Use of Complementary and Alternative Medicine (CAM) during pregnancy in Kunming, China

Abstract

Background The use of Complementary and Alternative Medicine (CAM) during pregnancy is common and increasing globally. Previous studies showed CAM is used by women who experienced symptoms during pregnancy. Moreover, most pregnant women used unprofessional information sources of CAM use, with a low disclosure rate. There is limited data in Kunming city, which is an ethnically diverse and developing area in China. We aim to determine the prevalence and factors of CAM use during pregnancy, also to explore the motivations and safety issue during pregnancy in China. Method A cross-sectional survey was conducted on 430 pregnant women visiting antenatal care (ANC) outpatient department in two local public hospitals (the Kunming City Maternal and Child Hospital and the Jinkai District People’s Hospital) during February, 2017. Data on social-demographic, medical characteristics as well as modalities, reasons, information source, disclosure of CAM use and perception of safety and effectiveness of CAM use during pregnancy were collected through self-reporting and face-to-face interview with a pre-structured questionnaire. Descriptive statistics and Chi-square test were performed to determine prevalence and associated factors of CAM use during pregnancy. Results Data of 389 respondents were included for final analysis, among them 68.1% used CAM during current pregnancy. Most CAM users aged 26-30 (49.4%), had over 16 years’ education, and lower income level (< 7,000 Yuan). In the term of medical characteristics, 53.6% of participants were in 3rd trimester of pregnancy, primipara (71.3%), without pregnancy related complication (74.3%), had a pregnancy plan (62.3%), and visited ANC regularly (94.7%). Self-reported less healthy and prior CAM use was significantly related to CAM use during pregnancy. Vitamins (91.3%) and Diet support (85.3%) were the two most commonly used modalities. The use of Chinese Herbal Medicine (CHM), olive oil, and mind-body therapies were found significantly associated with common cold, skin problem, and back pain respectively. Nutritional support and facilitating normal vaginal delivery were the most common reasons for CAM use, and the use of goose’s egg was considered helpful in detoxification of uterus. Majority CAM users got informal information and many of them did not disclose to doctors. Though conventional medicine doctors played a decisive role in the women’s decision making on CAM use, and Traditional Chinese Medicine (TCM) doctors were the main CAM providers. Over 80% of women, living in Kunming city, regarded CAM use as extremely or quite a bit safe and effective during pregnancy. Conclusion The prevalence of CAM use was common among Chinese pregnant women. Those who regard themselves as less healthy and experience more symptoms appeared to use CAM therapies. The idea of “Fetal Toxicity” seems a main motivation of CAM use in China, but there is lack of evidence-based guide for pregnant women. Due to the gap of professional knowledge between obstetrics and TCM department, it is hard to ensure the safety and monitor effectiveness of CAM use. Therefore, government should set up an appropriate integrative medicine healthcare delivery system in general hospitals, through strengthening cooperation between the two departments.