Women's use of complementary and alternative medicine in pregnancy: Narratives of transformation

Background: Pregnancy and childbirth constitute a time of transition in women’s lives. Many women turn to complementary and alternative medicines (CAM) during pregnancy. However, little is known about women’s experiences of CAM in relation to their pregnancy and childbirth journey. Methods: a narrative study aimed to gain insight into the experiences of women who use CAM in pregnancy and to explore the contribution CAM made to their pregnancy and childbirth journey. Interviews were conducted with 14 women who had used a range of CAMs during pregnancy and birth. Data analysis focussed on the meaning and significance of CAM use in pregnancy and a number of core themes emerged.Results: This paper presents some findings from this research which reveals a narrative genre that can be defined as transformational. CAM has a positive transformational effect on women’s experience of pregnancy and childbirth. Conclusion: Women’s narratives illustrate the positive impact of CAM on the subjective experiences of pregnancy and childbirth.Key Words: complementary and alternative medicine, pregnancy, holism. narrativ

Acquisition, Distribution and Perspectives of Healthcare Information in Complementary and Alternative Medicines (CAM)

Merged with duplicate record 10026.1/2500 on 06.20.2017 by CS (TIS)From April 2001 until September 2005 1 worked as a Pilkington research fellow at the Department of Complementary Medicine, University of Exeter, which in 2002 was integrated as a unit of the Peninsula Medical School. All the publications presented here have been carried out during my time of employment in this post at the Complementary Medicine Unit of the Peninsula Medical School in Exeter, United Kingdom. During the first few months of my research post in 2001 1 recognized the importance of the Internet as a tool to obtain healthcare information. Under the supervision of Professor Edzard Ernst, director of CAM, I carried out five Internet surveys, of which I collected and summarized the data and drafted the first version of the manuscripts, which were then finalized by Professor Ernst's comments: * Health risks over the Internet: advice offered by'medical herbalists' to a pregnant woman. * Reflexologists' responses to a patient with abdominal pain -a survey on Internet advice. * Internet advice by acupuncturists -a risk factor for cardiovascular patients? * Are asthma sufferers at risk when consulting chiropractors over the Internet? * Aspects of MMR / MMR vaccination advice over the Internet

The use of complementary medicine during childbearing years: A multi-country study of women from the Middle East

The prevalence of self-prescribed complementary medicine (CM) use is an area of concern across the Middle East. We conducted a descriptive qualitative study to describe women’s use of CM during their childbearing years in Egypt, Jordan, Saudi Arabia and Iran. The study conducted using face to face audio-recorded interviews with 70 participants. Our findings showed that women used several herbal plants to ease pain and discomfort during menstruation and/or during pregnancy and in postpartum care. Acupuncture, meditation, and massage were less likely to be used by women. The impact of CM was often described in relation to perceived usefulness and safety of herbs. Cultural beliefs and roles of women contributed to the use of herbs among women. Given the high use of herbal medicine, there is a need for discussion about the potential of adverse effects of some plants or their metabolites following self-medication during the childbearing years

Complementary medicine products used in pregnancy and lactation and an examination of the information sources accessed pertaining to maternal health literacy: A systematic review of qualitative studies

© 2018 The Author(s). Background: The prevalence of complementary medicine use in pregnancy and lactation has been increasingly noted internationally. This systematic review aimed to determine the complementary medicine products (CMPs) used in pregnancy and/or lactation for the benefit of the mother, the pregnancy, child and/or the breastfeeding process. Additionally, it aimed to explore the resources women used, and to examine the role of maternal health literacy in this process. Methods: Seven databases were comprehensively searched to identify studies published in peer-reviewed journals (1995-2017). Relevant data were extracted and thematic analysis undertaken to identify key themes related to the review objectives. Results: A total of 4574 articles were identified; 28 qualitative studies met the inclusion criteria. Quantitative studies were removed for a separate, concurrent review. Herbal medicines were the main CMPs identified (n=21 papers) in the qualitative studies, with a smaller number examining vitamin and mineral supplements together with herbal medicines (n=3), and micronutrient supplements (n=3). Shared cultural knowledge and traditions, followed by women elders and health care professionals were the information sources most accessed by women when choosing to use CMPs. Women used CMPs for perceived physical, mental-emotional, spiritual and cultural benefits for their pregnancies, their own health, the health of their unborn or breastfeeding babies, and/or the breastfeeding process. Two over-arching motives were identified: 1) to protect themselves or their babies from adverse events; 2) to facilitate the normal physiological processes of pregnancy, birth and lactation. Decisions to use CMPs were made within the context of their own cultures, reflected in the locus of control regarding decision-making in pregnancy and lactation, and in the health literacy environment. Medical pluralism was very common and women navigated through and between different health care services and systems throughout their pregnancies and breastfeeding journeys. Conclusions: Pregnant and breastfeeding women use herbal medicines and micronutrient supplements for a variety of perceived benefits to their babies' and their own holistic health. Women access a range of CMP-related information sources with shared cultural knowledge and women elders the most frequently accessed sources, followed by HCPs. Culture influences maternal health literacy and thus women's health care choices including CMP use

