I
Empowering women: homoeopathy in midwifery practice Bridget Cummings This is a brief introduction to the principles of homoeopathy, and to how homoeopathy can be prescribed safely and effectively in pregnancy and birth. Women may choose to self-prescribe for minor ailments or to seek a practitioner's advice whilst remaining in control of their health-care decisions. Case examples are given to illustrate how women can achieve empowerment through homoeopathy and birth by having more choices open to them, using their self-corrective abilities and relieving distress. Midwives learn from mothers, and the increase in interest in homoeopathy amongst midwives is because mothers want to avoid chemical or mechanical intervention in birth. Midwives can see that to realistically support the empowerment of women to give birth naturally, mothers need a non-toxic therapeutic approach to relieve distress.
... homoeopathy can be a positive choice f o r the mother.
Bridget Cummings SRN, RM, MCH, RSHOM, Independentmidwife and registered homoeoparh, HomoeopathicMidwifery Service, 217 Lower Kilmacud Road, Stillorgan, Co. Dublin, Republic of Ireland. Tel: 00 353 I 2187718
INTRODUCTION I became a midwife in 1987 after being inspired by the midwife who attended me for the home birth of my second son. My independent practice began in 1989, the year in which I enrolled on a 4-year parttime homoeopathy course. Since qualifying as a homoeopath, I have successfully combined both professions and now work as an independent midwife in Dublin, Ireland. The cases presented below show women who requested homoeopathic remedies and, although I was in attendance primarily as a midwife, I utilized my skills as a trained homoeopath where necessary. I feel that it is reasonable to expect midwives to be conversant with what homoeopathy is (not necessarily to know how to prescribe, although training is available for midwives who want it) because of a growing disillusionment with the orthodox approach of the use of chemical, surgical and mechanical means to finish what nature started, be it disease or birth. Women are aware of alternatives, such as the use of homoeopathy and other complementary medicines, and their nontoxic aspect and gentle sphere of action is attractive.
C H O I C E FOR B I R T H Choice for birth is about recognizing individual wants and needs and enabling them to be met as far
as possible. To give a personalized, respectful and sympathetic service can increase women's satisfaction and promote good outcomes. Midwifery is about avoiding unnecessary interference with birth, the new baby, breastfeeding and the mother's adjustments to the postnatal period, allowing mothers to stay in control how and where they choose. Alongside the Maternity Services Charter (Department of Health 1994), midwives recognize the commitment to offering more choice, control and information to women. The growing acceptance of the importance of continuity of carer will also empower women to make informed decisions about her own, and her baby's, health.
HOMOEOPATHY Alternative medicine such as homoeopathy can be a positive choice for the mother where she is not solely at the mercy of the medical profession to maintain her own or her baby's health. The mother may decide to self-prescribe a homoeopathic remedy in recognition of its therapeutic action and/or choose to seek a doctor's or homoeopath's opinion. Consulting a homoeopathic physician is an option where the practitioner acts as a catalyst for the mother to adapt herself to healthy changes and gain relief through her body's self-healing abilities. The therapeutic action of the remedy is accurately
ComplementaryTherapiesin Nursing& Midwifery (I 998) 4, 13-16 9 1998Harcourt Brace & Co. Ltd
14 Complementary Therapies in Nursing & Midwifery opinion empowers the mother to feel comfortable in her choice. Midwifery: Being with women, providing expert professional care and advice for childbearing women. Empower: Authorize to do, enable pursuit of health, harmony and physiological
THE AWARE MIDWIFE
potential in pregnancy, birth, parenting and baby development. Homoeopathy: From the Greek words homios('similar') and pathos('suffering'). A pharmacological therapeutic system of medicine, based on the Law of Similars. This law was first described 2500 years ago by Hippocrates, but was made practical by Dr Samuel Hahnemann (1755-1845). tt states that 'like cures like' - the symptoms caused by too much of a substance are those that can be relieved by a homoeopathically prescribed minute dose of that substance. For example, coffee is a stimulant and can cause sleeplessness, but when prescribed in a minute dose for a mother who is over excited and cannot sleep, it can relieve. Hahnemann realized, through testing his medicines on humans, that psychologicaland emotional effects were also part of the picture and went on to view these symptoms as the most important aspect of a case. Where nature showed itself to need support in the form of symptoms expressed by a person, Hahnemann would prepare a homoeopathic medicine and consider the change in symptoms of the person as his best guide to an accurate prescription.
