Social Representations and Practices Surrounding the Use of Oxytocic Plants During Labour in Toviklin, South-western Benin in 2024

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Methods A descriptive and interpretive qualitative study was conducted in 2024 in Toviklin (Couffo, Benin). In-depth interviews were carried out with women who had recently given birth, recruited through snowball sampling. Inductive thematic analysis was guided by the principles of grounded theory. Results Twenty-eight women were interviewed. Oxytocic plants were perceived as means of controlling the timing of labour and reducing risks associated with prolonged childbirth. Their intrapartum use was socially regulated, recommended by female authority figures, and embedded within pluralistic care-seeking pathways. While positive effects were reported, self-declared unpleasant experiences also emerged, often minimized, yet contributing to the continued social acceptance of the practice. Conclusion The use of oxytocic plants is embedded in a coherent system of representations and practices aimed at the social regulation of obstetric risk, highlighting the need for culturally sensitive maternal health interventions. Oxytocic plants Labour Social representations Qualitative study Figures Figure 1 Figure 2 INTRODUCTION In many low-resource settings, childbirth remains a high-risk event, with its management strongly shaped by social representations of the female body, obstetric temporality, and maternal danger. In Africa, as in other regions of the world, medicinal plants occupy a central place in women’s reproductive health owing to their accessibility, low cost, and the social trust they command [ 1 ]. They are widely used during pregnancy, childbirth, and the postpartum period, particularly to induce or accelerate labour and to prevent perceived complications. Ethnobotanical evidence highlights the scale of these practices. In Mexico, more than 185 plant species are used in women’s reproductive health, several of which are employed as oxytocic agents to hasten childbirth [ 2 ]. In sub-Saharan Africa, use is nearly universal in some contexts: in Uganda, 100% of women surveyed report using plants to induce labour, manage postpartum haemorrhage, or provoke abortion [ 3 ]. These practices are generally recommended and supervised by female authority figures such as traditional birth attendants or elder women within the community [ 4 ]. Despite the abundance of ethnobotanical and pharmacological data, women’s lived experiences, their perceptions of obstetric risk, and the social and collective logics underlying intrapartum plant use remain poorly explored, particularly in the Beninese context. This qualitative study, conducted in Toviklin, seeks to address this gap by providing an in-depth analysis of the representations, practices, and embodied experiences associated with the use of oxytocic plants during childbirth. STUDY DESIGN AND METHODS This study adopted a descriptive and interpretative qualitative approach aimed at exploring the social representations, decision-making logics, and practices associated with the use of oxytocic plants during labour in Toviklin, in the Couffo Department of south-western Benin. It was conducted in 2024 among women who had recently given birth and who had used, directly or indirectly, such plants during labour, regardless of the place of delivery. Participant recruitment relied on purposive snowball sampling, a strategy particularly well suited to the investigation of sensitive and socially situated practices. Initial index cases were identified with the support of community health intermediaries and local health actors, after which participants progressively referred the research team to other women with comparable experiences. Recruitment continued until theoretical saturation was reached, defined by the absence of newly emerging relevant information. Data were collected through in-depth individual interviews guided by semi-structured interview guides developed specifically for this study and iteratively refined during fieldwork. The semi-structured interview guide is provided as Supplementary File 1. Interviews were conducted in the local ADJA language or in French according to participants’ preferences, without a translator. Participants were informed about the study procedures and gave verbal consent , confirmed by their thumbprint as a signature. They were free to choose the presence of their husband or another person , the location of the interview , and the level of confidentiality , and they could decline to answer any question or stop the interview at any time. All interviews were audio-recorded with consent, fully transcribed, and translated when necessary. Field notes were taken to document contextual elements, interactions, and non-verbal cues. Data analysis followed an inductive thematic approach inspired by grounded theory, combining immersive reading, line-by-line open coding, aggregation of codes into analytical categories, and the progressive construction of core themes. The analytical focus included social representations of oxytocic plants, perceptions of benefits and risks, sources of knowledge, intrapartum modes of use, and interactions with the formal healthcare system. Data management and analysis were supported by the R statistical environment, which was used as a tool for organizing and visualizing the textual corpus. From an ethical standpoint, the study was conducted in accordance with fundamental principles of health research ethics. Required authorizations were obtained from local authorities, and anonymity, confidentiality, and respect for local beliefs and practices were ensured throughout the study. Participants were free to withdraw at any time without any consequences. RESULTS Socio-anthropological characteristics of participants The study included 28 women who had given birth within the twelve months preceding the survey. Participants were aged between 18 and 41 years, were predominantly married or in a stable union, and resided in both rural and semi-urban areas of the municipality of Toviklin. Most were engaged in