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Jan. 13, 2000 (Baltimore) -- A survey of nurse-midwives in North Carolina published in the January issue of the journal Obstetrics and Gynecology reveals that many of them are offering their pregnant patients alternative and complementary therapies.
Of the 82 nurse-midwives who responded to this study, 77% reported using, recommending, or referring patients for alternative or complementary medicine therapies in the past year.
"This survey underscores the need for additional studies to assess the safety and efficacy of alternative therapies used by pregnant women," says Alexander Allaire, MD, MSPH, a fellow in obstetrics at the University of North Carolina at Chapel Hill and lead author of the study. According to Allaire and his co-authors, most of the treatments the midwives reported using have not been adequately studied for safety in pregnant women.
"The biggest surprise to me in this study was the percentage of herbal therapies being used," Allaire tells WebMD.
Seventy-three percent of the nurse-midwives said they had recommended herbal therapy to their pregnant or postpartum patients. Herbal therapy was used most commonly for nausea and vomiting but was also used to stimulate labor. Allaire says, "About 76% of those nurse-midwives who used herbal therapies used them for labor stimulation."
Other alternative or complementary therapies the nurse-midwives reported using include massage therapy, acupuncture, homeopathy, and therapeutic touch.
"Women who desire alternative therapies might gravitate to midwives, or midwives might provide an environment that allows women to feel safe in reporting use of complementary and alternative medicine," says Allaire.
According to Marion McCartney, director of professional services at the American College of Nurse-Midwives and a certified nurse-midwife, use of herbs to stimulate labor is not a cause for alarm. "One thing this study fails to mention is that the overwhelming majority of deliveries attended by nurse-midwives, about 96%, take place in the hospital. So if herbs are being used to augment labor, the safety mechanisms are in place." McCartney was not involved in the study.
McCartney continues, "I would also like to know how questions were asked of the nurse-midwives surveyed. Did they say, 'Have you recommended?' or was the interest really initiated on the patient's side and the nurse-midwife simply said she had no reason not to recommend a particular therapy? Many women who choose nurse-midwives do so because they have a strong interest in managing their own normal pregnancy and don't want to make it a medical event."