Contents lists available at ScienceDirect Complementary Therapies in Clinical Practice journal homepage: www.elsevier.com/locate/ctcp Effect of aromatherapy on post-partum complications: A systematic review Khadije Rezaie-Keikhaie a , Marie Hastings-Tolsma b , Salehoddin Bouya c , Fahime Shojaei Shad d , Mahdieh Sari e , Maryam Shoorvazi f,∗ , Zeinab Younes Barani e , Abbas Balouchi g a Zabol Medicinal Plants Research Center, Zabol University of Medical Sciences, Zabol, Iran b Nurse Midwifery, Louise Herrington School of Nursing, Baylor University, Dallas, TX, USA c Clinical Immunology Research Center, Ali-ebne Abitaleb Hospital, Zahedan University of Medical Sciences, Zahedan, Iran d MSC in Nursing, Nursing and Midwifery School, Zabol University of Medical Sciences, Zabol, Iran e Student Research Committee, Nursing and Midwifery School, Zabol University of Medical Sciences, Zabol, Iran f Department of Nursing, School of Nursing, Neyshabur University of Medical Sciences, Neyshabur, Iran g Student Research Committee, Nursing and Midwifery School, Iran University of Medical Sciences, Tehran, Iran ARTICLEINFO Keywords: Aromatherapy Essential oils Post-partum symptoms Systematic review ABSTRACT Introduction: and purpose: Aromatherapy is a known popular method to reduce the symptoms of various phy- siologic processes and diseases. The aim of the study was to determine whether aromatherapy improves symptoms commonly experienced by women during the postpartum period. Methods: In the present systematic review, four international databases (PubMed, Google Scholar, Web of Science, and Scopus) were searched from inception of databases through August 2018. References for each study were manually reviewed to ensure that relevant works were included. Results: Thirty-four (34) articles were identified with 17 studies meeting eligibility criteria and included a total of 1400 women using a variety of aromatherapies. Results demonstrated that aromatherapy can improve symptoms commonly experienced in post-partum period, including depression, stress, pain, anxiety, and fatigue. Conclusion: There are therapeutic effects in use of aromatherapy during the post-partum period. Aromatherapy, however, should be used with caution as safety concerns have not been conclusively demonstrated. 1. Background The postpartum period is considered as a crucial time associated with various physical and emotional symptoms including pain, im- paired sleep quality, stress, anxiety, and fatigue [1–4]. In the post- partum period, more attention is paid to the neonates, and mothers are particularly less evaluated for post-partum symptoms. Screening, di- agnosis, and treatment of postpartum symptoms are also essential. The results of studies show that along with treatment of physical symptoms during this period, social support is necessary for improvement of psychological symptoms [5,6]. Various studies indicate that the post- partum period is often associated with having “postpartum blues,” which include temporary transient symptoms, the development of de- pression and anxiety, as well as feelings of forgetfulness, irritability, headache, and dizziness [7,8]. The prevalence of these symptoms range from 25% to 85% varying in different countries [9–11]. Available treatments for common post-partum symptoms include complementary and alternative therapy approaches - though they often lack evidence for safety and efficacy [12], and complication-specific pharmacologic therapies [13,14]. Both approaches are designed to minimize postpartum morbidity and mortality and improve quality of life. The use of complementary and alternative therapies has become very popular in recent years [15,16]. Complementary and alternative therapies are popular methods among pregnant women as well. Re- search from varied countries demonstrate rates of aromatherapy use among pregnant women ranging from 13 to 78% [17]. In addition, studies indicate that most women use at least one complementary therapy during pregnancy [18–20]. Aromatherapy is one complementary and alternative therapy that is very popular considering its ease of use and availability [21]. Aar- omatherapy medicinally applies aromatic substances or essential oils to effect health and mood. Essential oils are volatile oils obtained from raw vegetable material through a process of distillation with water or steam, or by dry distillation and are known to have antiseptic, anti- microbial, antiviral, antifungal, and antioxidant properties [22]. Some of the plants used in the creation of essential oils include rosemary, jasmine, rose, tangerine, patchouli, cinnamon, and lavender. Ar- omatherapy is typically used through topical application or inhalation https://doi.org/10.1016/j.ctcp.2019.03.010 Received 11 December 2018; Received in revised form 21 February 2019; Accepted 12 March 2019 ∗ Corresponding author. Nursing and Midwifery School, 15 Khordad S, Neyshabur, Iran. E-mail addresses: jahant1990@gmail.com, Shoorvazim@gmail.com (M. Shoorvazi). Complementary Therapies in Clinical Practice 35 (2019) 290–295 1744-3881/ © 2019 Elsevier Ltd. All rights reserved. T