Review highlights need for more education and guidance on CAM use in midwifery

Feb 23, 2011

Complementary and alternative medicine (CAM) is increasingly popular in maternity care, but healthcare professionals need formal evidence-based education and guidance about its use, according to a review in the March issue of the Journal of Advanced Nursing.

There is also need for greater respect and cooperation between conventional and alternative practitioners and improved communication with patients about the growing use of CAM.

University-based members of the Network of Researchers in the of Complementary and (NORPHCAM) reviewed 19 studies covering the views of more than 3,000 maternity professionals from Australia, Canada, the USA, UK, Germany, New Zealand and Israel.

The studies, which were all based on interviews or surveys, were published between 1999 and 2009, 13 in the last five years.

"There is no doubt that the popularity of CAM – including acupuncture, chiropractic, naturopathy, herbal medicine and yoga – has grown in recent years" says lead author Dr Jon Adams, Associate Professor at the University of Queensland, Australia, and Executive Director of NORPHCAM.

"The use of CAM during pregnancy has been debated by practitioners and policy makers around the world and it is clear that there is a real need to develop an integrated approach to . However this has been hampered by a lack of understanding of the attitudes and practice of mainstream maternity care professionals towards CAM. Our review aimed to provide a clearer picture by pulling together a wide range of published studies based on interviews and surveys."

Key findings from the most recent 2008 and 2009 studies include:

  • A survey of 343 midwives from Canada and New Zealand found that 72% had recommended or offered CAM. The most common referrals were to homeopaths (51%), acupuncturists (50%), naturopaths (48%), chiropractors (36%), massage therapists (31%) and osteopaths (20%).
  • All but one of the 381 obstetric departments who took part in a German survey said they offered at least one CAM therapy, with acupuncture (97%), homeopathy (93%) and aromatherapy (77%) heading the list.
  • 78% of the 227 midwives who took part in an American study reported using CAM and 89% would refer a patient to CAM providers. The three most commonly used treatments were herbal preparations (85%), pharmacologic/biologic treatments (82%) and mind-body interventions (80%).
  • A study of 401 American obstetricians found that 98% routinely endorsed, provided or referred patients for at least one CAM treatment. Movement therapies topped the list at 86%, followed by biofeedback and acupuncture (both 80%).
"Despite the increasing popularity of CAM in maternity care, and a generally positive attitude towards it, our research review revealed very diverse attitudes towards the practice of alternative treatments between, and within, professions" says Dr Adams.

"For example, our study suggests that, in general, midwives have a more positive view of CAM than obstetricians and that understandings and perceptions of CAM appear to be closely linked with wider notions of professionalism and professional identity.

"In particular, the holistic nature of CAM has a close affinity with the philosophy, professional goals and care perspectives of many midwives."

The authors raise concerns that their research review showed that most medical professionals have no CAM training and little understanding of the pharmacological nature of alternative therapies and their possible risks to pregnant women.

"There have recently been calls for nursing and midwifery education to include CAM training" says Dr Adams. "In addition, a number of medical organisations and registration boards, including the Royal College of Midwives and Australian Nursing Federation, have issued position statements endorsing the linking of care standards to education and knowledge of CAM.

"We hope that our research review will provide a first step in developing an evidence base on this important topic and provide vital insights for those managing, practising and receiving maternity care."

Explore further: Experts call for higher exam pass marks to close performance gap between international and UK medical graduates

More information: Attitudes and referral practices of maternity care professionals with regard to complementary and alternative medicine: an integrative review. Adams et al. Journal of Advanced Nursing. 67.3, pp472-483. (March 2011). DOI: 10.1111/j.1365-2648.2010.05510.x

add to favorites email to friend print save as pdf

Related Stories

More white Americans turn to lower-cost alternative meds

Feb 01, 2011

The use of complementary and alternative medicine (CAM) therapies experienced a significant growth in the United States in the last decade, and a new analysis finds that CAM use becomes more likely when access ...

Recommended for you

Obese British man in court fight for surgery

Jul 11, 2011

A British man weighing 22 stone (139 kilograms, 306 pounds) launched a court appeal Monday against a decision to refuse him state-funded obesity surgery because he is not fat enough.

2008 crisis spurred rise in suicides in Europe

Jul 08, 2011

The financial crisis that began to hit Europe in mid-2008 reversed a steady, years-long fall in suicides among people of working age, according to a letter published on Friday by The Lancet.

New food labels dished up to keep Europe healthy

Jul 06, 2011

A groundbreaking deal on compulsory new food labels Wednesday is set to give Europeans clear information on the nutritional and energy content of products, as well as country of origin.

Overweight men have poorer sperm count

Jul 04, 2011

Overweight or obese men, like their female counterparts, have a lower chance of becoming a parent, according to a comparison of sperm quality presented at a European fertility meeting Monday.

User comments : 1

Adjust slider to filter visible comments by rank

Display comments: newest first

Alcedine
not rated yet Feb 23, 2011
Just how much more loaded could an article be with subtext? Shame on them western-medical pooh-bahs for disrespecting alternative practitioners! So lamentable that they pretend to live in a fantastical la-la land, where medical practices are judged by science- and evidence-based validity, and not popular opinion.

As much as I try to keep an open mind, retaining any kind of integrity of thought seems to preclude canonization of these methods. My apologies -- I see nothing but voodoo here.

More news stories

Filipino tests negative for Middle East virus

A Filipino nurse who tested positive for the Middle East virus has been found free of infection in a subsequent examination after he returned home, Philippine health officials said Saturday.

Study says we're over the hill at 24

(Medical Xpress)—It's a hard pill to swallow, but if you're over 24 years of age you've already reached your peak in terms of your cognitive motor performance, according to a new Simon Fraser University study.

NASA's space station Robonaut finally getting legs

Robonaut, the first out-of-this-world humanoid, is finally getting its space legs. For three years, Robonaut has had to manage from the waist up. This new pair of legs means the experimental robot—now stuck ...

Ex-Apple chief plans mobile phone for India

Former Apple chief executive John Sculley, whose marketing skills helped bring the personal computer to desktops worldwide, says he plans to launch a mobile phone in India to exploit its still largely untapped ...

Egypt archaeologists find ancient writer's tomb

Egypt's minister of antiquities says a team of Spanish archaeologists has discovered two tombs in the southern part of the country, one of them belonging to a writer and containing a trove of artifacts including reed pens ...

Airbnb rental site raises $450 mn

Online lodging listings website Airbnb inked a $450 million funding deal with investors led by TPG, a source close to the matter said Friday.