Minor ailments in pregnancy seem to be minor to everybody except the sufferer/
applied on an individual basis and doses are submolecular by nature. Homoeopathy has simple principles to follow and, once a remedy has been matched to the symptoms expressed, on the principle of like curing like, a successful result is likely, The homoeopathic prescription has been likened to a lock and key system where only the correct key will turn the lock. The main principles are: 9 The law of similars - matching the symptom picture of the person to the symptom picture of the materia medica 9 The minimum dose - using microdoses of a medicine to stimulate the body's corrective power 9 One medicine at a time - for clarity of reaction to stimulus and thus clearly observed results. This is a general rule. Minor ailments in pregnancy seem to be minor to everybody except the sufferer! A homoeopathic remedy for haemorrhoids, morning sickness or carpal tunnel syndrome not only gives results but also a sense of doing something for o n e ' s self using natural remedies. The remedy taken by the mother in labour, such as Arnica, given primarily for bruising, bleeding, swelling and overexertion, empowers her because she has chosen a natural therapy to avoid trauma and interference with birth and, in a sense, she is nurturing herself away from undue pain, medicalization of birth and morbid influences like sepsis. The breastfeeding mother is the sole source of her baby' s milk. The baby' s health can be affected in the same way as the mother's, for better or for worse. Supporting the breastfeeding mother encourages breastfeeding as a natural preventative medicine, and encourages independence from overly-keen prescriptions of orthodox drugs should a minor ailment arise in the mother or baby. Recognizing her preference for alternative approaches such as homoeopathy for treating ailments and also giving her ready access to orthodox
The midwife would feel more able to understand a mother's chosen model of health if the principles of homoeopathy were made known to midwives in the workplace. A professional register of homoeopaths to which the midwife could refer w o m e n for specialist opinion would also be useful. Midwives and w o m e n do have self-trust but still rely on scientists or other 'experts' to validate their views. It could be the case that midwives need empowerment themselves in order to help women. Often our ideas of empowerment take us from one teacher or workshop to the next, seeking new scientific information to satisfy our 'professional' standing (Schiff 1995). Rather than rely on other people's knowledge, theories or beliefs, we could look within ourselves as midwives and mothers to find what we need to facilitate birth. The individual, in each case, has questions and answers and our decisions can, of course, be guided by the truly 'wise' expert or researcher. However, midwives have known for generations that there is also a deep intuitive wisdom guiding mothers and midwives during births that need not be ignored just because it cannot be measured. The empirical evidence for the effectiveness of homoeopathy in all areas of health and its safe principles attracts w o m e n to its use. We gain our experience from attending w o m e n so it is no surprise that it is w o m e n using homoeopathic remedies therapeutically, in order to stay in control, that is stimulating the increasing interest in homoeopathy amongst midwives. W o m e n can be empowered when they are listened to, acknowledged and objectively worked with to meet their needs and observe their condition, progress and safe birthing of their child. Mothers can feel how they are doing, can sense any disturbance and know what could be inhibiting the birth. M i d w i v e s are skilled in objective observation. Working as a 'team' with mothers who are self-prescribing or are under the care of a professional homoeopath, midwives can offer their observations to support the use of homoeopathy as a stimulating therapeutic tool. Midwives could offer homoeopathic remedies in an acute or chronic situation provided that they have been appropriately trained and work within the Scope of Professional Practice ( U K C C 1992). The option of home birth and/or waterbirth also empowers w o m e n to choose an environment that may meet their needs and ease the birth. An obstetric model for birth has not been drawn up as the incorporation of a mother's mental, emotional and intuitive feelings are commonly separated from the 'mechanics' of birth. This means
Empowering women: homoeopathy in midwifery practice
Homoeopathy helps women to feel their own strength and does not detract from achievement in giving birth to their own child using that strength.
