Plants used during pregnancy, childbirth and postpartum healthcare in Laos
Reported, December 24, 2011
In many Southeast Asian cultures the activities and diet during the postpartum period are culturally dictated and a period of confinement is observed. Plants play an important role in recovery during the postpartum period in diet, traditional medicine, steam bath and mother roasting (where mother and child placed on a bed above a brazier with charcoal embers on which aromatic plants are laid). This research focuses on the use of plants during pregnancy, parturition, postpartum recovery and infant healthcare among three ethnic groups, the Brou, Saek and Kry. It aims to identify culturally important traditions that may facilitate implementation of culturally appropriate healthcare.
A total of 55 different plant species are used in women’s healthcare, of which over 90% are used in postpartum recovery. Consensus Analysis rejects the hypothesis that the three ethnic groups belong to a single culture for postpartum plant use, and multidimensional scaling reveals non-overlapping clusters per ethnic group.
Medicinal plants have a significant role during pregnancy, birth and postpartum care in many rural areas of the world. Plants used in women’s health related conditions such as female fertility, menorrhea, birth control, pregnancy, birth (parturition), postpartum (puerperium) and lactation, including infant care, have been documented for various ethnic groups . In Western traditional medicine the label “old wives’ tales” has been applied to all knowledge of interest to women – fertility, birth, childcare – transmitted orally from one generation of women to the next, and the derogatory label reflects male devaluation and relegation to folklore of this exclusively female realm of knowledge . Research focusing on the use of these plants often focuses on the realm of knowledge of male traditional healers, and scholars have missed the wealth of knowledge that is held by women. It has been suggested that this expertise being exchanged and applied in secrecy as traditional knowledge relating to women’s health, empowers women and undermines male dominance . Pregnancy, parturition and the puerperium each mark a significant step in matrescence , and are not without risk to the mother and infant. According to the latest data, the infant mortality rate (deaths per 1000 live births) and maternal mortality (maternal deaths per 100 000 live births) for Laos is 60.3 and 660 respectively.
Steam bath is common throughout Southeast Asia.Steam baths or baths often involve making a decoction out of medicinal plants. The participant may either take a bath directly as is common for the Yao in Laos, Thailand and Yunnan province, China , sit in a special room into which steam from the decoction is led, or sit in a tent-like construction with , or on a seat-less chair over , a pot containing the steaming decoction. By lifting the lid of the pot the steam is let out, containing essential oils and other volatile substances, for inhalation and absorption through the skin, and as the water cools down the mother uses the decoction to cleanse the body.
Diet is important during pregnancy, confinement and in some cultures also after confinement. Postpartum avoidance of foods classified as cold, such as fresh fruits and vegetables, cold foods, and plain water, is almost universal. Many ethnic groups report the prescription of hot decoctions of ginger (Zingiber officinale Roscoe) or turmeric (Alpinia galanga (L.) Sw.), boiled rice, boiled vegetables and boiled chicken or fish, all combined with salt for drying out the womb.
Plants used in women’s health
Plant use during pregnancy, childbirth and postpartum healthcare among the Saek, Brou and Kry ethnic groups inhabiting the upper Nam Theun, Nam Noi and Nam Pheo is common with 55 species mentioned during 38 interviews. A summary of all respondent data allows for a quick overview of plant species used, part used, treatment and preparation per village and ethnic group. Plants were reported to be used during childbirth, to treat menstruation problems, for infant care and postpartum recovery. The latter could be subdivided into recovery after miscarriage, postpartum haemorrhage (locally defined as unusually profound bleeding), lactagogue and normal postpartum recovery. The reported uses are classified into the following application categories: Steam bath and body wash; External use either applied as poultice or placed on bed or sleeping mat; Oral use, as decoction, infusion or cold extract; Eaten, either boiled or roasted; and used for Mother Roasting.
Plant use is common during postpartum recovery among the Brou, Kry and Saek ethnic groups. Observing a period of confinement for the mother and newborn infant is common during which a variety of treatments are practiced, such as mother roasting, steam baths, cleansing with herbal decoctions, drinking herbal decoctions and infusions and abiding by food proscriptions and prescriptions. These treatments and the plant species used in the treatments aim to relieve postpartum abdominal pain, reduce postpartum haemorrhage, aid in physical recovery, augment lactation, and treat illness in infants. Knowledge of the plant species used, where to collect them, how to harvest them, how to prepare them and how to use them is an important realm of knowledge possessed by women in these communities, but shared with men.
These traditions are common and widespread in Southeast Asia, and form the core of primary maternity healthcare in many rural areas in Laos. Modernization of healthcare in Laos could benefit from incorporating these treatments and their plant use into healthcare modernization programmes through active involvement of traditional rural midwives. It would facilitate the implementation of culturally appropriate healthcare that respects traditional knowledge and contributes to bio-culturally sustainable development.
Increasing the existing documentation of ethnobotany of the ethnic groups inhabiting mainland Southeast Asia: Laos, Northern and Northeastern Thailand, Vietnam, Myanmar, Cambodia and Yunnan Province, China is essential as rapid assimilation with mainstream culture increases. Data collection aimed specifically at plant species used in women’s healthcare remains scarce, and general ethnobotanical studies often overlook the variety and relative importance of plants used in women’s healthcare. Recent ethnobotanical studies in the area report few species used in women’s healthcare . Anderson studied the Lisu, Lahu, Karen, Akha, Mien (Yao) and Hmong extensively in Northern Thailand and identified nearly 700 species of medicinally used plants, of which at least 115 are used in women’s healthcare. Weckerle et al studied the Bai in the Shaxi Valley, Yunnan and list 176 medicinal plant species of which 16 can be classified as used in women’s healthcare. The research by Anderson and Weckerle did not focus specifically on women’s health and illustrates that a meticulous study, regardless of a gender bias, can nonetheless document medicinal plant use in women’s healthcare.
The rich cultural diversity of the ethnic groups in Southeast Asia is emphasized by the divergence in knowledge found in this study of three ethnic groups inhabiting the same geographical area. There is a clear need for ethnobotanical research to document plant use, and in particular to focus on traditionally ignored subjects such as women’s health care. Acknowledging limitations in breath of results in publications focusing solely on the male knowledge realm is another aspiration. Research focusing on the pharmacological mechanisms and the efficacy of these treatments, that are both ancient and widespread, could provide insights that could help to augment and improve both local and Western postpartum care.
Credits:Hugo de Boer and Vichith Lamxay
More information:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2749814/