Abstract
The popularity of non-prescription, over-the counter (OTC) medicines, vitamins, minerals, homeopathic remedies and herbal supplements (CAM) has grown significantly in recent years. However, we have limited data on the extent of women's use of OTC medicines and CAM during pregnancy. Equally there is very little knowledge relating to the philosophical base for why pregnant women use OTC medicines and CAM and how this may relate to the cultural provision of maternity care. Lay people do not necessarily accept biomedical definitions of health and illness uncritically; instead they have a complex web of beliefs, constructs and understandings about health and illness. These inform people's health behaviour, including decisions about whether to self-manage, seek help within local or lay networks, or consult a health professional. Using a mixed method questionnaire and interview approach framed from a feminist perspective, this study explored the nature and extent of over-the-counter and complementary medicines use in a sample of pregnant women, the role and influence of others on choice and to what extent a desire to maintain choice and control influenced decision making. This study found that 78% of women reported using one or more over-the-counter medicines in pregnancy and 57% reported use of one or more complementary or alternative medicines. The reasons the women who were interviewed gave for using CAM broadly fell into two areas centred essentially on the contrasting advantages of CAM and disadvantages of conventional medicine. The women saw CAM as outside of biomedicine and part of a holistic approach to health and well-being over which they are able to maintain their personal control. There is a need to invest research time in OTC medicines and CAM and their use in pregnancy and childbirth not simply to provide a bio-medical evidence base but also to understand the sociological drivers for OTC medicines and CAM as a healthcare phenomenon. With a better understanding of the societal underpinning of OTC medicines and CAM use there may be a clearer way toward providing safe advice while acknowledging the autonomy of women in pregnancy and childbirth.