This section explains the benefits and risks of complementary therapies commonly used in pregnancy and childbirth. References to research studies and authoritative texts are included.
Complementary therapies and natural remedies can be relaxing during pregnancy and aid progress during labour
It's estimated that around 80% of expectant mums use natural remedies during pregnancy and birth. Aromatherapy oils, herbal remedies such as raspberry leaf tea and homeopathic arnica for bruising are particularly popular. You may have used complementary therapies before becoming pregnant or you might decide to visit a private therapist in pregnancy, perhaps for help with specific discomforts such as backache or sickness, or just simply for some "me time". However, it's important to make sure any natural remedies used at this time are safe for you and your baby, especially if you have any medical or pregnancy complications.
Research suggests that therapies such as massage, aromatherapy and reflexology in pregnancy help you to cope better in labour. Hypnosis relaxation (often called "hypno-birthing") is popular for preparing for the birth. Acupuncture, reflexology or massage in labour can help you progress normally, so it's less likely you'll need drugs to start or speed up contractions, or to have a Caesarean. If you're relaxed in labour, the stress hormone, cortisol, will be low so that the birth hormone, oxytocin, helps your body to work more efficiently.
Many midwives train with Expectancy and some maternity units offer services including labour aromatherapy, hypnosis preparation for birth, moxibustion to turn breech babies, or natural induction for women who are overdue. Expectancy is committed to training midwives and other maternity professionals to use complementary therapies safely. All those who train with Expectancy follow a Professional Code of Practice to ensure the highest quality of care and safe practice.
Acupuncture is a Chinese therapy, increasingly used in pregnancy and labour
Acupuncture is an ancient Chinese technique based on the principle of internal energy channels linking one part of the body to another. When you're completely healthy - in body, mind and spirit - your internal energy, or life force, (called "chi") flows round your body without any interruptions but if you're unwell, the energy can become blocked or too strong or too weak at certain points along the energy lines. Fine disposable needles are inserted into these points by the acupuncturist to re-balance your internal energies, helping to restore and maintain a normal healthy balance. Sometimes, instead of inserting needles, the practitioner will use finger and thumb pressure to stimulate the acupuncture points (acupressure).
It can be useful to consult an acupuncturist if you have difficulty in conceiving. In pregnancy, it is helpful for sickness, back and pelvic pain, heartburn, carpal tunnel syndrome (wrist tingling) and many other aches and pains. Research suggests acupuncture positive affects your body's "feel good" chemicals, so it can also be quite relaxing (despite the needles!) and may make you feel less stressed or tired. During labour, acupuncture is very effective for pain relief, as well as stimulating contractions when they have slowed down.
Expectancy offers an acupuncture course for midwives and some midwives now provide acupuncture on the NHS whilst others work in private practice. See our "Find a practitioner" section to see if there is an Expectancy-trained acupuncture-midwife near you. Other acupuncturists who provide treatment in pregnancy and labour should be registered with the British Acupuncture Council and be in possession of insurance to work with pregnant mums.
Are complementary therapies safe in pregnancy and childbirth?
Many mums-to-be ask if it is safe to have complementary therapies or take natural remedies during pregnancy. There are many therapies which can be very relaxing and help to ease the discomforts of pregnancy. However, it is essential to find a practitioner who is appropriately trained, insured and experienced in treating pregnant and birthing mums (see Finding a complementary therapist for pregnancy treatments).
The NHS Choices website states that you should be cautious about using any complementary therapies and natural remedies in pregnancy - and I would agree wholeheartedly. However, both the NHS and the National Institute for Health and Care Excellence (NICE) take this approach because they feel there is not enough research evidence to support the use of complementary therapies in pregnancy and birth.
Whilst it is true that we always need more research to demonstrate that healthcare is both effective and safe, it is not true that there is a lack of research. It may not be quite to the standard which doctors feel is required to show unequivocally that complementary therapies are safe, but there is published research on many aspects of complementary medicine.