Narrative accounts of women who use complementary and alternative medicine in pregnancy: 'Forewarned, forearmed and relaxed'

Pregnancy and childbirth are events of major significance in women’s lives. In western countries women are increasingly using complementary and alternative medicine (CAM) (see glossary of terms) during this time. However, there is little research exploring and minimal empirical evidence to judge the significance and impact of CAM on pregnancy and childbirth. This thesis explores the experiences of women who use CAM during pregnancy and childbirth in an attempt to understand the meaning they ascribe to CAM use.A narrative approach was chosen to explore women’s experiences of CAM as it emphasises the meaning that individuals ascribe to life events (Czarniawska 2004, Elliott 2005). Additionally, through narratives it is possible to learn about the world of individuals, about their lives and their experienced reality (Engel et al. 2008).A purposive sample of 14 women who had used a variety of complementary therapies during pregnancy and childbirth participated in the study. Women’s narratives were obtained through open ended interviews on two or three occasions. The narratives were analysed using a 5 stage process. The words of one participant eloquently portrayed the significance and meaning of CAM use as one of being ‘Forewarned, Forearmed and Relaxed’. These words then became a framework to re-present participants’ narratives.Beck’s (1992a) and Giddens’ (1990) concept of risk and reflexivity provides a theoretical framework to aid interpretation of the data. The study findings offer insights into how CAM meets women’s physical, emotional and spiritual needs during pregnancy and childbirth. CAM use signifies women’s desire to achieve a normal birth without medical intervention, a need to make choices and be in control of their healthcare practices and a desire to enjoy their pregnancy and birth without fear

Utilisation of and attitude towards traditional and complementary medicine among ebola survivors in sierra leone

© 2019 by the authors. Licensee MDPI, Basel, Switzerland. Background and objectives: In addition to conventional healthcare, Ebola survivors are known to seek traditional and complementary healthcare (T&CM) options to meet their healthcare needs. However, little is known about the general beliefs of Ebola survivors regarding T&CM and the impact of these beliefs in influencing their decisions around T&CM use. This study examines Ebola survivors’ attitudes towards T&CM use in Sierra Leone. Materials and Methods: We conducted a nationwide quantitative cross-sectional study of 358 Ebola survivors in Sierra Leone between January and August 2018. We used descriptive analysis, chi-square tests and backward stepwise binary logistic regression for data analysis. Results: Close to half of the survivors (n = 163, 45.5%) had used T&CM since their discharge from an Ebola treatment centre. Survivors who viewed T&CM as boosting their immune system/resistance were 3.89 times (95%CI: 1.57–9.63, p = 0.003) more likely to use T&CM than those who did not view T&CM as boosting their immune system/resistance. Additionally, survivors who viewed T&CM as having fewer side effects than conventional medicine were more likely to use T&CM [OR = 5.03 (95%CI: 1.92–13.19, p = 0.001)]. Ebola survivors were more influenced to use T&CM based on their personal experience of the effectiveness of T&CM than by clinical evidence [OR = 13.72 (95%CI: 6.10–30.84, P < 0.001)]. Ebola survivors who perceived T&CM as providing them with more control than conventional medicine over their health/body were more likely to use T&CM [OR = 4.15 (95%CI: 1.74–9.89, p = 0.001)] as opposed to those who did not perceive T&CM in this way. Conclusions: Considering the widespread use of T&CM, an understanding of Ebola survivors’ attitudes/beliefs towards T&CM is useful to healthcare providers and policymakers with regard to public education and practitioner–survivors communication, T&CM regulation and research in Sierra Leone. Ebola survivors appear to turn to T&CM not only for treatment, but also to fill gaps in conventional health care services

Characteristics of women who practice yoga in different locations during pregnancy

Objectives: Yoga practice during pregnancy is gaining increasing popularity. This study examined the characteristics of pregnant women who practiced yoga in regard to the different locations (at home, in yoga classes, or both). Design: The study sample was drawn from the Australian Longitudinal Study on Women's Health (ALSWH), a national longitudinal study of women to investigate multiple factors affecting health and wellbeing of women over a 20-year period. Setting: Postal survey. Participants: Women born between 1973 and 1978, who were randomly selected from the national Medicare database and identified as being pregnant or having recently given birth (n=2316). Outcome measures: Relationships between yoga use (attending yoga classes and/or practising yoga at home) and women's characteristics (demographic measures, pregnancy-related health concerns, health service utilisation, attitudes to complementary and alternative medicine). Results: Practising yoga both at home and in classes was associated with perceiving complementary and alternative medicine (CAM) as preventative (odds ratio (OR)=1.62); perceiving CAM as affording health control (OR=1.50); experiencing sadness (OR=1.72); preparing for labour (OR=2.31); birthing in a birth centre (OR=7.97); and experiencing less vomiting (OR=0.38). Practising at home only was associated with perceiving CAM as affording health control (OR=1.76); perceiving CAM as promoting a holistic health approach (OR=1.65); and birthing in a birth centre (OR=3.54). Practising in classes only was associated with experiencing stress (OR=1.97); and birthing in a birth centre (OR=4.85) (all p<0.05). Conclusions: The findings suggest that the location in which a woman practices yoga is associated with attitudinal, health-related and birth environmental factors

