Therapies

Question 1

What is reflexology?

Answer 1

• Reflexology can be a safe, non-invasive, complementary health therapy that can enhance relaxation and well-being. Reflexologists work by stimulating the feet, lower leg, hands, face, or ears to reduce stress.
• The theory of reflexology is that all the systems and organs of the whole body are mirrored or reflected in smaller peripheral areas
• The reflexologist simply work on these reflected areas with their fingers, aiming to bring those areas back to balance and therefore aiding the body to work as well as it can. Reflexology works on an individual basis, the reflexologist provides professional facilitation of your body’s own potential for well-being.

Question 2

what are the benefits to reflexology?

Answer 2

• After 38 weeks of pregnancy, reflexology can be used to stimulate the uterus as well as the production of oxytocin- helping to naturally induce labour
• Reflexology is a relaxing treatment which targets the nervous system, helping the body into a calm and relaxed parasympathetic state- decreasing cortisol levels helping labour to progress
• Reflexology can also help with regulating contractions, reducing pain, anxiety, backache and normalising breathing in labour
• Reflexology may also be used in the antenatal and postnatal period to help relieve symptoms like: fatigue, constipation, heartburn, joint pain
  Studies have shown that reflexology in pregnancy can significantly reduce labour pain and reduce the length of the first stage of labour.

Question 3

what are the risks of reflexology?

Answer 3

Generally, reflexology is very safe. It is a non-invasive, relaxing procedure to have done that has some benefits. The few risks/side effects reflexology can pose are:

• Fatigue
• Cold/flu like symptoms
  Emotional sensitivity

Question 4

who is reflexology not suitable for?

Answer 4

• Have a history of miscarriage
• Have a risk of pre-eclampsia
• Any other pregnancy complications
• Have Deep Vein Thrombosis (DVT) or any other clotting risk

Question 5

what does evidence say about reflexology?

Answer 5

The duration of 2nd stage of labour was found to be 44 mins less with reflexology and they had the lowest rate of interventions within the 3 groups. No adverse effects were experienced by the reflexology group

The intensity of labour pain was found to be significantly lower in the reflexology

Question 6

what is neroli?

Answer 6

• Neroli is an essential oil that can be used in aromatherapy
• Made from the blossom of bitter orange
• Has a rich, floral scent with citrus overtones
• Is often used as base notes in perfumes and scented products
• It has antiviral, antibacterial and wound healing effects

Question 7

what are the benefits to neroli?

Answer 7

• Inhalation aromatherapy using neroli oil may help reduce stress, anxiety and anxiety-induced depression.
• Studies have shown that during the first stage of labour neroli oil may reduce feelings of anxiety and the experience of pain
• Neroli oil has anti-inflammatory properties and may have significant potential benefits as a treatment for inflammatory- associated diseases.
• Neroli oil may help lower blood pressure by reducing cortisol levels.
• Studies also suggest that neroli can help reduce acne breakouts and skin irritation.

Question 8

what are the risks of neroli?

Answer 8

• Neroli oil is a rather strong sedative, therefore it is recommended that you do not use it when you are required to concentrate as it could make you fall asleep.
• Neroli is used in herbal medicine as a stimulant and appetite suppressant.
• Neroli supplements have been linked to several side effects including; fainting, heart rhythm disorders, heart attacks, strokes and in some cases death.
• There have been reports of healthy people ingesting bitter orange by itself or along with caffeine that have experienced these side effects.
  Another side effect of Neroli essential oil includes its photosensitivity. When using the oil it is highly recommended that you do not expose your skin to the sun.

Question 9

what are the benefits to Yoga?

Answer 9

• Improving Strength, balance, and flexibility
• Relaxation
• Boost in energy and mood
• Improved heart health
• Commonly practiced yoga poses include the downward dog, tree pose, cat\cow pose, and the plank. However, yoga uses a combination of poses, meditation, and deep breathing exercises to bring about the benefits mentioned above and mental clarity. It isn’t only ‘physical’!

Question 10

what are the advantages of yoga?

