Modern medicine has brought us greatly improved outcomes in high-risk pregnancies and births. At the same time, technology that helps deliver these results has become ubiquitous in labor and delivery departments in hospitals. For over 20 years, the Cesarean section has been the most common hospital surgical procedure performed in the U.S. C-sections now account for over 34% of all U.S. births. A lot of babies owe their lives to technology.
Still, technology is relied upon too much in pregnancy and birth in the U.S. Despite the high rate of money and use of technology in obstetric care that surpasses all other countries, the U.S. consistently ranks poorly in infant mortality and birth outcomes worldwide.
In addition, conventional doctors prescribe an excessive amount of prescription medications to pregnant women, many of which have significant risks. Thalidomide is off the market thankfully as it caused horrific birth defects and problems for the babies exposed in utero for years to come. Even what we consider safe OTC medications like Tylenol are no longer seen that way. The most common medication given to pregnant women for yeast infections increases miscarriage some studies now show.
What’s more is the amount of prescription medications that pregnant women are taking, including narcotics. One study examined the pattern of prescription drugs dispensed to more than one million women enrolled in Medicaid for at least 3 months before and then throughout pregnancy from 2002 to 2007. Almost 83% of these women were dispensed at least one medication; half of these were antibiotics.
Another study found that the rate of narcotics dispensed to pregnant women who were enrolled in Medicaid in these same years increased from 18.5% to 22.8% with rates exceeding 30% in five states. Among women of reproductive age generally in the United States from 2008 to 2012, almost 40% of Medicaid-enrolled women and 28% of commercially insured women filed claims for narcotics.
When you consider this excessive use of medications, incorporating herbs during pregnancy seems pretty good. However, some herbs do have safety warnings for use during pregnancy. Just because it’s natural doesn’t automatically make it safe for pregnant women.
Many pregnant women have a desire to avoid unnecessary medical interventions, which makes it appealing to seek out natural approaches and alternatives.
The use of herbs for the treatment of common pregnancy symptoms is very common. Studies estimate that up to 45% of women use herbal therapy at some point during pregnancy. Keep in mind that anyone can post anything to the internet, so it’s crucial that you use reliable, verifiable sources of information that you can trust. Read on for more information.
Herbs during pregnancy: are they safe?
Herbs have been used to alleviate symptoms during pregnancy for thousands of years. Little is known scientifically about the safety of most herbs during pregnancy, as most have not been formally evaluated and ethical considerations limit human clinical investigation during pregnancy.
We can say the same for many pharmaceuticals, most of which have not been tested or proven safe during pregnancy. Medications previously thought to be safe in pregnancy, including Tylenol, have now been found to cause potential problems for the baby.
Most of what we know about using herbs during pregnancy is based on a significant body of empirical, historical, and observational evidence. Some animal and pharmacological studies have been conducted. In general, most herbs are safe with little evidence of harm. And pregnant women many times find natural remedies to be milder, gentler, and safer than prescription or OTC drugs.
Most adverse events from herbal use during pregnancy occur from toxic herbs, inappropriate use or dosage of herbs, or adulterations of botanical therapies. It’s important to remember that lack of proof of harm does not equate to proof of safety. Some harmful effects may not be evident until use has ended. Or harm may occur from cumulative use. It’s important to become educated on herbal use during pregnancy.
Schools of thought differ on whether herbs should be used during pregnancy. Some believe that since most herbs are not proven safe during pregnancy, they should be entirely avoided, while others see certain herbs more as foods that can provide an additional source of nutrition during pregnancy, or as tonics that can encourage and support optimal pregnancy health and uterine function.
Perhaps the most reasonable approach to herb safety is a “risk: benefit” one that takes into consideration the safety of the individual herb, the severity of the symptom or condition and comparing this to the safety of the corresponding conventional medical approach.
Certain signs and symptoms arising during pregnancy always warrant medical attention, and should not be treated with herbs. These include:
- Edema of the hands and face
- Severe headaches, blurry vision, or epigastric pain
- Rupture of membranes prior to 37 weeks pregnancy
- Regular uterine contractions prior to 37 weeks pregnancy
- Cessation of fetal movement
- Persistent vaginal bleeding
- The initial outbreak of herpes blisters during the first trimester
- Severe pelvic or abdominal pain
- Persistent, severe mid-back pain
Using herbs during pregnancy
It’s safest to avoid using herbs during your first trimester unless medically indicated, or if there isn’t a safer or more effective medical alternative.
