INDIGENOUS BELIEFS AND PRACTICES ASSOCIATED WITH THE USE OF
HERBS DURING PREGNANCY IN MANONYANE COMMUNITY, LESOTHO
E. Mugomeri (MTech. Biomed. Tech.)1*, K. Seliane (BSc. Nursing and Midwifery)2, N.K. Musa (B.Pharm. Hons)1
1
Department of Pharmacy, National University of Lesotho
Department of Nursing, National University of Lesotho
*
Corresponding author: Eltony Mugomeri | Tel (Cell): +26658500112 | email: emugomeri@yahoo.com
2
ABSTRACT
The use of herbs during pregnancy is common in African settings. Use of herbs during pregnancy
is not without dangers. This study reports the use of herbs and the predictors of their use during
pregnancy in Manonyane community of Lesotho. This was a non-experimental and analytical
study on 72 pregnant women who attended antenatal care (ANC) at St Joseph’s Hospital between
March and April 2014. The study used purposive sampling to collect data using a structured
questionnaire. Tests of association between use of herbs and test variables were performed using
Fischer’s exact test and t-test in STATA®. Overall, 34 (47.2%, n=72) women conceded use of
herbs at least once during pregnancy. Leucorrhoea of pregnancy (5.9%, n=34), prevention of
placenta praevia (8.9%), prevention of abortion (5.9%) and inducing foetal growth (5.9%) were
the most common reasons for using herbs. However, 55.9% did not specify any reason why they
used herbs. Grandmothers (52.9%, n=34), village traditional healers (26.5%) and mothers-in law
(14.7%) provided most of the herbs used. Use of herbs was not significantly influenced by age
(p=0.233), marital status (p=0.113), literacy level (p= 0.719) and previous loss of pregnancy
(p=0.490). Parity (p=0.147) and gravida (p=0.234) were also not significantly associated with use
of herbs during pregnancy. Grandmothers, village traditional healers, mothers-in-law and
traditional birth attendants are the main drivers of herb use during pregnancy. There is need to
incorporate indigenous beliefs and practices into the training curriculum for traditional birth
attendants and professional midwives to increase awareness of the dangers of herb usage during
pregnancy.
Key words: Herbs; Pregnancy; Manonyane; Lesotho
INTRODUCTION
The use of herbs during pregnancy is common in African settings for various reasons including
inducing labour, reducing pain during delivery and expelling the placenta after birth.[1] The main
drivers of the use of herbs in African settings include cultural practices enforced by elderly family
members such as mothers-in-law and grandmothers who tend to prefer herbs to western remedies.
Traditional births attendants and traditional healers also commonly administer herbal medicines to
pregnant women. [2-4]
Use of herbs during pregnancy is not without dangers. Studies show that some herbs are poisonous
while some are known to interfere with the normal physiology of pregnancy and labour resulting
in complications during delivery.[5, 6] Herbs may potentiate or supress the effect of oxytocin.[1] Use
of herbs concurrently with antiretroviral (ARV) drugs during pregnancy is likely to be common in
Southern African countries given the high prevalence of HIV in these countries.[6, 7] Some herbs
interfere with drug metabolic pathways such as cytochrome P450 system resulting in increased
plasma levels of some drugs to toxic levels.[8]
The study determined the proportion of women using herbs during pregnancy and the predictors
of herb usage during pregnancy in Manonyane community of Lesotho.
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METHODS
Study design and data collection
This was a non-experimental and analytical study on 72 pregnant women who attended antenatal
care (ANC) at St Joseph’s Hospital between March and April 2014. St. Joseph’s Hospital serves
Manonyane community which constitutes about 6% of Lesotho's population.[9] Manonyane
community is in Maseru District of Lesotho. Lesotho (GPS coordinates: Latitude: 29º 30´S,
Longitude: 28º 30´E) is a small landlocked country completely surrounded by South Africa. The
study used purposive sampling. The data was obtained by means of a structured questionnaire. The
study was approved on the 10th of January 2014 (ID145-2013) by the Ministry of Health of
Lesotho. All ethical considerations were observed during data collection.
Participants were asked to complete a predesigned questionnaire which collected information
including demographic data, herbs used, source of herbs, trimester when herbs were used and the
reasons for using herbs.
Data analysis
Data was analysed using STATA® version 12 (StataCorp, Texas, USA). The proportion of
proportion using herbs was calculated and the respondents’ characteristics associated with the
usage of herbs were determined. Tests of association between use of herbs and categorical
demographic variables such as marital status, level of education and literacy level was performed
using Fischer’s exact test. Continuous variables such as age, number of pregnancies (gravida) as
well as the number of children (parity) were tested for association with use of herbs using the ttest.
RESULTS
Demographic characteristics of the pregnant women
The ages of the 72 respondents who attended ANC ranged from 15 to 40 (see figure 1). However,
the child bearing age groups were tilted towards the younger age groups with the largest age groups
attending ANC in this population being 15-18, 22-24 and the 25-27 age group.
Overall, 80.6% (n=72) were married and 13.9% (n=72) were single. The remainder were widowed
(1.4%), separated (2.8%) or divorced (1.4%).
When literacy level was considered, 58.3% (n=72) of the women had primary school education,
40.3% had secondary education and 1.4% had tertiary education. The number of pregnancies
experienced by respondents (gravida) ranged from one to six. However, most of the women
(36.1%, n=72) were pregnant for the first time followed by those who were pregnant for the second
time (26.4%) and 18.1% for the third time. Only 19.4% were pregnant for the fourth time or more.