informal economic activities (agriculture, small-scale trading) and had a low to moderate level of formal education. Deliveries occurred either at home, in health facilities, or along mixed trajectories characterized by movements back and forth between the domestic sphere and healthcare structures. From an anthropological perspective, childbirth is widely perceived as a fundamentally female and social event, rooted as much in embodied experience as in the support provided by local female authority figures (mothers, mothers-in-law, traditional birth attendants). This social configuration constitutes the substratum within which representations and practices related to the use of oxytocic plants are embedded. Thematic analysis of social representations and practices Inductive thematic analysis identified four closely interrelated core themes. Social representations of oxytocic plants: “bringing the baby out” and controlling the timing of childbirth Oxytocic plants are socially represented as substances capable of unblocking, accelerating, or normalizing labour perceived as excessively slow. In participants’ narratives, labour is conceived as a process that should not “last unnecessarily,” with prolongation associated with suffering, danger, and, at times, a form of feminine failure. When it drags on, it’s not good. The plant helps the body do its work. (Woman, 29 years) These representations are grounded in a dynamic conception of the female body, sometimes described as “lazy” or “closed,” requiring external stimulation to complete childbirth. The plant thus becomes an instrument for controlling obstetric time, standing in contrast to the waiting perceived as passive within hospital settings. Intrapartum use practices: modalities, timing, and patterns of recourse In practice, plant use occurs during labour, most often when pain is considered insufficient or cervical dilation is perceived as slow. Plants are administered in various forms (decoctions, infusions, macerations), sometimes combined with other bodily practices such as massage or hot baths. Recourse may be anticipated at home or initiated during labour, sometimes even prior to referral to a health facility. Several women reported consuming the plants without informing healthcare providers, reflecting deliberate strategies of concealment. We drank it before going to the health centre. There, if you say it, they will scold you. (Woman, 34 years) These practices illustrate a pragmatic form of therapeutic pluralism, whereby women combine traditional and biomedical resources according to circumstances. Actors of recommendation and circulation of knowledge Recommendations for plant use rarely originate from the women themselves. Instead, they are predominantly initiated by key female actors: mothers, mothers-in-law, traditional birth attendants, and older women recognized for their obstetric experience. These figures play a central role in knowledge transmission and decision-making during the critical moment of labour. It was my mother-in-law who said that without it, the baby would not come out quickly. (Woman, 22 years) The legitimacy of these recommendations is grounded in lived experience and narratives of successful births circulating within female social networks. This oral circulation confers upon the plants the status of tried-and-tested solutions, which are rarely questioned, even in the absence of formal knowledge of their physiological effects. Lived experiences, perceived effects, and self-reported adverse experiences While most participants described a perceived effectiveness of the plants—such as accelerated labour and intensified contractions—several women also reported unpleasant experiences, sometimes retrospectively minimized but clearly articulated during interviews. These included excessive pain, contractions described as “too strong,” extreme fatigue, malaise, and a sense of loss of control. The pains came all at once, too strong… I couldn’t take it anymore. (Woman, 31 years) Some participants associated these experiences with difficult deliveries or perceived complications, without always establishing an explicit causal link. Nevertheless, these narratives suggest a lived impact of plant use, understood not in statistical terms but as a subjective effect on the childbirth experience. DISCUSSION Taken as a whole, the findings show that the use of oxytocic plants during labour in Toviklin is embedded within a coherent system of representations and practices structured by gender relations, hierarchies of experience, and a context of therapeutic pluralism. Women are neither passive nor irrational; rather, they act within constrained environments by mobilizing socially legitimized forms of knowledge to respond to fears of obstetric risk and the uncertainty inherent in labour. The results indicate that, for the women interviewed, prolonged labour constitutes a central risk, perceived as dangerous for both mother and child. This perception is grounded less in formal biomedical criteria than in a social interpretation of the female body, in which a labour that “drags on” is understood as a dysfunction requiring intervention. Some participants even referred to “mystical interventions preventing the baby from coming out” (A.S., woman aged 29). Such interpretations resonate with the findings of Ononge et al. (2016), who showed that in rural Ugandan contexts, prolonged labour and bleeding are interpreted through locally constructed categories of danger that shape preventive and home-based management practices [ 5 ]. Similarly, Nabatanzi et al. (2023) report that women primarily identify obstetric risk through lived signs—duration, intensity, and exhaustion—prompting early recourse to plants to avert perceived deterioration [ 3 ]. Oxytocic plants are thus invested with a central function: to accelerate, unblock, and normalize labour. They operate as local technologies for managing obstetric time, positioned in opposition to what is perceived as passive waiting within biomedical settings. This function is well documented in the literature. Cabada-Aguirre et al. (2023) report that in Mexico, 16 plant species