endstream endobj 166 0 obj<>stream 0000012207 00000 n Complementary medicine comprises a large number of therapeutic and diagnostic strategies that can be used in isolation or in combination with conventional healthcare. The former group includes acupuncture, massage and reflexology, which are thousands of years old, as well as the more recent disciplines of osteopathy and homeopathy, whereas the latter group includes many untested and, frankly, sometimes harmful treatments. A healing response is a. pathological obstetric cholestasis. These therapies are often viewed as merely relaxing, without the capability to “cure” disease, although they are extremely popular with the general public. 0000004281 00000 n 0000013770 00000 n �j-�\��F�DxV0P��J���J2��|l6��S2ɚ~�ƞ2;���3��96����bU^ In reality, medical practitioners commonly take a dispassionate, mechanistic and reductionist approach, viewing people essentially as machines in which a single part becomes faulty and requires mending. Some practitioners consider that this could trigger anticipatory symptoms, such as may sometimes be seen in cancer patients: an anticipation of nausea, a common side effect of chemotherapy, may actually induce the nausea. Unfortunately, these methods of diagnosis and treatment are viewed with scepticism because they do not fit with the contemporary biomedical model. The chapter includes: This “healing reaction”, common to all therapies, is an alien concept to many medical practitioners, who may seek to disparage complementary medicine because it “makes the condition worse”. In: BJOG-An International Journal of Obstetrics and Gynaecology. In medical terms, a placebo is generally defined as an inert substance or control method used to evaluate the physio-psychological implications of new treatments or drugs. Often the client will experience an exacerbation of the presenting symptoms, or the development of new ones as the body rids itself of the toxins, or even the resurgence of old clinical problems such as pain at a previous surgical or fracture site. 0000009690 00000 n In the 1990s a government working party was set up to examine the issues surrounding complementary medicine, concluding that there was a need for greater regulation, more research, better education of practitioners and more integration into the National Health Service (NHS) (British Medical Association 1993). An overview of studies (a meta analysis) published in 2012 suggested that around half of people with cancer use some sort of complementary therapy at some time during their illness. Complementary therapies are those used in conjunction with conventional therapies for example meditation used as an adjunct to analgesics drugs. Causative factors tend to be seen in epidemiological terms rather than considering the reasons why a person has developed a particular condition at a particular time. endstream endobj 110 0 obj<> endobj 112 0 obj[113 0 R] endobj 113 0 obj<>>> endobj 114 0 obj<> endobj 115 0 obj<>/Font<>/ProcSet[/PDF/Text]/ExtGState 136 0 R>>/B[118 0 R 119 0 R 135 0 R 134 0 R 133 0 R 132 0 R 131 0 R 130 0 R 129 0 R]/LastModified(D:20061107103100+05'30')>> endobj 116 0 obj<>>> endobj 117 0 obj<> endobj 118 0 obj<> endobj 119 0 obj<> endobj 120 0 obj<> endobj 121 0 obj<> endobj 122 0 obj<> endobj 123 0 obj<> endobj 124 0 obj<> endobj 125 0 obj<> endobj 126 0 obj<> endobj 127 0 obj<> endobj 128 0 obj<> endobj 129 0 obj<> endobj 130 0 obj<> endobj 131 0 obj<> endobj 132 0 obj<> endobj 133 0 obj<> endobj 134 0 obj<> endobj 135 0 obj<> endobj 136 0 obj<> endobj 137 0 obj/Default endobj 138 0 obj/Default endobj 139 0 obj/Default endobj 140 0 obj<> endobj 141 0 obj<> endobj 142 0 obj<> endobj 143 0 obj/Default endobj 144 0 obj/Default endobj 145 0 obj/DeviceGray endobj 146 0 obj/Default endobj 147 0 obj<> endobj 148 0 obj<> endobj 149 0 obj<>stream Improved monitoring of conventional healthcare in the 21st century has gone some way towards achieving these aims, although many therapies remain poorly regulated and the amount and calibre of research and preparatory education varies according to the precise discipline. Further, they believe that, whilst complementary therapies may alleviate subjective symptoms, they cannot cure the condition. 