy-massage in healthy postpartum mothers. A quasi-experimental between-groups design was used. Mothers who received aromatherapy-massage were compared with a control group who received standard postpartum care. Thirty-six healthy, first-time mothers with vaginal delivery of a full-term, healthy infant participated in this study. Sixteen mothers received a 30-minute aromatherapy-massage on the second postpartum day; 20 mothers were in the control group. All mothers completed the following four standardized questionnaires before and after the intervention: 1) Maternity Blues Scale; 2) State-Trait Anxiety Inventory; 3) Profile of Mood States (POMS); and 4) Feeling toward Baby Scale. In the aromatherapy-massage group, posttreatment scores significantly decreased for the Maternity Blues Scale, the State-Anxiety Inventory, and all but one of the Profile of Mood States subscales. Posttreatment scores in the intervention group significantly increased in Profile of Mood States-Vigor subscale and the Approach Feeling toward Baby subscale. Scores in the intervention group significantly decreased in Conflict Index of Avoidance/Approach Feeling toward Baby subscale. Our results suggest that aromatherapy-massage might be an effective intervention for postpartum mothers to improve physical and mental status and to facilitate mother-infant interaction.

PMID: 16504900

[PubMed - indexed for MEDLINE]

 

14. Complementary and alternative medicine for low-back pain in pregnancy: a cross-sectional survey.

Wang SM, DeZinno P, Fermo L, William K, Caldwell-Andrews AA, Bravemen F, Kain ZN.

http://www.ncbi.nlm.nih.gov/pubmed/15992230

 

Source

Department of Anesthesiology, Yale University School of Medicine, New Haven, CT 06518, USA. shu-ming.wang@yale.edu

Abstract

OBJECTIVE:

To identify common treatments used for low-back pain (LBP) during pregnancy.

DESIGN:

A two-part anonymous survey.

SETTING/LOCATION:

New Haven, Connecticut.

SUBJECTS:

Pregnant women and providers of prenatal health care (nurse educators, nurse midwives, and obstetricians).

RESULTS:

We found that the majority of pregnant women who participated in our survey (61.7%) reported that they would accept complementary and alternative medicine (CAM) therapy as treatment for LBP during pregnancy. Similarly, 61% of providers of prenatal health care in our sample reported that they would consider using CAM as treatment for LBP during pregnancy. Massage (61.4%), acupuncture (44.6%), relaxation (42.6%), yoga (40.6%), and chiropractic (36.6%) were the most common CAM therapies recommended for LBP in pregnancy by the providers of prenatal health care in our sample.

CONCLUSIONS:

This two-part survey study found that both providers of prenatal health care and pregnant women in New Haven county are likely to use CAM treatments for pregnancy-induced LBP. Further investigation should focus on whether it is a nationwide phenomenon, as well as if various CAM therapies are an efficacious treatment for LBP during pregnancy.

PMID: 15992230

[PubMed - indexed for MEDLINE]

 

15. Update on nonpharmacologic approaches to relieve labor pain and prevent suffering.

Simkin P, Bolding A.

http://www.ncbi.nlm.nih.gov/pubmed/15544978

 

Source

pennyink@aol.com

Abstract

The control of labor pain and prevention of suffering are major concerns of clinicians and their clients. Nonpharmacologic approaches toward these goals are consistent with midwifery management and the choices of many women. We undertook a literature search of scientific articles cataloged in CINAHL, PUBMED, the Cochrane Library, and AMED databases relating to the effectiveness of 13 non-pharmacologic methods used to relieve pain and reduce suffering in labor. Suffering, which is different from pain, is not an outcome that is usually measured after childbirth. We assumed that suffering is unlikely if indicators of satisfaction were positive after childbirth. Adequate evidence of benefit in reducing pain exists for continuous labor support, baths, intradermal water blocks, and maternal movement and positioning. Acupuncture, massage, transcutaneous electrical nerve stimulation, and hypnosis are promising, but they require further study. The effectiveness of childbirth education, relaxation and breathing, heat and cold, acupressure, hypnosis, aromatherapy, music, and audioanalgesia are either inadequately studied or findings are too variable to draw conclusions on effectiveness. All the methods studied had evidence of widespread satisfaction among a majority of users.

PMID: 15544978

[PubMed - indexed for MEDLINE]

 

16. Complementary and alternative medicine for labor pain: a systematic review.

Huntley AL, Coon JT, Ernst E.

http://www.ncbi.nlm.nih.gov/pubmed/15295342

 

Source

Complementary Medicine, Peninsula Medical School, Universities of Exeter and Plymouth, Exeter, United Kingdom. alyson.huntley@pms.ac.uk

Abstract

OBJECTIVES:

The purpose of this study was to systematically review the literature for, and critically appraise, randomized controlled trials of any type of complementary and alternative therapies for labor pain.

