Wills Gemma, Forster Della
Mercy Hospital for Women, 163 Studley Rd, Heidelberg 3084, Australia.
Midwifery. 2008 Dec;24(4):390-8. doi: 10.1016/j.midw.2007.05.002. Epub 2007 Sep 11.
to determine what advice and support midwives give to women experiencing nausea and/or vomiting in pregnancy, with a particular interest in if and how herbal and alternative therapies are prescribed.
cross-sectional survey.
a public, tertiary maternity hospital in Melbourne, Australia.
forty-nine midwives who provide antenatal care.
the advice most commonly given to women experiencing nausea and/or vomiting was to eat frequent small meals and snacks (91%). Other common advice was given by half the midwives or less: avoidance of fatty/spicy foods (53%); eating before rising in the morning, e.g. consumption of dry biscuits/toast (51%); and keeping hydrated (49%). Most midwives (39/46, 85%) included some form of vitamin or herbal supplement in their advice for nausea and vomiting in pregnancy; however, many were unaware of potential harmful side effects or what would constitute appropriate doses.
advice for nausea and vomiting in pregnancy was generally consistent with that documented in the literature. The findings suggest that it is likely that herbal medicines and alternative treatments are often included in common advice given for nausea and vomiting of pregnancy; however, there is little evidence to guide practice in this area. Similarly, common advice for nausea and vomiting in pregnancy is based more on anecdotal evidence than rigorous scientific evidence, highlighting a need for more research in this area.
it is crucial that midwives support women experiencing nausea and vomiting in pregnancy, and that the issue is not treated as merely something women need to 'cope with' as part of pregnancy. Advice given to pregnant women needs to include what is known about the safety and efficacy of various treatments in pregnancy, so they can make informed choices. There is a need for increased awareness of the issues around the safety and efficacy (or otherwise) of herbal supplements and alternative treatments when prescribed or used during pregnancy, and midwives need to be aware of the evidence for any treatment or supplement they suggest to women. Due to the small size of this study and the lack of other literature on this topic, further research would be of benefit.
确定助产士为孕期出现恶心和/或呕吐的女性提供何种建议与支持，尤其关注是否以及如何开具草药和替代疗法。
横断面调查。
澳大利亚墨尔本的一家公立三级妇产医院。
49名提供产前护理的助产士。
对于孕期出现恶心和/或呕吐的女性，最常给出的建议是少食多餐（91%）。其他常见建议由半数或更少的助产士给出：避免食用油腻/辛辣食物（53%）；晨起前进食，如食用干饼干/吐司（51%）；保持水分充足（49%）。大多数助产士（39/46，85%）在其针对孕期恶心和呕吐的建议中纳入了某种形式的维生素或草药补充剂；然而，许多人并不知晓潜在的有害副作用或何种剂量才算合适。
孕期恶心和呕吐的建议总体上与文献记载一致。研究结果表明，草药和替代疗法很可能经常被纳入孕期恶心和呕吐的常见建议中；然而，几乎没有证据可指导该领域的实践。同样，孕期恶心和呕吐的常见建议更多基于传闻证据而非严格的科学证据，这凸显了该领域需要更多研究。
助产士为孕期出现恶心和呕吐的女性提供支持至关重要，且该问题不应仅被视为女性孕期需“应对”的一部分。给予孕妇的建议应包括各种孕期治疗方法的安全性和有效性信息，以便她们能做出明智选择。当孕期开具或使用草药补充剂和替代疗法时，需要提高对其安全性和有效性（或反之）相关问题的认识，并且助产士需要了解他们向女性建议的任何治疗或补充剂的证据。鉴于本研究规模较小且缺乏关于该主题的其他文献，进一步研究将有所助益。
