Which Herbs Should I Avoid During Pregnancy? (And Why)
I’ve been meaning to write about this topic for some time because as an herbalist, I keep getting asked this question by women, primarily. It’s a pretty important question, too: Are herbs safe to use during pregnancy, and if so, which ones are ok? Also, and more important, especially in the first trimester, are the herbs to completely avoid.
Just because herbs are natural and are plants does not necessarily mean they are safe.
Many adults are used to drinking their chamomile and calendula tea, and these herbs (among many others) are quite safe for the typical adult and even children.
However, when you are pregnant, you need to exercise caution. And I’m talking caution to the point that you just assume that NO herbs are safe until you’ve done your research, have asked an herbalist (or three), and spoken with your medical professional.
This is because during pregnancy, everything you ingest affects your baby, for better or worse. That tea made with chamomile and calendula I just mentioned contains extremely safe herbs, however, calendula has emmenagogue properties, which contraindicates it (it’s a big NO) for pregnant women!
It’s far better to err on the side of caution, in my opinion.
Just because an herb is natural does not mean it is good for you.
This line of thinking also applies to over the counter medications and even many prescription drugs that are routinely prescribed during pregnancy.
You need to do your own research so you can make your best decisions.
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Which Herbs Should Pregnant Women NOT Take?
Pregnancy is a special time, and it’s vital to make good decisions about what you decide to put into your body. Just because a plant is natural does not make it safe to use during pregnancy, or even possibly lactation.
So many herbalists feel so strongly about their belief that plant medicine is the BEST medicine (and I’m raising my hand here) that they throw caution to the wind (not me) when it comes to special circumstances. I definitely believe a more conservative attitude is the wisest mindset while you’re pregnant.
It can be very dangerous to be just a “little educated” about using herbs for your health. It’s tempting to learn a little bit about herbs and get all excited….and then make some very poor decisions when using herbs.
And prescription and over the counter medications are really no safer. Doctors may prescribe medications during pregnancy that are possibly unsafe as well. This is why I keep stating YOU must do your own research on all remedies and medications before taking them.
The FDA has made labeling changes in recent years to help make prescribing drugs easier for doctors and also over the counter medication labels more clear about dangers. However, I have read reports from people stating that they suspect they were prescribed medications they should not have been, and drugs are prescribed to pregnant women that should absolutely not be.
Plus, we all know now how toxic certain drugs like acetaminophen is to the liver—-and if you are pregnant and decide to take a Tylenol…guess who else is getting a dose of liver toxin? Your baby.
Herbs can be a great alternative to OTC medications, but you still need to know what you are taking, the actions of the specific herb, and potential effects.
Juliet Blankespoor, of the Chestnut School of Herbal Medicine, wisely states that a pregnant woman should “begin with assuming that the herb isn’t safe. Then you can research whether the herb is, in fact appropriate and safe.” The fact of the matter is that there are MANY normally safe herbs that are just NOT safe during pregnancy for a variety of reasons.
Even culinary herbs, such as rosemary, thyme, and cinnamon, among others, can be dangerous when used in large amounts, or medicinal dosages. Normal culinary use may be fine, but when used in higher amounts, potential problems may be more likely.
The first trimester, especially, is the most dangerous in terms of potential issues and the one in which the most caution should be taken. I would advise not taking anything at all during this time period, if you can help it.
Here are some main groups of herbs to completely avoid during pregnancy and possibly even while breastfeeding. The herbs listed here are not an exhaustive list by any means. This is where the burden for deciding what herbs to take falls squarely on your shoulders, as it does for us all.
Do your research. Look to more than just one or two reputable places for information. Trust your gut and your instincts. If you don’t “feel right” about taking something (and that includes OTC and Rx), then respect those feelings and keep trying to get answers.
Categories of Herbs to Completely Avoid During Pregnancy
Uterine Stimulants & Emmenagogues
Any herb with an action stating “emmenagogue” is contraindicated. This is because they have actions on the uterus that may start a miscarriage or premature labor. Some examples of herbs to avoid include yarrow, feverfew, pennyroyal, black cohosh, blue cohosh, motherwort, dong quai, blessed thistle, ashwagandha, calendula, and others.
Some emmenagogues are used at the very end of pregnancy, late in the third trimester as types of childbirth remedies, but these should only be used under medical supervision by a doctor, midwife, or experienced herbalist.
Emmenagogues generally support healthy menstruation, and pregnancy is not indicated for these kinds of herbs. Emmenagogues stimulate the uterus and increase blood flow in the female reproductive area, which helps expel menstrual fluid. Some have hormone balancing effects as well.
Some herbs you may hear are safe and are commonly found in teas, such as calendula, which has an extremely safe track record in general. However, calendula, as “safe” as it is, supports female reproductive health and specifically menstruation….so I would say “NO” to even calendula, as gentle as it is, at least in large amounts. Calendula has emmenagogue actions, but unless you do plenty of research, you may not know this.
