Complementary therapies in pregnancy and childbirth: a guide for student midwives

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BMJ Best Practice is a single source combining the latest research evidence, guidelines and expert opinion — presented in a step-by-step approach and covering prevention, diagnosis, treatment and prognosis. It is regularly updated. There are many pregnancy-related topics covered.

Learning Outcomes

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Complementary Therapies in Maternity Care

Licensed under a Creative Commons Attribution 4. Search this Guide Search. Subjects: Medicine. Home Cookies. BMJ Best Practice BMJ Best Practice is a single source combining the latest research evidence, guidelines and expert opinion — presented in a step-by-step approach and covering prevention, diagnosis, treatment and prognosis. Search the catalogue. It is suggested that practitioners meditate for 20 minutes in the morning and again in the evening.

Complementary Therapies in Maternity Care

TM is easily learned and is practiced by people of every age, It is not a philosophy and does not require specific beliefs or changes in behavior or lifestyle Centering Prayer Though similar to TM in several respects, centering prayer is based in Christianity and is designed to reduce the obstacles to contemplative prayer and union with God.

Thomas Keating , the founder of the centering prayer movement, describes centering prayer as a discipline designed to withdraw our attention from the ordinary flow of thoughts. Keating suggests that, like boats or floating debris, our thoughts and feelings must be resting on something. In centering prayer, as with TM, people are encouraged to find a comfortable position, to close their eyes, and to focus on a sacred word. Keating notes that 20 to 30 minutes is the minimum amount of time necessary for most people to establish interior silence and to get beyond their superficial thoughts.

Relaxation Response The relaxation response incorporates four elements that are common in many of the other relaxation techniques: a quiet environment, a mental device, a passive attitude, and a comfortable position. Some people prefer a church or chapel for meditating, but such a place may not be readily accessible. People should select the place they wish to use for meditation and continue to use that place. This eliminates adjusting to new surroundings and stimuli each time a person meditates.

Walking the Labyrinth A labyrinth is a single-path unicursal structure that has an unambiguous route to the center and back and is not designed to be difficult to navigate. As a spiritual tool or practice, it is thousands of years old. As noted by Curry , the labyrinth has roots that extend into prehistoric times and transcend geographic and cultural boundaries.

Walking the labyrinth, for many, is a spiritual and even transformative process that can lead to self discovery and insight. Breath Awareness Breathing is common to all meditation techniques, but the use of the breath varies across meditation practices. Some meditation practices, such as Zen Buddhist meditation, direct that the practitioner control the breath. Other practices, such as vipassana, or awareness meditation, prescribe passive breathing that is carefully observed.

A simple definition of prayer is the lifting up of the heart and soul to a Supreme Being. Prayer, simply, is having a conversation with a loving God. Many spiritual assessments include information about the beliefs people hold, how The Joint Commission notes the minimal spiritual assessment should obtain information about the faith community or denomination of the patient and what beliefs and spiritual practice, if any, are important to the patient. Joint Commission Findings from the spiritual assessment will guide the nurse in deciding if, when, and how to use prayer as an intervention.

USES The use of storytelling in health care settings, health care research, and teaching is unlimited. This section will share some examples of the use of storytelling. Nurses can use storytelling in multiple situations across the life span for a variety of purposes. Stories can be used in family therapy and can assist members to tap into the flow of meaning of the past, present, and future, and help patients open up possibilities for making meaning and healing Energy and Biofield Therapies Therapies in this category use energy originating in or near the body as well as energy coming from other sources.

The concept of energy and its use is universal. Most cultures have a word to describe energy: qi pronounced chee is a basic element of traditional Chinese medicine TCM ; ki is the Japanese word for it; in India it is prana; the Dakota Indian word is ton; and the Lakota Indians term it REIKI: Reiki is an energy healing method that can be used as an alternative or complementary therapy for a broad range of acute and chronic health problems.

Increasingly, it is gaining acceptance as an adjunct to management of chronic conditions: pain management, hospice and palliative care, and stress reduction.