Supernatural Healing: Narratives of individuals who report on the healing of a sensorineural hearing loss

A thesis submitted to the Faculty of Humanities, University of the Witwatersrand, Johannesburg, South Africa. In the fulfilment of the requirements for the Degree of Doctor of Philosophy 2017Background: Science and Religion have been debated for centuries. Healthcare assessments and management have traditionally focused on the medical model of detecting and curing a disease, facilitating a narrow focus on the physical needs. There is little consideration for the psychological, social and spiritual factors that affect a human life. Healthcare however should operate in both the temporal and the spiritual spheres. More inclusive models of healthcare are becoming favourable as diversity of patients and health practitioners becomes more evident, hence this applies to the practice of Audiology services too. Hearing loss the ‘hidden disability’ is regarded as the number one disability in the world thus a significant proportion of the world’s population is affection directly or indirectly by this communication hindering disability. Prior to rehabilitation, finding a cure was the ultimate goal when considering any medical pathology. Presently there is still no surgical method available to replace the damaged hair cells of the cochlea that cause a sensorineural hearing loss (SNHL). The culturally diverse South African population comprises of individuals who belong to various ethnic and religious groups, thus the melting pot of rehabilitation techniques for any illness may vary from the predominantly used medical model. Supernatural healing may occur in various forms and from various sources within the South African population, including traditional healers, spiritual healers or religious leaders. Hence this study explored the narratives of individuals who claim that they have been healed supernaturally of a sensorineural hearing loss. Methodology: This study aimed to fulfil three main objectives: to identify the recurring themes within the narratives of participants who reported a healing, with the purpose of deconstructing the aspect of healing amongst participants; to describe the cultural, religious, spiritual and social influences that impact the individual with a hearing loss; and to design a proposed working Audiological Model: An Integrated Model of service delivery in Audiology. There were three sub-objectives: to document the diagnosis of the sensorineural hearing loss; to identify the ‘turning point’ event or events that caused the reported healing; and to explore the influences of the healing on the participant’s life. This study was an exploratory case-study design within a qualitative paradigm. Snowball sampling was employed. Semi-structured interviews were conducted with seven participants, six of which were female and one male. Two of the participants’ mothers were interviewed as the reported healing occurred when the participants were children. All ethical parameters were maintained. The data analysis included a narrative inquiry into the context of the main event which was the supernatural healing. Thereafter the Supernatural Healing: Narratives of individuals who report on the healing of a sensorineural hearing loss. 3 University of the Witwatersrand PhD by Dhanashree Pillay 2017 content associated with the participant’s life before and after the event was analysed and discussed. Thematic content analysis was employed to identify the common categories and themes within the narratives of this study. Results and Discussion: This study identified four main categories and 13 themes within the narratives obtained. Categories included: Identification, assessment and management of a hearing loss; cause of a hearing loss; the healing event and the areas of a participant’s life that changed by the healing event. Major themes included: Hearing loss and its relation to sin and curses; physical and non-physical healing; the life of prayer and reactions to the healing. The narratives illustrated that individuals with a hearing loss are seeking alternative healing practices in conjunction with Audiological care. There is a barrier between the audiologist and the individual with a hearing loss as there appears to be a lack of freedom to discuss pertinent aspects such as alternative care. There is a need for change within the service delivery model in Audiology, a shift from the medical model of practice to a more holistic and integrated model of service delivery that encompasses all areas of life into the assessment and management process. Conclusion: A cohesive, integrated referral system and collaboration between professionals and caregivers are often the dictators of the assessment and early diagnosis of the hearing loss. A service delivery model that incorporates all aspects of life is therefore recommended within the profession of Audiology. The argument for a change in the current service delivery model in Audiology is supported by the evidence in the narratives obtained in this study. Individual’s with a hearing loss are seeking for alternative means of healing and it is negligent and divisive to disregard the interconnectedness of the medical, psychological, social and spiritual facets that affect the individual being seen by an audiologist. The diversity in South Africa must be embraced and incorporated into the healthcare service delivery model to ensure that the individual with a hearing loss is receiving contextually based services that are appropriate and necessary. Training of future audiologists must include multicultural and multidisciplinary areas as audiologists need to be equipped for success when they are faced with areas that are not familiar to the current medical model of practice. Healing is multidimensional and clinical practice in the field of Audiology must consider and include the aspects of healing that are relevant to the individual seen. A proposed case history section was developed from the evidence obtained in this study. The section allows the audiologist to explore religious and spiritual beliefs of the individual with a healing loss and his/her family. This study is one of the first studies that explore the relationship between medicine, religion and spirituality however these areas have been intertwined Supernatural Healing: Narratives of individuals who report on the healing of a sensorineural hearing loss. 4 University of the Witwatersrand PhD by Dhanashree Pillay 2017 for centuries. The findings and recommendations in this study will assist audiologists in managing individuals in an integrated holistic manner. Keywords: Healing, Supernatural, Hearing loss, Audiology practice, Alternative Practices, Biopsychosocial-Spiritual Practice.GR201