In addition, although the NHS and NICE support the use of some aspects of complementary therapies in pregnancy, some of their information is incorrect. For example, they state that there is evidence to show that ginger can help morning sickness - which is correct. What they do not tell you is that there is also plenty of evidence to indicate that ginger is not appropriate or safe for all mums-to-be with morning sickness. Just because something has been shown to work, it does not always mean it is safe.
Natural remedies in particular should be used with extreme caution in pregnancy, birth and while breast feeding. This includes aromatherapy oils, herbal remedies such as ginger and raspberry leaf tea. All aromatherapy oils and herbal medicines which you take by mouth act in exactly the same way as drugs. Do not assume that they are always safe! if something has the power to do good, it can also potentially be harmful when not used correctly.
My advice is to be very cautious about injudicious use of natural remedies and complementary therapies when you are planning a pregnancy, are pregnant, in labour or breast feeding. NO natural remedies should be taken routinely. Take advice from qualified professionals before using any oils, herbs or homeopathic remedies. If you're wanting to consult a complementary therapy practitioner, check their qualifications, insurance and experience.
If you have any doubts or questions - get in touch with me. I'm always happy to help.
Aromatherapy involves the use of concentrated plant oils containing chemicals which have both physical and emotional effects.
In aromatherapy, highly concentrated plant oils are blended into an aromatic blend for massage, or for use in the bath, as a compress or in creams or lotions. The oils contain hundreds of chemicals which give them a range of therapeutic properties and which can have both physical and emotional effects.
Massage is the most popular aromatherapy treatment. The oils are absorbed from the skin and pass into your bloodstream. When you smell the aromas the chemicals also pass into your lungs and from there into your bloodstream. In addition, breathing in the aromas sends chemicals via your smell system to the mood system in your brain, affecting how you feel emotionally. Once inside your body the chemicals work in exactly the same way as drugs. All plant essential oils also cross the placenta to your baby so it is vital to use only small amounts of those oils known to be safe in pregnancy or birth. There are many oils which should not be used at all if you're trying to conceive, or are pregnant. Some oils should not be used until you are in labour.
It's wise to avoid using aromatherapy oils in early pregnancy unless you consult a qualified aromatherapist who's trained and insured to use the oils at this time. Your midwife may also be able to advise you about safety. However, regular aromatherapy treatments towards the end of pregnancy can have a positive effect on your labour - because you'r less stressed, you feel less pain and your body works more efficiently so your labour progresses normally.
Expectancy's Educational Director, Denise Tiran, author of Aromatherapy in Midwifery Practice, has trained over 2000 midwives to provide aromatherapy during labour, both in the Uk and overseas. Aromatherapists or doulas who provide treatments for expectant mums must complete specialist maternity aromatherapy training and have appropriate insurance cover.
For our information leaflet for mums-to-be, see our Shop
Bach flower remedies are thought to balance emotional and psychological wellbeing and can safely be used by most expectant mums
Bach flower remedies are liquid plant remedies which are thought to balance your emotions. Dr Edward Bach was a physician in the early 20th century who realised that our emotions can have an impact on our physical health. He researched various plants and found that, when developed in a specific way, they appeared to work energetically, in a way similar to homeopathy (rather than chemically, as drugs do). We still don't fully understand how Bach remedies work but they are generally thought to be safe to use in pregnancy. However, as they are preserved in brandy, they should be avoided by anyone with an alcohol-related problem or liver disorder.
Rescue remedy, a combination of five of the 38 remedies, is the most popular remedy, and is particularly good as an anti-stress remedy. You might find it helpful if you are anxious about having blood taken during your pregnancy. In labour, as you approach the second stage you may feel very stressed and Rescue remedy can help you through the last part until it is time to ive birth to your baby. It is available as a liquid, spray, cream or lozenges. Other remedies help with other emotions and can be helpful in pregnancy, labour and after the birth of your baby. For example, olive or hornbeam can help if you feel especially tired; mimulus may ease fear of labour; crab apple may relieve feelings of "uncleanliness" if you have stitches; and walnut may assist you in adapting to your changing role in life. However, if you are undergoing any form of counselling or if you have any mental health problems, it is wise not to take Bach remedies unless you can consult a qualified practitioner who can help you to select the most appropriate remedies.
