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Healthcare professional views and experiences of complementary and alternative therapies in obstetric practice in North East Scotland: a prospective questionnaire survey

Authors: Stewart D, Pallivalappila A R, Shetty A, Pande B, McLay J SJournal: BJOG : an international journal of obstetrics and gynaecologyPublished: July 1, 2014DOI: 10.1111/1471-0528.12618
Limited EvidenceCross Sectionaln=135 participants

In Plain Language

The aim of this study was to investigate the use of complementary and alternative medicines (CAMs) therapy by UK healthcare professionals involved in the care of pregnant women, and to identify key predictors of use. A prospective survey. Maternity services in Grampian, North East Scotland. All healthcare professionals (135) involved in the care of pregnant women (midwives, obstetricians, anaesthetists). Questionnaire development, piloting, and distribution. Descriptive and inferential statistical analysis. A response rate of 87% was achieved. A third of respondents (32.5%) had recommended (prescribed, referred, or advised) the use of CAMs to pregnant women. The most frequently recommended CAMs modalities were: vitamins and minerals (excluding folic acid) (55%); massage (53%); homeopathy (50%); acupuncture (32%); yoga (32%); reflexology (26%); aromatherapy (24%); and herbal medicine (21%). Although univariate analysis identified that those who recommended CAMs were significantly more likely to be midwives who had been in post for more than 5 years, had received training in CAMs, were interested in CAMs, and were themselves users of CAMs, the only variable retained in bivariate logistic regression was 'personal use of CAM', with an odds ratio of 8.26 (95% CI 3.09-22.05; P < 0.001). Despite the lack of safety or efficacy data, a wide variety of CAM therapies are recommended to pregnant women by approximately a third of healthcare professionals, with those recommending the use of CAMs being eight times more likely to be personal CAM users.

Key Findings: what this cross-sectional study found

  • ✓Approximately one-third of healthcare professionals (32.5%) in maternity services recommended complementary and alternative medicines to pregnant women.
  • ✓Reflexology was recommended by 26% of healthcare professionals who used CAMs, making it the sixth most frequently recommended modality after vitamins/minerals, massage, homeopathy, acupuncture, and yoga.
  • ✓The most commonly recommended CAM therapies were vitamins and minerals (55%), massage (53%), and homeopathy (50%), indicating that physical and nutritional interventions were preferred over other modalities.

What This Means for You

While reflexology was recommended by about a quarter of surveyed healthcare professionals, this study shows these recommendations are based more on personal preference than on proven safety or effectiveness data.

What This Means for Practitioners

Healthcare professionals are most likely to recommend reflexology when they personally use complementary therapies, but this survey highlights the need for stronger evidence to support recommendations to pregnant women.

Study Design: how this cross-sectional study was run

Sample Size
135 participants
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Common questions about this study

What does this study mean in practice?

While reflexology was recommended by about a quarter of surveyed healthcare professionals, this study shows these recommendations are based more on personal preference than on proven safety or effectiveness data.

What did this study find?

Approximately one-third of healthcare professionals (32.5%) in maternity services recommended complementary and alternative medicines to pregnant women. Reflexology was recommended by 26% of healthcare professionals who used CAMs, making it the sixth most frequently recommended modality after vitamins/minerals, massage, homeopathy, acupuncture, and yoga. The most commonly recommended CAM therapies were vitamins and minerals (55%), massage (53%), and homeopathy (50%), indicating that physical and nutritional interventions were preferred over other modalities.

How strong is this evidence?

This is a cross-sectional study and we rate its evidence limited. It covers 135 participants. It was published in BJOG : an international journal of obstetrics and gynaecology. This study is indexed here for context; it did not test reflexology itself.

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