Read More
Herbal supplements and pregnancy
Herbal supplements are used during pregnancy for a variety of reasons; some are safe, others can be harmful. The majority of herbal remedies have not been studied, and their effects during pregnancy are unknown. Herbal supplement use during lactation is covered briefly in Module 8, Breastfeeding Assessment and Support.
| Product | Purported Use | Comments (Including safety, efficacy, evidence) |
| Black Cohosh | Uterine stimulant Labor-inducing aid |
Efficacy is unclear Caution during pregnancy (especially during the first trimester) because of potential (though unproven) labor-inducing properties Caution during lactation is suggested, due to potential hormonal effects Blue cohosh (not black) is also used for gynecologic disorders and has a greater potential for toxicity than black cohosh. |
| Echinacea | Anti-infective agent, remedy for viral infections (especially upper respiratory infections) | Evidence for use in treating upper respiratory infections is strong Oral consumption during the first trimester was not associated with an increased risk of major malformations Caution for use during lactation until stronger evidence about safety is available Consider potential for interactions between echinacea and other medications |
| Ginger | Treatment of hyperemesis | 250 mg powdered capsules The American College Obstetricians and Gynecologists Practice Pattern suggests this as option (ACOG, 2015) Some controversy over safety of high doses, 1.0-1.5 g doses have been shown effective in some RCTs (in vitro studies of specific, isolated constituents indicated mutagenicity; not borne out in clinical trials) (Low Dog, 2009) |
| Ginkgo | Memory boosting Treatment for asthma, sexual disfunction, hormonal changes |
Major safety concern with use during pregnancy is anti-platelet activity and prolonged bleeding during delivery Some case reports of adverse effects during pregnancy related to product adulteration; clinicians should be aware of manufacturers who use Good Manufacturing Practices (GMP) Theoretical evidence for avoiding raw ginkgo seed during pregnancy and lactation Consider potential for interactions between gingko and other medications |
| St. John’s Wort | Enhance uterine tone Treatment for depression |
Caution is warranted related to use during pregnancy; safety studies are weak |
References: Smeriglio A, Tomaino A, Trombetta A. Herbal Products in Pregnancy: Experimental Studies and Clinical Reports. Phytotherapy Research. 2014;28(8):1107-1116. Low Dog T. The use of botanicals during pregnancy and lactation. Alt Ther Health Med. 2009;15(1):54-58. |
||
Table 2-1. Selected herbal supplements and implications during pregnancy
| Herbs to avoid during pregnancy | |
| Herb | Action |
| Blue cohosh | Oxytoxic |
| Black cohosh | Uterine stimulant effects (used by some midwives in preparation for labor) |
| Chamomile, valerian | Antispasmodic, sedative |
| Goldenseal | Oxytoxic |
| Dong quai | Stimulant, relaxant |
| Comfrey "internal use" | Liver toxicity |
| Ephedra | Uterine stimulant |
| Chaste tree | Uterine stimulant |
| Pharmacologic dose of zinc | Premature and stillbirth |
| Reference: Born D, Barron ML. Herb use in pregnancy: what nurses should know. MCN 2005; 30(3):201-206. | |
Table 2-2. Herbs to avoid during pregnancy
Copyright 2007 | Disclaimers
Last updated: 02/13/2019