are specifically used as oxytocic agents to induce or hasten labour [ 2 ]. In Africa, Njamen et al. (2013) describe numerous plants in African pharmacopoeia that are used for their oxytocic or emmenagogic properties, reflecting an active logic of regulating female reproductive functions [ 1 ]. Aworet Samseny et al. (2016) demonstrate that Dichrostachys cinerea induces a dose-dependent increase in the strength and frequency of uterine contractions, with effects comparable to oxytocin [ 6 ]. Complementarily, Monji et al. (2016) show that Ananas comosus exhibits uterotonic activity mediated through serotonergic pathways [ 7 ]. Conversely, Ameen (2023) highlights that some plants, such as Crataegus aronia , exert uterine relaxant effects, illustrating the diversity of physiological mechanisms involved [ 8 ]. Our findings further show that plant use rarely results from an individual decision. Instead, it reflects collective female decision-making, driven by mothers, mothers-in-law, and traditional birth attendants. This dynamic has been widely described by Collins et al. (2017), who show that traditional birth attendants in Madagascar administer uterotonic infusions based on orally transmitted knowledge, and by Nabatanzi et al. (2023), who emphasize the central role of elder women and traditional attendants in recommending plant use [ 3 , 4 ]. Cabada-Aguirre et al. (2023) report similar mechanisms in Mexico, where narratives of successful births structure the intergenerational transmission of practices [ 2 ]. The intrapartum use of plants, sometimes concealed from healthcare providers, reflects a strategic form of therapeutic pluralism in which women combine traditional and biomedical resources. This phenomenon is well documented by Collins et al. (2016), who describe a conflicted coexistence between village practices and hospital care, with plant-related complications often managed in emergency biomedical settings [4]. Nabatanzi et al. (2023) similarly report mixed therapeutic trajectories, with intrapartum plant administration occurring before or during referral to health facilities [3]. Women’s accounts reveal experiential ambivalence: perceived effectiveness on the one hand, and excessive pain or loss of control on the other. This ambivalence aligns with pharmacological evidence. Aworet Samseny et al. (2015) and Monji et al. (2016) demonstrate that certain plants can induce powerful uterine contractions [ 6 , 7 ], while Collins et al. (2016) report complications such as uterine hypertonicity, retained placenta, and haemorrhage associated with plant use [ 4 ]. Poth et al. (2011) identify uterotonic cyclotides that are resistant to enzymatic degradation, suggesting prolonged and potentially difficult-to-control effects [ 9 ]. Despite unpleasant experiences, the practice persists. Perceived positive effects reinforce social acceptance, while negative experiences are often silenced. This mechanism is described by Collins et al. (2016), who note that complications are rarely explicitly attributed to plant use, allowing for their social reproduction [ 4 ]. Nabatanzi et al. (2024) further show that the absence of data on dosage and toxicity sustains this paradox between recognized effectiveness and invisible risk [ 3 ]. Perspective / Socio-anthropological implication The intergenerational and community-rooted circulation of knowledge and practices surrounding oxytocic plants reveals a deeply entrenched system that transcends individual decision-making. To transform maternal health outcomes while respecting local epistemologies, socio-anthropological strategies must target the critical point of intervention : the network of elder women and traditional birth attendants who mediate knowledge and legitimize use. By engaging these key actors through culturally sensitive dialogue, co-designed education, and participatory workshops, it becomes possible to disrupt the perpetuation of potentially risky practices without alienating the community. This approach not only preserves social cohesion but also creates a sustainable leverage point—a pivot—where biomedical guidance and traditional wisdom can converge to enhance maternal safety across generations. Study Limitations This study presents some limitations inherent to qualitative research and the specific context of Toviklin. The sample size, limited to 28 participants, and the focus on a single community restrict the generalizability of the findings to the broader Beninese population. Additionally, the data are based on subjective accounts , which may introduce potential recall bias. However, these limitations were mitigated through rigorous recruitment using snowball sampling , by ensuring theoretical saturation , and by employing a semi-structured interview guide iteratively refined during fieldwork , which ensured depth and consistency of the information collected. Complete transcription, systematic translation, and the use of detailed field notes to capture contextual and non-verbal cues further strengthened the trustworthiness and analytical richness of the results. Thus, despite the constraints inherent to this approach, the study provides a robust and nuanced understanding of community representations and practices surrounding the use of oxytocic plants. CONCLUSION Overall, the use of oxytocic plants during labour in Toviklin emerges as a socially structured practice grounded in shared representations of the body, obstetric time, and risk. Far from being irrational, it constitutes an adaptive strategy embedded in a context of therapeutic pluralism, through which women mobilize available resources to secure their childbirth experience. These findings call for a rethinking of maternal health interventions based on a nuanced understanding of local logics, rather than a simplistic opposition between traditional and biomedical practices. Declarations Ethics approval and consent to participate Ethics approval was obtained from the Local Committee for Biomedical Research Ethics of the University of Parakou (CLERB-UP), Benin, prior to the start of data collection. Written informed consent was obtained from all participants