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 cite 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 whatever 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 used 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.
- Anti-abortive: 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 years, 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, it 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 aberrations 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 a week’s time 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 aberrations 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 can happen 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 bloodstream.
Some animal studies have shown Tribulus to cause movement 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 oils 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 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 to be safe for use during pregnancy to maintain proper health and alleviate common pregnancy complaints, while also maintaining a healthy immune system.
The following herbs have been shown to be 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, promotes general relaxation and promotes healthy digestion and proper inflammatory responses. Wonderful for women who have insomnia in pregnancy.
Cranberry (Vaccinum macrocarpon): Not to be confused 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 treat upper respiratory infections.
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. Its 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 expedite 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!
- Group B Strep Infection
- Herpes outbreak
- 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 healthcare practitioners use. Feel free to ask your healthcare practitioner what herbs may be used for your labor, delivery support, postpartum healing, and breastfeeding support!
- Romm, A. J. (2010). Botanical medicine for women’s health. St. Louis, MO: Churchill Livingstone/Elsevier.
- Toxicity. (n.d.). Retrieved from: https://www.merriam-webster.com/dictionary/toxicity
- Cytotoxicity. (n.d.). Retrieved from: https://www.merriam-webster.com/dictionary/cytotoxicity
- Aberration. (n.d.). Retrieved from: https://www.merriam-webster.com/dictionary/aberration
- Teratogenic. (n.d.). Retrieved from: https://www.merriam-webster.com/dictionary/teratogenic
- Toxic. (n.d.). Retrieved from: https://www.merriam-webster.com/dictionary/toxic
- American Botanical Council. (1997). Herbs Useful and Contraindicated in Pregnancy and Lactation. Retrieved from: http://cms.herbalgram.org/herbclip/pdfs/101071-121.pdf
- Mutagenicity. (n.d.). Retrieved from: https://www.merriam-webster.com/dictionary/mutagenicity