Acupuncture in obstetrics: delivery room integrative medicine for anxiety and pain.

Abstract

Objectives: Supportive and palliative care include non-oncology settings where patients suffer from pain and quality of life-related concerns. Integrative medicine plays important roles in supportive care and symptom management, including Integrative Obstetric (IOb) programmes within peri-partum settings. Multidisciplinary approaches may help nurse-midwives and obstetricians improve patient care and associated outcomes. This study presents a national perspective on IOb programmes in Israel.

Methods: A qualitative research methodology was codesigned by the Society for Complementary Medicine and Society of Maternal-Fetal Medicine, Israel Medical Association. A questionnaire with 17 open-ended questions was distributed throughout obstetrics and gynaecology departments across Israel. Respondent narratives were qualitatively analysed using ATLAS.Ti software for systematic coding.

Results: 22 senior obstetricians and IOb directors across 11 centres with IOb programmes completed the questionnaire. Core themes considered essential for the design and operation of IOb programmes included (1) determining major goals and indications for referral, primarily pain and anxiety; (2) targeting patients most likely to benefit; (3) identifying barriers and enablers to implementation and communication with the obstetric team; (4) designing the referral process and (5) documenting outcomes and safety of the IOb intervention in electronic medical files.

Conclusions: Designing and implementing IOb models of care that effectively support holistic symptom management within obstetric settings requires identifying barriers and enablers and establishing effective communication between obstetric and integrative medical teams. Further research should explore other multidisciplinary models of IOb care and structured referral development and testing while assessing risks and effectiveness.