Definitions of aromatherapy

In document Aromatherapy in Midwifery Practice (Page 32-35)

• history of aromatherapy

• contemporary regulation of aromatherapy

• European Union (EU) Directives

• what essential oils are

• extraction of essential oils from plants

• purchasing quality essential oils for aromatherapy practice

• storage of essential oils

• dosages in maternity aromatherapy

• blending of essential oils

• methods of administration of essential oils:

• administration of essential oils via the respiratory tract:


• administration of essential oils via the skin: massage

• administration of essential oils via the skin: in water

• principles of administration of aromatherapy in pregnancy and childbirth.

Definitions of aromatherapy

Aromatherapy is considered to be an artistic and scientific modality based on the principle that highly concentrated aromatic essential oils extracted from different parts of plants are administered in various ways for their therapeutic purposes in order to enhance health and wellbeing.

There are, in fact, three different ‘sciences’ within the overall umbrella term of aromatherapy. First, aromachology, or psycho-aromatherapy, is based on the impact of the aromas of the essential oils on the brain, notably the limbic system, and the effects of those aromas on emotions and feelings.

Second, aromatology is concerned with the internal use of essential oils

(gastrointestinal, per vaginam, per rectum), administered as medicines, as practised in parts of Europe outside the United Kingdom, normally by medically qualified physicians and medical herbalists. In this case, the term

‘aromatology’ is misleading as the aromas have virtually no effect once the oil has passed via the mucosa.

Third, aromatherapy, as defined by the US Sense of Smell Institute, involves the therapeutic use of the aromas of essential oils on physical or psychological conditions. This term has, however, been interwoven into a modality in which the method of administration, such as massage, plays a part in the overall therapeutic effect, and many medical authorities deem aromatherapy to have little more than a placebo effect. Indeed, Lis-Balchin (2010) disparages modern UK aromatherapy as insufficiently evidence-based, suggesting that it is often practised by inadequately trained practitioners who purport to apply a scientific approach and who sometimes combine it with

‘more dubious alternative disciplines’ such as cosmology, crystals and chakra balancing. The fact that most clients consult aromatherapists for ‘stress-related’ disorders and that any improvement is due largely to an increased sense of relaxation further fuels her disenchantment with contemporary aromatherapy as a clinical modality in the Western world.

Despite Lis-Balchin’s somewhat negative perspective on modern therapeutic aromatherapy, this book is concerned with the generally held view of aromatherapy as a healing modality. In maternity care, it offers the possibility of a return to normality in childbirth and enables women to enjoy their experiences of pregnancy, which like so many other situations has become yet another ‘medical’ condition. (See Chapter 1 for more discussion on the reasons why women seek aromatherapy.)

There is certainly an increasing interest in the stress-reducing impact of aromatherapy amongst conventional healthcare professionals. We know that high levels of stress hormones have adverse effects on health and wellbeing, including impairment of the immune system, greater perception of pain and interference with other endocrinological functions (see Chapter 3). Thus the benefits of a relatively inexpensive, easily administered and generally enjoyable therapy suggest that its value goes beyond the purely scientific evidence currently available. Also, in maternity care, the impact of human touch – in this case, massage – is invaluable in this era of technological intervention, electronic monitoring and staff shortages, providing a much appreciated human interaction. In addition, whether or not aromatherapy works through some placebo effect may not yet be fully understood. However, there is ample evidence that the placebo effect in itself can be beneficial in many medical conditions, and doctors are now encouraged to ‘exploit’ this in their care and advice to patients (Flaherty, Fitzgibbon and Cantillon 2015).

For whatever reason, the interaction between therapist and client, the use of

touch, the client’s – or the therapist’s – belief in the efficacy of the treatment, or some other factor, may give rise to a positive alteration in the wellbeing of the client.

Essential oils contain numerous chemicals which have a range of physical and emotional effects. These chemical constituents work pharmacologically (see Chapter 3), having physiological effects on different organs within the body, as well as psychological effects via the limbic system in the brain. The oils can be applied via the skin as a massage, which is by far the most popular method. Dermal administration can also be achieved by adding the essential oils to water, in the bath, a footbath or spray, or as a compress. Inhalation via the respiratory tract can be used as a specific method of administration in its own right but in the United Kingdom is less commonly used than massage.

However, every woman receiving aromatherapy treatment by any other method of administration will also inhale the aromas and she is therefore inhaling the chemicals, which will have a physical and emotional impact – with both positive and potentially negative effects.

Oils can also be administered via the mucus membranes, rectally as suppositories, or vaginally as pessaries, but these methods are not appropriate in pregnancy and birth, and should not be used by midwives, doulas or therapists. Finally, essential oils can be given orally via the gastrointestinal tract, but this method is generally only used by medical practitioners, in those European countries where aromatherapy is incorporated into mainstream medicine, with some essential oils being regulated as prescription-only drugs (aromatology). In the United Kingdom it is not possible to obtain indemnity insurance cover for oral administration unless the practitioner is a fully qualified aromatherapist who has undertaken further study in the gastrointestinal administration of essential oils.

The therapeutic effects of aromatherapy are thought to be achieved through a combination of the physiological action of the chemicals in the essential oils, the method of administration and the psychological impact of the aromas. The practitioner, usually in partnership with the client, chooses appropriate essential oils and a method of administration which best suits the client’s condition and smell preferences, with the aim of treating specific issues. Aromatherapy is generally considered relaxing, especially when administered as massage, but essential oils can have numerous other effects. Whilst many essential oils are known to have a relaxant effect, such as lavender (Sayorwan et al. 2012), or even sedating – for example, chamomile (Chang and Chen 2015) – others are more stimulating. Examples include the following: peppermint, which stimulates the skin and hair (Oh, Park and Kim 2014); grapefruit, which stimulates the sympathetic nervous system (Nagai et al. 2014); and black pepper, a rubefacient (warming) oil affecting the circulation (Butt et al. 2013). Essential oils such as clary sage and

lavender have been shown to lower the systolic and diastolic blood pressure respectively (Seol et al. 2013), whereas others are known to raise it, including rosemary (Fernández, Palomino and Frutos 2014). Several essential oils have been found to relieve pain – for example, lemon (Ikeda, Takasu and Murase 2014) and lavender (Hadi and Hanid 2011).

Many essential oils should not be used in the preconception, antenatal and intrapartum periods. Others should be used with caution or may be contraindicated at certain times during the childbearing period, or for women with particular medical or obstetric conditions. It stands to reason, then, that incorrect or inappropriate treatment may, at the very least, fail to have the desired effects, and may even pose risks to the health and wellbeing of the mother and/or fetus. (See Chapter 4 for more on the safety of aromatherapy in pregnancy and childbirth).

In document Aromatherapy in Midwifery Practice (Page 32-35)