Abstract
Midwives have been using raspberry leaf and other herbs in their practice for centuries to assist labour. Raspberry leaf use during pregnancy in Australia is widespread. There has been little research exploring the potential beneficial or harmful effects of raspberry leaf on mothers and babies. More research is needed to appropriately inform childbearing women and maternity healthcare professionals on the effects of raspberry leaf so that women can make informed choices. As conventional augmentation of labour with Syntocinon is known to have adverse effects, there is worthy reason to pursue research into the use of herbal options. This research aimed to build evidence on the action (if any) of raspberry leaf for facilitating labour and birth and to identify the motivations and psychological aspects of the use of the herb by women.This research used a parallel mixed methods design, encapsulating both the qualitative and quantitative aspects of the work and four discrete research projects to contribute to the overarching aim. A systematic review with meta-synthesis was completed to identify what was known about women’s motivation, perception, and experience of complementary and alternative medicine broadly in pregnancy. A systemic integrative review examined the research literature on the biophysical properties of raspberry leaf. An observational study (n=92) was undertaken to measure associations between raspberry leaf and augmentation of labour and determine the motivation and experience of taking the herb. Women having their first baby, with no complications, were recruited from the two public hospitals in Canberra, Australia. Women who took raspberry leaf and women who did not, were included to compare. Data were derived from questionnaires which captured demographic information and herbal use in pregnancy. Clinical outcomes were accessed from the maternity services’ clinical database. Data analysis was conducted in R via package ‘brms’ an implementation for Bayesian regression models. A descriptive approach was used to categorise the psychological aspects of using raspberry leaf obtained from open ended questions in the survey (n=46), identifying the motivations and experience of women surveyed.
Women were using complementary and alternative medicine in their pregnancy to pursue a natural and safe childbirth. Raspberry leaf influences animals’ uteri both in vitro and in vivo. It was more likely than not, that women took some form of herbal medicine in their pregnancy, with raspberry leaf being the most common. Women reported that raspberry leaf supported their sense of self-determination. It appeared to be important to women’s preparation for labour and was considered a ‘necessary’ part of some women’s ‘ritual’ while they were pregnant. A smaller proportion of women in the raspberry leaf cohort had augmentation of labour, epidural anaesthesia, instrumental birth, caesarean section, and postpartum haemorrhage. A larger proportion of women in the raspberry leaf cohort had a vaginal birth and length of all phases of labour were shorter. Under these conditions the use of raspberry leaf was strongly predictive of women not having their labours medically augmented.
Women are using complementary and alternative therapies, including herbal medicine in their pregnancy. It is established that women are taking raspberry leaf through their pregnancy to foster a positive birth experience. There has been inconclusive evidence published on raspberry leaf’s effect on labour and birth. While our study demonstrated that raspberry leaf was strongly predictive of women not having their labours medically augmented, the results should not be generalised to the wider population of pregnant women. While there was no safety concerns observed in our study, this should not be taken as evidence that raspberry leaf is safe. Given the high prevalence of herbal use during pregnancy, a randomised controlled trial is urgently needed to provide women and healthcare providers with robust evidence on which to base practice. It appears that raspberry leaf is very important to some women’s preparation for labour. It may be that self-determination and taking affirmative steps towards birth have an impact on outcomes despite the actual physical properties of the herb which could be further investigated.
| Date of Award | 2025 |
|---|---|
| Original language | English |
| Supervisor | Deborah DAVIS (Supervisor) |