If you'd like to have complementary therapies during your pregnancy or the birth of your baby, it's important to find the right therapist for you
If you want to have complementary therapy treatment during pregnancy it's important to find a therapist who is well-trained, qualified and insured to work with pregnant mums, and registered with one of the therapy regulating organisations. Osteopathy and chiropractic are regulated by law but there is no legal requirement for other therapists to be registered - technically anyone can call themselves a "therapist" without any training. The Federation of Holistic Therapists, Federation of Antenatal Educators, Association of Reflexologists and International Federation of Aromatherapists will provide lists of suitably-trained practitioners. Acupuncturists are normally registered with the British Acupuncture Council, herbalists with the National Institute of Medical Herbalists and homeopaths with either the British Homeopathic Association or the Society of Homeopaths.
Don't rely on the Internet, local paper or Yellow Pages to find the best therapists, and don't just walk into the nearest beauty salon for help with specific pregnancy problems. Word of mouth is by far the best way to find local practitioners, or you could ask your midwife, doctor or health visitor. Ask about the therapist's qualifications, training and experience in maternity work. Don't be afraid to ask to see their certificates, and if you're not sure, walk away and find someone else. The therapist should check your medical history and how your pregnancy is progressing, ask for your consent to treat you and keep notes on the treatments provided. All therapists working with pregnant mums and newborn babies should have indemnity insurance cover specific to maternity work and have clearance from the Disclosure and Barring Service (DBS, formerly CRB).
Herbal (plant) medicines contain chemicals which work in exactly the same way as drugs and should be used with extreme caution before and during pregnancy
Plants have been used as medicines for centuries, to maintain health and to treat specific illnesses and in many cultures, traditional remedies continue to be a major part of healthcare. During pregnancy, many women want to avoid drugs and medicines. However, herbal remedies work exactly the same way as drugs, and can lead to serious complications when taken inappropriately. Just because they're “natural” doesn't mean they're always safe, and many herbal remedies should not be taken at all when trying to conceive or in pregnancy, except on the advice of a qualified practitioner.
Guide to using herbal remedies during pregnancy and birth
For our downloadable information leaflet about Raspberry Leaf Tea, see our Shop
For our downloadable information leaflet about Raspberry Leaf Tea, see our Shop
Homeopathy is a gentle system of energy-based medicine which treats the whole person
Homeopathy treats the whole person and is based on the principle of “treating like with like”. It doesn't work chemically like drugs, but is a form of physical energy or “vibrational” medicine. It's very gentle, but very powerful. Even though the amount of active substance in the remedies is minute, the remedies must be used correctly and carefully. Homeopathy can be helpful in pregnancy but it's best to consult a qualified homeopath or midwife trained in homeopathy so that the remedies are prescribed for your specific symptoms. Arnica is one of the most popular remedies used by mums. It's thought to relieve bruising and shock after the birth, especially if you've had stitches. You can buy arnica in health food stores - it's best to use the 30C dose. Take just one arnica tablet three times a day for the first three days after the birth and then stop. If you take too many tablets, too often or for too long you may actually develop the symptoms you are trying to treat - in this case your bruising may get considerably worse rather than better.
How to take homeopathic remedies
Things to avoid when using homeopathic remedies
Certain substances can stop the remedies from working properly, including some strong drugs and aromatic substances. Here is a list of common substances o avoid when you're taking a course of homeopathic remedies.
