Lead toxicity is usually cumulative; the brain, kidneys, and digestive system eventually become compromised. (Medical condition overview) by "Journal of the Australian Traditional-Medicine Society"; Health, general Alternative medicine Research Pregnancy Pregnant women Some of the herbal preparations may include Gotu kola, Bacopa monnieri, Shankapushpi, Celastrus paniculatus, Ashoka, or Terminalia arjuna (Posmontier & Teitelbaum, 2009). In complementary and alternative medicine, many therapeutic skills, i.e. (2004). Additional resources that provide information on herbs and herbal formulations include Hale Publishing ( http://www.ibreastfeeding.com), the United States Breast-feeding Committee ( http://www.usbreastfeeding.org), and Breastfeeding.com ( http://www.breastfeeding.com/reading_room/herbs.html). Ayurvedic medicine, the traditional medicine of India, approaches health and wellness by addressing the physical, emotional, mental, and spiritual health of the person (Posmontier & Teitelbaum, 2009). A Swedish report published several years ago showed that low back pain, which affects up to three-quarters of all women during pregnancy, can be greatly relieved by acupuncture. The National Institutes of Health (NIH) consider this system of health care practices and products significant to the health of the population, and the NCCAM addresses issues related to complementary and alternative medicine. Committee opinion no. Acupuncture has been shown to relieve anxiety and is considered a safe alternative as it does not adversely interact with drug therapies (Dong, 1993). One of the reasons complementary therapies are becoming so popular is that they offer a holistic approach to pregnancy, allowing women to maintain personal control outside of the biomedical model. & Lee, A. et al. Have a comment or questions? Massage and relaxation therapies have been used for hundreds of years to relieve tension, increase circulation, and calm pain receptors in the body (Field, 2000). However, few studies have evidenced the benefit of acupuncture for depression (Freeman, 2009; MacPherson, Thorpe, Thomas, & Geddes, 2004; Xue, Zhang, Greenwood, Lin, & Story, 2010). (2014) suggest, with such a wide array of therapies available - each of which carries a unique set of risks and benefits - it can be difficult for maternity staff to maintain sufficient knowledge to safely guide or advise their patients. The most common complementary and alternative medicine therapies used or recommended during pregnancy were herbalism, massage therapy, chiropractic, mind-body interventions (hypnosis, biofeedback, and relaxation techniques), and acupressure. Acupuncture. They may not be as costly as modern therapies and medications. Chiropractic and osteopathy are used to reduce low back and pelvic pain in pregnant women. While some drug-herb interactions were negligible or the herb enhanced the drug, the authors maintained that significantly more research must be done to determine safety in drug-herb interactions (Kennedy & Seely, 2010). American College of Obstetricians and Gynecologists, Committee on Obstetric Practice. Potential side-effects and complications. This article provides a brief overview of complementary and alternative therapies that may be used by women during pregnancy and postpartum. Studies have been conducted on the safety of St. John’s wort for lactating women and their infants; however, the outcomes of these studies do not provide conclusive evidence for the safety to the infant or the efficacy of the herb in the treatment of postpartum depression (Freeman, 2009; Klier, Schäfer, Schmid-Siegel, Lenz, & Mannel, 2002; Klier et al., 2006). PATIENTS AND METHODS We retrospectively surveyed the parents of 583 pediatric patients diagnosed with cancer in British Columbia between 1989 and 1995. Explanations for the presence of these contaminants are the area where the herb is grown (contaminated soil or water), purposeful addition of these elements for their chemical actions on the body, or accidental contamination during manufacturing (Weier & Beal, 2004). Nurses should consider assessing for complementary and alternative medicine utilization in pregnancy as a potentially protective factor for mental health symptoms. U.S. Food and Drug Administration. National Center for Complementary and Alternative Medicine. These kinds of therapies have been used with varying degrees of effectiveness. For example, for each therapy it’s important to know: As Strouss et al. Bearing all these factors in mind, the Royal College of Midwives (2014) have published the following recommendations to help guide midwives in their conversations about CAM: As Gaffney and Smith (2004) note, there is a need for much more research before complementary therapies can be considered safe for use during pregnancy. The reasons for the increasing use of complementary therapies and natural remedies in pregnancy and childbirth are explored, together with the growing interest in its use amongst midwives and other maternity professionals. Association of Complementary and Alternative Therapies With Mental Health Outcomes in Pregnant Women Living in a