Use of Medicinal Plants during Pregnancy, Childbirth and Postpartum in Southern Morocco

Epidemiological, clinical, and obstetrical profile of women who used medicinal plants during labor and delivery: a retrospective survey in the Guelmim-Oued Noun region, Morocco

In Morocco, pregnant women commonly use phytotherapy to facilitate childbirth. However, data on the safety and effects of medicinal plants during labor remain scarce and limited from a toxicological point of view. This retrospective descriptive study investigates the epidemiological, clinical and obstetric profiles of women who used medicinal plants during labor and delivery at the regional hospital of Guelmim. Data were collected from the records of women who gave birth between 2015 and 2021. A total of 22 523 files were examined, including 216 cases of women who had used medicinal plants during labor and delivery. Among these women, 57.8% were young primigravidas and primiparous women, the majority (83.79%) having received prenatal care and 78.24% of women having been admitted in the latency phase. In 65% of cases, delivery took place vaginally, with a significant reduction in the duration of labor. Nevertheless, 34.72% of women underwent a caesarean section. Complications were noted in 58.79% of cases: foetal and neonatal distress, post-partum haemorrhage, meconium-stained amniotic fluid, uterine hyperkinesis, premature rupture of membranes, neonatal death and perineal tears. These complications occurred in women who had used medicinal plants such as Lepidium sativum L., Crocus sativus L., Cinnamomum verum J. Presl. and Peganum harmala L, raising about a possible link. Further research is needed to better understand the effects of these plants and their consequences for maternal-foetal health. The frequent association of these plants with adverse effects suggests that they may contribute to the complications observed during labor and delivery. Further research is needed to assess the risks in the obstetric context and establish clear recommendations on its use.

Patient-physician communication on herbal medicine use during pregnancy: a systematic review and meta-analysis

INTRODUCTION

Lack of transparent communication between patients and physicians regarding the use of herbal medicine (HM) presents a major public health challenge, as inappropriate HM use poses health risks. Considering the widespread use of HM and the risk of adverse events, it is crucial for pregnant women to openly discuss their HM use with healthcare providers. Therefore, this systematic review and meta-analysis aims to estimate the pooled prevalence of pregnant women's HM use and disclosure to healthcare providers and to examine the relationship between HM disclosure and various maternal and child health (MCH) measures.

METHODS

A systematic search of five databases was conducted for cross-sectional studies on HM use during pregnancy published from 2000 to 2023. Data extraction followed a standardised approach, and Stata V.16.0 was used for data analysis. Also, Spearman's correlation coefficient was calculated to examine the association between use and disclosure of HM and various MCH indicators.

RESULTS

This review included 111 studies across 51 countries on the use of HM among pregnant women. Our findings showed that 34.4% of women used HM during pregnancy, driven by the perception that HM is presumably safer and more natural than conventional medical therapies. However, only 27.9% of the HM users disclosed their use to healthcare providers because they considered HM as harmless and were not prompted by the healthcare providers to discuss their self-care practices. Furthermore, a significant correlation was observed between HM disclosure and improved MCH outcomes.

CONCLUSION

Inadequate communication between pregnant women and physicians on HM use highlights a deficiency in the quality of care that may be associated with unfavourable maternal outcomes. Thus, physician engagement in effective and unbiased communication about HM during antenatal care, along with evidence-based guidance on HM use, can help mitigate the potential risks associated with inappropriate HM use.

Prevalence, motivation, and associated factors of medicinal herbs consumption in pregnant women from Eastern Mediterranean Regional Office: a systematic review

CONTEXT

Worldwide access to medication remains a major public health problem that forces pregnant women to self-medicate with several sources, such as medicinal plants. This alternative medicine is increasing in many low- and high-income countries for several reasons.

OBJECTIVE

This a systematic literature review on the prevalence of herbal use during pregnancy from the World Health Organization (WHO) Eastern Mediterranean Regional Office.

METHODS

Cross-sectional studies were searched from January 2011 to June 2021 on PubMed, Scopus, and Web of Science. We used the Rayyan website to identify the relevant studies by screening the abstracts and titles. These were followed by reading the full texts to identify the final studies to be included. The data were extracted, and the quality of the studies was assessed using the quality appraisal tool.

RESULTS

Of the 33 studies included in this review, 19 were conducted in Iran, 5 in Saudi Arabia, 4 in Palestine, 2 in Egypt, and 1 each in Oman, Iraq, and Jordan; the prevalence of herbal medicine use among pregnant women varied from 19.2% to 90.2%. Several plants were mentioned for pain management during the pregnancy period. The findings suggest family and friends are major motivating sources for the use of herbal medicine.

CONCLUSIONS

The wide variety of herbal products used in this study reflects the traditions and geographic diversity of the region. Despite the importance of literature-based data about the use of herbal medicine, it is necessary to obtain knowledge, attitude, and motivation for herbal consumption among pregnant women.