Are Preconception Herbs Safe During Pregnancy?

Are Preconception Herbs Safe During Pregnancy?

The safety of preconception herbal remedies during pregnancy can be hard to understand and worrisome. When a person does a search on the Internet for “herb safety during pregnancy”, what comes up in the search is some basic information, but often this information is incomplete. Most sites list the most important herbs to avoid during pregnancy, but these lists often do not say why you should avoid those particular herbs, nor site where the information came from. Before considering any type of herb use in pregnancy, it is important to prepare your body for a healthy pregnancy, prior to actually becoming pregnant. Now, I know this is not always possible. I surprisingly got pregnant without much thought as to how healthy I should be prior to pregnancy. But, many of you are here because you want to prepare your body for pregnancy, are working to heal fertility issues prior to pregnancy, or to do what ever it takes to become pregnant.

If you are not yet pregnant, visualize what you might look like pregnant. How do you feel, what thoughts come up about yourself, thoughts about your health, your body image? What kind of birth would you like, natural or epidural? If you are already pregnant, ask yourself these same questions. The reason I am asking you to ask yourself these questions, is because it is very powerful what society tells pregnant mothers. Media, doctors, midwives, friends, family; they all have their opinion. What really matters is how you view yourself as a pregnant woman. I want you to take a moment to say the following out loud, even if you are not yet pregnant, “I am a beautiful woman. Pregnancy is a natural part of life. My body is capable and healthy.”

It is important to view pregnancy as a natural part of the cycle of life. Pregnancy is best left untouched by medications or medicinal herbs. In some instances we may come to find during pregnancy we are sick or in need of some kind of outside support, and in those times, we need to be educated about herb safety, so we can make informed decisions. If you are desiring to continue herbs into pregnancy, or begin any herbal supplementation, it is always best to be under the supervised care of your midwife, naturopathic doctor, or medical doctor. Never begin taking herbs you are unsure about, in pregnancy.

How Can Herbs Harm Me or My Unborn Baby?

There are some words that are important to know when considering how herbs may affect your pregnancy. Some are scientific medical terms, and others are words that describe a medicinal action of an herb. Knowing the meaning of these words will help you to determine if an herb has a potential for harming either you, or your unborn baby. If any herb that you are researching for use during pregnancy, or if you are wondering if you should continue on with an herb that you are currently taking, identifies its actions with any of these words, please talk to your health care provider about discontinuing use of it. It is important to note that some herbs may elicit a hormone like effect. In this case you may need to make a plan of how to wean off of that herb slowly, over time, so as to not disrupt the natural hormonal cycle of the pregnancy.

Scientific Medical Words to Know:
These are most often use in reference to scientific studies.

  • Toxicity: The measure of the degree to which something is toxic or poisonous.
  • Acute toxicity: Adverse effects of a substance that result in either a single exposure or multiple exposure in a short amount of time (24 hours). To be classified as acute toxicity, the person must have experienced adverse effects within 14 days of exposure.
  • Teratogenicity: The ability to cause birth defects.
  • Aberration: To deviate from the expected course. May alter the natural course of the pregnancy or growth of the baby.
  • Cytotoxicity: Toxicity to cells.
  • Mutagenicity: An agent that can induce the mutation of an organism.

Medicinal Actions of Herbs to Know:
The following definitions are directly related to possibly causing a change in the uterus. Not all of these are harmful to pregnancy. Any herb that is defined to have one of these actions should not be self prescribed, but may possibly be used under the supervised care of your midwife, herbalist or naturopathic doctor.

  • Uterine Tonic: Strengthens and tones the uterus. Stimulates mild uterine contractions. Not to be used in the first trimester of pregnancy for women with a history of recurrent miscarriage.
  • Abortifacient: Potential to cause miscarriage.
  • Antiabortive: May help to prevent miscarriage. Herbs with this action should only be used under specific instruction from a qualified herbal practitioner.
  • Emmenagogue: Stimulates, normalizes menses flow. Because of this there is a pregnancy caution for herbs that may stimulate the menstrual cycle.
  • Parturient: Promotes labor. Never to be self prescribed. Not to be used until the end of the third trimester.