Postdisaster Recovery Environment Ama consists of partially digested food in the digestive tract that slows digestion and allows toxins to form. Treatment is determined by talking with the patient and assessing what aspects of the body are imbalanced. Visha is a reactive form of Ama and occurs when the body is not cleared of digestive toxins. Before a midwife can prescribe, advise or endorse the use of CAM in pregnancy, many considerations must be taken into account, especially for those therapies with a pharmacological action that may interact with prescribed medications (RCM 2014). The American College (renamed “Congress”) of Obstetricians and Gynecologists (ACOG), Committee on Obstetric Practice (2010) states that between 5% and 25% of women will experience postpartum depression at some time. After delivery, the issue may be whether the drug passes into the breast milk and affects the newborn. Information about the toxicity of some herbs and herbal formulations is limited, but alkaloids and terpenes have been found (Wang et al., 2009). Some complementary therapies involve using only natural ingredients in medications and treatments, and these are usually readily available in your kitchen cabinet, your garden, or from your natural surroundings. 38, No. Patients' use of CAM: results from the Health Survey for England 2005. Complementary and alternative medicine (CAM) use in Nigeria is becoming more popular [1–3], as in many other countries of the world.Globally, the prevalence of CAM use range from 30 to 75% .CAM includes various approaches/techniques outside the western conventional medicine that are used to prevent and/or treat illnesses/diseases as well as promote health. Due to the potential stigma of mental illness, many new mothers do not inform their obstetrician or pediatrician of their sadness, mood changes, or concerns about their feelings. The use of complementary and alternative therapies for depression is an issue of growing interest for practitioners who care for women. Helen SKOUTERIS, Eleanor H. WERTHEIM, Sofia RALLIS, Susan J. PAXTON, Leanne KELLY, Jeannette MILGROM, Use of complementary and alternative medicines by a sample of Australian women during pregnancy, Australian and New Zealand Journal of Obstetrics and Gynaecology, 10.1111/j.1479-828X.2008.00865.x, 48, 4, (384-390), (2008). The use of complementary and alternative therapies during lactation is another area of potential concern. The practitioner also needs to know the kind and dosage of dietary supplements, herbs, and herbal formulations (and their source), and whether the woman is consulting an alternative medicine practitioner. Read the latest articles of Complementary Therapies in Nursing and Midwifery at ScienceDirect.com, Elsevier’s leading platform of peer-reviewed scholarly literature A complementary therapy means you can use it alongside your conventional medical treatment. Gara Visha toxins include drugs, additives, artificial chemicals, and other elements that pollute the body. Anne has also studied many forms of complementary medicine and has extensive experience in the field of clinical hypnosis. (2006). (2009). Some herbs inhibit specific enzymes or decrease the efficacy of certain drugs, which can cause harm. The art of the interview is essential for nurses who care for women who may be experiencing or developing an anxiety or mental disorder during pregnancy or postpartum. (2009). A desire to maintain a more naturalistic approach to health care and illness prevention, as well as the increasing cost of health care, has helped create an interest in complementary and alternative therapies. One of the most widely researched therapies: studies have detailed the usefulness of … In addition, the postpartum period constitutes a time of highest risk for the development of emotional and mental disorders. Arsenic toxicity disrupts cellular electrolyte function, which damages the circulatory and central nervous systems. A common herb used for depression, including postpartum depression, is St. John’s wort (Hypericum perforatum). Medicinal herbs in the United States: Research needs. However, with so many specialities on offer, it can be difficult to keep up to date with current knowledge and identify which therapies are safe for use during pregnancy, and which could potentially cause harm. The authors found that ingredient analysis was conducted on only 35% of the herbs used in the studies. The practitioner might initially recommend dietary changes, such as eating foods that are fresh and easily digested (e.g., turkey, cooked grains, fruits, nuts) and avoiding foods that are highly processed, frozen, or microwaved. Xue, C.C., Zhang, A.L., Greenwood, K.M., Lin, V. & Story, D.F. Zhao, H., Wan, X. Use of herbal agents by breastfeeding women may affect infants. Many women may use these therapies during the postpartum period, considering them natural alternatives to pharmaceutical agents (Freeman, 2009). Klier, C.M., Schmid-Siegel, B., Schäfer, M.R., Lenz, G., Saria, A. Elviss, N.C., Little, C.L., Hucklesby, L., Sagoo, S., Surman-Lee, S. & de Pinna, E. et al. NCCAM is also responsible for conducting rigorous scientific research on these practices and products and disseminating the findings to professionals and the general public (NCCAM, 2010c). 