before participation. Confidentiality and anonymity were strictly maintained, and participants were informed of their right to withdraw from the study at any time without any consequences. Consent for publication Not applicable. No individual participant data or identifiable information are included in this manuscript. Availability of data and materials The qualitative data analysed during this study are not publicly available due to ethical considerations and the risk of participant identification but are available from the corresponding author upon reasonable request. Funding This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. Authors’ contributions Beaudouin Jean-de-Dieu Edaye conceived the study, conducted data collection, performed data analysis, and drafted the manuscript. All other authors contributed to data interpretation, critically revised the manuscript, and approved the final version. Competing interests The authors declare that they have no competing interests. Acknowledgements The authors sincerely thank the team of the Research Office in Epidemiology and Population Health (CaRESaP; www.caresap.org) for their technical and methodological support throughout the conduct of this study. References Njamen D, Mvondo MA, Djiogue S, Ketcha Wanda GJM, Magne Nde CB, Vollmer G. Phytotherapy and women’s reproductive health: the Cameroonian perspective. Planta Med mai. 2013;79(7):600–11. Cabada-Aguirre P, López López AM, Mendoza KCO, Garay Buenrostro KD, Luna-Vital DA, Mahady GB. Mexican traditional medicines for women’s reproductive health. Sci Rep 16 févr. 2023;13(1):2807. Nabatanzi A, Walusansa A, Nangobi J, Natasha DA. Understanding maternal Ethnomedical Folklore in Central Uganda: a cross-sectional study of herbal remedies for managing Postpartum hemorrhage, inducing uterine contractions and abortion in Najjembe sub-county, Buikwe district. BMC Womens Health 17 juin. 2024;24(1):349. Collins L, Mmari K, Mullany LC, Gruber CW, Favero R. An exploration of village-level uterotonic practices in Fenerive-Est, Madagascar. BMC Pregnancy Childbirth 1 avr. 2016;16:69. Ononge S, Okello ES, Mirembe F. Excessive bleeding is a normal cleansing process: a qualitative study of postpartum haemorrhage among rural Uganda women. BMC Pregnancy Childbirth 8 août. 2016;16(1):211. Aworet Samseny RR, Angone SA, Madingou NK, Mounanga MB, Datté JY. Study of pharmacological properties of the methanolic extract of Dichrostachys cinerea bark (L.) Wight et Arn (Leguminosae) in isolated myometrium from pregnant rats. J Ethnopharmacol 1 juill. 2015;169:195–9. Monji F, Adaikan PG, Lau LC, Bin Said B, Gong Y, Tan HM, et al. Investigation of uterotonic properties of Ananas comosus extracts. J Ethnopharmacol 4 déc. 2016;193:21–9. Ameen AAM. Uterodilation effect of unripe fruit extract of Crataegus azarolus var. aronia L. on rat uterine smooth muscles. Prostaglandins Other Lipid Mediat déc. 2023;169:106783. Poth AG, Colgrave ML, Philip R, Kerenga B, Daly NL, Anderson MA, et al. Discovery of cyclotides in the fabaceae plant family provides new insights into the cyclization, evolution, and distribution of circular proteins. ACS Chem Biol 15 avr. 2011;6(4):345–55. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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In Africa, as in other regions of the world, medicinal plants occupy a central place in women\u0026rsquo;s reproductive health owing to their accessibility, low cost, and the social trust they command [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. They are widely used during pregnancy, childbirth, and the postpartum period, particularly to induce or accelerate labour and to prevent perceived complications.\u003c/p\u003e \u003cp\u003eEthnobotanical evidence highlights the scale of these practices. In Mexico, more than 185 plant species are used in women\u0026rsquo;s reproductive health, several of which are employed as oxytocic agents to hasten childbirth [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. In sub-Saharan Africa, use is nearly universal in some contexts: in Uganda, 100% of women surveyed report using plants to induce labour, manage postpartum haemorrhage, or provoke abortion [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. These practices are generally recommended and supervised by female authority figures such as traditional birth attendants or elder women within the community [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eDespite the abundance of ethnobotanical and pharmacological data, women\u0026rsquo;s lived experiences, their perceptions of obstetric risk, and the social and collective logics underlying intrapartum plant use remain poorly explored, particularly in the Beninese context. This qualitative study, conducted in Toviklin, seeks to address this gap by providing an in-depth analysis of the representations, practices, and embodied experiences associated with the use of oxytocic plants during childbirth.\u003c/p\u003e"},{"header":"STUDY DESIGN AND METHODS","content":"\u003cp\u003eThis study adopted a descriptive and interpretative qualitative approach aimed at exploring the social representations, decision-making logics, and practices associated with the use of oxytocic plants during labour in Toviklin, in the Couffo Department of south-western Benin. It was conducted in 2024 among women who had recently given birth and who had used, directly or indirectly, such plants during labour, regardless of the place of delivery. Participant recruitment relied on purposive snowball sampling, a strategy particularly well suited to the investigation of sensitive and socially situated practices. Initial index cases were identified with the support of community health intermediaries and local health actors, after which participants progressively referred the research team to other women with comparable experiences. Recruitment continued until theoretical saturation was reached, defined by the absence of newly emerging relevant information.