While many medications have been tested on animals to see the potential for harmful effects, most herbs are not. We rely mainly on the thousands of years of wisdom of midwives and herbalists for information on herb use during pregnancy. I find that when there is research done on the safety of a particular herb, the scientists inject animals with very high doses of super concentrated amounts of a chemical constituent of a plant. This is not how a human would use an herbal remedy, ever. Not anyone I know, that is. Midwives and herbalists trained in herbal preparations for the childbearing year, are careful when selecting herbs, and often the herbs chosen may be different for each of the women they care for. Selecting herbal preparations to use for pregnancy is highly dependent on what the woman’s needs are, the state of her health and the action of the herbs chosen.

Herbs Used for Preconception to Avoid in Pregnancy

Because we are a preconception natural fertility based website, I feel it is extremely important to cover this topic. We get many questions each day on this subject. Here are some of them…“Is it safe to continue the herbs I am using after ovulation? What if I find out I am pregnant and I am taking Vitex?” “I am over the moon, I found out today that I am pregnant, I have been trying for years. I am taking some herbs and I am scared they may harm my baby, what should I do?” “I heard that maca supports progesterone production, so I guess it should be fine to continue into pregnancy, since I have a history of low progesterone, right?”

Hopefully providing pregnancy safety information on the most popular preconception herbs, that are part of our Natural Fertility Shop, will help all of you to make informed decisions about when to use certain herbs in the menstrual cycle, how they may affect pregnancy, and when to discontinue them.

Dong quai (Angelica sinensis): Not for use during menstruation, when trying to conceive, during pregnancy or breastfeeding. Dong quai is best used ahead of time in preparation for trying to conceive. If you are actively trying to conceive and using Dong quai within the same cycle, discontinue use of the herb right after ovulation and resume after your menstrual cycle has ended and you know you are not pregnant. In some cases may be used in pregnancy, only if suggested and used under the guidance of a Traditional Chinese Medical (TCM) practitioner.

Vitex, Chaste Tree Berry (Vitex agnus-castus): Placebo controlled studies for teratogenicity and mutagenicity were conducted in rats, using Vitex. Even when the animals were administered 74 times the dosage typically consumed by humans, no toxicity nor aberations in fetal development were seen. In addition the Botanical Safety Handbook provided no contraindications to use during pregnancy. Many midwives use Vitex to help prevent recurrent miscarriage.

While Vitex can be used to help a miscarriage that is acute, for safety reasons it is best to use at least 3 months prior to conception, and another progesterone therapy such as progesterone cream to maintain stable progesterone levels once pregnancy has occurred. Working with a health practitioner once you are pregnant to help you keep your progesterone levels up is the wisest option at that point.

Stopping Vitex cold turkey in the first trimester of pregnancy may affect hormone levels, or it may not, it depends on many different factors individual to each woman. It is best to wean yourself off of vitex over time, 1-2 weeks if you find out you are pregnant. You would first contact your doctor/midwife/naturopathic physician and request to get your hormone levels tested. They will help to determine if you may have low progesterone or may need to switch over to natural progesterone cream instead of Vitex. A practitioner can help to guide you through this transition.

If you are using Vitex while trying to conceive and you are worried about continuing it into pregnancy, it may be best to use it prior to ovulation only.

Maca (Lepidium meyenii): Maca is considered both a super food and a medicinal herb. Maca has been used for thousands of years by the peoples of Peru, they eat it daily; even during pregnancy. Acute toxicity and cytotoxicity studies have shown no potential toxicity for Maca. Hundreds of thousands of people have used maca with no reported side effects. All that being said, there are no studies to show if maca is potentially harmful during pregnancy. If you would like to continue maca into pregnancy, it would be best to do so under the care of your doctor or midwife. Because it is considered a nutritional supplement and herbal supplement, it is still advised that you get permission or talk to your health care provider about using Maca into pregnancy. It is always best to be on the safe side and let your health care provider know all herbs and supplements you are taking, especially if you are pregnant.

If you are choosing to continue Maca into pregnancy because you think it may aid the body in maintaining adequate progesterone levels, it would be best to see your doctor/midwife to have your hormone levels tested. If it is determined that you do have low progesterone, it would be best to talk to your health care provider about switching to natural progesterone cream instead. Maca is best used 3-6 months for pregnancy preparation.

