MD, PhD, FMedSci, FRSB, FRCP, FRCPEd

The aim of this survey was to investigate the use of alternative medicines (AMs) by Scottish healthcare professionals involved in the care of pregnant women, and to identify predictors of usage.

135 professionals (midwives, obstetricians, anaesthetists) involved in the care of pregnant women filled a questionnaire. A response rate of 87% was achieved. A third of respondents (32.5%) had recommended (prescribed, referred, or advised) the use of AMs to pregnant women. The most frequently recommended AMs modalities were: vitamins and minerals (excluding folic acid) (55%); massage (53%); homeopathy (50%); acupuncture (32%); yoga (32%); reflexology (26%); aromatherapy (24%); and herbal medicine (21%). Univariate analysis identified that those who recommended AMs were significantly more likely to be midwives who had been in post for more than 5 years, had received training in AMs, were interested in AMs, and were themselves users of AMs. However, the only variable retained in bivariate logistic regression was ‘personal use of AM’ (odds ratio of 8.2).

The authors draw the following conclusion: Despite the lack of safety or efficacy data, a wide variety of AM therapies are recommended to pregnant women by approximately a third of healthcare professionals, with those recommending the use of AMs being eight times more likely to be personal AM users.

There are virtually thousands of websites which recommend unproven treatments to pregnant women. This one may stand for the rest:

Chamomile, lemon balm, peppermint, and raspberry leaf are also effective in treating morning sickness. Other helpful herbs for pregnancy discomforts include:

  • dandelion leaf for water retention
  • lavender, mint, and slippery elm for heartburn
  • butcher’s broom, hawthorn, and yarrow, applied externally to varicose veins
  • garlic for high blood pressure
  • witch hazel, applied externally to haemorrhoids.

Our research has shown that midwives are particularly keen to recommend and often sell AMs to their patients. In fact, it would be difficult to find a midwife in the UK or elsewhere who is not involved in this sort of thing. Similarly, we have demonstrated that the advice given by herbalists is frequently not based on evidence and prone to harm the unborn child, the mother or both. Finally, we have pointed out that many of the AMs in question are by no means free of risks.

The most serious risk, I think, is that advice to use AM for health problems during pregnancy might delay adequate care for potentially serious conditions. For instance, the site quoted above advocates garlic for a pregnant women who develops high blood pressure during pregnancy and dandelion for water retention. These two abnormalities happen to be early signs that a pregnant women might be starting to develop eclampsia. Treating such serious conditions with a few unproven herbal remedies is dangerous and recommendations to do so are irresponsible.

I think the new survey discussed above suggests a worrying degree of sympathy amongst conventional healthcare professionals for unproven treatments. This is likely to render healthcare less effective and less safe and is not in the interest of patients.

11 Responses to Alternative medicine for pregnant women?

  • ”Might’, ‘likely’…. Not a lot of substance here is there? Pregnant women don’t like using strong meds if they can avoid it. Thalidomide put a damper on that.
    ‘Treating such serious conditions with a few unproven herbal remedies is dangerous’ yes it is except they’re just warning signs and nobodies actually talking about managing eclampsia with garlic.

    • I don’t think that your argument is correct.
      there is no good evidence that dandelion effectively treats water retention – full stop.
      making false therapeutic claims is wrong!
      the medical profession has learnt from the thalidomide disaster; and we should heed the lesson.

  • I was a bit surprised to see that “most midwives” do this, until I noticed most of the surveys were US based. Midwifery in the states has a totally different history to midwifery in the UK. I am wondering if the UK samples were random ones (have not read the original paper as yet) but in the abstract this is not stated.
    I agree though that this is unprofessional practice and potentially dangerous. When left solely to “nature” huge numbers of women and babies die or suffer damage.

  • This study tells me that one should never touch the “herbal” stuff if you don’t make it yourself or have at least a reliable source of some kind.
    Its ordinary black tea for me please. I am not even sure if the “Sleepy tea” my wife likes so much doesn’t contain some poisonous weeds 😀
    Seriously, it must be especially important to avoid unknown drug effects and toxins in pregnancy.
    I am not sure which I despise more, those who peddle woo to cancer patients or to pregnant and birthing mothers?

    Midwifes in my part of the world are increasingly disturbing the normal birth process with aromatherapy and acupuncture. Even without getting proper prior consent. When labour has started the mothers are usually to distraught to make an informed decision.

    It was actually a nurse/midwife in the family who lighted the healthcare-skeptic flame in me about a year ago when she started an expensive “education” in iridology, aromatherapy and other nonsense.

    • So, EE, your conclusion from this ‘survey’ is that there is a “worrying degree of sympathy among conventional healthcare professionals…”?