\u003c/p\u003e \u003cp\u003eData were collected through in-depth individual interviews guided by semi-structured interview guides developed specifically for this study and iteratively refined during fieldwork. The semi-structured interview guide is provided as Supplementary File 1. Interviews were conducted in the local ADJA language or in French according to participants\u0026rsquo; preferences, without a translator. Participants were informed about the study procedures and gave \u003cb\u003everbal consent\u003c/b\u003e, confirmed by their \u003cb\u003ethumbprint\u003c/b\u003e as a signature. They were free to choose the \u003cb\u003epresence of their husband or another person\u003c/b\u003e, the \u003cb\u003elocation of the interview\u003c/b\u003e, and the \u003cb\u003elevel of confidentiality\u003c/b\u003e, and they could decline to answer any question or stop the interview at any time. All interviews were audio-recorded with consent, fully transcribed, and translated when necessary. Field notes were taken to document contextual elements, interactions, and non-verbal cues.\u003c/p\u003e \u003cp\u003eData analysis followed an inductive thematic approach inspired by grounded theory, combining immersive reading, line-by-line open coding, aggregation of codes into analytical categories, and the progressive construction of core themes. The analytical focus included social representations of oxytocic plants, perceptions of benefits and risks, sources of knowledge, intrapartum modes of use, and interactions with the formal healthcare system. Data management and analysis were supported by the R statistical environment, which was used as a tool for organizing and visualizing the textual corpus.\u003c/p\u003e \u003cp\u003e From an ethical standpoint, the study was conducted in accordance with fundamental principles of health research ethics. Required authorizations were obtained from local authorities, and anonymity, confidentiality, and respect for local beliefs and practices were ensured throughout the study. Participants were free to withdraw at any time without any consequences.\u003c/p\u003e"},{"header":"RESULTS","content":"\u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eSocio-anthropological characteristics of participants\u003c/h2\u003e \u003cp\u003eThe study included 28 women who had given birth within the twelve months preceding the survey. Participants were aged between 18 and 41 years, were predominantly married or in a stable union, and resided in both rural and semi-urban areas of the municipality of Toviklin. Most were engaged in informal economic activities (agriculture, small-scale trading) and had a low to moderate level of formal education. Deliveries occurred either at home, in health facilities, or along mixed trajectories characterized by movements back and forth between the domestic sphere and healthcare structures.\u003c/p\u003e \u003cp\u003eFrom an anthropological perspective, childbirth is widely perceived as a fundamentally female and social event, rooted as much in embodied experience as in the support provided by local female authority figures (mothers, mothers-in-law, traditional birth attendants). This social configuration constitutes the substratum within which representations and practices related to the use of oxytocic plants are embedded.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eThematic analysis of social representations and practices\u003c/h3\u003e\n\u003cp\u003eInductive thematic analysis identified four closely interrelated core themes.\u003c/p\u003e\n\u003ch3\u003eSocial representations of oxytocic plants: “bringing the baby out” and controlling the timing of childbirth\u003c/h3\u003e\n\u003cp\u003eOxytocic plants are socially represented as substances capable of unblocking, accelerating, or normalizing labour perceived as excessively slow. In participants\u0026rsquo; narratives, labour is conceived as a process that should not \u0026ldquo;last unnecessarily,\u0026rdquo; with prolongation associated with suffering, danger, and, at times, a form of feminine failure.\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003eWhen it drags on, it\u0026rsquo;s not good. The plant helps the body do its work.\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e\n\u003ch3\u003e(Woman, 29 years)\u003c/h3\u003e\n\u003cp\u003eThese representations are grounded in a dynamic conception of the female body, sometimes described as \u0026ldquo;lazy\u0026rdquo; or \u0026ldquo;closed,\u0026rdquo; requiring external stimulation to complete childbirth. The plant thus becomes an instrument for controlling obstetric time, standing in contrast to the waiting perceived as passive within hospital settings.\u003c/p\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eIntrapartum use practices: modalities, timing, and patterns of recourse\u003c/h2\u003e \u003cp\u003eIn practice, plant use occurs during labour, most often when pain is considered insufficient or cervical dilation is perceived as slow. Plants are administered in various forms (decoctions, infusions, macerations), sometimes combined with other bodily practices such as massage or hot baths.\u003c/p\u003e \u003cp\u003eRecourse may be anticipated at home or initiated during labour, sometimes even prior to referral to a health facility. Several women reported consuming the plants without informing healthcare providers, reflecting deliberate strategies of concealment.\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003eWe drank it before going to the health centre. There, if you say it, they will scold you.\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003e(Woman, 34 years)\u003c/h3\u003e\n\u003cp\u003eThese practices illustrate a pragmatic form of therapeutic pluralism, whereby women combine traditional and biomedical resources according to circumstances.\u003c/p\u003e\n\u003ch3\u003eActors of recommendation and circulation of knowledge\u003c/h3\u003e\n\u003cp\u003eRecommendations for plant use rarely originate from the women themselves. Instead, they are predominantly initiated by key female actors: mothers, mothers-in-law, traditional birth attendants, and older women recognized for their obstetric experience. These figures play a central role in knowledge transmission and decision-making during the critical moment of labour.