Hypnosis ("hypno-birthing") can help to prepare you for the birth
Hypnosis for childbirth, often referred to as “hypno-birthing”, is a form of deep physical and mental relaxation with altered consciousness, similar to the state of day dreaming. This enables your subconscious mind to adjust habits, fears or aspects of behaviour. Verbal “triggers” are used during the hypnosis session which can help you to overcome anxiety about the birth, cope with labour pain or stop smoking. Practising hypnosis relaxation during pregnancy may result in a shorter, easier labour. It may also help if you suffer sickness during your pregnancy, and may be useful if your baby is in the breech position in late pregnancy - the hypnosis appears to help both you and your baby to relax, enabling the baby to turn to head-first in readiness for the birth.
There are many different types of "hypno-birthing" or hypnosis preparation for birth, and it is important to choose the style that best suits you. Some styles encourage you to respond to a pre-determined set of suggestions, but this is not always helpful, especially if you develop any problems during labour or the birth of your baby. It is wise to try to find a hynposis practitioner who can tailor your hypnosis suggestions to your specific needs.
Massage can be wonderfully relaxing during your pregnancy, as well as during the birth of your baby
Massage involves the use of therapeutic touch to relax you - both emotionally and physically. Massage relaxes stiff muscles, - it can help backache in pregnancy - can ease swollen ankles, lowers your blood pressure and helps to get rid of toxins and waste products from your body. Rsearch shows that massage can help to ease pain in labour. We know that touch impulses reach your brain quicker than pain impulses, so massage helps by releasing "feel good" chemicals, which act as natural pain killers, also reducing stress hormones.
It would be wonderful to have regular massages during your pregnancy, especially towards the end when you are feeling more tired, heavy and uncomfortable. Do make sure that your therapist is trained and insured to work with mums-to-be. It can also be relaxing during the long first stage of your labour. Many midwives use massage - particularly around your lower back - to help you through labour.
Moxibustion is a traditional Chinese technique to turn a breech presentation to cephalic
Moxibustion is a traditional Chinese technique which has become increasingly popular in the UK and other countries to turn a breech baby to head first. Two specific acupuncture points on the toes are stimulated with heated herb (moxa) sticks near the skin. These points link via energy lines to the uterus, causing slight relaxation in the muscles and encouraging your baby to move around.
The procedure is usually done from about 34 or 35 weeks of pregnancy twice a day, for 15 minutes on both feet, for between 10 and 14 treatments. Research shows that it is about 66% successful - which compares very favourably with external cephalic version (ECV) which the doctor may advise. You can visit an acupuncturist to do this procedure for you, or your midwife may be able to teach you how to use the moxa sticks at home. However, it is vital that you find out if it is safe for you to do this procedure. If you have any medical or pregnancy problems or if the doctor has told you that ECV in the hospital is not advisable, you should not attempt moxibustion yourself or ask any other practitioner to do it. In particular, if you have had a Caesarean in a previous pregnancy or if you have high blood pressure, moxibustion may cause problems, either for you or your baby. For more detailed information download Expectancy's free leaflet.
Expectancy trains midwives to use moxibustion as it is generally safer than the ECV offered by the doctor. A few maternity units now offer a moxibustion service for mums whose babies are breech (bottom-first).
For our downloadable information leaflet about Moxibustion to turn a breech baby, see our Shop
Osteopathy and chiropractic focus on the relationship between bones, muscles, joints & ligaments
Osteopathy and chiropractic are similar therapies which work on the principle that your skeleton, and the joints, muscles and ligaments attached to it, comprise the body’s main supporting framework, rather like a scaffolding system. Injury, trauma or disease affects the structure and position of the "scaffolding", putting stresses and strains on the whole body. Treatment involves manipulation of joints, ligaments and bones to restore balance between nerves, muscles and the skeleton. The techniques used differ between osteopathy and chiropractic but generally involve manual manipulation of the body, sometimes combined with massage.
However, these therapies are not generally used merely for relaxation. Both therapies can be effective in treating pregnancy symptoms such as backache, sciatica, pelvic pain, neck pain and headaches and carpal tunnel syndrome (wrist tingling). Other symptoms, not directly related to your skeleton, such as sickness, heartburn and constipation also respond well to osteopathy and chiropractic. In addition, if your baby is breech osteopathy or chiropractice may help to turn your baby, and is especially effective if you also have a history of back or neck problems.