STUDY DESIGN:

Six electronic databases were searched from their inception until July 2003. The inclusion criteria were that they were prospective, randomized controlled trials, involved healthy pregnant women at term, and contained outcome measures of labor pain.

RESULTS:

Our search strategy found 18 trials. Six of these did not meet our inclusion criteria. The remaining 12 trials involved acupuncture (2), biofeedback (1), hypnosis (2), intracutaneous sterile water injections (4), massage (2), and respiratory autogenic training (1).

CONCLUSION:

There is insufficient evidence for the efficacy of any of the complementary and alternative therapies for labor pain, with the exception of intracutaneous sterile water injections. For all the other treatments described it is impossible to make any definitive conclusions regarding effectiveness in labor pain control.

PMID: 15295342

[PubMed - indexed for MEDLINE]

 

17. Use of complementary therapies in pregnancy: the perceptions of obstetricians and midwives in South Australia.

Gaffney L, Smith CA.

http://www.ncbi.nlm.nih.gov/pubmed/15089864

 

Source

Department of Obstetrics and Gynaecology, The University of Adelaide, South Australia, Australia.

Abstract

OBJECTIVE:

To examine South Australian obstetricians and midwives attitude's towards the use of complementary and alternative medicines (CAM) during pregnancy, to examine their referral patterns and their views on the usefulness and safety of these therapies during pregnancy.

DESIGN:

All members of the South Australian branch of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists and a 50% sample of midwives belonging to the South Australian Branch of The Australian College of Midwives, were sent a postal self-completion questionnaire.

RESULTS:

A response rate of 78% was obtained. Only 14% of doctors considered CAM was a threat to public health. Over 90% of midwives and obstetricians thought they should have some knowledge about CAM. A greater proportion of obstetricians (72%) held a view there needs to be an evidence base for CAM compared with 26% of midwives. The majority of obstetricians (68%) and midwives (78%) had formally referred a patient for use of one of the complementary therapies. Over 70% of obstetricians and midwives considered massage, acupuncture, vitamins, yoga, meditation and hypnosis to be useful and safe to use during pregnancy.

CONCLUSION:

The majority of clinician's held positive views towards CAM and considered some complementary therapies to be useful and safe for use during pregnancy. Limited evidence exists on the safety and efficacy of these therapies and attention needs to be given to undertaking high quality randomised controlled trials.

PMID: 15089864

[PubMed - indexed for MEDLINE]

 

18. Complementary therapies as adjuncts in the treatment of postpartum depression.

Weier KM, Beal MW.

http://www.ncbi.nlm.nih.gov/pubmed/15010661

 

Source

kweier@aya.yale.edu

Abstract

Postpartum depression affects an estimated 13% of women who have recently given birth. This article discusses several alternative or complementary therapies that may serve as adjuncts in the treatment of postpartum depression. The intent is to help practitioners better understand the treatments that are available that their clients may be using. Complementary modalities discussed include herbal medicine, dietary supplements, massage, aromatherapy, and acupuncture. Evidence supporting the use of these modalities is reviewed where available, and a list of resources is given in the appendix.

PMID: 15010661

[PubMed - indexed for MEDLINE]

 

19. The nature and management of labor pain: part I. Nonpharmacologic pain relief.

Leeman L, Fontaine P, King V, Klein MC, Ratcliffe S.

http://www.ncbi.nlm.nih.gov/pubmed/14524397

 

Source

University of New Mexico School of Medicine, Dept. of Family Practice, Albuquerque, New Mexico 87131, USA. lleeman@salud.unm.edu

Erratum in

  • Am Fam Physician. 2003 Dec 15;68(12):2330.

Abstract

Pain in labor is a nearly universal experience for childbearing women. A recent evidence-based symposium on the nature and management of labor pain brought together family physicians, obstetricians, midwives, obstetric anesthesiologists, and childbirth educators to discuss a series of commissioned systematic reviews. Although management of labor pain plays a relatively minor role in a woman's satisfaction with childbirth compared with the quality of the relationship with her maternity caregiver and the degree of participation she has in decision making, it is an important topic for women and their caregivers. Nonpharmacologic methods of pain relief such as labor support, intradermal water blocks, and warm water baths are effective techniques for management of labor pain. An increased availability of these methods can provide effective alternatives for women in labor.

Comment in

PMID: 14524397

[PubMed - indexed for MEDLINE]

Free full text