\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003eIt was my mother-in-law who said that without it, the baby would not come out quickly.\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003e(Woman, 22 years)\u003c/h2\u003e \u003cp\u003eThe legitimacy of these recommendations is grounded in lived experience and narratives of successful births circulating within female social networks. This oral circulation confers upon the plants the status of tried-and-tested solutions, which are rarely questioned, even in the absence of formal knowledge of their physiological effects.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003eLived experiences, perceived effects, and self-reported adverse experiences\u003c/h2\u003e \u003cp\u003e While most participants described a perceived effectiveness of the plants\u0026mdash;such as accelerated labour and intensified contractions\u0026mdash;several women also reported unpleasant experiences, sometimes retrospectively minimized but clearly articulated during interviews. These included excessive pain, contractions described as \u0026ldquo;too strong,\u0026rdquo; extreme fatigue, malaise, and a sense of loss of control.\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003eThe pains came all at once, too strong\u0026hellip; I couldn\u0026rsquo;t take it anymore.\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003e(Woman, 31 years)\u003c/h2\u003e \u003cp\u003eSome participants associated these experiences with difficult deliveries or perceived complications, without always establishing an explicit causal link. Nevertheless, these narratives suggest a lived impact of plant use, understood not in statistical terms but as a subjective effect on the childbirth experience.\u003c/p\u003e \u003c/div\u003e"},{"header":"DISCUSSION","content":"\u003cp\u003eTaken as a whole, the findings show that the use of oxytocic plants during labour in Toviklin is embedded within a coherent system of representations and practices structured by gender relations, hierarchies of experience, and a context of therapeutic pluralism. Women are neither passive nor irrational; rather, they act within constrained environments by mobilizing socially legitimized forms of knowledge to respond to fears of obstetric risk and the uncertainty inherent in labour.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eThe results indicate that, for the women interviewed, prolonged labour constitutes a central risk, perceived as dangerous for both mother and child. This perception is grounded less in formal biomedical criteria than in a social interpretation of the female body, in which a labour that \u0026ldquo;drags on\u0026rdquo; is understood as a dysfunction requiring intervention. Some participants even referred to \u0026ldquo;mystical interventions preventing the baby from coming out\u0026rdquo; (A.S., woman aged 29). Such interpretations resonate with the findings of Ononge et al. (2016), who showed that in rural Ugandan contexts, prolonged labour and bleeding are interpreted through locally constructed categories of danger that shape preventive and home-based management practices [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. Similarly, Nabatanzi et al. (2023) report that women primarily identify obstetric risk through lived signs\u0026mdash;duration, intensity, and exhaustion\u0026mdash;prompting early recourse to plants to avert perceived deterioration [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eOxytocic plants are thus invested with a central function: to accelerate, unblock, and normalize labour. They operate as local technologies for managing obstetric time, positioned in opposition to what is perceived as passive waiting within biomedical settings. This function is well documented in the literature. Cabada-Aguirre et al. (2023) report that in Mexico, 16 plant species are specifically used as oxytocic agents to induce or hasten labour [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. In Africa, Njamen et al. (2013) describe numerous plants in African pharmacopoeia that are used for their oxytocic or emmenagogic properties, reflecting an active logic of regulating female reproductive functions [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Aworet Samseny et al. (2016) demonstrate that \u003cem\u003eDichrostachys cinerea\u003c/em\u003e induces a dose-dependent increase in the strength and frequency of uterine contractions, with effects comparable to oxytocin [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. Complementarily, Monji et al. (2016) show that \u003cem\u003eAnanas comosus\u003c/em\u003e exhibits uterotonic activity mediated through serotonergic pathways [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. Conversely, Ameen (2023) highlights that some plants, such as \u003cem\u003eCrataegus aronia\u003c/em\u003e, exert uterine relaxant effects, illustrating the diversity of physiological mechanisms involved [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eOur findings further show that plant use rarely results from an individual decision. Instead, it reflects collective female decision-making, driven by mothers, mothers-in-law, and traditional birth attendants. This dynamic has been widely described by Collins et al. (2017), who show that traditional birth attendants in Madagascar administer uterotonic infusions based on orally transmitted knowledge, and by Nabatanzi et al. (2023), who emphasize the central role of elder women and traditional attendants in recommending plant use [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. Cabada-Aguirre et al. (2023) report similar mechanisms in Mexico, where narratives of successful births structure the intergenerational transmission of practices [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e].\u003c/p\u003e \u003cp\u003e The intrapartum use of plants, sometimes concealed from healthcare providers, reflects a strategic form of therapeutic pluralism in which women combine traditional and biomedical resources. This phenomenon is well documented by Collins et al. (2016), who describe a conflicted coexistence between village practices and hospital care, with plant-related complications often managed in emergency biomedical settings [4]. Nabatanzi et al. (2023) similarly report mixed therapeutic trajectories, with intrapartum plant administration occurring before or during referral to health facilities [3].