I think that there is a difference in what CNMs say or do or discuss and that was the main thrust of the questionnaires. Many clients ask for information or alternative suggestions from midwives, much more so than asking a doctor so - you do find that CNMs do "discuss" herb use and may even make some recommendations, not always positive recommendations either. And they learn it from other midwives- for instance thru CEU classes- this is how providers do learn for the most part from someone else or their clients, and personal inclination. I have taught classes and attended many classes and some offer very clear info about studies and others do not but almost all on the CNM ceu level are referenced . I think that surveys are limited as to how they define things- I think that there is consumer demand, some education which would include what things are most likely safe or studied, and environments they learn in -so if a preceptor uses more herbs then a CNM will probably learn thru experience that level of practice- but I do not know any CNMs who use herbs over drugs for postpartum hemorrhage unless it is a client preference. On the other hand I do see that CNMs will say to clients facing induction or transfer out of their care if they go past 41 weeks and the clients ask for what else can be done- they have a list- from repeated membrane stripping , prostaglandin ripening... and a whole list that may or may not include giving inference to "historical" or "common" herb use and they do usually say it hasn't been studied and clients choose from the list of things- very often they are not the ones administering the herbs- on the other hand direct entry midwives are probably doing administration and they are more likely to be asked to not use a drug ... so you could bring it up to CNMs perhaps one would have enough interest and find a physician to sign off and find the financial backing- you see the long term studies on delayed cord clamping -chose preterm babies for a reason- not only could they benifit more and it would be dramatic but these babies will get lots of ongoing follow-up anyway and so the studies would not have to completely fund follow-up.
BTW there are some older studies on shepherd's purse- saying it has oxytoxic action
an example of some referenced classes - Dr Low Dog taught a class on herbs and breastfeeding mainly to lactation consultants but there were some other providers there- in any case her presentation included what things had been studied, what kind of studies what things we may come across, and other things like fenugreek is used as food everyday and how much of that is eaten in India pretty much giving us a comparable amount so it is generally regarded as safe up to that amount which is far more than is frequently recommended here for increasing breastmilk.
there is a Saunders publication - A Midwife's Handbook , by Constance Sinclair - it is a pretty decent overview of how I have seen CNMs handle alternative/complementary care recommendations including herbs.
BTW there are some older studies on shepherd's purse- saying it has oxytoxic action
an example of some referenced classes - Dr Low Dog taught a class on herbs and breastfeeding mainly to lactation consultants but there were some other providers there- in any case her presentation included what things had been studied, what kind of studies what things we may come across, and other things like fenugreek is used as food everyday and how much of that is eaten in India pretty much giving us a comparable amount so it is generally regarded as safe up to that amount which is far more than is frequently recommended here for increasing breastmilk.
there is a Saunders publication - A Midwife's Handbook , by Constance Sinclair - it is a pretty decent overview of how I have seen CNMs handle alternative/complementary care recommendations including herbs.
she was archiving our midwifery discussion group for a long time- yes the cord blood info is very disturbing, pregnant women are so inunidated with terrible info it is really hard to even talk about this = lots of the things have to do with mom's lifetime exposures and pregnancy will not really change what will be transferred- quite a while back there was some study and question about increased need for vitamin K in newborns because of maternal PCB lifetime exposures so besides diet changes we also have some things that seem to change how much K we (including newborns) need-- but that is another discussion entirely- there are now some excellent herbal teachers out and many are aware of studies