Answer 10

• increased odds of normal vaginal birth and tolerance for pain.
• yoga exercises can possibly facilitate vaginal delivery and help shorten the duration of delivery
• Promotes relaxation and helps manage stress in labour
• Improves overall stamina which is needed for labour!
• Increases strength ability and flexibility- this can help mum breathe through contractions and is also more likely to get into a comfortable position for the woman
• Deep toning of birth muscles including pelvic floor- reduces tears by strengthening the pelvic floor muscles
• Helps woman to birth consciously
• Empowers the woman in labour ! Yoga is also a mindfulness exercise which helps empower the woman This could give her an overall more positive birthing experience

Question 11

what are the risks of yoga?

Answer 11

• There are potential risks to the foetus resulting from maternal exercise including hypoxia, hyperthermia and abnormal HR changes.
• Yoga or any form of exercise also poses the risk of falling.
• Any yoga performed or practiced should be tailored by professionals to suit pregnancy.

Question 12

what does evidence say about yoga in the antenatal period?

Answer 12

• Reduce anxiety
• Reduce depression
  Reduce perceived stress

Question 13

what does evidence say about yoga in the intrapartum period?

Answer 13

• helps to tone the abdominal and pelvic floor muscles therefore helping to facilitate labour and birth and reduces the risk of tears.
• shorter total duration of labour and experience less pain postpartum.
• increases the levels of endorphins and serotonin in the body. Which assists in raising the threshold of pain which the labouring woman can withstand.
• coping mechanisms for labour and birth, leading to better birth experiences.
  Studies have also found that yoga improved birth weight, pregnancy induced hypertension, intrauterine growth restriction (IUGR) and decreased preterm labour.

Question 14

what are the benefits of postpartum yoga?

Answer 14

• Can reduce the risk of postpartum depression
• Supports bonding with baby - mother and baby yoga
• Promote social time to prevent isolation - yoga classes
• Promotes quality “me” time - helps tone, stretch and relax
  Can help heal quicker from nay discomfort

Question 15

what are the antenatal benefits and risks of peppermint oil?

Answer 15

Antenatal – Can effectively manage headaches and nausea in 2nd and 3rd trimester.
Can be applied on skin or inhaled, but peppermint tea also has the same desirable effects.

Antenatal – Shouldn't be used during 1st trimester due to the small risk of the oil causing uterine contractions.

Question 16

what are the intrapartum benefits and risks of peppermint oil?

Answer 16

Intrapartum – Can be used to reduce pain and anxiety during labour.
Also associated with reducing nausea post caesarean section.

Intrapartum – Some of the side effects may include heartburn, nausea, headaches and dizziness, so it could hinder a pregnant person's labour.

Question 17

what are the postpartum benefits and risks of peppermint oil?

Answer 17

Postnatal –Used in the aid of breastfeeding as it can act as a pain relief, and it is also known to encourage the healing of cracked nipples.

Postnatal – Known to have a negative effect on an infant's breathing, so when using it for cracked nipples, the oil should be wiped off before feeds and then reapplied afterward.

Question 18

what is homeopathy?

Answer 18

• Homeopathy is a medical system based on the belief that the body can cure itself. Those who practice it use tiny amounts of natural substances, such as plants and minerals, as they believe these can stimulate the healing process.
• Homeopathy emphasises the importance of treating people as individuals and of understanding the ‘whole’ person as opposed to only the area of discomfort, so it is a more holistic approach to medicine.
• The most prominent basic belief is homeopathy is “like cures like” meaning that an illness with similar symptoms can be treated with symptoms – in small doses – of a healthy person.

Question 19

what are the benefits of homeopathic therapies?

Answer 19

• Herbal remedies are most often used for treating the most common pregnancy-related problems, such as nausea, stretch marks, and varicose veins.
• They have also been advocated to shorten or, where appropriate, increase the duration of the gestational period, augment or induce labour, decrease the duration of the birthing process, relieve perineal pain after birth, alleviate pain associated with cracked nipples and engorged breasts and increase breast milk production.
• It has also been proven to regulate blood pressure which may reduce susceptibility to developing preeclampsia. Black pepper oil can also regulate heart rate as it is high in potassium.
• Homeopathic medicines are non-toxic and harmless and many do not have any adverse side effects

Question 20

what are the risks of homeopathic therapies?

