Traditional cultures often rely on the beneficial effects of herbal remedies during pregnancy and the period around childbirth. At some stage in their lives, most Nigerians in rural areas turn to traditional healthcare due to its accessibility, availability, affordability, and inherent trust in this method.
During pregnancy and childbirth, traditional medicine relies on the use of certain herbs for their beneficial effects to tone the uterus muscle, induce labour, remove retained placentas, and manage postpartum bleeding.
The state of maternal health in Nigeria is poor. It can be attributed to inadequate access to reproductive health services, poverty, and, in some areas, cultural resistance that affects, in particular, women from rural areas with low access to primary healthcare.
The 2023 UN report on Trends in Maternal Mortality from 2000–2020 revealed that nearly 28.5 percent of global maternal deaths happen in Nigeria. Also, it stated that a woman in Nigeria has a one in 19 lifetime risk of dying during pregnancy and the period around childbirth. In contrast, in the most developed countries, the lifetime risk is one in 4900.
However, researchers believe that documentation and standardisation of medical plants and their correct use will improve the reproductive health of local populations in Nigeria. At least as importantly, scientific validation of these traditional remedies is a crucial step in the discovery of natural drugs for the treatment of childbirth-related complications.
Recently, researchers tried to document, analyse, and validate the traditional use of frequently used herbal preparations during pregnancy, facilitate childbirth, and manage postpartum complications in Sokoto.
The study, entitled “Uterine Contractility of Plants Used to Facilitate Childbirth in Nigerian Ethnomedicine,” was published in the Journal of Ethnopharmacology.
The participants in the survey included professional herbalists or traditional medical healers (who also function as birth attendants), local midwives (local birth attendants), farmers or local traders, teachers, and artisans.
The semi-structured and open interviews that used questionnaires triggered the collection and identification of traditional remedies for treating childbirth-related complications.
The relative traditional importance of each medicinal plant was determined based on their frequent mention for use. Extracts of these plants were analysed for their ability to start or augment models that depict human wombs in the laboratory.
The analysis of the water extracts from nine of these plants induced a significant sustained ability to start or augment contraction of cells of the womb, with varying efficiencies depending upon time and dose of exposure.
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 characterised.
Calotropis procera is the apple of sodom or Ewe Bomubomu. Sida corymbosa is broom weed or Aramwemmvbi in Edo. Commelina africana is Wandering Jew (English) and Gbagodo-Yoruba; Sclerocarya birrea is jelly plum, or Loda in Hausa; Duranta repens is golden dew drop; Hyptis suaveolens is bush mint or Ebefue (Edo); and Saba comorensis is rubber vine or Eciwo-Hausa or Orombo-Ososo.
The survey also documented how the remedies were made, including the mode of administration and usage. This includes having the stem bark powder of Calotropis procera macerated in water for a few hours and the extract taken orally. It is used to dilate the birth canal during labour.
The slimy aqueous extract from the leaves of Commelina africana is taken orally during delayed labour, while the leaves of Duranta repens are boiled or decocted in water for a few days and are taken orally to ease childbirth pain.
Fresh leaves of Hyptis suaveolens are boiled or decocted in water for oral administration and used to reduce the length of labour and labour pains.
Freshly collected African basil is squeezed in water with a pinch of salt for oral administration, and taken for painless delivery. The steamed soup of leaves is also used as a food supplement, and boiled leaves are used for gentle abdominal massage after delivery.
The extract of the root bark or powdered root bark of Saba comorensis is also boiled in water for several minutes, taken orally, or used for many maternal conditions, including labour induction.
In addition, the stem bark of Sclerocarya birrea is powdered and decocted in water for oral administration to facilitate birth and milk production, while freshly collected weeds of Sida corymbosa are pounded until slightly slimy, extracted with water for oral administration, and taken during labour to facilitate delivery.
Also, food supplements in soup or fresh leaves of bitter leaf are washed and squeezed in clean water, with the extract administered orally during labour or taken as soup regularly when delivery is close.
Interestingly, African basil and bitter leaf are regularly consumed as food additives during pregnancy, normally in the form of a soup called bitter leaf soup, to promote easy progression, strengthen or tone the walls of the womb, and prevent complications such as pain, bleeding, and abortion.
However, one of the traditional healers advised that the plant Sida corymbosa should only be administered when the patient is already in the delivery room, as it quickly induces labour and the birth process.
All informants reported that the patients are free of complications during and after delivery when using the above-described herbal remedies, and they clarified the absence of commonly associated rituals such as repetitions, incantations, forbidden foods, and postures during the administration of the plant preparations.
The extracts of Commelina africana, Sida corymbosa, and bitter leaf yielded the biggest increases in contractility in the uterine model. Most of the extracts maintained the contractile effect for 2.5 to 3.5 hours, suggesting an added benefit in terms of being long-acting and having a sustained contraction of the womb. It also validates the rationale for their use by the traditional healers in Nigeria to aid or induce childbirth.
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