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Aromatherapy in midwifery

Along with many other complementary therapies, aromatherapy has experienced a recent surge in interest and popularity. It is often the concepts of self-help and a natural alternative to medication that draws many people to therapies such as this, as they can often be self-prescribed by the individual (Balaskas 1990). The term complementary implies that aromatherapy should be used in harmony with more orthodox medical therapies, however in late pregnancy, many of the common ailments are discomforts which cannot be alleviated by conventional medicine. It is at this point that therapies such as aromatherapy really come in to their own.

This essay will examine the use of aromatherapy during the later stages of pregnancy for minor ailments and discomforts, and as a preparation for childbirth. While some oils will be mentioned, space limitations prevent the listing of effective oils for all uses. These oils may be found from any aromatherapy text. The role of the midwife as an aromatherapy practitioner will be explored, as will aspects of safety pertinent to the use of complementary therapy. Serious complications of pregnancy will not be discussed here, as although some therapies may be useful at this time, medical advise should always be sought before commencing any treatment. Minor complications of early pregnancy will also not be examined as a great deal of contradiction exists within the literature regarding the relative safety of much treatment during these early months (Davis 1995, Burke and Chambers 1996, Balaskas 1990).

Before embarking on any aromatherapy consultation with an existing client, it is the midwifes responsibility to be properly informed and receive adequate training and qualification (UKCC 1992). If the midwife has not received specialist training, the client should be encouraged to seek guidance from a qualified aromatherapy practitioner before starting any form of self treatment. Tiran (1996) believes this training should become integrated into the initial midwifery training program, enabling all midwives to offer this service, thus offering this option to a greater number of clients without private fees.

Although the physiological effectiveness of many oils remains mostly unproven (Tiran 1996, Vickers 1998), the ‘feel-good factor’ provided by the use of aromatherapy remains undisputed by even the most sceptical (Stevenson 1998, Featherstone and Forsyth 1997). The often pleasant aromas have the ability to lift the spirits, and distract the mind, particularly when used in conjunction with other therapies such as massage, shiatsu or reflexology. Aromatherapy cannot however be used alongside homeopathy, as the strength of the oils is thought to cancel out the delicate homeopathic treatment (Davis 1995).

One of the few studies that have been carried out in recent years examines the effectiveness of different types of lavender oil on emotional and behavioural stress levels in cardiac patients. The study indicated a positive link between the application of different lavender oils and the reduction of stress levels in the patient (Buckle 1993 cited by Trevelyan and Booth 1994). This study suggests that some oils may also be found useful for the emotional issues that often arise in late pregnancy. Taking a holistic approach, by reducing stress levels and clearing the mind of anxiety and worry, minor aches and pains that may be related to stress start to dissipate, and the client feels a physical improvement.

Some oils are thought to act directly on the body systems, and can be used to combat problems such as varicose veins, oedema (swelling and fluid retention), cramp and constipation to name but a few (Featherstone and Forsythe 1997, Tiran 1996, Davis 1995). The very nature of aromatherapy often means that these symptoms will get worse before they improve as much aromatherapy is based on drawing impurity out of the body. Aromatherapy cannot be used to alleviate some ‘normal’ side effects of pregnancy such as increased micturition (Tiran 1996) which is in part due to the increased pressure exerted on the bladder by the growing uterus. The oils are more appropriately used to restore balance where an imbalance is present in the body.

While the majority of oils are regarded as safe to use during pregnancy, certain oils such as camphor should be avoided due to their possible toxic effects on the mother and the fetus (Featherstone and Forsythe 1997). Oils known as emmenagogic oils such as rose and roman chamomile should also be avoided as it is thought they have the ability to induce uterine contractions and bleeding in the mother (Tiran 1996). Towards the end of pregnancy, some of these oils may be used with caution to help prepare the uterus for labour, but only under the supervision of a qualified aromatherapist.

Oils are usually applied to the body through massage heavily diluted in a carrier oil such as sweet almond. Very few oils can be used neat, and this is not recommended in pregnancy (Tiran 1996). After advise, massage can be performed by the partner, and is also suitable during labour. The client may also be encouraged to massage dilute oils into her perineum in a squatting position in the weeks leading up to the birth. This is thought to reduce the possibility of severe perineal trauma during delivery. Massage of the breasts with oils such as jasmine is thought to encourage milk production, and could also be commenced in the weeks leading up to the birth (Tiran 1996). Oils may also be used in a bath, burner or compress depending on the desired effect.

The ease of use, and relatively low cost makes aromatherapy extremely accessible to all who wish to try it. Although the effectiveness in many cases is yet to be confirmed, aromatherapy is one of the more pleasurable therapies available, and often appears to have positive results. Caution however should be used with all treatment, and much of the available literature is contradictory and inaccurate. The trained midwife aromatherapist is well placed to inform and advise, and as such this training should be promoted and encouraged, even for those midwives who do not intend to practice as aromatherapists. Safety is of primary importance, and aromatherapy should never completely replace more orthodox medical therapies without seeking medical advice.

The space limitations of this essay prevent a more in depth study of the uses of aromatherapy in pregnancy, and as such many issues raised have not been explored. This is an extremely complex subject with many issues arising from it that has only been touched upon here.

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