Answer 20

• Some homeopathic remedies may contain substances that aren’t safe or interfere with the action of other medicines
• No evidence that homeopathy is effective as a treatment for any health condition
• Many homeopathic remedies are diluted to such an extent, it is unlikely there’s a single molecule of the original substance in the final remedy
• Success rates very low

Question 21

How is homeopathic therapies made and work?

Answer 21

• Creating homeopathic medicines involves a sequence of ‘potentisation’ and succussion. Which is the repetition of diluting and mixing substances. This is believed to make the remedies competent of stimulating the body’s natural healing forces.
  Homeopathic remedies contains materials such as herbs, minerals, or animal products. Which are crushed and disintegrated into a liquid such as lactose or alcohol then shaken and stored.
• Homeopathy triggers the body’s individual natural healing response. Therefore, the remedies are given on a unique basis. Before choosing the remedy, you need to take into consideration physical, mental and emotional symptoms, in order to select the optimum homeopathic therapy.

Question 22

what are the risks of black pepper?

Answer 22

• Whilst using black pepper oil on skin is completely safe, black pepper oil should be used in moderation
• Overusing black pepper oil can lead to stomach problems such as acidity, indigestion and heartburn
• Taking black pepper oil by mouth specifically can lead to numerous digestive issues as it is often digested incorrectly especially when taken with water
  Black pepper oil is safe to use in pregnancy and breastfeeding when found in foods, however there is not enough evidence to conclude whether taking black pepper as medication is safe when breastfeeding

Question 23

what are the pros of aromatherapy in induction?

Answer 23

• Research shows that a few essential oils can assist with inducing labour and in recent years the use of aromatherapy by pregnant women has started to increase.
• Some women prefer to try aromatherapy products over an Oxytocin drip, Prostaglandin pessary or other invasive options because they want very natural birth experiences.
• Aromatherapy is an alternative and more natural way to assist labour induction. Oils can be dropped onto cotton balls or put into diffusers to be inhaled. Even used in massage.
• Aromatherapy when used for induction is said to reduce levels of pain, muscle tension and even blood pressure for some women, hopefully creating a less medicalised induction experience. This can assist in lowering stress and fear for some.
• Clary sage on its own (or mixed with lavender), for example, is very effective in bringing on contractions and is very safe when used at term.
  Clary sage is so successful in induction that many hospitals stock it, use it and promote it’s use.

Question 24

what are the cons to aromatherapy in inductions?

Answer 24

• The main precaution is doing correct research to find a safe, good quality, suitable oil for the women.
• Aromatherapyoils are highly concentrated so there are risks such as skin irritation and rashes to avoid this women should not ingest these oils as there is not enough research to say if it’s safe for the woman and her baby also not to put the oil directly on their skin as it often needs to be diluted.

Question 25

what are aromatherapy pros in labour?

Answer 25

• Studies suggest it can decrease pain, anxiety and fear during labour
• Can boost contractions resulting in a shorter labour
• It is non-invasive
• Helps calm and relax bodies in the room and soothe thoughts
• Can be massaged with a carrier oil, diffused or dropped into a bath for the effects
  Important to find an oil to suit, but lavender and clary sage both have positive reports for aromatherapy uses during labour

Question 26

what are aromatherapy cons in labour?

Answer 26

• No significant side effects noted in majority of studies however some studies show no effect on labour pain or anxiety.
• These minor side effects include constipation, diarrhoea and headaches. However, it is unknown if these are effects from labour or the therapy.

Question 27

what are the pros to lavendar oil?

Answer 27

can have a soothing effect on the nervous system
- Can help to improve hair and skin health
- Contains antiseptic properties
- Can help ease pain
- Works as a mood booster
Can help to improve sleep

Question 28

what are the cons to lavender oil?

Answer 28

• May cause irritation or an allergic reaction
  Some people may experience headaches, nausea or chills using lavender oil

Question 29

WHAT IS HYPNOBIRTHING?

Answer 29

• Hypnobirthing is a pain relief technique used in labour and birth.
• It reduces fear, pain and anxiety through breathing techniques, self-hypnosis, visualisation and positive suggestions and affirmations.
• Hypnobirthing classes are available in the UK any time after a woman’s had her 20 week scan. Most woman begin hypnobirthing classes between 28-32 weeks to leave them plenty of time to prepare and get into the right mindset for labour and birth, it is best practised 2-3 times each week. Some babies born to a mother who has used hypnobirthing techniques are proven to feed and sleep better.

