Denise and her blog
Traditional Medicine Approval
I was pleased to read recently that Burkina Faso in central Africa has approved an additional eighteen traditional medicines for use within healthcare, to supplement the 53 products already approved. These are herbal remedies long used as local family medicines that have been validated through a range of formal processes and now legitimised in law. As with other countries in which traditional herbal remedies play a prominent part in healthcare, regulating specific plants in law prevents the plundering of locally grown plants for development as medicines by the largely European pharmaceutical industry; plants known to have therapeutic properties in Burkina Faso and elsewhere can not be harvested by external industry without formal governmental permission.
There is a wealth of indigenous knowledge and power in people using natural remedies to help themselves. Whilst modern medicine (pharmaceuticals) has its place, so does traditional medicine. It empowers the population to help itself rather than relying on the disempowering state system (such as the UK's NHS). Traditional medicine uses freely available plants to encourage good health at a fraction of the cost of sometimes unnecessary drugs. It also treats holistically (whole person care) rather than systemically (seeing an individual as an engine with different parts). On the other hand, many developed countries have a growing interest in alternative systems of medicine, and the international trade in herbal medicines and other types of traditional remedies has grown exponentially.
In addition to Burkina Faso, other countries that have legalised indigenous plants include China, India and several South American countries which facilitate holistic medicine alongside orthodox medicine. indeed, the World Health Organisation has a traditional medicines programme to facilitate the expansion, where appropriate, of herbal medicine use. In other countries, such as Canada, herbal medicines are regulated as drugs; in the UK the post-Brexit Traditional Medicines Regulations tacitly approve remedies that have been in common use for thirty years or more, although these remedies continue to sit outside the legislature pertaining to drugs.Unfortunately, this lack of formal recognition contributes to a general disparagement of herbal medicines by the establishment – government, the healthcare regulatory organisation and the medical profession, ably reinforced by the media. This leads to those who wish to explore alternatives to drugs doing so surreptitiously, either through a sense of embarrassment or fear of reprimand.
Pregnancy and birth are of particular concern when it comes to self-administration of active herbal medicines – not because they don’t work but because, in fact, they DO. All herbal medicines act pharmacologically and have the power to be therapeutic when used appropriately. However, anything that has the power to do good also has the potential to do harm when not used appropriately. Herbal remedies may cause adverse effects if taken in too high a dose or for too long, and may interact with prescribed conventional medication. Many herbal remedies contain chemicals which have anticoagulant properties, or which have anti-diabetic effects or which impact on the liver.
Expectant parents’ use of raspberry leaf tea for birth preparation, ginger for nausea, clary sage to enhance contractions, evening primrose oil to encourage cervical ripening and many more remedies must be sued appropriately in order to be safe. Midwives, doulas, obstetricians and GPs must take account of the fact that many women choose to self-administer natural remedies in the belief that, because they know drugs should generally be avoided and because herbal medicines are “natural” they must obviously be safe (or safer). Maternity care professionals should:
- ask women at booking about their use of herbal medicines and aromatherapy oils and document their answers
- ask again towards the end of the third trimester as they prepare for birth and in early labour to determine if they wish to use any natural remedies
- advise women on any other medication NOT to take herbal remedies unless prescribed by a fully qualified medical herbalist practitioner, to avoid interactions which may potentiate or inhibit conventional medicines
- advise women booked for elective Caesarean to DISCONTINUE all herbal remedies at least two weeks before surgery to minimise the risk of bleeding.
Caesarean Birth Is Not A Lifestyle Choice!
The alarming rate of Caesareans, not just in the UK but in other countries too, is of grave concern. There is, of course, a multitude of reasons, not least the incidence of greater pathology in many women, lack of midwives to help maintain physiological birth, obstetric and managerial fear of litigation from failure to act when labour deviates from physiological progress and changing social trends in relation to childbirth and parenting. In the UK we are fast approaching a 50% Caesarean rate; in private care in South Africa, it can be as high as 90%. I cannot believe that almost 100% of the birthing population has so many issues that operative delivery is the only answer. However, with induction of labour rates at 60% or more in some UK units, it is hardly surprising that the “cascade of intervention” leads to increasing indications to manage and control birth.
Sadly, as I’ve mentioned before, Caesarean has become so normalised that young couples accept it as something that is, without challenge, part of their childbearing journey. My almost-daughter-in-law said she hadn’t made her mind up yet about the possibility of having a Caesarean, as if it is a lifestyle choice (no criticism intended, Ninka – and having twins in South Africa definitely increases the possibility of needing one). But Caesarean is not something on which you can make a decision until the time comes, usually shortly before or during labour, that indicates its necessity. It’s not like choosing whether to buy a new car or become vegetarian or change jobs.
Many expectant parents seem to take it in their stride that Caesarean may be needed, but I doubt they fully understand its implications. Caesarean is a major operation, the risks of which have been belittled by its frequency. It carries risks for both mother and baby that are rarely discussed at length with parents, just that it is “necessary”, with little opportunity to opt out. It has long-term sequelae that are almost never mentioned, not least a longer postnatal recovery time and the possibility of poor parent-infant bonding. Having a Caesarean is like having your appendix out – and having a baby as well. It is difficult enough recovering from physiological vaginal birth and caring for a newborn baby which, for most, is a completely alien concept until it happens. There is no rule book for caring for newborns – you are just expected to get on with it, deal with the sleepless nights, the difficulties of learning to breastfeed, the change in relationships between partners and sometimes the loss of identity for those who may, even temporarily, be stay-at-home parents rather than the competent professionals they were before pregnancy.
Caesarean birth – and its little sidekick, induction – are at risk of changing the microbiome of the human race. Will women evolve with zips down their abdomens that can conveniently be opened to lift the baby out? Women’s bodies are intended to become pregnant and to give birth – billions of people for thousands of years have been doing just that. Yes, there are some who experience difficulties or even die in childbirth, but that is not usually dependent on operative delivery – of course, in some cases, surgery can be a lifesaver for either or both mother and baby. But whilst we continue to normalise such deplorable and increasing rates of what can only be termed operative assault on women’s bodies, the higher the rates will rise.
Expectant parents need the facts, applied to their individual situations rather than a blanket policy of reaching for the scalpel as if all other avenues have failed. They need to know the benefits and the risks of both having or not having a Caesarean. As a society we need to stop treating major surgery as a minor inconvenience. And professionally, we need to acknowledge that childbirth is a normal biopsychosocial life event that, in the main, progresses without complications and brings a baby into the world without drama or trauma. Caesarean is NOT a lifestyle choice!
Birth Of My Son
My son, Adam, was born at home in July 1989, after a 24 hour labour with a four hour transition, ending in a forceps birth (yes, at home – it’s not what you know but who you know!) The consultant obstetrician was a friend who agreed to care for me even if it meant coming out to the birth. Adam was 10lb four ounces (4.3 kg). I was looked after by two midwives who were friends; my husband spent the very hot day washing cars and ordering in pizza for the midwives, whilst I huffed and puffed my way through first stage. To think Adam has just celebrated his 37th birthday is amazing.
See his proud grandfather with a newborn Adam.
Previous articles
Traditional Medicine Approval
Caesarean Birth Is Not A Lifestyle Choice!
Birth Of My Son
Paternalism in Maternity Care: The “Just In Case Syndrome”
Transitioning Role From Midwife To Grandmother
Midwifery, Aromatherapy and Natural Birth Under Attack Again
About Midwifery
Quality Of Education In Midwifery Complementary Therapies
Safe Maternity Care
The Publication Of The Ockenden Report
