Bayles Bryan P
Center for Integrative Health, Department of Family and Community Medicine, The University of Texas Health Science Center, San Antonio, TX 78229-3900, USA.
J Midwifery Womens Health. 2007 Sep-Oct;52(5):473-8. doi: 10.1016/j.jmwh.2007.03.023.
This cross-sectional survey sought to document complementary and alternative medicine (CAM) use by Texas midwives, as well as to determine whether licensed direct-entry midwives (LMs) and certified nurse-midwives (CNMs) differed significantly in their patterns of use. All respondents (n = 69) indicated that they used, recommended, or referred their clients for at least one CAM therapy during the preceding year. Ninety percent (90%) of respondents used, recommended, or referred their clients for an herbal remedy (not including homeopathic tinctures). Herbal therapies were among the top three modalities recommended for 7 of 12 (58%) clinical indications. Herbs were the most salient CAM therapy used for cervical ripening (83%), followed closely by use for nausea, vomiting, and hyperemesis (80%), and labor induction (77%). Herbal therapies also constituted 50% or more of the CAM therapies used for the following indications: anemia/iron supplementation (70%), perineal healing (66%), and anxiety/stress/fatigue (50%). LM respondents used, recommended, or referred their clients for a greater number of herbal therapies compared to CNMs. While several of the CAM modalities used or recommended by Texas midwives show potential for clinical benefit, few have been studied sufficiently to determine their efficacy or safety during pregnancy.
这项横断面调查旨在记录得克萨斯州助产士使用补充和替代医学(CAM)的情况,并确定持牌直接准入助产士(LM)和认证护士助产士(CNM)在使用模式上是否存在显著差异。所有受访者(n = 69)均表示,在前一年中,他们曾使用、推荐或为其客户推荐过至少一种CAM疗法。90%的受访者使用、推荐或为其客户推荐过草药疗法(不包括顺势疗法酊剂)。在12种临床适应症中的7种(58%)中,草药疗法位列推荐的前三种疗法之中。草药是用于促宫颈成熟最主要的CAM疗法(83%),其次是用于恶心、呕吐和妊娠剧吐(80%),以及引产(77%)。草药疗法在用于以下适应症的CAM疗法中也占50%或更多:贫血/铁补充(70%)、会阴愈合(66%)以及焦虑/压力/疲劳(50%)。与CNM受访者相比,LM受访者使用、推荐或为其客户推荐的草药疗法更多。虽然得克萨斯州助产士使用或推荐的几种CAM疗法显示出临床益处的潜力,但很少有疗法经过充分研究以确定其在孕期的疗效或安全性。