Question 30

how do hypnobirthing in the antenatal period work?

Answer 30

• Hypnobirthing may work better for a person if it is practised throughout the pregnancy so that when it comes to labour you know exactly what you’re doing and can feel confident in it.
• Used throughout the antenatal period, hypnobirthing can also help to relive feelings of stress or fear around giving birth or having an (EL/EM)LUSCS. It can help to maintain feelings of being in control of your mind and body.
• Hypnobirthing can have other benefits during the antenatal period such as using it as a technique to help bond with your baby in the womb. This can be done by using positive affirmations, breathing and talking to your baby in utero.

Question 31

what is the hypnobirthing environment involve?

Answer 31

• Hypnobirthing is often perceived as only being useful in situations where the atmosphere is ideal. When you think of hypnobirthing, you think of a quiet, warm room with low lighting and minimal people.

Question 32

what are the effectiveness of hypnobirthing?

Answer 32

• Decreased the fear of labouring (Uludaga and Meteb 2021)
• The duration of labour is reduced (Darma 2020)
• Women feel more confident, relaxed, focused, and more in control (Darma 2020)
• Increased the level of satisfaction with labour (Darma 2020)
• Reduced costs incurred during labour – less intervention (Uludaga and Meteb 2021)
• The need for analgesia appears lower (Gavin-Jones 2016)
• The research into the efficacy of hypnobirthing has been less reliable (Gavin-Jones 2016)
• Many studies focus on the reduction of analgesia as a measure of success (Gavin-Jones 2016)
• There is much more to birth satisfaction than analgesia used
• Studies are limited to labouring women

Question 33

what is ginger?

Answer 33

• Commonly used
• Increases responsiveness of the GI tract
• No consensus or official guidelines on what the safe dosage of ginger is while pregnant
• Many forms I.e tea, supplements & fresh ginger.
  No clinical evidence to induce labour

Question 34

peppermint oil…

Answer 34

1. Some evidence that inhaling peppermint oil reduces the severity of nausea and vomiting in comparison to a placebo group; others say it doesn’t.
2. Lifestyle advise also given which could have impacted the effectiveness of the intervention.
3. Placebo group in all studies viewed also showed a reduction in severity of nausea and vomiting, so is the effect purely a placebo one?

Methods of use

1. Diffuser
2. Bath / shower
3. Sniffy pot / cotton wool

Contraindications

1. Avoid with heart condition such as cardiac fibrillation – could cause bradycardia
2. Limited evidence (not scientific) that it causes a reversible reduction in breastmilk
3. May disturb sleep patterns due to its stimulant properties. Opposing view that in tea it has a calming effect.
4. The oil contains ketones which can be neurotoxic in large quantities / used for long periods

Will it induce labour?

1. Unlikely
2. Acts as an antispasmodic and ??calm the uterine muscles
3. Limited evidence to suggest an emmenagogue effect – increased blood flow to the pelvic area, abortion risk, avoid in excessive amounts in early pregnancy (Tisserand and Young 2014)

Question 35

lemon…

Answer 35

• Randomized clinical trial of inhalation of lemon infused oil on 100 pregnant women (Yavari Kia et al 2014)
• Results indicate significant reduction in nausea & vomiting intensity on the 2nd & 4th day
• Lemon scent can be effective in reducing intensity of nausea & vomiting in pregnancy

Question 36

chamomile…

Answer 36

• A digestive anti -inflammatory & relaxant
• Tea, infusion & oral capsules effective in reducing pregnancy -related nausea & vomiting
• Reduces frequency & severity
• A uterine stimulant
• Effective in inducing labour
  Max. limit of 2 teacups daily

Question 37

cardamon…

Answer 37

• Fragrant herb commonly used as a spice in cooking and as a mouth freshener
• Has anti -nausea effects due to its topical effects on the gastrointestinal wall
• Can be taken by making tea, in capsule form or by inhalation therapy such as by using aromatherapy oil
• Ozgoli et al. (2015) demonstrated that intake of capsules containing 500 mg cardamom powder three times a day significantly reduced the severity of nausea and vomiting in pregnancy
  Cardamon should be avoided if there is a history of gall bladder issues or allergies as it can cause allergic reaction such as dermatitis, hives or respiratory issues.