When parity or the number of children alive was considered, most of the women (41.7%, n=72)
indicated that they had no children alive. Twenty three (31.9%, n=72) had one child and ten women
(13.9%) had two children alive. Only nine (12.5%) women had 3 or more children alive. The ratio
of the number of pregnancies to the number of children alive (gravida to parity ratio) indicated that
63.9% (n=72) of the women had lost at least one pregnancy and only 36.1% (n=72) had not lost
any pregnancy.
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Figure 1: Age distribution of the respondents included in the study
Use of Herbs
Overall, 34 (47.2%, n=72) women conceded use of herbs at least once during pregnancy. Herbs
were used mostly (50.0%, n=34) in the second trimester and in the first trimester (30.9%). Only
19.1% used herbs in the third trimester.
Figure 2 presents the reasons for use of the herbs by the 34 women who indicated that they used
herbs during pregnancy. Of the 34 women who used the herbs, about 55.9% did not specify any
reason why they used herbs beside cultural practises.
Beside unspecified reasons, leucorrhoea of pregnancy (5.9%, n=34), prevention of placenta
praevia (8.9%), prevention of abortion (5.9%) and foetal growth (5.9%) were the most common
reasons for using herbs. Names of herbs used by the pregnant women, parts of plants used and
uses of the herbs are presented in table 1.
Grandmothers provided most of the herbs used (52.9%, n=34). Village traditional healers provided
herbs to 26.5% of the women who used herbs. Mothers-in law accounted for 14.7% of the herbs
used whilst traditional birth attendants (TBA) also provided herbs to 5.9% of the women.
Use of herbs was not significantly influenced by age (p=0.233), marital status (p=0.113), literacy
level (p= 0.719) and previous loss of pregnancy (p=0.490). Parity (p=0.147) and gravida (p=0.234)
were also not significantly associated with use of herbs during pregnancy.
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60
50
Percent (%)
40
30
20
10
0
Reasons for using herbs
Figure 2: Reasons for use of herbs during pregnancy
Leucorrhoea of pregnancy = odourless vaginal discharge caused by increased blood flow to the vagina during
pregnancy and may be mistaken for sexually transmitted infections; [10] Placenta praevia = improper implantation of
the placenta near the uterine cervix which is usually associated with severe maternal haemorrhage during labour[11]
Table 1. Names of herbs used during pregnancy and their uses
Vernacular name
Botanical name
Qobo
Setima-mollo
Gunnera perpensa
Pentanisia
prunelloides
Hermannia depressa
Zantedeschia
albomaculata
Eucomio autumnalis
Dicoma anomala
-
Seletjane
Mohalalitoe
Mathethebane
Hoenya
Bohome bo boputsoa
Part of plant
used
root bulb
tubular roots
Reasons for use of herbs
roots
root bulb
Waist pain, Prevent placenta praevia
Prevent abortion
tubular
tubular
Leaves, roots
relief of labour, leucorrhoea of pregnancy
Headache; constipation
Foetal growth
relief of labour
Prevent placenta praevia
Bokhoe
Ledebouria
marginata
root bulb
sooth painful waist and treat leucorrhoea of
pregnancy; genital warts
Unknown herb
-
-
Unspecified reasons
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DISCUSSION
The proportion of women using herbs during pregnancy in this study (47.2%, n=72) was very high.
However, it was comparable to the one reported in KwaZulu Natal, South Africa (43.7%,
n=577).[12]
About 55.9% of the women who used herbs in this study did not specify any reason why they used
herbs beside cultural practises. This highlights the role culture and tradition play in influencing the
use of herbs during pregnancy. Grandmothers, village traditional healers and mothers-in law
emerged as the main drivers pushing for the use of herbs during pregnancy in this study. This
indicates the need to need to educate the elderly population such as grandmothers on safe use of
herbs. The study in KwaZulu Natal, South Africa, parents and elderly relatives as well as
traditional birth attendants wield the most influence towards younger generations of pregnant
women.[12].
Traditional birth attendants (TBA) also provided herbs to 5.9% of the women in this study. This
highlights the need to incorporate indigenous beliefs and practices into the training curriculum for
traditional birth attendants and professional midwives to increase awareness of the dangers of herb
usage during pregnancy.
In this study, the elderly women provided herbs to the pregnant women without giving full
explanations about the nature of the herbs and the intended use in 55.9% of the cases. This
highlights the possible dangers pregnant women are exposed to by the elders. Herbs may potentiate
or supress the effect of oxytocin resulting in labour complications.[1] In HIV-positive pregnant
women, herbs have been reported to interact with ARVs resulting in toxic levels of ARVs.[8]
None of the test variables considered in this study emerged as significant influencers of herb usage
during pregnancy in this study. This indicates that herb usage by pregnant women is not influenced
by age (p=0.233), parity (p=0.147) and gravida (p=0.234). It also implies that marital status
(p=0.113), literacy level (p= 0.719) and previous loss of pregnancy (p=0.490) does not influence
herb usage by pregnant women.
CONCLUSION
A high proportion of women in Manonyane community of Lesotho use herbs during pregnancy
despite the dangers posed by the herbs. Herb usage by pregnant women is independent of age,
marital status, literacy level and previous loss of pregnancy. Grandmothers, village traditional
healers, mothers-in-law and traditional birth attendants are the main drivers of herb use during
pregnancy. There is need to incorporate indigenous beliefs and practices into the training
curriculum for traditional birth attendants and professional midwives to increase awareness of the
dangers of herb usage during pregnancy.
ACKNOWLEDGMENTS
The researchers would like to thank the Ministry of Health of Lesotho for approving this study.
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