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. This sheet talks about whether exposure to herbal products may increase the risk for birth defects over that background risk. This information should not take the place of medical care and advice from your health care provider.

What are herbal products?

Herbal products are considered dietary supplements rather than medications. Herbal products are sold to treat almost any medical problem, and are used by many cultures all over the world. They come in many forms, including, teas, infusions, caplets, dried extracts, and tinctures. Herbal products should be prescribed by a qualified naturopath or herbalist familiar with safety of herbs.

Herbs are in many prepared foods and do not pose risk when used in moderation as part of a balanced diet. However, doses used in herbal supplements may contain high amounts of active compounds that may pose risk or have not been evaluated in pregnancy.

Many patients forget to tell their other health care provider(s) that they use herbal products, but it is important to let all of your health care providers know about all over the counter supplements that you use.

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

Yes. Herbal products for sale in the United States are not regulated by the Food and Drug Administration (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. Dosages of herbal preparations will vary depending on growing and harvesting conditions, plant parts used, and the way they are made into supplements. Some herbal products might contain contaminants such as metals, pesticides, chemicals, microorganisms, or other products not listed on the label. Tinctures and liquid products may contain alcohol, which should be avoided in pregnancy. Dangerous side effects and interactions with prescribed medications or anesthesia have been reported, so talk with your health care provider before starting or stopping the use of any herbal products.

I use herbal products. Should I stop using them before becoming pregnant?

First tell 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 ability to get pregnant or a future pregnancy. A pregnant woman or a woman planning a pregnancy may wish to consider other therapies for which more reproductive data is available.

Some herbal medications have been shown to have high levels of lead, which can be stored in our bodies. If it is possible that you have been exposed to lead, your health care provider can test for this prior to a pregnancy and create a treatment plan to reduce levels of lead in your body.

Can taking herbal products make it harder to get pregnant?

Possibly. Some products have been shown to cause changes in hormones important for conception. Each product’s ingredients should be looked at carefully.

Can herbal products cause miscarriage?

Possibly. Some products have been shown to cause pregnancy loss and hormone imbalance or uterine contractions that could lead to pregnancy loss. Each product’s ingredients should be looked at carefully before pregnancy.

Do any herbal products cause birth defects or other problems in pregnancy?

There is limited information on first trimester use of most herbal products. There is even less information on using herbal products in the second and third trimesters of pregnancy. Most current data does not suggest an increased chance for birth defects when used while pregnant. However, some products have been shown to cause pregnancy loss and 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 health care provider.

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 health care provider.

What if the father of the baby takes herbal products?

Some herbal products may make it more difficult for a man to get his partner pregnant. All herbal products’ ingredients should be looked at carefully before using them 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 and Pregnancy at: http://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/pdf/.

Selected References:

  • Ashar B H and Rowland-Seymour A. 2008, Advising Patients Who Use Dietary Supplements. Am J Med 121(2):91-7.
  • Ciganda C and Laborde A. 2003, Herbal infusions used for induced abortion. J Toxicol Clin Toxicol 41(3):235-239.
  • Dante G et al. 2013, Herb remedies during pregnancy: a systematic review of controlled clinical trials. J Maternal-Fetal and Neonatal Med 26(3): 306-312.
  • Dante G et al. 2014, Herbal therapies in pregnancy: what works? Curr Opin Obstet Gynecol 26:83-91.
  • Frawley J et al. 2015, Women’s Use and Self-Prescription of Herbal Medicine during Pregnancy: An Examination of 1,835 Pregnant Women. Women’s Health Issues 25-4, 396-402.
  • Smeriglio A, Tomaino A, Trombetta D. 2014, Herbal Products in Pregnancy: Experimental Studies and Clinical Reports. Phytother Res 28: 1107-1116.
  • Wang CC et al. 2013, Pregnancy Outcomes, Embryonic and Fetal Development in Maternal Exposure to Chinese Medicines. Birth Defects Res (Part C) 99:275-291.