A Study to Assess the Effectiveness of Honey in the Reduction of Constipation and Insomnia among Antenatal Mothers during the Third Trimester of Pregnancy

ABSTRACT

A quasi-experimental quantitative approach with pre and posttest design was conducted at urban public health center (UPHC). Forty antenatal mothers were recruited and were separated into two groups in experimental and control groups. In both the groups, a pretest was done by assessing the level of the constipation-by-constipation assessment tool. The experimental group were provided with honey with warm water continuously for six days in the morning and evening as the control group received routine care. Posttest was conducted on the 7^th day in both groups using the same scale to assess the level of constipation and insomnia. The study result concluded that calculated independent “t” test value of t = 2.327 was found to be statistically significant at P < 0.01 level with posttest level of constipation and insomnia between the experimental and control group.

INTRODUCTION

Pregnant women experience physiological and hormonal changes during their antenatal period. The most common problem is constipation which affects 38% of mothers. According to recent studies, 38% and 20% of women suffer from constipation.[1] Constipation is a condition that causes infrequent bowel movements, and incomplete evacuation, resulting in the passage of hard stool. It is projected that approximately 11% and 38% of pregnant women develop constipation. Later in pregnancy, an expanding uterus might hinder bowel movement. Certain substances help patients in getting relief from constipation. Some of these include the increased use of dietary fibers, fluids, and daily exercise.[2] According to National Health Interview Survey reports, about 4.4 million pregnant women complain of constipation.[3] A sedentary lifestyle may also cause or worsen constipation. Honey is a substance which has probiotics used to treat constipation.[4] The medical community is now conducting research on honey. For many centuries, honey is used as a natural laxative because of its moisturizing characteristics.[5] Honey helps in the production of intestinal mucus, hydrates the colon, and infuses water into dried stool. Constipation could occur due to anxiety and depression risk of constipation.[6] It provides about 304 calories it has a low content of fat, dietary fiber, and protein. WHO recommends sufficient water and nutritional fiber intake to prevent constipation during pregnancy. Some research shows that dietary factors such as water intake may prevent or ease gastrointestinal issues during and after pregnancy.[7]

METHODS AND MATERIALS

The quantitative approach with quasi-experimental pretest and posttest research design was adopted for the study. The study was conducted for a duration of one month. After obtaining clearance from the Institutional Human Ethics Committee of Saveetha Institute of Medical and Technical Sciences and formal permission from the departmental head of General Medicine, the study was conducted. Antenatal mothers both primi and multigravid who were in the third trimester 27–40 weeks of gestation, with constipation were included in the present study. Sixty pregnant women were randomly assigned to either the intervention or the placebo experimental group and were given 100 ml of warm water mixed with 5 ml of honey with warm water continuously for six days in the morning and evening were as control group received routine care, on the seventh day, the study participants reassessed the level of constipation and insomnia in both groups using constipation assessment tool.

RESULTS AND DISCUSSION

Section A: Assessment of constipation among antenatal mothers in the experimental and control group

In the experimental group, in the pretest, 13 (52%) had moderate constipation and 12 (48%) had constipation, whereas in the posttest, 12 (48%) had moderate constipation, 9 (36%) were normal, and 4 (16%) had severe constipation. In the control group, in the pretest, 15 (60%) had medium constipation and 10 (40%) had moderate constipation, whereas in the posttest, 15 (60%) had severe constipation, 6 (24%) had normal constipation.

Section B: Effectiveness of honey consumption in the reduction of constipation among antenatal mothers in the experimental and control group

The pretest mean score of the effectiveness of honey consumption in the reduction of constipation among antenatal moderate in the experimental group was 122.84 ± 13.05 and the posttest mean score was 112.84 ± 15.29 as showed in table 1. The mean difference score was 10.0. The calculated paired “t” test value of t = 11.521 was found to be statistically significant at P < 0.001 level which clearly infers that there was reduction in the constipation after the administration of honey.

Table 1.

Comparison of constipation among antenatal mothers within and between the experimental and control group n=50 (25+25)

Group	Pretest		Posttest		Mean difference score	Paired “t” test
	Mean	SD	Mean	SD
Experimental group	122.84	13.05	112.84	15.29	10.0	t=11.521, P=0.0001, S***
Control group	122.44	11.86	121.44	12.92	1.0	t=1.777, P=0.088, NS
Mean difference score	0.40		8.60		***P<0.001, *P<0.05. S—Significant, NS— Not significant
Student’s independent “t” test and P	t=0.113, P=0.910, NS		t=2.148, P=0.037, S*

The pretest mean score of effectiveness of honey consumption in the reduction of constipation among antenatal moderate in the control group was 122.44 ± 11.86 and the posttest mean score was 121.44 ± 12.92. The mean difference score was 1.0. The calculated paired “t” test value of t = 1.777 was not found to be statistically significant. Another study findings were also supported with the findings of Ananthi,[8] a quasi experimental study was conducted to assess the effectiveness of constipation of honey among antenatal mothers in the third trimester in which 60 sample were enrolled in this study in which 30 mothers in experimental control and 30 mothers in control groups. For the experimental group, 10 ml of honey in 100 ml of warm water was administered twice a day for three days, and for the control group, routine care was given. The results showed that comparison between pretest and posttest among experimental group, t = 6.75, and it was statistically significant with P value = 0.001. The results of current study clearly stated that there are differences in the results of pre and posttest interventions. Back-stretching exercise arouse the spinal cord, passes signals to the neurotransmitters of medulla oblongata to reach the hypothalamus, and helps to release of relaxin hormone thereby it reduces pain. Stretching exercises act to tone the perineal area by stretching the ligaments and strengthening the inner thighs and abdominal muscles. Body alignment is also maintained, which reduces back pain.

Section C: Effectiveness of consumption of honey on reduction of insomnia among antenatal mothers

Table 2 depicts that the pretest mean score of insomnia in the experimental group 28.96 ± 5.34 and posttest mean score was 12.96 ± 3.29. The mean difference score was 16.0. The calculated paired “t” test value of t = 23.749 was statistically significant at P < 0.001 level. This clearly shows that after the administration of honey with warm water on reduction of insomnia among antenatal mothers the level of insomnia had significantly reduced among the antenatal mothers. The pretest mean score of insomnia in the control group was 29.04 ± 5.28 and posttest mean score was 28.86 ± 5.37. The mean difference score was 0.18. The calculated paired “t” test value of t = 1.703 was not statistically significant which infers that there was no significant difference between the pretest and posttest level of insomnia in the control group who had undergone normal routine measures.

Table 2.

Effectiveness of consumption of honey on insomnia among antenatal mothers in the experimental group and comparison of pretest and posttest level of insomnia among antenatal mothers in the control group n=60 (30+30)

Variables	Pretest		Posttest		Mean difference score	Paired “t” test and P
	Mean	SD	Mean	SD
Experimental group	28.96	5.34	12.96	3.29	16.0	t=23.749, P=0.0001, S***
Control group	29.04	5.28	28.86	5.37	0.18	t=1.703, P=0.095, NS
Mean difference score	0.08		15.90		***P<0.001. S—Significant, NS—Not significant
Student’s independent “t” test	t=0.075, P=0.940, NS		t=17.832, P=0.0001, S***

Contribution

The authors conceived and designed the review, acquired, analyzed and interpreted the data, drafted the article, approved the version to be submitted, and take full responsibility for the integrity of the work.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.