Tribulus (Tribulus terrestris): Tribulus is not recommended for use during pregnancy. A woman who is trying to conceive should only use this herb prior to ovulation. Tribulus has demonstrated aberration to the health of pregnant women. Tribulus has been shown to cause or contribute to cholestsis when used during pregnancy. Cholestasis is a liver disease that only happens during pregnancy. In women who develop cholestasis, the normal flow of bile from the gallbladder is affected by very high levels of pregnancy hormones. The gallbladder holds bile from the liver, aiding in the breakdown of fats for digestion. Cholestasis slows this function down, which may cause bile acids to spill into the blood stream.

Some animal studies have shown to cause locomotor disorder known as staggers. While another showed decreased survival rate of offspring when taken during pregnancy. This is why Tribulus should not be used in pregnancy. Discontinue use of Tribulus once you find out you are pregnant, or if you think you may be pregnant.

Evening Primrose Oil (Oenothera biennis)– It is believed that the high levels of LA and GLA’s in Evening Primrose Oil have a direct effect on uterine cells. These contract and relax smooth muscle tissue. This action on the uterus is toning for the uterine muscles in preparation for pregnancy. EPO is NOT suggested for use after ovulation when a woman is trying to conceive. If a woman is pregnant, or thinks she may be pregnant, she should not not use EPO because the uterus may begin to contract. In some women this may lead to pre-term labor or miscarriage; though there is little evidence as such. Nonetheless, it is always best to use caution when using EPO if you think you may be pregnant.

Some of you may have heard that EPO is safe for pregnancy. This is because EPO has been used to prepare (ripen) the cervix, in the last trimester of pregnancy, for hundreds of years by midwives. This is either done by rubbing the cervix with the oil, having the mother use an EPO capsule as a vaginal suppository, or having the mother take it in internally the last few weeks of her pregnancy. This should only be done under the care of a highly qualified midwife or other qualified medical professional.

Using Herbs for Pregnancy Wellness

One way to ensure optimal wellness in pregnancy, besides eating a nutrient dense, high protein diet and regular exercise, is to consume nutritive herbs. Herbs are not meant to be a substitute for dietary and lifestyle changes! Below are some herbs that have been shown safe for use during pregnancy to maintain proper health, alleviate common pregnancy complaints, while also maintaining a healthy immune system.

The following herbs have been shown safe for general use in pregnancy.

Almonds (Amygdalis communis): One of the best remedies for heartburn in pregnancy. I used to carry around a bag of them everywhere I went. Chewing 8 to 10 almonds very slowly, then swallowing, several times a day may help to reduce and prevent heartburn during pregnancy.

Chamomile (Matricaria recutita): Works to calm the nerves, promote general relaxation, promotes healthy digestion and proper inflammatory response. Wonderful for women who have insomnia in pregnancy.

Cranberry (Vaccinum macrocarpon): Not to be mixed up with sweetened cranberry juice! Pure cranberry juice is wonderful at preventing and treating urinary tract infection (UTI).

Dandelion root (Taraxacum officinale): Great nutritive herb, digestive bitter. May help to increase appetite in women with nausea or vomiting. Aids in maintaining adequate iron levels.

Echinacea (Echinacea spp.): It is not uncommon to catch a cold or other respiratory infection during pregnancy. Have you ever wondered if it was okay to take that over-the-counter cold medication? Well Echinacea may be the best safe alternative. Echinacea may reduce the duration of a cold, prevent the recurrence of colds and upper respiratory infection.

Ginger (Zingiber officinalis): The best herb for nausea, especially in the 1st trimester. Promotes healthy digestion.

Nettles (Urtica Doica): Nettles is one of the best nutritive herbs out there. Helpful in boosting iron levels. May aid in allergic rhinitis, sometimes common in pregnancy. Never consume in very high quantities.