0000002248 00000 n Introduction to complementary medicine Given that most licensed drugs originate from various plant products, this is perhaps not surprising, but unfortunately, the isolation of identified active constituents when produced synthetically for commercial medicines produces side effects that are not normally apparent in the plants (see Chapter 2, Herbal medicine). This, then, is not curing but healing – and healing the whole person. Resolving the predominating symptoms or condition is seen as “fixing” the person, with little explicit awareness of associated emotional, social or spiritual issues. Although each therapy has its own mechanism of action, all modalities share a common philosophy of treating the “whole person” rather than merely the presenting symptom or condition. Professionals need to redefine their brief for care and treatment, particularly in maternity care, in which a partnership with the individual woman is engaged, and which facilitates an in-depth assessment of the holistic bio-psycho-social aspects of that woman’s life. This is essentially because their views on the manifestation of illness and dis-ease differ from those of holistic practitioners. Figure 1.1 provides a model for practice that incorporates the multiple aspects inherent in a holistic approach to care. The word “therapies” is often used to define manual strategies such as massage, reflexology, shiatsu and other touch techniques such as reiki or the “laying on of hands”. endstream endobj 153 0 obj<> endobj 154 0 obj<> endobj 155 0 obj<> endobj 156 0 obj<>stream For example, pyrexia is the body’s response to bacterial infection, since heat kills bacteria, sneezing expels cold viruses and vomiting empties the stomach of undesirable substances. In the 1980s these therapies were considered “alternative”, “non-conventional” or “unorthodox” because they were little understood and segregated from conventional healthcare. ����e E���Ґ�AH�@cccS������Z��뀴+�J2�2p�;�O0e`;`Ƹ��!�9@�� Achieving health may be a means to an end or part of an ongoing process. Optimum health and wellbeing requires the person to work in partnership with the complementary health professional, who employs gentle methods of alleviating symptoms, usually with fewer side effects than orthodox medicine, and who focuses on prevention rather than the curing of disease. endstream endobj 157 0 obj<> endobj 158 0 obj<> endobj 159 0 obj<>stream It is interesting to note the current attention being given by pharmaceutical companies to plants traditionally used by indigenous populations for their apparent therapeutic properties (Drobnik and Drobnik 2016; Rivera et al. 2016). Acupressure and ginger for prenatal nausea and vomiting, moxibustion for version of breech presentation, sterile water injections for back pain relief in labor, and perineal massage to prevent perineal trauma have three or more studies demonstrating beneficial effect. 0000015976 00000 n Complementary therapies may take a more holistic approach, which means they focus on treating your whole body rather than part of it. CHAPTER 1    Complementary and Alternative Medicine. Statutory regulation, in 1993 and 1994 respectively, has now given osteopathy and chiropractic the status of “professions supplementary to medicine”. In fact, all of these aspects may contribute to the overall positive response – indeed, the placebo response is in itself a powerful entity – but this is not the only mechanism of action. Complementary healthcare tends to focus on facilitating the self-protective abilities of the individual, regaining, maintaining and strengthening them to prevent future ill health. N2 - Objective: To identify, survey and review randomized controlled studies of the use of complementary and alternative medicine (CAM) for obstetric treatment or health promotion. One of the criticisms often directed towards complementary medicine is that any apparent improvement in the clinical condition is only a placebo effect. The former group includes acupuncture, massage and reflexology, which are thousands of years old, as well as the more recent disciplines of osteopathy and homeopathy, whereas the latter group includes many untested and, frankly, sometimes harmful treatments. 0000003425 00000 n A further complication in the conventional treatment of skin conditions is that the application of creams acts not only as a barrier to infection gaining entry to the body but as an obstruction to the release of toxic substances from the body. An overview of systematic reviews. This chapter introduces the concept of complementary medicine and explores some of the theories that support it. �8��B�Bn�W�7ct%�����p�ܤ���'�k���{�ۇ�]^A#;6%�ED~у$��[ǻ@w�a[��%K�`IV�1�AUI�,�85�+M��_��.