2. One of the major issues with the studies of TCM is the lack of systematic, randomized controlled trials and quality of the studies (Zhao, Wan, & Chen, 2009). Given the prevalence of this potentially incapacitating health issue, it is important to address screening and treatment of all pregnant and postpartum women. The ACOG, Committee on Obstetric Practice (2010) recently released a statement encouraging all obstetricians to screen pregnant and postpartum women for depression. Allaire says, "About 76% of those nurse-midwives who used herbal therapies used them for labor stimulation." Microbiological study of fresh herbs from retail premises uncovers an international outbreak of salmonellosis. An Ayurvedic approach to postpartum depression. Alternative and complementary therapies used in postpartum depression include acupuncture, dietary supplements, herbs, massage, aromatherapy, and relaxation therapy. Scientific evidence for CAM and CAT in the field of obstetrics mainly covers pain relief in labor. This could include body-mind therapies, manipulation therapies, acupuncture, and others. Chabrol, H. & Callahan, S. (2007). Other alternative or complementary … Because of these fears and concerns, many new mothers turn to complementary or alternative therapies for help and relief (Weier & Beal, 2004). The role of alternative medicine in treating postnatal depression. A secondary focus is to generate a call to action for further research in this area to improve the health of all women. These issues are important and sometimes critical for practitioners to address with the mother. The converse is also true: The client needs to inform the practitioner because a well-informed practitioner will be able to discuss all possibilities with the client and better formulate a mutually agreeable plan of care. However, little clinical evidence shows that massage therapy is effective for depression treatment (Coelho, Boddy, & Ernst, 2008). An alternative therapy is one that is used instead of a conventional therapy or medicine (National Center for Complementary and Alternative Medicine [NCCAM], 2010b). In addition, more women are educating themselves about the potential side and adverse effects of prescriptions drugs and are exploring complementary and alternative therapies. As Tiran (2006) notes, it’s not enough to just say that a particular therapy is effective - it must also be proven to … As Hall, Griffiths and McKenna (2015) suggest, although midwives are usually supportive, how they communicate with women about the safe use of alternative therapies has received little attention. / Complementary Therapies Complementary and alternative medicine (CAM) can be helpful in treating less severe nausea and vomiting of pregnancy. Clinically based evidence of drug-herb interactions: A systematic review. Hall, H, Griffiths, D & McKenna, L 2015, 'Complementary and Alternative Medicine: Interaction and Communication Between Midwives and Women'. They may also be combined into one phrase – complementary and alternative therapies (CAMs). Alternative and complementary therapies used in postpartum depression include acupuncture, dietary supplements, herbs, massage, aromatherapy, and relaxation therapy. Postpartum depression: An update. Lack of knowledge, language barriers and workplace constraints mean that in most cases, it remains up to pregnant women themselves to initiate any CAM based conversations. (2014) discovered, while many healthcare providers were supportive of CAM, very few recommended it. Some of the milder adverse reactions were headache, nausea, vomiting, diarrhea, constipation, dizziness, and abdominal pain. Dr. Gossler is Assistant Professor, University of Tennessee, Knoxville, College of Nursing, Knoxville, Tennessee. (2014) suggest that although there are a wide range of therapies that women can use either independently or alongside conventional care, they can broadly be classified into the following five categories: Based on recent surveys conducted by the Royal College of Midwives (2014), it’s thought that as many as 87% of women use natural remedies at some point during their pregnancy, either self-administering or via a private consultation with a trained practitioner. Instead, the focus is to generate an intellectual curiosity and inquiry regarding complementary and alternative therapies used during this time in a woman’s life. Massage. National Center for Complementary and Alternative Medicine. Massage therapy for the treatment of depression: A systematic review. Ayurvedic practitioners recommend combinations of diet, sleep, massage, herbs, and herbal formulations (i.e., combinations of herbs) to rid the body of toxins and restore balance to all aspects of the body (Mantle, 2002; Posmontier & Teitelbaum, 2009). St. John’s wort (hypericum perforatum) and breastfeeding: Plasma and breast milk concentrations of hyperforin for 5 mothers and 2 infants. A review on the effects of aromatherapy for patients with depressive symptoms. The articles prior to January 