      Well, let’s see. In the U.S. in the last 37 years, no one has died from taking herbs. Now here is the worrying part: In the U.S., 100,000 die each year from properly prescribed medications that were taken properly. The number is likely higher. The mistakes by the MDs or patients likely take countless hundreds of thousands more lives. I have heard of many pregnant women who are given the OK to take a prescription medication or two, not to mention over-the-counter meds. Many are considered safe, yet are very potent and many of these meds don’t do what they are touted to do either. So, IMO, there is far greater risk going to the MD than the midwife. So why get your knickers in a knot?

      EE wrote: Our research has shown that midwives are particularly keen to recommend and often sell AMs to their patients. In fact, it would be difficult to find a midwife in the UK or elsewhere who is not involved in this sort of thing.”

      Oh, my! Well you may not know it over there, but here the oncology trade is the only group that can buy drugs (chemotherapeutic agents) and then ‘recommend’ (translation: SELL) their own drugs to distraught, desperate cancer patients. They buy a bottle for $1000 and get about 20 doses from it which they sell at $1000 – $2000 or more per treatment to various patients. The costs of medical care here are completely out-of-control.

      So that is quite a tidy profit: pay $1000, return on investment is around $20,000 – $40,000 Not bad. (Can anyone calculate the markup? It has been found, unfortunately, that there is no science for just about everything about chemo (every hospital has a different protocol of chemo and radiation) and a particular drug the doctor ‘recommends’ (translation: SELL) may not be the one in the patient’s best interest.

      EE, do you have a have “worrying degree of sympathy” about this? Oh, well, business is business. But herbs? Sorry, too dangerous.

      • I cannot discuss with someone who presents pure fantasy as fact.

      • SkepdicProf, get back to us when you are diagnosed with a real disease, such as cancer.

        Dr. E–Over at sciencebasedmedicine.org the argument is often made that massage, and yoga (gentle exercise) are really not alternative, although some of the claims made for them might well be.

        Regardless, it is frightening to think of pregnant women getting this kind of advice, especially from supposed medical professionals. I had assumed that the study was of UK midwives, but another commenter says many were US. That would explain a lot as over here, many, if not most, midwives are “lay” midwives and are deep into pseudo-medicine. There was a great Doc Martin episode about a midwife some time back where he told her off after she got Louisa to stop taking approved for pregnancy meds. Very gratifying turn of events!

        By the way, I had two babies at home with a nurse midwife attendant for one. No AM involved–just a well-trained and very experienced nun. The other was very precipitous and just popped out before I could get my things together to leave the house. I had OB provided prenatal care with both and lived very near a major academic hospital. I think there’s a place for midwives and birthing centers and even home birth on occasion, but only if free of non-medical nonsense. Birth is an event and under normal or average circumstances needn’t be overly medicalized, but no one can deny that there is some risk–which is greatly magnified in case of pseudo-medical involvement.

        Sorry for the length, but I always feel I must explain my birthing choice as a skeptic. I think my situation was fairly unique and have never proselytized for any birthing method.

  • Irene wrote:
    “I think there’s a place for midwives and birthing centers and even home birth on occasion, but only if free of non-medical nonsense. Birth is an event and under normal or average circumstances needn’t be overly medicalized, but no one can deny that there is some risk–which is greatly magnified in case of pseudo-medical involvement.”

    Yes, you have made yourself perfectly clear. Non-medical, natural and non-drug approaches have no place in nature’s blessed event. In the world according to Irene, there should only be a place for medical births and medical nonsense. Right?

    Irene also wrote:
    “SkepdicProf, get back to us when you are diagnosed with a real disease, such as cancer.”

    Well, thanks so much for your pleasant thoughts and warm wishes. Good night, Irene.

    • @SkepdicProf (completely wrongly named),
      “Yes, you have made yourself perfectly clear. Non-medical, natural and non-drug approaches have no place in nature’s blessed event. In the world according to Irene, there should only be a place for medical births and medical nonsense. Right?”
      That isn’t what she said but, given your other nonsense posts, this doesn’t surprise me.

  • As a pregnant woman, I find it extremely frustrating that I cannot get access to many proven medicines OTC via a Pharmacist (eg Canesten, Piritin), even though they are safe for use in pregnancy and have been advised by my GP and midwife. However, the same pharmacist who denies me these medicines (and even refused to test my blood pressure on the basis that I am pregnant) will happily sell me untested herbal and homepathic ‘remedies’.
    Also, a few of my friends are midwives (UK, Ireland) and the majority of them, and their colleagues, would believe in alternative therapies that have been widely debunked. I think this is dangerous because if a pharmacist or trained midwife is recommending a therapy it gives it credence, which many do not have. At best it’s a waste of time and money, at worst it can be life threatening.

  • God forbid a woman in labor drink chamomile tea and do some light strecthing and get a massage from their husband. Oh no!!! Alternative medicine!!!!

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