Decision-making for use of complementary and alternative therapies by pregnant women and nurse midwives during pregnancy: An exploratory qualitative study

Abstract

Millions of people use complementary and alternative medicine (CAM) therapies. Such therapies are used across a wide spectrum of health conditions, but the use is particularly notable during pregnancy. Despite the widespread use, little is known about the perceptions of patients and clinicians in deciding about use of varied therapies. This study describes pregnant women and obstetrical provider (nurse midwives) perceptions in decision-making for use of CAM therapies during pregnancy. Pregnant women and nurse midwives were interviewed in focus groups with transcribed data analyzed using content analysis. Four themes emerged from the session with pregnant women and 3 from the nurse midwives. Data underscore the need to dialogue with all pregnant women about CAM use, and to mainstream CAM in education programs. Given the paucity of evidence for safety and efficacy during pregnancy for most CAM therapies, decision-making strategies to fill those knowledge gaps are urgently needed.

Factors influencing women’s decision-making regarding complementary medicine product use in pregnancy and lactation

“…Self-determination in health care choices may influence pregnant or breastfeeding mothers’ choices to use CMPs [13–16], especially in relation to desiring holistic health care [15]. Common reasons given for mothers’ use of CMPs include t reatment of common conditions of pregnancy or lactation [3, 17, 18], to prepare for a natural childbirth [13, 16, 19], and to support and maintain health [20] or breastmilk production [3, 17, 21]. Other factors identified that have been associated with use of complementary therapies, including CMPs, in pregnancy include cultural factors, positive experiences with previous use, and perceptions that complementary medicines may be a safer choice than pharmaceutical medications [16, 22].…”

“…Common reasons given for mothers’ use of CMPs include t reatment of common conditions of pregnancy or lactation [3, 17, 18], to prepare for a natural childbirth [13, 16, 19], and to support and maintain health [20] or breastmilk production [3, 17, 21]. Other factors identified that have been associated with use of complementary therapies, including CMPs, in pregnancy include cultural factors, positive experiences with previous use, and perceptions that complementary medicines may be a safer choice than pharmaceutical medications [16, 22]. Many women feel a responsibility to bear healthy children, leading to balancing what they perceive as possible harms to the health of their unborn or breastfeeding babies and themselves while also considering their health care practitioners’ (HCPs’) advice [22].…”

“…Other research into decision-making around use of complementary and alternative medicine (CAM), including CMPs in pregnancy and lactation, has found that women’s decisions are influenced by personal beliefs and previous experiences of CAM due to difficulties in finding reliable information [16]. Perceptions of their HCPs’ personal beliefs regarding CAM, scope of practice, and time spent in consultation also influence women’s information-seeking behaviours [16]. While both biomedical and CAM HCPs may be consulted during pregnancy and lactation, women actively seek information on CMPs from their CAM HCPs whom they view as providing holistic care.…”

“…While both biomedical and CAM HCPs may be consulted during pregnancy and lactation, women actively seek information on CMPs from their CAM HCPs whom they view as providing holistic care. Biomedical providers’ opinions on CMPs may be dismissed if they are perceived to have little expertise in CAM therapies and to either be against or uninformed about CAM therapies [16]. Time constraints of appointments with obstetricians and midwives are also frustrating for women wanting to discuss their pregnancies or breastfeeding difficulties, furthering their appreciation of time spent with CAM HCPs [16, 23].…”

How Safe Is Ginger Rhizome for Decreasing Nausea and Vomiting in Women during Early Pregnancy?

“…Some studies showed that the women had a positive opinion on the safety of herbal remedies during pregnancy [ 16 , 17 ]. Moreover, a minimum of one-third of the healthcare professionals are willing to recommend the use of CAM to pregnant women [ 18 , 19 ], and the majority (69.2%) agreed that there was some value in CAM use during pregnancy [ 20 ].…”