Women's health literacy and the complex decision-making process to use complementary medicine products in pregnancy and lactation.

Larisa A J Barnes,Parisa Aslani,Lesley Barclay,Kirsten Mccaffery

doi:10.1111/hex.12910

Abstract

BackgroundLittle is known about women's decision‐making processes regarding using complementary medicine products (CMPs) during pregnancy or lactation.ObjectivesTo explore the decision‐making processes of women choosing to use CMPs in pregnancy and lactation; and to investigate how women's health literacy influences their decisions.Design, setting and participantsIn‐depth interviews and focus group discussions were held with twenty‐five pregnant and/or breastfeeding women. Data were analysed using thematic analysis.ResultsKey to women's decision making was the desire to establish a CMPs safety and to receive information from a trustworthy source, preferably their most trusted health‐care practitioner. Women wanted positive therapeutic relationships with health‐care practitioners and to be highly involved in the decisions they made for the health of themselves and their children. Two overarching components of the decision‐making process were identified: (a) women's information needs and (b) a preference for CMP use. Women collated and assessed information from other health‐care practitioners, other mothers and published research during their decision‐making processes. They showed a strong preference for CMP use to support their pregnancy and breastfeeding health, and that of their unborn and breastfeeding babies.Discussion and ConclusionsComplex decision‐making processes to use CMPs in pregnancy and lactation were identified. The participants showed high levels of communicative and critical health literacy skills in their decision‐making processes. These skills supported women's complex decision‐making processes.

Highlights

The use of most complementary medicine products (CMPs) is not considered to be part of conventional biomedical practice,[3] some CMPs have been studied in clinical trials and subsequently have been co‐opted or included in biomedical practice.[5,6]
One multinational study found that 28.9% of participants reported use of herbal medicines in pregnancy, with highest rates reported in Russia (69%), Eastern Europe (51.9%) and Australia (43.8%).[7]
Women's health literacy needs were defined as the information needed and desired to make decisions about using CMPs in pregnancy and lactation, and the factors involved in obtaining and understanding this information.[56] antenatal classes, pregnancy and postnatal yoga classes and support groups, in pharmacies and allied health practices, on free local classi‐ fied advertising networks, and through [the Institution's] electronic media channels

Summary

Introduction

Complementary and alternative medicine (CAM) includes multi‐ ple CAM practices (therapies) as well as complementary medicine products (CMPs) like vitamin or mineral supplements or herbal med‐ icines.[1,2,3] The World Health Organization refers to CAM as ‘a broad set of health care practices that are not part of that country's own tra‐ dition or conventional medicine and are not fully integrated into the dominant health‐care system’.4 the use of most CMPs is not considered to be part of conventional biomedical practice,[3] some CMPs have been studied in clinical trials and subsequently have been co‐opted or included in biomedical practice (eg some herbal medicines and some probiotic strains).[5,6] CMPs like herbal medicines and nutritional supplements are commonly used in preg‐ nancy and lactation by women around the world.[7,8,9] The practice of herbal medicine is often based on traditional knowledge and use, as passed down by traditional medicine healers in different cultures.[10]. Objectives: To explore the decision‐making processes of women choosing to use CMPs in pregnancy and lactation; and to investigate how women's health literacy influences their decisions. Women collated and assessed information from other health‐care practitioners, other mothers and published research during their decision‐making processes. They showed a strong preference for CMP use to support their pregnancy and breastfeeding health, and that of their unborn and breastfeeding babies. The participants showed high levels of com‐ municative and critical health literacy skills in their decision‐making processes. These skills supported women's complex decision‐making processes

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