that women may be transferred from a midwifery model of care which does incorporate an holistic approach to an obstetric policy that is unable to adopt these aspects of birth (Tew 1990). Here, homoeopathy could be used in a preventative capacity before transfer to obstetric care is considered. This is because the homoeopathic principles consider the mental and emotional signs and physical symptoms as the most important aspects of the mother's presenting condition. They are given priority because homoeopathy recognizes that a disturbance setting limitations on the physical level commonly has its roots in the mental and emotional levels. As discussed, a remedy is matched to the expression of disturbance in the mother, whether physical or emotional, and selected from the pharmacopoeia on the basis of 'like cures like'.
P R O M O T I N G N A T U R A L BIRTH
... empowerment is about supporting the mother to find the self-trust, strength and capability to ask f o r and receive the situation she needs to give birth.
Enabling women to have access to the homoeopathic model of health empowers women, not by physical means as the remedy is an energy stimulus only and not a material dose, but by giving choice within the parameters of what we term normal. It also stimulates a reaction within the whole person to progress through this natural physiological process without resorting to chemical or mechanical means. This means that the resources used to correct a disturbance belong to the mother and can be described as her own. Homoeopathy helps women to feel their own strength and does not detract from achievement in giving birth to their own child using that strength. Avoiding the cascade of events leading from obstetric intervention, particularly around the onset of labour, within our maternity units is an important part of this (Inch 1982). Equally, homoeopathy can play its part in the demedicalization of childbirth, whilst encouraging the strengths and abilities needed to be a mother (abilities such as taking responsibility for one's health; adopting a measure of independence; and nurturing the mental, emotional, and physical growth of a child as well as meeting one's own needs). After all, a mother is less able to meet the needs of others if she is struggling to meet her own and especially if she has a lot of healing to do over and above what is natural in birth.
CONCLUSION My belief is that empowerment is not about giving over control or power. It is about supporting the mother to find the self-trust, strength and capability to ask for and receive the situation she needs to give birth in and to nurture her child. I find that a homoeopathic prescription can relieve trauma, aid
15
adaption to stresses and secure the healing process whilst helping to avoid sepsis and consequently reduce the vulnerability of a mother and baby. A successful homoeopathic prescription, because of the natural self-healing aspect, gives confidence to the mother for all future parenting decisions, her nuturing of future babies and her attitude to other parents seeking support with, for example, breastfeeding. Women content with their experience of birth and parenting can help to empower others. Michel Odent described the US way of birth as lacking in instincts due to second generation medicalized births (Odent, oral communication 1987). How can women be empowered to reach into their deepest wisdom ? Midwives know that women are designed to give birth and they also know that the use of orthodox medicine and obstetric intervention (from ultrasound scans to forceps or caesarean births) is apparent. We provide a service and, hopefully, meet the needs of parents so now let us contemplate the realistic requirements necessary for the empowerment of women to give birth naturally. One aspect has to be the acknowledgement and support for the parents who choose homoeopathy as a means to pursue harmony and physiological potential in birth, either through self-administration or from an appropriately-trained practitioner.
Case study I Jenny, breastfeeding her first baby, felt hard lumps in her breast with radiating pains shooting out when nursing. The breast was red in one area and slightly hot. She took her midwife's advice about nursing the baby and gently massaging the area towards the nipple and, reading that breast inflammation is often non-infective (RCM 1991), wanted to use remedies. Her doctor had asked her to call in for a prescription of antibiotics the next morning. Meanwhile, Jenny was feeling very uncomfortable, needed pain relief and was worried about taking antibiotics and the effects of this for her baby at the breast. Jenny decided not to wait until the morning and arranged to collect the homoeopathic prescription of Phytolacca 6c (Clarke 1991) to be repeated as necessary. The report was that within a short space of time the pain had gone and the breast had returned to normal by the morning. Jenny was very impressed and hoped to find out more about homoeopathy so that she could have more choice in health-care decisions.