Herbs with Laxative Actions
Any laxative that is stimulating to the intestinal tract should be avoided during pregnancy. These herbs cause and/or enhance peristalsis (the rhythmic contractions) of the intestines, which may also cause stimulation to the uterus, which is located near the intestines.
These kinds of laxatives are usually more harsh than just using much safer fiber bulking plants such as oatmeal, flaxseed, and psyllium. Bulking plants that contain lots of fiber are absolutely safer alternatives than herbs with laxative actions because they don’t cause any kind of contraction in smooth muscle.
If you experience constipation during pregnancy, it is best to increase your water and fiber intake, as well as gentle exercise such as walking. You can use demulcent (soothing) herbs too, as long as they are otherwise not contraindicated for pregnant women.
Herbs that stimulate peristalsis and should be completely avoided include senna, aloe vera, cascara sagrada, buckthorn, and there are others.
Hormone Supporting Herbs
These are herbs that balance or otherwise affect the hormones. These types of herbs should be avoided because pregnancy revolves around specific hormonal health and balance in a woman’s body.
However, herbalists and midwives do debate which ones should be left alone and which are actually ok to use. Red clover (Trifolium pratense) and also the much touted female herb, red raspberry leaf (Rubus spp.) are examples of herbs that many herbalists say are just fine to use during pregnancy, while others say not to use them at all. Again, I suggest always erring on the side of caution.
Essentially, avoid herbs with strong effects on hormones. These include black cohosh, fenugreek, hops, licorice, and even motherwort and vitex.
This kind of goes without saying, right?
These herbs are sometimes called “low-dose” herbs, and are sometimes be used with medical or naturopathic supervision….but never during pregnancy. These plants contain constituents that are absolutely harmful to a developing fetus and to adults when taken incorrectly.
These herbs are usually avoided by most herbalists anyway. Some of these include digitalis (foxglove), mistletoe, lily of the valley, pennyroyal, tansy, and rue.
Bioactive Herbs, Teratogens, Abortifacients
These kinds of herbs contain constituents that act directly on the body in some mighty powerful ways. They may contain alkaloids that are concentrated or other chemicals that have been proven harmful to embryos or fetuses and perhaps even healthy adults. These herbs will have traditional cautions against use in pregnancy.
Some of these herbs may also induce or stimulate abortion (abortifacients) or cause an embryo to become malformed (teratogens). Teratogens and abortifacients are not always herbal, as certain medications and even commonly taken substances, such as alcohol, fall under this category too.
Herbs we believe to be safe for everyone, such as ginger, may actually fall into the category of potentially harming a fetus if taken in large enough quantities. Research is still being done, and so far, only in rats, but just knowing this fact should cause one to pause before reaching for that “safe” herbal remedy.
Sarsaparilla, lomatium, horse chestnut, frankincense, elecampane, eucalyptus, lobelia, mugwort, and many, many others are included in this list.
Pyrrolizidine Alkaloids (PA’s)
These are special alkaloids scientists are just beginning to discover and understand in certain herbs that may have been used internally for years. One of these is comfrey, for example. Comfrey for many years was thought to be a wonderful herb to take internally, as it helps tissues heal and repair themselves quickly.
However, in recent years, researchers are finding out a great deal about PA’s, and herbs that contain high levels are no longer considered safe for internal use!
PA’s are especially dangerous to the liver development of embryos, fetuses, nursing infants, and toddlers.
PA’s are dangerous for adults too, especially when taken internally over long periods of time!
One of the problems with PA’s is that symptoms of issues may not appear until irreversible damage has already been done. This is why most herbalists are recommending even healthy people who are not pregnant and nursing stay away from internal use of herbs containing these compounds.
These should be completely avoided by those who are pregnant and nursing. Other plants besides comfrey that contain PA’s include borage, ragwort, coltsfoot, and butterbur.
We are still learning a lot about these compounds, so with that said—-avoid them completely.
Herbs and Breastfeeding
Breastfeeding babies should be treated similarly to a fetus because most plant constituents pass through the mammary glands to the milk. Some herbs that are contraindicated during pregnancy are ok during breastfeeding, such as uterine stimulants, because the chance of premature labor is no longer an issue.
However, some herbs should still be avoided.
Remember, all herbs should still be considered (possibly) dangerous unless your research proves otherwise anytime your baby’s health is on the line.
How to Have a Healthy Pregnancy
I am a grandmother now, and my pregnancy days are long, long gone. However, I still remember not wanting to take any kind of medication back in the 80’s when I was having children, and I didn’t even know about natural remedies back then.
As an elder woman, I recommend what most wise women recommend during pregnancy: eating a healthy diet, drinking enough healthy fluids, and getting exercise that is appropriate for your stage of pregnancy.
I must note that eating a healthy diet does not include processed foods, junk, or the garbage commonly found in the middle aisles of the grocery store. Try to eat whole foods: vegetables and fruits, and clean meats. Food that comes as directly from the earth as possible.
And as far as fluids go….water. Lots of good, detoxifying water, maybe with a bit of lemon juice or some fruit for infusing. Cucumbers are great too.