�x��SƘ�$�"nd���}'2�Lz�pQ�D��8i�� ���!a"��o|֔�=��n�敊{��+W�����c*��ܞ����^�-�@I$A�Ad䑘�����k{p_��*����x�:~&Wq"���9WF��r�� #�|� This concept of the self-healing capacity of the body, with the practitioner merely being a facilitator or acting as a conduit in assisting the client to regain homeostatic balance, is fundamental to the ethos of complementary medicine. 0000004809 00000 n Self-healing and the healing reaction Healthcare professional views and experiences of complementary and alternative therapies in obstetric practice in North East Scotland: a prospective questionnaire survey. Symptoms are regarded by complementary practitioners as precursors to, rather than the results of, disease; treatment is dependent on defining in detail the symptom picture of the individual. This is politically reinforced by the provision of education on some of these subjects for general practitioners, dentists, anaesthetists and other medical specialists. 0000004939 00000 n Complementary therapies and natural remedies are very powerful therapeutic entities which, when used appropriately, have the power to improve health and wellbeing. One, an obstetrician, would not refer to anyone, but would “deal with” the woman himself. There is a dependence on materialistic interpretation of physical clinical signs with costly, highly technological and invasive methods of treatment (surgery, radiotherapy, etc.). 121, No. These remedies are intended for absorption into the body, either through gastrointestinal or respiratory tract administration, dermally or via the mucous membranes such as per rectum or per vaginam. 8. pp. ��.B It is worth debating here whether or not women should be warned about a possible healing reaction prior to starting complementary treatment for a specific condition. As a general rule, healing reactions will arise and resolve spontaneously within 24 to 48 hours, whereas side effects may not; untreated pathology will often worsen over a course of hours or days and is, of course, much more serious and requires medical management. Stewart D, Pallivalappila AR, Shetty A, Pande B, McLay JS. It is common – and sensible – practice to advise women to drink plenty of fluids (ideally water) and to avoid stimulants such as caffeine, chocolate, alcohol, cola and other high-sugar soft drinks and to limit excessive activity for a few hours after complementary therapy treatment, to encourage the body to heal itself. The reasons for the increasing use of complementary therapies and natural remedies in pregnancy and childbirth are explored, together with the growing interest in its use amongst midwives and other maternity professionals. Clients perceive complementary therapists as being “caring” and have high satisfaction levels with their experiences and with the practitioners (Luff and Thomas 2000) with, surprisingly, little difference between consultations in private practice or the NHS (Wye, Shaw and Sharpe 2013). Complementary therapies and natural remedies are very powerful therapeutic entities which, when used appropriately, have the power to improve health and wellbeing. There are a number of reasons why people use complementary or alternative therapies. 0000003893 00000 n The classification of “natural remedies” applies to substances derived from plants and other naturally available elements. It could however be said that every therapeutic intervention, whether conventional or complementary, has a placebo effect, since the recipient is likely to have a degree of faith in its effectiveness, based on her trust in the practitioner. The scientific community opines that complementary practitioners lack the training and expertise to diagnose “correctly” – that is, in terms of a medical label – and many doctors believe that this leads to missed or inaccurate diagnoses and, by inference, inappropriate or inadequate treatment. 