\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eWomen\u0026rsquo;s accounts reveal experiential ambivalence: perceived effectiveness on the one hand, and excessive pain or loss of control on the other. This ambivalence aligns with pharmacological evidence. Aworet Samseny et al. (2015) and Monji et al. (2016) demonstrate that certain plants can induce powerful uterine contractions [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e], while Collins et al. (2016) report complications such as uterine hypertonicity, retained placenta, and haemorrhage associated with plant use [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. Poth et al. (2011) identify uterotonic cyclotides that are resistant to enzymatic degradation, suggesting prolonged and potentially difficult-to-control effects [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eDespite unpleasant experiences, the practice persists. Perceived positive effects reinforce social acceptance, while negative experiences are often silenced. This mechanism is described by Collins et al. (2016), who note that complications are rarely explicitly attributed to plant use, allowing for their social reproduction [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. Nabatanzi et al. (2024) further show that the absence of data on dosage and toxicity sustains this paradox between recognized effectiveness and invisible risk [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e].\u003c/p\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003ePerspective / Socio-anthropological implication\u003c/h2\u003e \u003cp\u003eThe intergenerational and community-rooted circulation of knowledge and practices surrounding oxytocic plants reveals a deeply entrenched system that transcends individual decision-making. To transform maternal health outcomes while respecting local epistemologies, socio-anthropological strategies must target the \u003cb\u003ecritical point of intervention\u003c/b\u003e: the network of elder women and traditional birth attendants who mediate knowledge and legitimize use. By engaging these key actors through culturally sensitive dialogue, co-designed education, and participatory workshops, it becomes possible to \u003cb\u003edisrupt the perpetuation of potentially risky practices\u003c/b\u003e without alienating the community. This approach not only preserves social cohesion but also creates a sustainable leverage point\u0026mdash;a pivot\u0026mdash;where biomedical guidance and traditional wisdom can converge to enhance maternal safety across generations.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003eStudy Limitations\u003c/h2\u003e \u003cp\u003eThis study presents some limitations inherent to qualitative research and the specific context of Toviklin. The sample size, limited to 28 participants, and the focus on a single community restrict the generalizability of the findings to the broader Beninese population. Additionally, the data are based on \u003cb\u003esubjective accounts\u003c/b\u003e, which may introduce potential recall bias. However, these limitations were \u003cb\u003emitigated through rigorous recruitment using snowball sampling\u003c/b\u003e, by ensuring \u003cb\u003etheoretical saturation\u003c/b\u003e, and by employing a \u003cb\u003esemi-structured interview guide iteratively refined during fieldwork\u003c/b\u003e, which ensured depth and consistency of the information collected. Complete transcription, systematic translation, and the use of detailed field notes to capture contextual and non-verbal cues further strengthened the \u003cb\u003etrustworthiness and analytical richness\u003c/b\u003e of the results. Thus, despite the constraints inherent to this approach, the study provides a \u003cb\u003erobust and nuanced understanding\u003c/b\u003e of community representations and practices surrounding the use of oxytocic plants.\u003c/p\u003e \u003c/div\u003e"},{"header":"CONCLUSION","content":"\u003cp\u003eOverall, the use of oxytocic plants during labour in Toviklin emerges as a socially structured practice grounded in shared representations of the body, obstetric time, and risk. Far from being irrational, it constitutes an adaptive strategy embedded in a context of therapeutic pluralism, through which women mobilize available resources to secure their childbirth experience. These findings call for a rethinking of maternal health interventions based on a nuanced understanding of local logics, rather than a simplistic opposition between traditional and biomedical practices.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cul\u003e\n \u003cli\u003e\u003cstrong\u003eEthics approval and consent to participate \u0026nbsp;\u003c/strong\u003e\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003eEthics approval was obtained from the Local Committee for Biomedical Research Ethics of the University of Parakou (CLERB-UP), Benin, prior to the start of data collection. Written informed consent was obtained from all participants before participation. Confidentiality and anonymity were strictly maintained, and participants were informed of their right to withdraw from the study at any time without any consequences.\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003e\u003cstrong\u003eConsent for publication \u0026nbsp;\u003c/strong\u003e\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003eNot applicable. No individual participant data or identifiable information are included in this manuscript.\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003e\u003cstrong\u003eAvailability of data and materials \u0026nbsp;\u003c/strong\u003e\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003eThe qualitative data analysed during this study are not publicly available due to ethical considerations and the risk of participant identification but are available from the corresponding author upon reasonable request.