Complementary medicine products: Information sources, perceived benefits and maternal health literacy.

BACKGROUND: Maternal health literacy plays an important role in women's decisions regarding health care during pregnancy and lactation. This systematic review aimed to investigate the use of complementary medicine products by pregnant and breastfeeding women; information sources accessed, and the role health literacy plays in women's use of complementary medicine products.

METHODS: Seven databases were searched for peer-reviewed quantitative or mixed- methods studies (1995-2017). Thematic analysis identified key themes regarding women's use of complementary medicine products for perceived benefits to the mother, pregnancy, baby and/or breastfeeding process.

RESULTS: 4574 papers were identified; 56 met the inclusion criteria. Most (n=53) focused on the use of complementary medicine products during pregnancy; six focused on use in lactation. Herbal medicines were the main complementary medicine product type discussed (n=46) for both pregnancy and breastfeeding. Women perceived complementary medicine products to be beneficial in supporting their own pre and postnatal health, their pregnancies, growing foetuses, labour and birth, and/or breastfeeding. Health care professionals, followed by other interpersonal relationships and the media were the most commonly reported information sources accessed. An interactive model of health literacy revealed that information sources within a woman's health literacy environment, combined with other information sources, influenced her decision making regarding complementary medicine product use.

CONCLUSIONS: Pregnant and breastfeeding women use complementary medicine products for various self-perceived benefits related to their own, unborn or breastfeeding babies' health. Examining these with reference to an interactive health literacy model helps identify the decision-making process mothers undergo when choosing to use complementary medicine products.