Red Raspberry Leaf (Rubus idaeus): An herb that supplies high levels of iron and other minerals to the uterus, it can help to build a nourishing uterine lining. Raspberry leaf works to tone the uterine muscles, preparing for the hard work of labor. It’s high nutritional content is a valuable tool for women preparing for pregnancy, and to maintain adequate nutrition through pregnancy. Useful in curbing diarrhea. Has been used to promote and expedient labor. Note: Not to be used in the 1st trimester for those women with a history of recurrent miscarriage.

If you have any of the following conditions and desire to use a natural approach to healing, which may include the use of herbs, please find a qualified herbalist, midwife or naturopathic doctor, someone you can work one-on-one with. Never self prescribe herbs for these conditions, it is best to seek the guidance of a herbal health care professional. A qualified practitioner will be able to complete a full assessment and suggest herbs that are just right for your particular needs!

  • Constipation
  • Hypertension
  • Anemia
  • Group B Strep Infection
  • Herpes outbreak
  • Hemorrhoids
  • Chronic Insomnia
  • Threatened Miscarriage

There are hundreds of herbs that can safely be used in pregnancy under the right circumstances, prescribed by qualified professional care of your midwife, herbalist or naturopathic doctor. If you feel that a natural approach to healing is what is best for you and your baby, find a good natural health care practitioner in your area! There are many other herbs for labor and delivery that these health care practitioners use. Feel free to ask your health care practitioner what herbs may be used for your labor, delivery support, postpartum healing and breastfeeding support!

References:
1. Botanical Medicine for Women’s Health; Aviva Romm. Churchill Livingstone, 2010
2. wikipedia.org/wiki/Acute_toxicity
3. wikipedia.org/wiki/Cytotoxicity
4. thefreedictionary.com/aberration
5. medical-dictionary.thefreedictionary.com/teratogenicity
6. wikipedia.org/wiki/Toxicity_%28disambiguation%29
7. cms.herbalgram.org/herbclip/121/review42145.html
8. thefreedictionary.com/mutagenicity

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[-] 14 Comments
  1. Hi. I could really use some advice on Vitex right now. I started taking it 3 months ago because I had seriously irregular cycles, now I am 7 weeks pregnant and I’m still taking Vitex since I don’t believe it’s a good idea to stop cold turkey. I am currently taking 800 mg a day and I am planning to reduce it to 400 mg a day soon and then every other day till I reach 12 weeks. BUT the problem is that my doctor put me on extra progesterone suppositories since I have had 2 early mc in the past. I have been taking extra progesterone over a week now and I would really like to know is it safe to take these two things together? I have been driving myself crazy to find any info online.

    • Dear BB,

      Congratulations!

      Fertilica Vitex can be taken with progesterone. But, we have to suggest Vitex be weaned off of in early pregnancy (first trimester). It is not a good idea to stop cold turkey, you are correct. That being said, the purpoase of taking Vitex is to help the body produce and increase progesterone. Because you are now supplementing with progesterone, per your doctor’s instructions, Vitex may no longer be needed.

      The general approach by herbalists for miscarriage prevention support is to continue the herbal miscarriage prevention protocol, in this case Vitex, until at least 2 weeks past the last weeks’ gestation of the previous miscarriage. For example: if the previous miscarriage occurred at 8 weeks, continue the formula until at least 10 weeks. Remember, it is extremely important to work with an herbal practitioner, someone who can monitor your herbal program.

      All my best to you! Again, Congratulations!

  2. Hi Elizabeth!
    It’s me again! 🙂 so sorry but I got a quick update – I’m still taking all the supplements I mentioned before (see thread below). This is my first cycle since taking them for about a month. Good news is my cycle is down to 28 days from 31/32 days cycle! Not so good news is I am getting cramps and clots in my menses (sorry tmi!). Is that normal as my cycle is stabilizing? Thanks!

    • Hello Layla!

      Menstrual cycle shifts can happen for some women when they start taking herbs that have an action on hormonal balance, which both Fertilica Vitex and Fertilica Maca do. It sounds as though the body is responding to the action of these herbs. If menstrual bleeding has remained close to normal and is bright red, there may be little cause for concern, but consider learning how to support the body through menstrual cramps.

      I hope this finds you well!