Question 38

raspberry leaf tea…

Answer 38

• Raspberry leaf tea has been reported to relieve nausea (Hess 2013)
• Also includes vitamins A, C and E
• However, it is not recommended until after 37 weeks due to the concern of stimulating uterine tone and inducing pre -term labour (Smeriglio, Tomaino and Trombetta 2014)
• It is considered safe to alleviate nausea in labour

Question 39

benefits of using clary sage?

Answer 39

• aids uterine function, increasing frequency and strength of contractions
• positive impact on birth hormones

Question 40

WHAT IS MOXIBUSTION?

Answer 40

• Used in midwifery as an alternative option in the management of breech presentation
• It is thought to increase fetal movements to encourage the fetus to become active enough to move from a breech to a cephalic position
• Involves the burning of moxa (dried mugwortleaves) close to acupoints located in the little toes of each foot until enough heat is transferred to the skin at these localised points.
  Performed at 33-35 weeks gestation as the fetus is still small enough to turn but large enough to remain in cephalic position if it is successful

Question 41

evidence on moxibustion…

Answer 41

• Results: Compared to the control group, moxibustion significantly increased cephalic presentation at birth. Moxibustion also seemed to elicit better clinical outcomes in the Asian population.
• The effects of acupuncture on correcting breech presentation were inconsistent relative to the control group.

Question 42

when is moxibustion not recommended?

Answer 42

• Placenta previa
• History of ante-partum haemorrhage
• Multiple pregnancy
• Known abnormality of the uterus or pelvis
• History of premature labour or premature ruptured membranes
• Previous c-section within 2 years
• Oligohydramnios
• Rhesus antibodies
  Known hydrocephalic fetus

Question 43

possible affects of moxibustion?

Answer 43

• Smoke inhalation
• Burns / blisters
• Allergy
• Infection
• Nausea and vomiting
  Fetal distress

Question 44

what are the benefits to frankincense?

Answer 44

• Neurological and physiological effects that can be used in partnership with other essential oils such as lavender. ❖ Recognised for creating calming environments that have sedative and qualities.
• Known to release tension, deepen breathing, and ease hyperventilation.
• May also help to relieve and balanced emotions such as depression, nervousness, tension, and fear.
• Studies have highlighted that frankincense oil has benefited women to manage pain while reducing the requirement for pharmacology assistance during labour.
• In pregnancy - alleviate colds, flu, sinus congestion, relaxation & balancing of emotions.
• In labour – analgesia qualities, relieves anxiety/tension and supports women with transition.
  In the postnatal period – depression and baby blues.

Question 45

Contraindications of frankincense?

Answer 45

• All essential oils are toxic in high dosages and incorrect concentrations and there is limited research to their effectiveness (Bertone and Dekker 2021).
• There could be concerns with “inappropriate use of aromatherapy due to a mistaken belief that natural equals safe” (Tiran 2016 p. 132).
• It should not be used around infants or neonates and children under the age of 3 months. This is due to fears around steam insulation of essential oils and immature skin (Tiran 2016).

Question 46

what are the benefits of relaxation techniques?

Answer 46

• Increasing blood flow to major organs
• Reduces anger and frustration
• Boosts confidence to handle problems
• Reducing activity of stress hormones
• Reduces muscles tension and chronic pain
• Lowers blood pressure
• Improves focus and mood
  Slows breathing rate

Question 47

what is the importance of creative imagery?

Answer 47

• Is there somewhere you dream of visiting? Or somewhere that brings back amazing memories?
• A soothing memory or picture can help you stay calm and relaxed.
• By imagining yourself here and using your senses to create this picture, you will focus less on the pain of labour.

Question 48

what are breathing techniques?