2014 are part of the back file collection and are not available with a current paid subscription. (2007). This brief review of selected literature concerning complementary and alternative therapies during pregnancy, postpartum, and lactation is not intended to be a comprehensive evaluation of the literature. Acupuncture for depression: First steps toward a clinical evaluation. This allows staff to be aware of their use and avoid adverse reactions or interactions with conventional care and pharmaceutical preparations. Acupuncture, aromatherapy, supplements, and the like—more and more people across the nation are using these therapies. Acupuncture is one of the most popular alternative therapies for use with low-back pain, especially during pregnancy. Types of complementary therapies Acupuncture or acupressure. Her background includes working as a hospital midwife, Critical Care nurse, lecturer in Neonatal Intensive Care, and as a Clinical Nurse Specialist for a company making life support equipment. (2010c). & Fisher, K.D. Two major concerns in using complementary and alternative therapies are the purity and safety of the herbs and herbal formulations and the potential lack of communication between the client and health care provider. Safe and effective policies should be developed based on the best available evidence with clear parameters of practice. (2010a). Address correspondence to Sandra M. Gossler, PhD, APRN-BC, IBCLC, Assistant Professor, University of Tennessee, Knoxville, College of Nursing, 1200 Volunteer Boulevard, Office 143, Knoxville, TN 37996-4180; e-mail: .firstname.lastname@example.org, Tell us what you think about Healio.com », Get the latest news and education delivered to your inbox, Journal of Psychosocial Nursing and Mental Health Services, https://doi.org/10.3928/02793695-20100930-02, National Center for Complementary and Alternative Medicine [NCCAM], 2010b, MacPherson, Thorpe, Thomas, & Geddes, 2004, Xue, Zhang, Greenwood, Lin, & Story, 2010, Klier, Schäfer, Schmid-Siegel, Lenz, & Mannel, 2002, http://www.breastfeeding.com/reading_room/herbs.html, http://www.internationalbreastfeedingjournal.com/content/2/1/6, http://nccam.nih.gov/research/intramural/research_train.htm, http://nccam.nih.gov/health/whatiscam/#definingcam, http://nccam.nih.gov/health/whatiscam/#role, http://www.fda.gov/RegulatoryInformation/Guidances/ucm144657.htm, Managing Workplace Violence With Evidence-Based Interventions: A Literature Review. Freeman, M.P. Not all women have an equal interest or ability to access these therapies, however. Most midwives seemed to take an open-minded and positive approach to the use of CAM because they considered the therapies to be philosophically congruent, providing safe alternatives to medical interventions and supporting the woman's autonomy (Hall, McKenna & Griffiths 2012). & Beal, M.W. In addition, Briggs, Freeman, and Yaffe (2008) published Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk to inform practitioners about the safety of pharmaceutical agents and herbal formulations in breast milk. Some herbs and herbal formulations may have serious adverse effects or interactions with other pharmaceutical agents (Matthews, Lucier, & Fisher, 1999; Posmontier & Teitelbaum, 2009; Weier & Beal, 2004). Traditional Ayurvedic practitioners consider different treatments depending on the person and the symptoms presented. The practitioner may prescribe specific herbal creams depending on the symptoms presented. A new paradigm for depression in new mothers: The central role of inflammation and how breastfeeding and anti-inflammatory treatments protect maternal mental health. Although it’s tempting to assume that natural is synonymous with safe, this is not necessarily true, and many of the less well-known CAM therapies have little or no evidence-based research to support their use. (2010b). This chapter introduces the concept of complementary medicine and explores some of the theories that support it. Coelho, H.F., Boddy, K. & Ernst, E. (2008). Kennedy, D.A. Alternative and Complementary Therapies is the leading Journalzine® delivering practical and evidence-based research on integrating alternative medical therapies and approaches into private practice or hospital integrative medicine programs. The use of complementary and alternative medicine (CAM) and complementary and alternative therapies (CAT) during pregnancy is increasing. The importance of the provider’s trust, honesty, and communication with the client cannot be overstated. St. John’s wort is known to increase photosensitivity and inhibit monoamine oxidase. Lyndall Mollart, Jon Adams, Maralyn Foureur, Pregnant women and health professional's perceptions of complementary alternative medicine, and participation in a randomised controlled trial of acupressure for labour onset, Complementary Therapies in Clinical Practice, 10.1016/j.ctcp.2016.06.007, 24, (167-173), (2016). Traditional Chinese medicine (TCM) views the person in a holistic manner with energy, emotion, and physical aspects of the body (Mantle, 2002; Weier & Beal, 2004; Xue et al., 2010). 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