2nd Edition of the Public Health and Midwifery World Conference 2026

Abstract

Background:  Globally, about 60% of women in Western countries use traditional herbal medicines (THMs) during pregnancy and labour, while in Sub-Saharan Africa, an estimated 22,404 pregnant and lactating women use them, with prevalence at 32% and 45% in Africa and East Africa respectively. Although widely used, the chemical composition of most traditional herbal medicines for labour remains unstudied, with only ~1% of tropical species screened. Given conflicting claims of safety and efficacy, urgent chemical analysis of labour-related remedies is essential to validate or challenge their purported pharmacological properties.

Purpose:  The purpose of this study was to analyse and characterize the chemical composition of traditional herbal medicines (THMs) used for labour, with particular focus on identifying oxytocin-like compounds. The findings aim to generate evidence that can inform policy development and guide the safe integration of THMs into maternal health services.

Methodology: This analytical study investigated selected traditional herbal medicines (THM) commonly used for labour in Zambia for the presence of oxytocin. The study focused on Achyranthes aspera (Mutobolo), Azanza garckeana (Mutobo), velvet fruit (Cincenya), Brassica oleracea (Tende), and elephant dung (a widely used non-herbal agent). Five remedies were randomly selected from ten identified by traditional birth attendants, community health workers, and herbalists collectively. The analysis was performed at the National Food and Drug Control Laboratory, University Teaching Hospital, using High-Performance Liquid Chromatography with UV detection (HPLC-UV). Following USP protocol, samples were dried, powdered, and extracted in water and methanol (100 g/1000 ml), agitated for 48 hours, filtered, and concentrated at 40 °C. Separation employed a mobile phase of distilled water and acetonitrile with 0.1% trifluoroacetic acid, flow rate 1.0 ml/min, and detection at 220 nm. Oxytocin (Rt 12 min) and Cytotec (Rt 7 min) served as controls. The Evidence-Based Approach framework guided the study.

Results: This study revealed oxytocin-like properties in some of the THMs for labour. Mutobolo showed strong oxytocic and Cytotec-like activity, validating it’ widespread use. Mutobo and Tende Brassica oleracea /Kale collard greens) exhibited milder effects, while Cincenya (Velvet fruit) and elephant dung lacked detectable activity despite community claims. Mutobolo (Achyranthes aspera) was extracted in both aqueous and organic solvents aligning with common preparation practices. Peaks near oxytocin’s retention time affirm likely uterotonic compounds, while additional peaks suggest other bioactive or contaminant constituents. These findings underscore the need for scientific validation, regulation, and integration of THMs into maternal health policy.

Conclusion: The study findings show that Mutobolo, Mutobo (Azanza garckeana) and Tende (Brassica oleracea /Kale collard greens) exhibit oxytocin-like properties, with Mutobolo (Achyranthes aspera) also demonstrating misoprostol-like activity. These results validate traditional use for labour with Mutobolo effective in both aqueous and organic extractions. Cincenya and elephant dung lacked laboratory evidence, highlighting possible unidentified compounds or reliance on traditional knowledge consistent with findings by other scholars.