Answer 48

• Breathing correctly in labour is an important skill which can effectively help women feel empowered and in control of their labour and offer analgesic properties when using practiced techniques.
• Feeling relaxed and the release happy hormones oxytocin and endorphins which relax your body and mind, preserves energy and helps labour progress we’ll and helps stops production of adrenaline which can slow down or complete stop early labour.
• Deep, controlled and rhythmic breathing in itself will reduce mothers heart rate and blood pressure which will be easier to perform and master when contracting in early labour.
• Panic breathing and hyperventilating can be common and easy to fall into doing as the body is experiencing new types of pain on top of the anxieties already surrounding birth. In addition more controlled breathing allows good blood flow to the womb and stops the pins and needles, chest pain and light headed feelings that hyperventilating can cause.

Question 49

what was music therapy?

Answer 49

• Music therapy reduces anxiety and physical effects of stress
• It improves healing
• It helps to reduce symptoms of psychological disorders including schizophrenia
• Music therapy improves self-expression and communication
• Your heartbeat changes to mimic the music that you listen to
• Listening to happy vs. sad music can affect the way you perceive the world around you
  Music triggers activity in the same part of the brain that releases dopamine

Question 50

what is music therapy in labour?

Answer 50

• Music can reduce pain.
• Music can distract and help pass the time.
• Music can help regulate breathing.
• Music can improve the ability to manage stress.
• Music can influence emotions and provide emotional support.
• Music can help you create an intentional mood to your birth environment.
• Music offers you more control over your birth environment.
• Music can help reinforce your memories of the birth.
  Music can help promote bonding with your baby or birth partner.

Question 51

what is focal point?

Answer 51

• During Labour it can be very beneficial to focus your attention on a focal point
• Using a focal point involves focusing on something other than the pain during a contraction
• This can be something you can see, I.e. a person or an object in the room
• This can be something as simple as a picture on the wall or a piece of furniture but can also be something with more meaning to you like a favourite picture, or a sentimental item like an ultrasound picture
  Using a focal point during Labour can help to keep your breathing regular and also helps you stay as relaxed as possible

Question 52

what are the benefits of ginger?

Answer 52

• Relieves morning sickness and nausea
• Helps with Digestion and bloating
• Helps you fight cough and cold
• Helps with inflammation
• Helps keep your blood sugar levels normal
  Helps with blood circulation and lowers cholesterol

Question 53

what is accupressure?

Answer 53

Acupressure should never be painful. If you feel any pain, tell your therapist at once. Some people may feel sore or have bruises at acupressure points after a session. You may also feel lightheaded for a while.

Acupressure is a specific massage technique that aims to decrease pain, clear tension in muscles, increase blood circulation and promote deep states of relaxation. Acupressure can be effective to relieve headaches, back ache and help to manage conditions such as fibromyalgia.

Question 54

what are the benefits to accupressure?

Answer 54

• Acupressure therapy stimulates the bodies lymphatic, circulatory and hormonal systems. It also improves the function of the immune system.

Acupressure is often used to manage:

• Menstrual cramps
• Nausea and vomiting
• Insomnia
• Muscle pain
• Fatigue

Acupressure is a deeply relaxing massage that has many benefits:

• Improves sleep
• Relieves stress and anxiety
• Relaxes muscles and joints
• Reduces digestive issues
• Improves headaches
  Alleviates chronic pain

Question 55

what is the benefits of accupressure in pregnancy?

Answer 55

• Many believe acupressure eases a variety of pregnancy symptoms such as; heartburn, swelling in legs, carpel tunnel syndrome, back pain, sickness and headaches.
• Acupressure can be powerful during labour and can help your body prepare for giving birth.
• Overall acupressure can ease discomfort and pain in the late stages of pregnancy.

Question 56

what is the risks to acupressure?

Answer 56

some woman report feeling false hope as it had little to no impact on their labour pain.
- Only midwives trained on acupressure should preform it to avoid confusion for the woman and to have the best effect.
- Slight swelling or bruising around pressure points that have been targeted.
Pressure points around the abdomen should be avoided until 40 weeks gestation.

Question 57

what is the benefits of patchouli?

Answer 57

• Using them by being diluted and massaged into the skin can help with pain, this is particularly helpful in muscles and joints
• Patchouli being diffused during acupressure can help with insomnia as well as stress and anxiety. By being massaged into the skin it can help relieve depression and can help with headaches.
• It can also help with reproductive health and libido in both males and females