Case study 2 Marita, having her second baby at home, was experiencing erratic feeble contractions for several hours. She felt miserable, was easily brought to tears, and could not decide what she wanted or where to settle,
16 Complementary Therapies in Nursing & Midwifery
although she knew that she wanted everyone with her in the same room. The midwife was uncertain that labour was in fact ongoing, but discussing examination brought more weeping and indecision. Pulsatilla 6c was given for a couple of doses whereby the mother suddenly went upstairs, made herself comfortable and coped beautifully with strong regular contractions, progressing to a normal birth. A natural delivery of the placenta occurred spontaneously a minute later. Pulsatilla was prescribed mainly on the mental and emotional symptoms seen to be disturbing the normal course of events for this birth. During the 'proving' of this remedy (or 'drug trials') it was observed that symptoms of sadness, weeping easily, needing company, indecisiveness and erratic contractions were characteristic of Pulsatilla (Clarke 1991). This meant that where these symptoms were apparent in a person, a homoeopathic dose of Pulsatilla would rectify the problem, as it did in this case. Birth is a powerful experience. Women can achieve empowerment from the actual birth through acceptance of their idiosyncrasies, whether they have an elective caesarean or use homoeopathy to address subtle inhibitions in a home birth.
Case study 3 Angela, having her first baby, was finding the intensity of the contractions to be extremely painful. Mentally, she became very excitable, irritable and very cross. She could not bear the pain any longer and appeared to need strong analgesia. The pain was cutting and the anguish was unbearable for all the attendants also. Rather than transfer to hospital for pain relief, the mother wanted to stay at home (having previously discussed such a scenario) and to use remedies first. The remedy ChamomiUa 200c (Clarke 1991) was prescribed for its ability to calm mental anguish and sensitivity to pain. The relief was such that the mother coped well and had a
normal birth at home. The remedy needed to be repeated, and Arnica 30c (Clarke 1991) was also prescribed to relieve the effects of overexertion, swelling and bruising. Empowerment using homoeopathy lay in the mother's reaction to stimuli on the emotional level. Angela's anguish was modified, enabling her to accept and allow the inevitable progression of birth without distress. REFERENCES
Clarke J H 1991 Dictionaryof Practical MateriaMedica, 3rd edn. HomeopathicBook Service, Kent DOH 1994The Patient's Charter MaternityServicesLeaflet. Departmentof Health Inch S 1982 BirthRites. Hutchinson,London RCM 1991 SuccessfulBreastfeeding.ChurchillLivingstone, London Schiff M 1995 The Memory of Water - Homeopathyand the battle of ideas in the new science.Thorsons,London Tew M 1990Safer Childbirth?Chapman& Hall, London UKCC 1992The Scope of ProfessionalPractice. London FURTHER READING
Castro M 1992Homoeopathyfor Mothers and Baby. Macmillan,London Moskowitz R 1992HomeopathicMedicinesfor Pregnancy and Childbirth.North AtlanticBooks The Society of Homoeopaths 1995 Homeopathyin Pregnancy and Childbirthleaflet. The Society of Homoeopaths, Northampton Tiran D, Mack S 1995 ComplementaryTherapiesfor Pregnancyand Childbirth.BailliereTindall,London USEFUL ADDRESSES
The Societyof Homeopaths 2 ArtizanRoad, NorthamptonNNI 4HU, UK The RoyalLondonHomoeopathicHospitalNHS Trust, 60 Great OrmondStreet, LondonWC1N 3HR, UK Tel: 0171 837 8833