PURPOSE:
This presentation focuses on the need for increased professional awareness of the safety of self-administered herbal remedies in pregnancy and birth, and for the subject to be included in pre-registration midwifery education.

DISCUSSION:
The use of herbal remedies (HRs) in pregnancy may be up to 80% in developed countries, as women seek to combat high intervention rates in childbirth. In developing countries too, traditional remedies are frequently self-administered to avoid or resolve complications, especially when medical facilities are far away. Ill-informed use of pharmacologically-active HRs, can adversely affect conception, embryological / fetal development, labour progress and newborn health. HRs can interact with prescribed medications, causing serious adverse effects. Pre-registration education does not include the subject of HRs despite midwives often being asked about popular HRs including ginger for sickness, raspberry leaf for birth preparation and clary sage oil to initiate labour (communications with midwives). Also, as midwives increasingly introduce pharmacologically-active aromatherapy oils into practice, they must understand precautions, contraindications, side effects and possible complications, to ensure safe practice.

EVIDENCE WHERE RELEVANT:
There is a wealth of significant evidence on the benefits and especially on the potential side-effects of HRs, including non-clinical and clinical trials. Unfortunately, pregnancy-specific evidence is confined to collation of adverse effects of HRs, since clinical trials on pregnant women are unethical.

KEY MESSAGE:
It is paramount that students and midwives understand popular HRs commonly self-administered by pregnant and labouring women. Pre-registratio0n education should include at least an introduction to the subject. Further, national bodies responsible for setting standards for pre-registration education and for practice, must address omissions from training programmes that leave midwives without even a basic understanding of this important subject area. Poster session 3 (Group B)