These therapies are regulated by UK law and are now considered “professions supplementary to medicine” rather than "alternative therapies". Osteopaths are registered with the General Osteopathic Council and Chiropractors with the General Chiropractic Council.
Reflexology works on numerous pressure points on the feet, thought to represent a map of the whole body
Reflexology is based on the principle that your feet (and sometimes your hands) represent a map in miniature of your whole body, with pressure points linking to other parts of your body. Working on these pressure points relays messages through your body to rebalance and maintain health and wellbeing. However, reflexology is not simply a foot massage, although regular reflexology in pregnancy can be very relaxing and has been shown to lower stress hormones.
There are many different styles of reflexology, including those based on Chinese acupuncture, general reflexology, sometimes called the Ingham method, used by most reflexologists in the UK and reflex zone therapy (RZT), a clinical system based on the anatomical relationships of the body and used by many midwives in Germany, Austria and Switzerland. Expectancy's Educational Director, Denise Tiran, author of Reflexology in Pregnancy and Childbirth, has trained many midwives to use RZT. This style of reflexology is more focused on treating specific problems rather than just giving you a relaxing foot treatment. RZT is effective for treating pregnancy and postnatal discomforts, stimulating contractions, easing labour pain and dealing with retained placenta.
Just a word here about the use of reflexology to help you get into labour. Many mums-to-be get fed up at the end of pregnancy, waiting for the baby to arrive, but it is important to remember that childbirth is a normal physiological event and that any intervention, even natural techniques like reflexology, may be inappropriate. Applying pressure to certain points on your feet can, indeed, trigger labour contractions and can mean you avoid having to have labour induced in hospital if you go overdue. However, please make sure that the therapist you see is trained and insured to use reflexology specifically for this purpose. There are many maternity reflexologists who are extremely experienced in this technique, which involves applying pressure to the reflex point on the feet for the pituitary gland which is the part of the brain which produces the hormones that stimuate the uterus to contract. On no account should your reflexologist massage or apply pressure to the point on the feet which represents the uterus.
Reiki is a complementary therapy that aims to restore and maintain an individual's universal life energy
Reiki is a Japanese complementary therapy, which originated in the mid-1800s. It is based on the principle that the body has an energy field which travels throughout the body via pathways called meridians, similar to traditional Chinese medicine and shiatsu. When you are in optimum health, phsyically, emotionally and spiritually, the energy flows around your body without interruptions, but at certain times in your life, some energy lines or specific points can become blocked, weakening the energy. Treatments aim to restore and maintain your universal life energy by unblocking and stimulating the energy. It encompass hands-on massage, non-touch techniques and visualisation. Reiki is thought to reduce stress, stimulate the immune system and relieve pain and discomfort. It is a gentle and safe technique, and has been used successfully by nurses, doctors, physiotherapists and midwives, particularly in the USA where it is known as Therapeutic Touch.
Shiatsu is a modern Japanese therapy similar to ancient Chinese acupressure
Shiatsu is a modern Japanese therapy similar to ancient Chinese acupressure, but it was only developed in the 1950s. The term "shiatsu" comes from a Japanese word meaning "finger pressure" and it incorporates simple thumb, finger and elbow pressure applied over various points on the body, combined with holding techniques and gentle stretching exercises. This pressure is applied along the meridians (energy lines which connect one part of the body to the others) and aims to restore and maintain health and wellbeing by balancing your internal life force or Ki, pronounced "chee".
Shiatsu can be very relaxing in pregnancy, aiding sleep and easing stress, constipation, oedema, sickness and heartburn. During labour, shiatsu can help to relieve contraction pain, stimulate contractions if necessary and deal with retained placenta. After the birth of your baby, shiatsu can help with milk production, help with postnatal depression and treat problems such as constipation and fatigue.