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Can mugwort help during childbirth?

BACKGROUND

At one time, mugwort was considered one of the most important herbs in European traditional medicine. Its use in treating menstrual and childbearing difficulties earned it the name Mother of Herbs. Its Latin name, Artemisia vulgaris, comes from the Greek goddess Artemis who presided over childbirth.

In Ireland, the plant was associated with mid-summer festivals honouring St John. It was thrown on the fire as its vapours were thought to help with “nerves” and generally strengthen the sick. In addition, the smoke was believed to ward off evil spirits and bring good luck. The plant was originally burned to repel pests like midges. The name “mugwort” might come from Old English terms meaning “midge plant”.

Mugwort is gaining new interest from its use in traditional Chinese medicine.

Moxibustion involves burning mugwort in small cones placed on or over various acupuncture points. It is used for many ailments, although two have received particular attention. One is to aid during childbirth and the other is to decrease nausea and vomiting in cancer patients undergoing chemotherapy.

EVIDENCE FROM STUDIES

Research has been conducted on the volatile oil found in mugwort. Numerous oils and other constituents have been identified, many of which are biologically active. One called thujone is known to be toxic if taken in large amounts or over extended periods.

However, no research was located examining the effectiveness or adverse effects of taking mugwort orally in herbal remedies or teas.

In contrast, a small number of trials have examined moxibustion and contributed to interest in this use of mugwort. In 1998, a randomised controlled trial reported that when Chinese women presented with babies in a breach position, significantly more babies turned to a head-down position after seven days of moxibustion compared with those who used no intervention.

The report appeared in the respected Journal of the American Medical Associationin its first special issue on complementary medicine which drew significant attention.

Many breech babies turn on their own, so this study needs to be repeated to ensure it was not a chance result. A 2008 Cochrane Collaboration review found little further evidence on moxibustion with breach babies. One challenge here is that it is difficult to understand how moxibustion could cause the foetus to change position.

A systematic review published earlier this year found five studies in relation to using moxibustion to alleviate the adverse effects of chemotherapy.

Overall, the trials showed some effectiveness in reducing nausea and vomiting. However, all trials were of poor quality, leading the reviewers to conclude that the evidence does not allow any clear recommendation to be made.

PROBLEMATIC ASPECTS

Mugwort is one of the main causes of hay fever and allergic asthma in Europe. For this reason, anyone with these conditions should avoid using it. Anyone allergic to members of the daisy family should also be cautious as mugwort belongs to this family.

Although traditionally used during childbirth, mugwort has also been used in attempted abortions. Some evidence suggests that thujone stimulates uterine contradictions, and therefore mugwort should not be taken orally during pregnancy.

Reports also exist that mugwort can cause excessive bleeding in people who are taking “blood thinning” medications.

Anyone taking warfarin should talk to a doctor or pharmacist before taking mugwort.

Most trials of moxibustion have not discussed adverse effects. In those that have, either mild or no adverse effects were noted.

RECOMMENDATIONS

Although mugwort has a long history of use in herbal medicine, little controlled research has been conducted on it.

As mugwort can lead to uterine contradictions, its use during pregnancy should be avoided. Given the lack of support for its numerous uses, and concerns over it allergenicity, there is little reason to recommend its use orally.

Burning mugwort in moxibustion has some preliminary supporting evidence and little evidence of adverse effects.

However, much further research is needed in this area also.


Dónal O’Mathúna has a PhD in pharmacy, researching herbal remedies, and an MA in bioethics, and is a senior lecturer in the School of Nursing, Dublin City University.

He is author of Alternative Medicine: The Christian Handbook, Updated and Expanded Edition, Zondervan, 2007