Although medicine has replaced most natural supplements with a synthetic substitute, there are many who still look to natural herbs and vitamins to provide essential nutrition and relief of common discomforts for pregnant women. Here we examine herbs in relation to pregnancy.
Herbs and Pregnancy: Risks, Caution, and Recommendations
Many herbalists believe that herbs are often better, cheaper, and healthier than their medical counterparts. However, many medical professionals do not recommend herbal remedies for pregnant women since safety has not been established through extensive research. Unlike prescription drugs, natural herbs and vitamin supplements do not go through the same scrutiny and evaluation process by the FDA. As a result, the quality and strength of an herbal supplement can vary between two batches of the same product and between products from different manufacturers.
Consumers have little way of knowing if a product will do what the label claims and how safe the product may be. Reliable information about the product may be hard to find, which makes researching these products’ effectiveness more challenging.
What are the risks of taking herbs while pregnant?
Although herbs are natural, not all herbs are safe to take during pregnancy. The FDA urges pregnant women not to take any herbal products without talking to their health-care provider first. Women are also urged to consult a trained and experienced herbalist (or other professionals trained to work with herbs) if they want to take herbs during their pregnancy. Some herbal products may contain agents that are contraindicated in pregnancy.
Herbs may contain substances that can cause miscarriage, premature birth, uterine contractions, or injury to the fetus. Few studies have been done to measure the effects of various herbs on pregnant women or fetuses.
Herbs of caution while pregnant
Depending on the source, some information will list a herb as safe to consume during pregnancy, whereas another source may list the same herb as unsafe. Therefore, it is best to consult with your health care provider or someone trained in using herbs before taking any natural medicine or herb during pregnancy.
Some organizations that specialize in herbs have done extensive testing on their safety. Often these organizations will list herbs with their safety ratings for the general population and for those who are pregnant or breastfeeding. These ratings can often be confusing and hard to interpret; this is why speaking with a professional who is familiar with using herbs during pregnancy is recommended.
One key thing when understanding the safety ratings is to pay attention to what type of use the rating is for. For example, the rating for rosemary is considered Likely Safe when used orally in amounts typically found in foods. (Rosemary has a Generally Recognized as Safe (GRAS) status in the US.)
But in pregnancy, rosemary is considered Possibly Unsafe when used orally in medicinal amounts. Because rosemary may have uterine and menstrual flow stimulant effects, it is best to avoid using it. There is insufficient reliable information available about the safety of the topical use of rosemary during pregnancy. This is a prime example of how the method of use of the herb changes its safety rating.
We know that rosemary sprinkled in your tomato sauce is not a risk to you and your baby.
However, if you were to use rosemary in a large dose, like that used in medicinal amounts, it could be dangerous for your pregnancy. The same goes for herbs such as garlic, sage, ginger, and turmeric. All of these herbs could be contraindicated in pregnancy when used in large or concentrated doses, but are considered safe when used in amounts found in food. 2
Herbs to avoid while pregnant
The following herbs are considered Likely Unsafe or Unsafe during pregnancy. 3
- Saw Palmetto – when used orally, has hormonal activity
- Goldenseal – when used orally, may cross the placenta
- Dong Quai – when used orally, due to uterine stimulant and relaxant effects
- Ephedra – when used orally
- Yohimbe – when used orally
- Pay D’ Arco – when used orally in large doses; contraindicated
- Passion Flower – when used orally
- Black Cohosh – when used orally in pregnant women who are not at term
- Blue Cohosh – when used orally; uterine stimulant and can induce labor
- Roman Chamomile – when used orally in medicinal amounts
- Pennyroyal – when used orally or topically
Recommended herbs while pregnant
Depending on what type of health care provider you see, he/she may recommend using herbs to help promote the health of your pregnancy. Remember, never try to self-dose or diagnose with any medications, including herbs. Because each pregnancy is different, the best way to use herbs is under the care of a midwife, physician, herbalist, naturopathic or homeopathic doctor.
Choosing to use herbs during pregnancy is a personal choice, but to ensure the best outcome for you and your baby, you should be well educated on the types of herbs, parts of the herb (root, leaf, etc…) and the way they could be used (caplet, tonic, tea). The herbs that are considered safe to use during pregnancy are often food or tonic herbs. These are typically found in either tablet, tea, or infusion form.
Common herbs used in pregnancy
The following herbs have been rated Likely Safe or Possibly Safe for use during pregnancy:4
- Red Raspberry Leaf – Rich in iron, this herb has helped tone the uterus, increase milk production, decrease nausea, and ease labor pains. Some studies have even reported that using red raspberry leaf during pregnancy can reduce complications and the use of interventions during birth.5 You may see pregnancy teas that are made from red raspberry leaf to help promote uterine health during pregnancy. (Read about herbal teas for more information.) There is some controversy about whether this should be used throughout pregnancy or just in the second and third trimester, so many health care providers remain cautious and only recommend using it after the first trimester.
- Peppermint Leaf – Helpful in relieving nausea/morning sickness and flatulence
- Ginger root – Helps relieve nausea and vomiting
- Slippery Elm Bark – (when the inner bark is used orally in amounts used in foods) Used to help relieve nausea, heartburn, and vaginal irritations
- Oats & Oat Straw – Rich in calcium and magnesium; helps relieve anxiety, restlessness, and irritated skin
There are a number of herbal pregnancy teas available with many of these ingredients.
Additional herbs rated Likely Safe or Possibly Safe:
- Blond Psyllium – when used orally and appropriately
- Black Psyllium – when used orally with appropriate fluid intake
- Garlic – when used orally in amounts commonly found in foods
- Capsicum (Cayenne, hot pepper) – when used topically and appropriately
The following herbs have been rated as having Insufficient Reliable Information Available by the Natural Medicines Database, even though many are recommended by homeopathic physicians, herbalists, and midwives who treat pregnant women.
More extensive research and discussions with your treating health care provider will help you make the decision about what herbs are safe for you to use.
- Dandelion – Rich in Vitamin A, calcium, and iron; dandelion root and leaf can also help relieve mild edema and nourish the liver
- Chamomile (German) – High in calcium and magnesium; also helps with sleeplessness and inflammation of joints
- Nettles (Stinging Nettles) – High in vitamins A, C, K, calcium, potassium, and iron. Used in many pregnancy teas because it is a great all-around pregnancy tonic. Note on the safety of Nettles: Natural Medicines Database gives Nettles a rating of Likely Unsafe, even though it is used in countless pregnancy teas and recommended by most midwives and herbalists. This may be contingent upon which part of the Nettles plant is used (the root or the leaves) and how much is used. According to other sources, the use of Nettles is encouraged during pregnancy because of its health benefits.6
Other popular herbs
The following are commonly used herbs which have a safety rating of Possibly Unsafe when used orally. Again, these are herbs you would want to do more extensive research on and discuss with your health-care provider before using.
- Ginseng (American & Korean)
- Evening Primrose
- Kava Kava
Want to Know More?
Compiled using information from the following sources:
1. 1, 2, 3 Natural Medicines Database
2. 4 Women’s Health Series: Herbs of Special Interest to Women. J Am Pharm Assoc. 40(2):234-242, 2000.
3. 5 Raspberry leaf in pregnancy: its safety and efficacy in labor. J Midwifery Women’s Health. 2001 Mar-Apr;46(2):51-9. PMID: 11370690
4. 6 Belew, C. (1999). Herbs and the childbearing woman: Guidelines for midwives. J Nurse-Midwifery. 44:231-252.