Beverages and teas that are known to be safe in moderate amounts like rose hips, nettles, lemon balm, chamomile, spearmint, and red raspberry. Using normal amounts of common cooking spices is also considered safe.
There are herbs whose chemical compositions are mostly gentle substances such as carbohydrates, vitamins, and minerals and which can be used safely in pregnancy as basic daily tonics. This includes milky oats (Avena sativa), red raspberry (Rubus idaeus), and nettles (Urtica dioica).
You should consult with a midwife, herbalist, or naturopathic physician trained in using herbals during pregnancy before using herbs medically, meaning to treat a specific symptom or medical condition.
In addition to common pregnancy symptoms, herbs can be used to alleviate symptoms of mild illness like headaches, colds, and indigestion. Herbs can help and be safer than OTC medications. Many of these problems can be addressed safely and gently with mild herbs such as echinacea, ginger, or chamomile respectively.
Herbs to avoid
While many herbs are known to be safe in pregnancy, there are other herbs that should be avoided. Some herbs can be used for brief or more extended periods of time for specific conditions.
Licorice is an example of such an herb. Used short term for a sore throat, for example, for no greater than one week, it may be entirely safe and appropriate, however, it is contraindicated in patients with hypertension, and long-term use of even licorice candy containing actual licorice extract has been associated with preterm birth.
Topical applications, including vaginal use (i.e., for the treatment of vaginal infections), of most herbs is considered safe, however, some herbs, for example, poke root, pennyroyal oil, and thuja, which are known to be toxic, should be avoided internally and topically.
Herbs for common pregnancy symptoms
The herbs cited in the medical literature as most frequently used for pregnancy concerns varies slightly among studies but includes echinacea, St John’s wort, ephedra; peppermint, spearmint, ginger root, raspberry leaf, fennel, wild yam, meadowsweet; blue cohosh, black cohosh, red raspberry leaf, castor oil, evening primrose, garlic, aloe, chamomile, peppermint, ginger, echinacea, pumpkin seeds, and ginseng.
In one study, women reported lower GI problems, anxiety, nausea and vomiting, and urinary tract problems as the most common reasons for using complementary therapies in pregnancy. Midwives most frequently recommend herbs for nausea and vomiting, labor stimulation, perineal discomfort, lactation disorders, postpartum depression, preterm labor, postpartum hemorrhage, labor analgesia, and malpresentation.
Getting ready for birth: do you need herbs to help?
Partus preparators are herbs sometimes used during the last weeks of pregnancy to tone and prepare the uterus for labor. They have historically been used to facilitate rapid and easy delivery. Examples include blue cohosh and, black cohosh.
Why would you use an herbal preparation to prepare the body for something it naturally knows how to do? Furthermore, the safety of these herbs prior to the onset of labor is questionable. Case reports have been reported suggesting an association between blue cohosh and profound ischemic episodes or myocardial infarction in the neonate.
Blue cohosh contains a number of potent alkaloids including methyl cysteine and anagyrine, the latter, which is known to have an effect on cardiac muscle activity. Other side effects of blue cohosh include maternal headache and nausea. Yet the use of blue cohosh represents one of the one widely applied botanical medicines by midwives, including CNMs, and one of those most commonly included in late pregnancy formulas self-prescribed by pregnant mothers. Much of this is due to medical pressure for induction of labor by 40 weeks of pregnancy.
Red raspberry leaf tea, 2 cups daily, on the other hand, is known to be safe in pregnancy, and several studies have now shown that taking it regularly in the last trimester can make labor easier, reduce the need for medical interventions in labor, and make the baby less likely to need any resuscitation. Red dates eaten in the 3rd trimester have also been shown to be safe and effective at making labor easier.
Final thoughts
Herbs can provide substantial relief for common symptoms that occur during pregnancy and childbirth. The power of herbs should be respected during pregnancy, and therefore, they should be used with caution. However, many herbs may be contraindicated on the basis of very limited findings, erroneous reports, or by association with a problem rather than a proven causal effect.
Many herbs that have not been evaluated may, nonetheless, offer simple, safe, gentle, and effective solutions for many common pregnancy problems ranging from anemia to vaginitis. A proper diet, exercise, and a healthful lifestyle including a positive outlook and strong social support are the greatest foundations for an optimal childbearing experience.