Avoid too much salt and sugar, and move your body. Walking especially, is great during pregnancy. With my fourth child, I was still doing some difficult hikes into my eighth month, and just a few days before birth, I was in the mountains, walking the trails. Stay active. It’s good for you. It’s good for the baby.
So, What Herbs CAN You Take During Pregnancy?
There are a few herbs that most will agree across the board are safe. Raspberry leaf tea is one of these (although I have come across one herbalist who says, NO, to raspberry. However, in all my studies and research, I have found far more “yeses” for raspberry leaf tea than this one, “no.”).
Echinacea for supporting the immune system
Peppermint for soothing stomach upset and digestion
Cranberry in the event of a UTI, or for supporting healthy urination
Chamomile for helping with anxiety and to relax
Ginger, in small amounts, for helping with nausea
Although herbs have been used for centuries by people for their health, pregnancy is a condition that warrants extreme caution. My suggestion based on my herbal studies is simply to assume an herb is not safe unless and until you do your research and talk with your doctor about using it.
Do not just take advice from anyone…do your own research, and be sure to search out sources that have a high reputation. PubMed, nih.gov, and others with clinical research studies are good sources. Herbal study materials from reputable herbalists are also good sources.
When you are sourcing information, when you note that there is agreement between most herbalists on when and how to use an herb, that is a good sign as well.
And if in doubt….err on the side of caution.
What do you think? I’d love to know your comments, questions, and any advice you may have as well, so leave these in the comments section!
You might also be interested in my special series on How to Get Started Using Herbs!
Other articles on the blog you may also enjoy include:
There are LOTS more over on the blog, so I hope you’ll go browse around!
By the way, would you like to learn more about home herbalism and how to use herbal remedies safely and effectively? It’s easier than you think to make your own natural products that can take the place of your over the counter medications and more.
You can find out more about how to become a home herbalist here: The Confident Herbalist: A Guide to Home Herbalism.
And take a look at the Herbal Academy of New England for lots of other courses for people of all experience levels and interests. They seriously have a course for everyone.
One other option for learning herbalism is to choose a membership site where you receive deep level, easy to learn content through video, hands-on projects, and tons of weekly interaction and live videos in a private student Facebook community. Take a look at The Confident Herbal Tribe….you have access to all the current and previous courses!
Hugs, Health, and Self-Reliance,
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Disclaimer: I am not a medical doctor. In no manner, stated or implied, is any content in this article or any of my platforms meant to treat, cure, diagnose, or prevent any disease or illness. Please be sure to seed the advice of a medical professional before using herbs or essential oils. These statements have not been evaluated by the FDA.
Chestnut School of Herbal Medicine, Online Foraging Course study materials, 2019.
Codekas, C., Helpful Herbs for Pregnancy, retrieved from https://www.growforagecookferment.com/helpful-herbs-for-pregnancy/ July, 2019.
Cragen, J. et. al.; Ensuring the Safe and Effective Use of Medications During Pregnancy: Planning and Prevention Through Preconception Care. Matern Child Health J. 2006 Sep; 10(Suppl 1): 129–135. Published online 2006 Jul 19. doi: 10.1007/s10995-006-0102-2 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1592140/
da Silva Costa, K., Bezerra, S., Norte, C., Nunez, L., de Olinda, T.; Medicinal Plants with Teratogenic Potential : Current Considerations, Brazilian Journal of Pharmaceutical Science 48(3):427-433 · September 2012 https://www.researchgate.net/publication/262629373_Medicinal_plants_with_teratogenic_potential_Current_considerations
Desai, R.; Hernandez-Diaz, S.; Bateman, B.; Huybrechts, K. Increase in Prescription Opioid Use During Pregnancy for Medicaid-Enrolled Women. Obstetrics & Gynecology. 123(5):997–1002, (2014) https://insights.ovid.com/article/00006250-201405000-00015
FDA (U.S. Food and Drug Administration Consumer Updates) Pregnant? Breastfeeding? Better Drug Information is Coming. Retrieved 7/2019 from https://www.fda.gov/consumers/consumer-updates/pregnant-breastfeeding-better-drug-information-coming
Jweihan, N. M.D.; Is Tea Safe to Drink During Pregnancy?, (updated 2019). https://momlovesbest.com/tea-during-pregnancy
Romm, A.J. The Natural Pregnancy Book: Herbs, Nutrition, and Other Holistic Choices (Potter/TenSpeed/Harmony, 2011).
Rose, L., Herbs to Avoid During Pregnancy and Breastfeeding. (2017). https://www.growingupherbal.com/herbs-to-avoid-during-pregnancy-and-breastfeeding/?
Other sources for further reading:
**Anything by Aviva Romm, actually
American Herbal Products Association’s Botanical Safety Handbook, 2nd ed. (CRC Press, 2013).
Gladstar, R. Herbal Healing for Women (Simon and Schuster, 1993).
Mills, S., and Bone, K. The Essential Guide to Herbal Safety (Elsevier Health Sciences, 2005).