Abstract
BackgroundThere is little known about women’s concurrent use of conventional and complementary health care during pregnancy, particularly consultation patterns with complementary and alternative medicine (CAM). This study examines health service utilisation among pregnant women including consultations with obstetricians, midwives, general practitioners (GPs) and CAM practitioners.MethodsA sub-study of pregnant women (n=2445) was undertaken from the nationally-representative Australian Longitudinal Study on Women’s Health (ALSWH). Women’s consultations with conventional practitioners (obstetricians, GPs and midwives) and CAM practitioners for pregnancy-related health conditions were analysed. The analysis included Pearson chi-square tests to compare categorical variables.ResultsThe survey was completed by 1835 women (response rate = 79.2%). A substantial number (49.4%) of respondents consulted with a CAM practitioner for pregnancy-related health conditions. Many participants consulted only with a CAM practitioner for assistance with certain conditions such as neck pain (74.6%) and sciatica (40.4%). Meanwhile, women consulted both CAM practitioners and conventional maternity health professionals (obstetricians, midwives and GPs) for back pain (61.8%) and gestational diabetes (22.2%). Women visiting a general practitioner (GP) 3–4 times for pregnancy care were more likely to consult with acupuncturists compared with those consulting a GP less often (p=<0.001, x2=20.5). Women who had more frequent visits to a midwife were more likely to have consulted with an acupuncturist (p=<0.001, x2=18.9) or a doula (p=<0.001, x2=23.2) than those visiting midwives less frequently for their pregnancy care.ConclusionsThe results emphasise the necessity for a considered and collaborative approach to interactions between pregnant women, conventional maternity health providers and CAM practitioners to accommodate appropriate information transferral and co-ordinated maternity care. The absence of sufficient clinical evidence regarding many commonly used CAM practices during pregnancy also requires urgent attention.
Highlights
There is little known about women’s concurrent use of conventional and complementary health care during pregnancy, consultation patterns with complementary and alternative medicine (CAM)
Women’s health and the rise of complementary and alternative medicine Complementary and alternative medicine (CAM) - a range of treatments and practices not traditionally associated with the conventional medical profession or medical curriculum [1] - is more commonly used by women than men [2,3]
Pregnancy and CAM: evidence, communication and risk Pregnant and birthing women have been identified as substantial CAM users with prevalence rates of between 20% to 60% [5] - a usage suggested to be in line with the search for a ‘natural’ pregnancy and birthing experience [10,11]
Summary
There is little known about women’s concurrent use of conventional and complementary health care during pregnancy, consultation patterns with complementary and alternative medicine (CAM). Women’s health and the rise of complementary and alternative medicine Complementary and alternative medicine (CAM) - a range of treatments and practices not traditionally associated with the conventional medical profession or medical curriculum [1] - is more commonly used by women than men [2,3]. 30% of pregnant women who consult CAM therapists do so without informing their midwife or doctor [15] yet there is evidence of CAM referral practices in maternity care [16]. CAM referrals during pregnancy are more likely to be midwife-led than obstetrician-led and obstetricians appear more cautious and sceptical than midwives about CAM use for women in their care [16]
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