  3. Hi, Elizabeth!
    I just found your site. I started Vitex April 25, 2014. I had been going through a very stressful time and noticed my hormones were out of whack. I started sprouting chin hairs. Yikes! I started acupuncture at the same time, twice weekly. I ran out of Vitex Jan 31 and didn’t start again until Feb. 16th, and also started taking dong quai. I quit taking the dong quai last week, after a missed period (LMP 1-28). I should say that we weren’t trying to get pregnant. I found out this morning that I AM PREGNANT (!!). I’m glad I stopped the dong quai, but now I’m wondering about the Vitex. I’ve been on it nearly a year now. I now only have a few chin hairs, phew! Thank you so much!!!

    • Dear McKenzie,

      Congratulations! This is wonderful news!

      Fertilica Vitex is best weaned off of in early pregnancy. Learn The Safe Way to Discontinue Herbs in Pregnancy here…

      All my best!

    • Thank you, Elizabeth! I just worry about my progesterone not staying up high enough. I would be devastated if we lost the baby because of that. Thanks for the article. I’m heading to it now! And thank you so much for the reply and help! I appreciate it. 🙂

    • Hello McKenzie!

      You are welcome! I know the article will be helpful and, as I am sure you know, it is best when concerned to reach out to your healthcare provider to discuss how to best support healthy progesterone levels given your specific need (if there even is need) in early pregnancy. Again, Congratulations!

  4. Hi there

    Thank you for the informative article on safety of herbs.
    I am currently taking wobenzym n and DIM capsules and I’m planning to start on maca and vitex as well (I have an ovarian cyst and a miscarriage before and TTC again now). My question is – how do I wean off wobenzym n and DIM if I find out I’m pregnant? Can all of those supplements be used all month long and are they safe for pregnancy? Thank you for your advice!

    • Dear Layla,

      Wobenzym N, DIM, Fertilica Vitex and Fertilica Maca can all be taken together, all cycle long prior prior to conception and while trying to conceive. We can not suggest they be continued into pregnancy unless being guided in using them by your healthcare provider or midwife.

      Wobenzym N, DIM and Fertilica Maca can be discontinued if you think you may be pregnant or confirm pregnancy. Fertilica Vitex is best weaned off of in most cases. Learn more in our article Herbs and Pregnancy Q&A: The Safe Way to Discontinue Herbs in Pregnancy.

    • Thank you Elizabeth for your prompt reply. Just another question – I started my regime of those herbs and supplements and noticed I have a nagging headache throughout the day. Is it the effect of those herbs working its way in my system? Or should I be concerned and lower the dosage? Or maybe spread out the pills more throughout the day? Also, my doctor just prescribed me penicillin antibiotics for a cough for about a week. Can I take those and still be on my herbal supplement regime or should I stop for the week?
      Thank you so much for your attention.

    • Hello Layla!

      So happy to be helpful!

      I am sorry you are having headaches! I am not able to speak to lowering doses as I am not sure how much you are taking. This being said, lowering your dose of Maca may be a place to start. A minor and infrequent side-effect (1-2% of users may experience) of Fertilica Vitex may be headache, although again this is rare. I have not heard of headaches being experienced from DIM, Castor Oil Therapy, or Wobenzym N.

      What dose of Maca and Vitex are you taking? Are you taking these with food or shortly before eating? Are you staying hydrated – drinking eight, 8 ounce glasses of filtered water a day?

    • Hi Elizabeth!
      Thanks again for your reply. I am taking 2 tablets of fertilica vitex once in the morning before breakfast (500mg each tab) and then after breakfast I take one tab of fertilica maca (750mg). Since yesterday I have started taking my Maca tablet later after dinner instead and this has seem to make my headaches disappear. I am not sure if that is the one that’s helping with the headaches but I guess I will continue with spreading out the supplements that way. Could that be the cause? I do try to stay hydrated throughout the day but I will make more effort at that from now on. Also what is your take on taking the antibiotics while on the sup? My dr said it is ok? Thank you.

    • Hi Layla!

      You are welcome!

      It sounds as though you have found a solution. I am thankful!

      Regarding antibiotics, if they are necessary, I can not suggest not to take them. If you have to do so, consider our Fertility Health Tip: Probiotics and Prebiotics… taking a probiotic too.

      All my best!