\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003e\u003cstrong\u003eFunding \u0026nbsp;\u003c/strong\u003e\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003eThis research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003e\u003cstrong\u003eAuthors\u0026rsquo; contributions \u0026nbsp;\u0026nbsp;\u003c/strong\u003e\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003eBeaudouin Jean-de-Dieu Edaye conceived the study, conducted data collection, performed data analysis, and drafted the manuscript. All other authors contributed to data interpretation, critically revised the manuscript, and approved the final version.\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003e\u003cstrong\u003eCompeting interests \u0026nbsp;\u0026nbsp;\u003c/strong\u003e\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003e\u003cstrong\u003eAcknowledgements \u0026nbsp;\u0026nbsp;\u003c/strong\u003e\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003eThe authors sincerely thank the team of the Research Office in Epidemiology and Population Health (CaRESaP; www.caresap.org) for their technical and methodological support throughout the conduct of this study.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eNjamen D, Mvondo MA, Djiogue S, Ketcha Wanda GJM, Magne Nde CB, Vollmer G. Phytotherapy and women\u0026rsquo;s reproductive health: the Cameroonian perspective. Planta Med mai. 2013;79(7):600\u0026ndash;11.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCabada-Aguirre P, L\u0026oacute;pez L\u0026oacute;pez AM, Mendoza KCO, Garay Buenrostro KD, Luna-Vital DA, Mahady GB. Mexican traditional medicines for women\u0026rsquo;s reproductive health. Sci Rep 16 f\u0026eacute;vr. 2023;13(1):2807.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNabatanzi A, Walusansa A, Nangobi J, Natasha DA. Understanding maternal Ethnomedical Folklore in Central Uganda: a cross-sectional study of herbal remedies for managing Postpartum hemorrhage, inducing uterine contractions and abortion in Najjembe sub-county, Buikwe district. BMC Womens Health 17 juin. 2024;24(1):349.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCollins L, Mmari K, Mullany LC, Gruber CW, Favero R. An exploration of village-level uterotonic practices in Fenerive-Est, Madagascar. BMC Pregnancy Childbirth 1 avr. 2016;16:69.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eOnonge S, Okello ES, Mirembe F. Excessive bleeding is a normal cleansing process: a qualitative study of postpartum haemorrhage among rural Uganda women. BMC Pregnancy Childbirth 8 ao\u0026ucirc;t. 2016;16(1):211.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAworet Samseny RR, Angone SA, Madingou NK, Mounanga MB, Datt\u0026eacute; JY. Study of pharmacological properties of the methanolic extract of Dichrostachys cinerea bark (L.) Wight et Arn (Leguminosae) in isolated myometrium from pregnant rats. J Ethnopharmacol 1 juill. 2015;169:195\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMonji F, Adaikan PG, Lau LC, Bin Said B, Gong Y, Tan HM, et al. Investigation of uterotonic properties of Ananas comosus extracts. J Ethnopharmacol 4 d\u0026eacute;c. 2016;193:21\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAmeen AAM. Uterodilation effect of unripe fruit extract of Crataegus azarolus var. aronia L. on rat uterine smooth muscles. Prostaglandins Other Lipid Mediat d\u0026eacute;c. 2023;169:106783.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePoth AG, Colgrave ML, Philip R, Kerenga B, Daly NL, Anderson MA, et al. Discovery of cyclotides in the fabaceae plant family provides new insights into the cyclization, evolution, and distribution of circular proteins. ACS Chem Biol 15 avr. 2011;6(4):345\u0026ndash;55.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Oxytocic plants, Labour, Social representations, Qualitative study","lastPublishedDoi":"10.21203/rs.3.rs-8722815/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8722815/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eIntroduction\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe use of oxytocic plants during labour remains common in West Africa despite potential risks and is still poorly understood in its social and practical dimensions.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA descriptive and interpretive qualitative study was conducted in 2024 in Toviklin (Couffo, Benin). In-depth interviews were carried out with women who had recently given birth, recruited through snowball sampling. Inductive thematic analysis was guided by the principles of grounded theory.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTwenty-eight women were interviewed. Oxytocic plants were perceived as means of controlling the timing of labour and reducing risks associated with prolonged childbirth. Their intrapartum use was socially regulated, recommended by female authority figures, and embedded within pluralistic care-seeking pathways. While positive effects were reported, self-declared unpleasant experiences also emerged, often minimized, yet contributing to the continued social acceptance of the practice.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe use of oxytocic plants is embedded in a coherent system of representations and practices aimed at the social regulation of obstetric risk, highlighting the need for culturally sensitive maternal health interventions.\u003c/p\u003e","manuscriptTitle":"Social Representations and Practices Surrounding the Use of Oxytocic Plants During Labour in Toviklin, South-western Benin in 2024","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-02-03 09:57:16","doi":"10.21203/rs.3.rs-8722815/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"12383a9a-e3b5-4fde-a6c8-fec72c5dc5be","owner":[],"postedDate":"February 3rd, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-02-09T23:09:16+00:00","versionOfRecord":[],"versionCreatedAt":"2026-02-03 09:57:16","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8722815","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8722815","identity":"rs-8722815","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}