Traditional cultures often rely on the beneficial effects of herbal remedies during pregnancy, birth and after child birth. The knowledge and the correct use of these natural medicines has been acquired and improved over many generations.
It is estimated that 85 per cent of the population in developing countries depend mainly on traditional healthcare systems. Majority of Nigerians in the rural areas, at some stage in their life, turn to traditional healthcare as a result of accessibility, availability, affordability and inherent trust in this method.
During pregnancy and childbirth traditional medicine relies on the use of certain herbs for their beneficial effects to tone the womb muscle, induce labour, in the removal of retained placenta and management of bleeding after child birth.
The state of maternal health in Nigeria is poor and can be attributed to inadequate access to reproductive health services, poverty and in some areas cultural resistance that affects in particular women of rural areas with low access to primary healthcare. For instance, in the year 2000, death due to pregnancy and pregnancy-related causes in Nigeria accounted for nearly half (49%) of all maternal deaths worldwide.
But documentation and standardisation of medical plants and their correct use will improve reproductive health of local populations in Nigeria. At least as importantly, scientific validation of these traditional remedies is a crucial step in the discovery of natural drugs for the treatment of childbirth-related complications.
Currently available therapies to induce or delay labour often have harmful side effects for mother and baby. This contrasts sharply with other. Hence, there is a great need for potent, selective and non-toxic therapeutic agents that regulate contraction of the womb, both as suppressors or as stimulators.
In line with the on-going effort at conserving important medicinal plants in Nigeria, scientists, in a new study documented and analysed 10 mostly used plants in Nigeria to manage and facilitate the childbirth process.
It was conducted in selected locations with very low access to primary healthcare services, including Sokoto; Kubwa and Wuse II in Abuja and Ososo in Edo State. Professional herbalists or traditional medical healers (who also function as birth attendants), local midwives (local birth attendants), farmers or local traders, teachers and artisans were interviewed orally using open, semi-structured questionnaires.
The survey included questions about the usage of plants to aid and to facilitate the birth process, to reduce the time and associated pain of labour, prevent retained placenta and manage postpartum complications.
The plants identified included Calotropis procera (Sodom apple, Giant milk weed Leaves or Bomubomu in Yoruba), Commelina africana (day flower, Gbagodo-Yoruba), Duranta repens (sky flower, yellow garden), Hyptis suaveolens (Bush mint, Ebefue-Edo), Ocimum gratissimum (African basil , efirin-aja in Yoruba and nchuanwu or arigbe in Igbo), Saba comorensis (rubber vine, Eciwo-Hausa or Orombo-Ososo), Sclerocarya birrea (jelly plum, Loda- Hausa), Sida corymbosa (broom weed, Aramwemmvbi-Edo) and Vernonia amygdalina (bitter leaf, Ebeoyara-Edo or Ewuro-Yoruba ).
The 2012 survey published in the Journal of Ethnopharmacology was entitled, “Uterine contractility of plants used to facilitate childbirth in Nigerian ethnomedicine.” It was carried out by Nigerian researchers in collaboration with others from the Medical University of Vienna, Centre for Physiology and Pharmacology, Vienna, Austria. They included Alfred F. Attah; Margaret O’Brien; Johannes Koehbach; Mubo A. Sonibare; Jones O. Moody and Terry J. Smith.
Laboratory assessment of the aqueous extracts from these nine plants, they indicated induced significant and sustained increases in labour, with varying efficiencies, depending upon time and dose of exposure.
Although the extracts of Day flower, Broom weed and Bitter leave yielded the biggest increases in contractility in the womb model, most of the extracts maintained the contractile effect for between 2.5 and 3.5 hours, suggesting an added benefit in terms of being long-acting and having a sustained contraction of the womb.
Based on the survey, over half of the documented plants occurred commonly as weed while others can be found in the wild. The participants in the survey reported that the patients are free of complications during and after delivery when using the above described herbal remedies and they clarified the absence of commonly associated rituals such as repetitions, incantations, forbidden food and postures during the administration of the plant preparations.
Interestingly, African basil and bitter leaf are regularly consumed as food additives during pregnancy, normally in the form of soup that is called bitter leaf soup, to promote easy progression, strengthen or tone the womb muscle and prevent complications, such as pain, bleeding and abortion. However, during labour, these two plants are administered fresh as squeezed leaves or aqueous extracts.
Furthermore, one of the traditional healers advised that the plant Sida corymbosa should only be administered when the patient is already in the delivery room as it quickly induces labour and the birth process.
So are these herbs used in childbirth and in the care of pregnant women? According to the respondents in the study, powder made from the stem bark of Apple of Sodom is macerated in water for a few hours and extract is taken orally. They claim that it helps to dilate the birth canal during labour.
The slimy aqueous extract of the leaves of Day flower or Gbagodo in Yoruba is taken orally during delayed labour when patient is stationary. Leaves of Sky flower or yellow garden plant are boiled and its decocted is taken for a few days to ease pain in childbirth.
The fresh leaves of Bush mint are extracted in heat in water before drinking it to reduce the length of labour and labour pains. It is also said to be used to repel mosquitoes. Freshly collected leaves of Bitter leave are squeezed in water together with a pinch of salt. The pregnant woman drinks this to ensure painless delivery.
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Hyptis suaveolens
Also, the steamed soup of bitter leaves is used as food supplement while its boiled leaves in aqueous medium are used for gentle abdominal massage after delivery.
The root bark of Rubber vine is either extracted with wine or boiled in water and its extract taken to induce labour. But the stem bark of jelly plum after it is made into a powder and boiled in water is given to facilitate birth and milk production.
Saba comorensis
Freshly collected leaves of broom weed are pounded until slightly slimy and extracted with water. This is taken during labour to facilitate delivery. Bitter leave is taken as food supplement in soup or fresh leaves are washed and squeezed in clean water. Its extract is taken orally during labour or taken as soup regularly when delivery is close.
Based on tests carried out on the extracts of these herbs in the laboratory, they wrote, “In summary, all nine plant species elicited a contractile effect on myometrial smooth muscle cells and this validates the rationale for their use by the traditional healers in Nigeria to aid or induce childbirth.”
Previously, scientists had reported that aqueous extract of bitter leave contains a potent chemical substance that can induce labour, similar to those of ergometrine which is conventionally used to induce labour.
Data: 19.10.2012
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