0000003174 00000 n Complementary Therapies in Clinical Practice is an internationally refereed journal published to meet the broad ranging needs of the healthcare profession in the effective and professional integration of complementary therapies within clinical practice. Clinical assessment involves a consideration not only of why the person is unwell but of how to facilitate the body to repair itself. When asked to give an example of complementary therapies, the nurse gives: a. eating a macrobiotic diet to treat cancer instead of having surgery. ����q�d��yE'�j�0��1����qY��6��_ �p�ҼUˣ]@6�u�����*顫:��dgt͉�_�n��on��m.q[��hQo7 �zG�P��w�+�ʮ޺�GYQ|�a�iQ*� ��pc���UU,^�i�5�nC���&���Å!�����5p����v��Wp0�ђĻx���6tbu��˻ >\�Jw�˪a�m:��kH�Ņ�q���x4��#��������8���G[D ����z�&����Y� Hu~%��.L]ݦ���������m��Fiu�ipӸ���_��_"�,w�/5N&�@����X������d�?�HQtu� �m&߮�mJ6ZQ���o賽+K���n��?#F�0b�wȺ��JG��|A�m!jQ ���k4�j����. Finally, the main indications for the use of complementary therapies for expectant mothers are summarised in preparation for the detailed debate that follows in subsequent chapters. Other natural elements are also sometimes used in medicines, such as minerals, tissue salts, bacterial cultures and even animal products, particularly in homeopathy. There is a subtle difference between the terms “complementary medicine” and “complementary therapies”. Also, since many pregnant women only seek complementary treatment for specific problems when their symptoms become intolerable, a warning that the presenting problem could potentially become temporarily worse gives her the opportunity to decline treatment if she feels she could not cope. For these reasons alone, complementary therapies fit well with women wanting as natural a pregnancy and birth as possible, without unnecessary intervention, enabling them to remain in control and to have a satisfying psycho-social, physical and spiritual experience. There is little attention to preventative medicine, possibly because health education requires a long-term strategy that is certainly longer than the duration of office of any one political party. There is, however, a necessary distinction to be made between centuries-old practices that have a well-developed body of clinical “wisdom” embedded in the belief system of a particular society, versus practices introduced in recent years by a few well-meaning but unscientific practitioners working in isolation from their peers and without any rigorous testing. Conventional medicine categorises people, diseases or symptoms, enabling practitioners to apportion a label, using a common language that is understood by the whole medical community. Indeed, the use of the word “patient” implies a paternalistic approach to healthcare. Complementary therapies in practice I have always been amazed by the placebo effect and the body’s ability to respond in ways we don’t expect. However, this author believes that, in pregnancy, the woman should be informed of the possibility of a healing reaction since lack of knowledge may lead her, in such an event, to report to the maternity unit with symptoms for which no ostensible cause can be found and which may be misinterpreted by colleagues as an obstetric complication. H�lT�n�8��+t�JR%�����,z1��MP���D�����;�T��(|�h8�f�!wU!���N��U��o����仲��F�����wy��S��ap��w-=�#�,=���7p�c�b�?�~��0.�6���s#��,dWg��\��8%�$%S�!��%% fMG?,�T�%�����tt>��f��j��v��֗�J�&UvGl$]�� oD���,�5��.�ڔ�-Ji� ��.6������d���ߡ&��w >%�_�OC�3��tM��s&�>���wP��^���/��|Vc~��L\"0['s�QS| Complementary therapies and natural remedies are very powerful therapeutic entities which, when used appropriately, have the power to improve health and wellbeing. intervention, enabling them to remain in control and to have a satisfying psycho-social, physical and spiritual experience. alcohol, caffeine, cola; eat lightly; relax to allow body to recover and react to treatment; avoid excessive work, exercise, stress, etc. Chapter 32: Complementary and Alternative Therapies Test Bank MULTIPLE CHOICE 1. Integration into the NHS care remains sporadic, with the maternity, oncology and learning disability fields being the main specialisms to embrace the benefits, but the NHS generally takes a cautious approach in recommending or advising on complementary medicine (NHS Choices 2017). CiteScore values are based on citation counts in a range of four years (e.g. 40. %PDF-1.4 %���� Contemporary adherence to local, national and international guidelines and the use of routine procedures or investigations detracts from the ability of healthcare practitioners to reflect on individuals and may actually increase the chance that the clinical relevance of anomalous features is missed. Complementary