This sheet talks about using herbal products in pregnancy and while breastfeeding. This information should not take the place of medical care and advice from your healthcare provider.

What are herbal products?

Herbal products are considered dietary supplements. They are not the same as medications. In the United States, dietary supplements cannot be sold for the purposes of treating, diagnosing, preventing, or curing diseases. They come in many forms, such as teas, infusions, caplets, dried extracts, and tinctures.

Herbs can be used in preparing foods. Herbs used in preparing food would not be expected to be of concern when used in moderation. However, herbal products could contain high amounts of active compounds that can be of concern in pregnancy or while breastfeeding. The Food and Drug Administration (FDA) does not check herbal products for safety and effectiveness before they are sold in stores or online. This means very few herbal products have scientific proof that they work in the way stated on the product label. Many herbal supplements have not been evaluated for use in pregnancy.

Often patients forget to tell their healthcare provider(s) that they use herbal products, but it is important to let all of your healthcare providers know about all over-the-counter products that you use.

Are herbal products different from using prescription or over-the-counter medications?

Yes. The safety and effectiveness of herbal products for sale in the United States are not regulated by the FDA. Most have been poorly studied regarding their safety and ability to work as they are advertised. Also, there are no standards for ingredients and strength. If claims sound too good to be true, they probably are. Be mindful of product claims such as “works better than [a prescription drug],” “totally safe,” or has “no side effects.” Be aware that the term “natural” does not mean safe.

Levels of active ingredients in herbal preparations will depend on the growing and harvesting conditions, plant parts used (e.g. root, stem, flower, and/or bark), and the way they are made into supplements.

Some herbal products might contain contaminants such as metals (lead, arsenic and mercury), pesticides, other chemicals, or microorganisms (e.g. fungi or bacteria). They may even contain other products not listed on the label. Tinctures and liquid products can contain alcohol, which should be avoided in pregnancy.

Dangerous side effects have been reported for some herbal products. Many herbal products can also affect how well prescribed medications or anesthesia work, so ask your healthcare provider if the supplement you are considering would be helpful for you before starting or stopping the use of any herbal products.

Can taking herbal products make it harder to get pregnant?

Some herbal supplements have been shown to cause changes in hormones important for getting pregnant. Other products have been suggested to increase the chances of getting pregnant, but their safety has not been proven.  Each product’s ingredients should be looked at carefully.

I just found out that I am pregnant, should I stop using herbal products?

Talk to your healthcare provider about all the products you use. Most herbal products have not been well studied during pregnancy, so it is not always possible to know how they might affect the chance to get pregnant. A pregnant woman or a woman planning a pregnancy may wish to consider other therapies for which more information is available.

Some herbal medications have been shown to have high levels of lead, which can be stored in our bones. Your healthcare provider can test your lead level before pregnancy. If needed a treatment plan to reduce levels of lead in your body can be discussed.

Do herbal products cause miscarriage?

Miscarriage can occur in any pregnancy. Some products have been shown to cause pregnancy loss from hormone imbalance or uterine contractions that could lead to pregnancy loss. Each product’s ingredients should be looked at carefully.

Do any herbal products if used in the first trimester increase the chance of birth defects?

In every pregnancy, a woman starts out with a 3-5% chance of having a baby with a birth defect. This is called her background risk. There is limited information on first trimester use of most herbal products. Most current data does not suggest an increased chance for birth defects when used while pregnant.

Information on products that contain multiple herb ingredients are very hard to study for safety.  There is concern about interactions between ingredients in these products and other medications an individual may be taking and concern over harmful substances not noted on the label. Some products have been shown to cause pregnancy loss, hormone imbalance, or uterine contractions that could lead to pregnancy loss or early labor. Read the label on the product and discuss each ingredient with your healthcare provider.

Could using herbal products in the second or third trimester cause other pregnancy complications?

There is very little information on using herbal products in the second and third trimesters of pregnancy. Some products have been shown to bring on labor, but their overall safety has not been proven.  Other products have been shown to cause pregnancy loss, hormone imbalance, or uterine contractions that could lead to pregnancy loss or early labor. Read the label on the product and discuss each ingredient with your healthcare provider.

Could using herbal products in pregnancy cause any long-term problems in behavior or learning for the baby?

At this time, there are no studies on the possible long-term effects of herbal products on the developing baby.  Therefore, it is not known if there is or is not any increased chance of long-term problems in behavior or learning for the baby.

Can I use herbal products while breastfeeding?

There is very little information on use of herbal products while nursing an infant. Read the label on the product and discuss each ingredient with your healthcare provider. Talk to your healthcare provider for all your breastfeeding questions.

If a man uses herbal products, could it affect his fertility (ability to get partner pregnant) or increase the chance of birth defects?

Some herbal products might make it more difficult for a man to get his partner pregnant. All herbal product ingredients should be looked at carefully before using when trying to get pregnant.

In general, exposures that fathers have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/pdf/.

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