Women's use of complementary and alternative medicine products and services during pregnancy : insights for safe, informed maternity care

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Aim: The aim of this project is to explore the use of complementary and alternative medicine (CAM) products and services by women during pregnancy, with a focus upon: determining the current prevalence of CAM use and examining the determinants, characteristics and attitudes of women who use CAM; investigating the utilisation of various information sources used by pregnant women to make decisions about the use of CAM; and examining the extent to which pregnant women choose to self-prescribe certain CAM products. Method: The study sample was obtained via the Australian Longitudinal Study on Women’s Health (ALSWH). The ALSWH is a longitudinal study of women in three age groups (“young” 18-23, “mid age” 45-50 and “older” 70-75 years), who were randomly selected from the Australian national Medicare database to investigate multiple factors affecting health and wellbeing of women over a 20-year period. This research project analyses data from a sub-study survey administered in 2010. Participants in the sub-study were identified based upon their reporting of being pregnant or as having recently given birth in the 2009 ALSWH Survey 5 (n=2,316) of the young cohort. A total of 1,835 women responded to the sub-study survey and were included in the analysis (79.2% response rate). Results: CAM use during pregnancy is high with 91.7% (n=1,485) of women using a CAM product (52.0% excluding vitamins and minerals) and 48.1% (n=623) of women consulting a CAM practitioner. CAM practitioner visits were more likely for selected pregnancy-related health concerns, namely back pain or backache, and neck pain. Employment was also found to be predictive of pregnant women’s visits to a CAM practitioner. Significant health history and demographic predictors of CAM product use were tiredness and fatigue, embarking on preparation for labour and having a university education. Further analysis found that of the 447 women who did consult a CAM practitioner prior to pregnancy 62.4% (n=279) continued to utilise a CAM practitioner during pregnancy. Certain attitudes were found to be associated with women who use CAM products during pregnancy and women were more likely to use herbal medicine if they suffered from anxiety, sleeping problems and/or fatigue. The self-prescription of herbal medicine was also found to be widespread. Of the women deciding whether or not to visit a CAM practitioner, nearly half (48%, n=493) were influenced by their own personal experience of CAM and 43% (n=423) by family and friends. Conclusion: CAM use by women during pregnancy is high. Maternity health care professionals need to inquire about CAM use during routine antenatal visits in order to ensure safe maternal outcomes.
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