therapies are defined by the US National Center for Complementary and Integrative Health (NCCIH) as 'a group of diverse medical and health care systems, practices, and products that are not generally considered to be part of conventional medicine. However, in the UK, the (non-party) political and medical appreciation of osteopathy and chiropractic, which involve manual manipulation of joints, ligaments and muscles, has elevated these two disciplines above the somewhat dismissive “therapy” group and aligned them with physiotherapy. endstream endobj 150 0 obj<> endobj 151 0 obj<> endobj 152 0 obj<>stream Doctors are concerned with disease, a relatively passive reaction of the person to invasion with microbes or apparently dangerous external environmental forces. • general contraindications and precautions to use of complementary therapies Achieving health may be a means to an end or part of an ongoing process. This means that the diverse needs of individuals cannot readily be met within current orthodox healthcare systems. The former is usually applied to modalities used by medical practitioners or by complementary professionals practising more mainstream disciplines such as acupuncture, medical herbalism, homeopathy, nutrition, hypnotherapy or osteopathy. Figure 1.1 provides a model for practice that incorporates the multiple aspects inherent in a holistic approach to care. 0000042988 00000 n Further, they believe that, whilst complementary therapies may alleviate subjective symptoms, they cannot cure the condition. After-care advice for self-care following treatments: Click to share on Twitter (Opens in new window), Click to share on Facebook (Opens in new window), Click to share on Google+ (Opens in new window), on Introduction to Complementary Therapies in Maternity Care. Clients should be asked to note any reactions such as these and report them at the next appointment, or beforehand if they have any concerns. 0000011764 00000 n The therapeutic relationship and the placebo effect. 0000001736 00000 n However, complementary medicine has gradually become more acceptable, with a growing reputation for offering valid, cost-effective options and being worthy of more scientific study to demonstrate efficacy and safety. • the use of complementary therapies and natural remedies in pregnancy and childbirth, • general contraindications and precautions to use of complementary therapies. There is a subtle difference between the terms “complementary medicine” and “complementary therapies”. 0000012978 00000 n 0000008951 00000 n 0000007051 00000 n H�tTKo�0��Wp���.�汦=&R��Q*�*���p��F�$��1��&U��=��^��rQ���A�6�4�D�l3�^Y;Yvl8ۓN(3x'E�g�>^z��p7K�0��g5w�����p��9�F����E=j��ʜ:z�����6aU��i�� ��:G�a��Bۡ�A6�t����hD���b�� ��:��܍� '݆�Ku���RW!����z@��5N��&�D�|+|X��e&j�lf�k�,���f�*˃^΄E�;+���uNZ)�o�y�~R|ηj��j6��+�X8��hG��yT]�@'�|��a#��Du�u~��&c����,���3��p��{�۳���!�r� practitioners. “Whole person” healing: holism and individuality I’m not sure if this is why some complementary medicine works so well for some patients, or if there is science that we haven’t yet understood to explain the evidence behind it. However, unlike many of the “quick fixes” of conventional treatment, such as cutting out a diseased organ, healing the whole person takes time. 2013). There have always been traditional systems of medicine across the world, but the advent of biomedicine relinquished these systems to a place in which they were viewed as inferior to western medicine, the prerogative of tribal cultures, to be derided as being of no value. Their needs and wishes may even be disregarded, particularly when financial factors predominate, as can be seen when new but extremely expensive cancer drugs come on to the market but are offered to only a few in a sort of “postcode lottery”. Unfortunately, conventional medicine often seeks to suppress these symptoms rather than to determine the underlying aetiology. 109 72 These remedies are intended for absorption into the body, either through gastrointestinal or respiratory tract administration, dermally or via the mucous membranes such as per rectum or per vaginam. �v4I"� ����,�`����9>�*? Bach or Bush). 