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The word Reiki is composed of two Japanese words—rei and ki. When Ki energy is unrestricted, there is thought to be less susceptibility to illness or imbalances of mind, body, or spirit Rand, In its combined form, the word Reiki is taken to mean spiritually guided life force energy or universal life force energy. The mind—body component to Reiki healing is evidenced in the underlying belief that the deepest level of healing occurs through the spirit.

The emphasis is on healing, not cure, which is believed to occur by Reiki energy connecting individuals to their own innate spiritual wisdom. Reiki flows through, but is not directed by, the practitioner, leaving the healing component to the individual receiving the treatment. Reiki is not only a healing technique, but a philosophy of living that acknowledges mind—body—spirit unity and human connectedness to all things. USES The range of potential practical applications with patients is broad and depends on the setting. The common theme described in many of these programs is the benefit of Reiki for pain relief, stress and anxiety reduction, and promoting relaxation.

Reiki may have particular application for people suffering from chronic physical and mental health conditions, such as fibromyalgia and depression. A study by Shore provides evidence that Reiki may reduce symptoms of depression that last as long as one year following treatment. This author is currently serving as co investigator in a study testing feasibility, acceptability, and safety of Reiki touch for premature infants Duckett, , a new area of Reiki application.

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The concepts of empowerment and self-treatment have This author teaches Levels I and II to clients with a variety of health problems, including fibromyalgia, mood disorders, cancer, and neurological problems, such as advanced amyotrophic lateral sclerosis ALS. Clients with physical limitations may gain particular benefits from learning Level II, or distance healing. Guidelines for Use Nurses can incorporate acupressure into the care of patients by using some common points that have specific actions to relieve common symptoms.

The Practising Midwife

The nurse can treat the patient with acupressure or teach the patient or family members how to use acupressure as part of a care plan. It is a specific pressure technique that works on precise reflex points of the feet that correspond to other body parts TCM posits that there are a number of invisible energy pathways, or meridians, within the body, that carry an energy called Qi, which is the vital energy behind all processes.

All organs are interconnected with each other by a meridian network system and, to maintain health, energy needs to be flowing in balance. Deficiency refers to the absence or relative insufficiency of one or more aspects of the life energies necessary for sustaining health and well-being. A deficiency or excess of life energy can allow outside factors to overwhelm the individual, thus inducing pathology, and leading to pain and illness. USES Research testing the effects of reflexology is limited and includes studies of many approaches to and practices of reflexology.

Some conditions for which it has been used are listed.

In another study, the duration of the effects of reflexology on pain was tested on patients with various types of cancer. The immediate effects on pain were supported, but the pain-relieving effects were not significant at 3 hours and 24 hours after In a study by Ross and colleagues , the effects of reflexology on anxiety and depression were compared with those of simple foot massage on two groups of cancer patients. These cancer patients received six sessions of intervention, and depression and anxiety were measured at baseline and within 24 hours after each session.

No significant differences were found between the groups with respect to anxiety and depression, but both groups indicated experiencing relaxing effects from the treatment.


Massage, in the form of back rubs, is a basic skill that has been included in nursing curricula since the beginning of modern nursing. However, a number of nurses have pursued education to become massage therapists; the practice of massage therapy is often separate from their practice of nursing, although some nurses who are massage therapists use this modality in nursing homes and in independent practice as advanced practice nurses.

Figure Various strokes are used to produce friction and pressure on cutaneous and subcutaneous tissues. The types of stroke and the amount of pressure chosen depend on the desired outcomes and the body part being massaged. There are a number of types of massage: Swedish a massage using long, flowing strokes ; Esalen a meditative massage using light touch ; deep tissue or neuromuscular an intense kneading of the body ; sports massage a vigorous massage to loosen and ease sore muscles ; Shiatsu a Japanese pressure-point technique to relieve stress ; and reflexology a deep foot massage that relates to parts of the body.

The different types of massage incorporate a variety of strokes, varying levels of pressure, and a multitude of procedures. Massage strokes can be administered to the entire body or to specific areas of the body, such as the back, feet, or hands.