"What If It Matters/Works?" Chinese Mothers' Stories of Using Complementary and Alternative Medicine

Background and purpose: Complementary and alternative medicine (CAM) is a range of medical and healthcare practices not fully integrated into a country's primary healthcare system. Chinese medicine is generally accepted and incorporated into China's healthcare system. However, other forms of CAM rooted in Chinese medicine were not provided by medical providers, such as folk prescription, food therapy, and GuaSha (special message). The use of CAMs during pregnancy and for children is widespread, ranging from 20% to 87% worldwide. Studies have reported how cancer or chronic disease patients used CAMs as supportive therapy. Little is known about the use of CAM among pregnant women and babies, especially in China. This study explored how Chinese mothers used their resources and actions to practice CAM for themselves and their children.

Methods: This secondary data analysis drew data from a narrative study about women's experience of becoming a mother. In the original study, we interviewed 18 Chinese women to hear their stories of becoming a mother. All women were married, and most had only one child (n=15, 83.4%). Their maternal age for the first child ranged from 24 to 32. The majority are college graduates and working mothers (n=16, 88.8%). Most mothers lived in urban areas, while two lived in rural hometowns during pregnancy.

We used thematic narrative analysis by Riessman (2008). First, seven stories about women using CAM were constructed, and verified by participants via member checking. Then we read, compared, and analyzed each story as a unit of analysis to understand how mothers perceived and practiced CAM in various contexts. The original interviews, story writing, and coding were all conducted in Mandarin Chinese.

Findings: The overarching story of using CAM among these mothers was "What if it matters/works?" Mothers were aware of diet taboos during pregnancy and breastfeeding for fear of potential harm to the baby ("What if it matters"). Social institutions, such as maternal mobile apps, "Yue Zi" centers and nannies (postpartum services), incorporated CAM into them. How strictly mothers obey CAMs depends on their beliefs.

During postpartum, when dealing with infancy medical conditions, mothers first sought professional help. However, when doctors suggested observation or the treatment didn't see an effect, women sought advice from their network and the Internet. They usually tried food therapy or non-invasive treatment such as GuaSha (using mouth) for reasons that at least they would do no harm, and then "What if it works." They executed logical thinking when deciding to use or not use them. When these methods worked, they gained confidence in their role as a mother. Practicing CAMs helped mothers reduce pregnancy- or child-caring-related anxiety.

Conclusion and implications: Many CAMs mentioned by the mothers were rooted in Chinese culture. However, more than 70% of patients did not reveal their usage of CAM to their providers. In the next three decades, more CAM discussions are expected to generate additional research agenda as an essential step for researchers to democratize knowledge and for practitioners to recognize clients’ knowledge in making treatment decisions.