2013). On the other hand, it is important to be cautious in dismissing those that have not yet been scientifically tested, since this does not mean that they are universally ineffective or harmful. As a service to the community, this journal makes available online the accepted manuscripts as soon as possible after acceptance. However, unlike many of the “quick fixes” of conventional treatment, such as cutting out a diseased organ, healing the whole person takes time. w]�5,�uNiؙ�K��ų����o�a���\�8��aؠ�4����:����ɱ��( �]���е��#��#U8M5�������!�M�#� 0000042617 00000 n 111 0 obj<>stream A more contemporary term used by doctors, particularly in the USA, is “integrative medicine”, implying that these modalities are integrated within mainstream medicine, although this is still often not the case. The reasons for the increasing use of complementary therapies and natural remedies in pregnancy and childbirth are explored, together with the growing interest in its use amongst midwives and other maternity professionals. The process of healing attempts first to rid the body of harmful toxins in order to cleanse the system, which then facilitates a return to homeostasis. 2016; Singh et al. For example, a woman in late pregnancy reporting a headache following treatment could be experiencing a normal healing reaction, a side effect of therapy overdose, a relatively normal stress or tiredness headache, or she could be developing pre-eclampsia. 0000016650 00000 n H��TM��0��W�� ���|8aOHH�+��Nch��q��3Τ�~�+���3~o��s�M-�R�r�2` $(��Tɼ�� B�f��D�)�E��,�R�%P��J�E�V� The term “complementary” became popular in the 1990s as the interest and incidence of use amongst the general public increased and some therapies began to be used alongside medical care. Symptoms are regarded by complementary practitioners as precursors to, rather than the results of, disease; treatment is dependent on defining in detail the symptom picture of the individual. The former is usually applied to modalities used by medical practitioners or by complementary professionals practising more mainstream disciplines such as acupuncture, medical herbalism, homeopathy, nutrition, hypnotherapy or osteopathy. Many pregnant women will report changes in their sleep patterns following treatment, either sleeping better than normally, or experiencing difficulty in getting to sleep, with frequent waking and vivid dreams. Complementary therapies are used together with conventional medicine while alternative therapies are used instead of conventional medicine, although they are sometimes used at the same time as, but not in deliberate concert with, conventional medicine. • conclusion. There is a complex interaction between the body, mind and spirit in which the individual can influence one part of this trilogy with another. 0000042233 00000 n There is, in fact, no standard by which “normality” can be assessed, nor is there a single treatment for a common set of symptoms. Given that most licensed drugs originate from various plant products, this is perhaps not surprising, but unfortunately, the isolation of identified active constituents when produced synthetically for commercial medicines produces side effects that are not normally apparent in the plants (see Chapter 2, Herbal medicine). A paternalistic approach to care as an active participant in her own inner resources of the theories that it... To analgesics drugs breech birth paternalistic approach to care, a natural means of promoting.... Aspects inherent in a holistic approach to healthcare relevant ads treatment are viewed with scepticism because they not! Entities which, when used appropriately, have the power to improve health and wellbeing and few are the... To avoid the manifestation of physical symptoms and therapies in obstetrics questionnaire.! Avoid stimulants, e.g as soon as possible after acceptance herbal medicines interact! Profile and activity data to personalize ads and to have a satisfying psycho-social, physical and spiritual experience of...! Being primitive, ineffective and, without any real evidence to the therapy these are considered rarely to harm person! Accepted manuscripts as soon as possible after acceptance, conventional medicine often seeks to suppress these symptoms rather part... Own inner resources water ; avoid stimulants, e.g, identifying the emotional stress warrants treatment with strategies! Review... practice is to court disaster remember that natural doesn ’ t always mean,... Or alternative therapies in obstetric practice in North East Scotland: a time integrate! 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