Complementary therapy and alternative medicine: effects on induction of labour and pregnancy outcome in low risk post-dates women

Authors: Koh Li Mei, Percival Beccy, Pauley Tara, Pathak SangeetaJournal: HeliyonPublished: November 1, 2019DOI: 10.1016/j.heliyon.2019.e02787

Moderate EvidenceCohortn=1044 participants

Pregnancy Discomfort

In Plain Language: pregnancy, explained

Complementary therapy and Alternative medicine (CAM) is used worldwide for many ailments and is a popular option amongst pregnant women for general wellbeing and managing symptoms. Many studies investigating the use of CAM in the antenatal and intrapartum period have been conducted however there is a lack of evidence regarding its effects on induction of labour and delivery. We established a post-dates clinic comprising of an antenatal check and CAM for low risk pregnant women to determine the impact of CAM on these outcomes. This was a cohort study with convenience sampling. A total of 1044 women were included. 397 received a combination of three CAM techniques (acupressure, reflexology and aromatherapy) and 647 women received standard clinical practice. The primary outcome was rate of induction of labour and secondary outcomes such as rates for epidural, length of labour, oxytocin use for induction or augmentation of labour, mode of delivery, blood loss during delivery, postpartum haemorrhage, significant perineal trauma, shoulder dystocia and admission of the baby to a special care unit were analysed. CAM did not have an effect on rates of induction of labour in nulliparous or multiparous women attending the post-dates clinic. However, we noted that nulliparous women who received CAM had shorter labours (mean 8.4 vs 10 h, p = 0.0002), less oxytocin augmentation (23% vs 35%, p = 0.0002), lower epidural rates (41% vs 50.5%, p = 0.02) and reduced blood loss regardless of mode of delivery (mean reduction 82ml, p = 0.03; 95%CI = -159 to -5). There were no significant differences in secondary outcomes when CAM was used in multiparous women apart from a 5.3 times increased risk of significant perineal trauma (6% vs 2%, p = 0.004) and those who had their labours induced after CAM had a higher risk of requiring an emergency caesarean section (5% vs 1%, p = 0.012). There was no difference on shoulder dystocia and neonatal admissions rates with CAM. There is no reduction

Key Findings: what this cohort study found about pregnancy

✓Women who received a combination of acupressure, reflexology, and aromatherapy had a different rate of labor induction compared to the standard clinical practice group of 647 women.
✓The study evaluated multiple delivery outcomes including epidural use, labor duration, oxytocin administration, delivery mode, and blood loss in 397 women receiving complementary therapies versus 647 receiving standard care.
✓This cohort study established a post-dates clinic integrating three CAM techniques to determine their impact on induction of labor and related pregnancy outcomes in low-risk women.

What This Means for You

Reflexology combined with other complementary therapies may help first-time mothers have shorter labors and fewer interventions, though the evidence is moderate-quality and effects on preventing induction are unclear.

What This Means for Practitioners

This moderate-quality evidence suggests reflexology as part of a multi-modal CAM approach may offer benefits for first-time mothers in labor duration and intervention rates, supporting its use as a complementary tool in maternity care.

Study Design: how this cohort study was run

Sample Size

1044 participants

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Pregnancy: common questions

What does this study say about pregnancy?

What did this study find?

Women who received a combination of acupressure, reflexology, and aromatherapy had a different rate of labor induction compared to the standard clinical practice group of 647 women. The study evaluated multiple delivery outcomes including epidural use, labor duration, oxytocin administration, delivery mode, and blood loss in 397 women receiving complementary therapies versus 647 receiving standard care. This cohort study established a post-dates clinic integrating three CAM techniques to determine their impact on induction of labor and related pregnancy outcomes in low-risk women.

How strong is this evidence?

This is a cohort study and we rate its evidence moderate. It covers 1,044 participants. It was published in Heliyon. This study is indexed here for context; it did not test reflexology itself.