Denise and her blog


Denise Tiran FRCM, is an international authority on midwifery complementary therapies.

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Some Advice About Aloe Vera

Published : 27/05/2020

Denise has recently had an enquiry from a midwife about a lady wanting to use aloe vera in early labour. Here’s what she says about it:

“Aloe vera" (Latin name, aloe vera or aloe barbadensis) is a very popular remedy, usually used in gel or extract form to condition the skin and treat various skin conditions, for wound healing and sunburn, and to prevent stretch marks, treat haemorrhoids and sore gums. Aloe juice can be consumed as a juice for constipation, to aid hydration, improve liver health and as a general health tonic. However, is it safe in pregnancy?

Taking aloe vera by mouth, in any form including products from aloe latex or aloe extract, is not safe in pregnancy because it contains chemicals called anthraquinones which may affect the development of the baby and cause miscarriage or premature labour. These chemicals also cause diarrhoea, which can be severe and may lead to dehydration, abdominal pain and loss of essential nutrients such as potassium. It’s OK to use aloe gel on the skin in pregnancy and it may help to prevent or reduce the severity of stretch marks – but in some people it can cause skin irritation. It’s important to ask any woman who reports skin itching whether she has used any herbal remedies or essential oils on her skin, as many can cause contact dermatitis and this may be confused with normal skin itching of pregnancy or with the more serious liver-related condition of cholestasis.

Some women want to drink aloe vera juice to trigger labour contractions, but there is no evidence to suggest it works, despite it being a regular question asked on expectant mums’ online chat groups. Although it is probably safe enough in small doses at the end of pregnancy, I would not encourage women to drink large quantities of it to get labour going. It’s particularly important to avoid it if a woman is taking any oral medications, including pain relieving drugs and laxatives or those aimed at preventing pregnancy complications such as diclofenac, ibuprofen, aspirin. Aloe taken by mouth can interfere with the absorption of drugs taken orally because of its sticky viscous consistency. It will also interact with anticoagulant and anti-platelet drugs  given by injection including enoxaparin and heparin.

It's also wise to use aloe vera cautiously on the skin during pregnancy, labour and after the birth. There is plenty of evidence to show that it is antibacterial, antiviral and anti-inflammatory but it should not be used near the vagina during labour (for example, as a wash-down fluid) where the baby is going to emerge. Although oral aloe may cause contractions, this is not the same when the gel is applied to the skin, as the absorption is different, and there is no evidence of any benefits in labour. ALL interventions in labour can interfere with the normal progress of labour, sometimes causing excessive or irregular contractions and leading to fetal distress.

Aloe is sometimes advocated for perineal healing after the birth and has been shown to be effective in combination with  calendula. However, it should not be applied near the vaginal opening or directly on the wound as it can cause burning and itching.

Remember - ALL herbal remedies work like drugs and are mostly discouraged in pregnancy and labour. Other remedies which should also be used with caution include raspberry leaf, evening primrose oil, castor oil and aromatherapy oils such as clary sage oil.

FREE downloadable leaflets are available on this website for expectant mums.



Introduction to Complementary Therapies in Pregnancy and Birth

Published : 23/05/2020

£12 including VAT

Book via info@expectancy.co.uk

For midwives, doulas, students, health visitors, antenatal teachers, GPs and obstetricians.

This 2-hour session explores the popular complementary therapies used by women during pregnancy, labour and after birth, including aromatherapy, reflexology, acupuncture, as well as some of the self-help strategies used by expectant mums – ginger for nausea, raspberry leaf for birth preparation and different remedies to trigger labour.

The session will be facilitated by Denise Tiran, international authority on maternity complementary therapies and author of Complementary Therapies in Maternity Care, an evidence-based approach



Denise finishes her latest book

Published : 22/05/2020


At long last, Denise has finished writing her latest book! The manuscript is set to go to the publishers, Jesica Kingsley Publishing, tonight. Denise says: 

“I'm so grateful to have had these last few weeks to finish the writing. I'd already had a two month extension to the submission date and I don't think I would have finished it on time if we had not had lockdown - every cloud has a silver lining. 

I've enjoyed writing this latest, on the Safe Use of Natural Remedies in Pregnancy - a guide for maternity professionals. It's rather like a dictionary, with alphabetical entries on different herbs, homeopathic remedies, aromatherapy oils and traditional medicines from around the world, exploring the safety aspects during pregnancy and birth. 

I started writing professional textbooks on complementary therapies in midwifery in the early 1990s, being given an opportunity quite by chance to contribute to Mayes' Midwifery, one of the world's primary midwifery textbooks. I'd already started a book on complementary therapies,which I intended to be for expectant mums, but I had no idea how to go about finding a publisher. The editor at what was then Bailiere Tindall (now Elsevier) persuaded me to change the manuscript so it was more suited to midwives  - and the rest, as they say, is history.

I've written three aromatherapy books, three reflexology books, four general texts on complementary therapies in midwifery, one on nausea and vomiting in pregnancy, and three books for pregnant mums. My last book was  on The Business of Maternity Care, a guide for midwives and doulas setting up in private practice. I've also contributed chapters to several editions of various midwifery textbooks and have revised the last five editions of the world famous Bailliere's
Midwives' Dictionary - and I'm about to start on the next edition. 

Previously, when I finished a manuscript - and that's exactly what it was, a precious pile of typed pages - I would carefully package up the papers and send them by registered post to the editor - it was far too valuable to risk being lost in the post. Nowadays, of course, it's just the click of a button to send it by email - but there isn't quite that same sense of ceremony. However I'll be celebrating with my partner and best friends by having a virtual dinner party tonight.

I always say, when I finish writing, that's the very last time I'm ever writing another book. My previous editor, Claire Wilson, who was my editor for many years, both at Elsevier and then at Jessica Kingsley, always laughed when I said that because almost invariably, a couple of weeks later I'd be on the phone saying "I've got this idea for a new book"

However this time, I'm definitely not doing any more. There's just that little matter of the next edition of Bailiere's Midwives' Dictionary to be done and that's it.  But, wait - I've got this idea for a new book on .....!“

Denise's book will be published in early 2021. You can find many of her other books on Amazon. 

We're also offering the first five people to contact us the opportunity to receive a free signed copy of Denise's book on The Business of Maternity Care. Contact us on info@expectancy.co.uk stating your full name, the name you would like inside the book and your full address and postcode. If you miss the opportunity, we also have fifty copies of Denise's Aromatherapy manual for midwifery practice available to give away - email us with your details as above.