Traditional cultures often rely on the beneficial effects of herbal remedies during pregnancy and around the time of birth.Most rural Nigerians turn to traditional medicine at some stage in their lives because of its accessibility, availability, low cost and an inherent trust in the method.
During pregnancy and childbirth, traditional medicine uses certain herbs that have the beneficial effect of toning the uterine muscles, inducing labor, removing retained placenta, and managing postpartum bleeding.
Maternal health in Nigeria is poor, which is attributed to inadequate access to reproductive health services, poverty and, in some areas, cultural resistance that affects women, especially in rural areas where access to basic healthcare is low.
A 2023 United Nations report titled “Trends in Maternal Mortality from 2000 to 2020” revealed that about 28.5% of the world’s maternal deaths occur in Nigeria. It also stated that Nigerian women have a 1 in 19 lifetime risk of dying during pregnancy and around the time of birth. In contrast, in the most developed countries, the lifetime risk is 1 in 4,900.
However, the researchers believe that the documentation and standardization of medicinal plants and their correct use will improve the reproductive health of local people in Nigeria. At least as importantly, the scientific validation of these traditional remedies is a crucial step in the discovery of natural medicines for the treatment of childbirth-related complications.
Recently, researchers have attempted to document, analyze and verify the traditional use of herbal preparations frequently used in Sokoto during pregnancy, to promote labour and to manage post-partum complications.
The study, titled “Uterotonic Power of Plants Used to Facilitate Childbirth in Nigerian Ethnomedicine,” was published in the Journal of Ethnopharmacology.
Study participants included specialist herbalists and traditional medicine healers (who also serve as birth attendants), local midwives (local birth attendants), farmers, local traders, teachers and artisans.
Semi-structured and open interviews using questionnaires facilitated the collection and identification of traditional remedies for treating birth-related complications.
The relative traditional importance of each medicinal plant was determined based on frequent mentions of its use. Extracts of these plants were analyzed for their ability to initiate or enhance a model replicating the human uterus in the laboratory.
Analysis of aqueous extracts from nine of these plants induced a significant and sustained ability to initiate or enhance uterine cell contractions, an effect that varied depending on exposure time and dose.
These were Calotropis procera, Commelina africana, Duranta repens, Hyptis suaveolens, African Basil, Saba comorensis, Sclerocarya birrea, Sida corymbosa and bitter leaf, which were documented and characterized.
Calotropis procera is Sodom’s apple or Ewe Bom-bom; Sida corymbosa is broom grass or Aramwembi in Edo; Dayflower is Wandering Jew (English) and Gbagodo Yoruba; Sclerocarya birrea is jelly plum or Roda in Hausa; Duranta repens is golden dewdrop; Hyptis suaveolens is bush mint or Ebehue (Edo); and Saba comorensis is rubber vine or Esiwo Hausa or Orombo Ososo.
The study also documented how to prepare the remedy, including how it was administered and used, which involves soaking powdered Calotropis procera trunk bark in water for several hours and then taking the extract orally, which is used to dilate the birth canal during childbirth.
A mucilaginous aqueous extract of Dayflower leaves is taken orally when labour is delayed, while Duranta repens leaves, when boiled or decoctioned in water for a few days and taken orally, can ease the pain of labour.
Fresh leaves of Hyptis suaveolens are boiled or decoctioned in water for oral administration and are used to reduce the length and pain of labour contractions.
Fresh African basil leaves are steeped in water and taken orally with a pinch of salt to aid in painless childbirth, a soup made from steamed leaves is used as a dietary supplement, and boiled leaves are used for gentle abdominal massage after childbirth.
Saba comorensis root bark extract or root bark powder, boiled in water for a few minutes and taken orally, is also used for a number of maternal conditions, including induction of labour.
Additionally, the bark of the stem of Sclerocarya birrea is powdered, decoctioned with water and given orally to stimulate parturition and milk production, while fresh weed of Sida corymbosa is pounded until slightly slimy, extracted with water, given orally and taken during labour to stimulate parturition.
They can also be used as a nutritional supplement in soup or the extract of fresh bitter leaf leaves washed in clean water and squeezed can be given orally during labour or taken as soup periodically as the birth approaches.
Interestingly, African basil and bitter leaf are regularly consumed as food additives during pregnancy, usually in the form of a soup called bitter leaf soup, to promote labour, strengthen and tone the uterine wall, and prevent complications such as pain, bleeding and miscarriage.
However, one traditional healer advised that the plant, Fern Corymbosa, should only be administered when the patient is already in the delivery room, as it rapidly induces labour and birth.
All informants reported that when using the above mentioned herbal remedies, patients do not experience any complications during and after childbirth and revealed that common rituals such as repetitions, spells, forbidden foods, postures, etc. are not performed during the administration of the plant preparations.
Extracts of Dayflower, Corymbosa Fern and Bitter Leaf produced the greatest increase in contractile force in the uterine model. Most of the extracts maintained their contractile effect for 2.5-3.5 hours, indicating an added benefit in terms of longer acting and sustained uterine contractions. This supports the rationale for the use of these extracts by traditional healers in Nigeria to aid and induce labour.
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