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 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 supplements could contain high amounts of active compounds that can be of concern in pregnancy or while breastfeeding. However, many herbal supplements have not been evaluated in pregnancy.

Many 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 supplements 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 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.

Levels of active ingredients in herbal preparations will vary depending on 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, pesticides, other chemicals, microorganisms (e.g. fungi or bacteria), or 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 supplements. Some herbal supplements can also affect how well your prescribed medications or anesthesia work, so talk with your healthcare 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 healthcare 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 herbal supplements have been shown to cause changes in hormones important for getting pregnant. Each product’s ingredients should be looked at carefully.

Can herbal products cause miscarriage?

Possibly. 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 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, 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.

Can I use herbal products while breastfeeding?

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

What should I take into consideration if I decide to use an herbal product?

  • Remember that the FDA is not authorized to 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.
  • When searching for an herbal product on the internet, it is better to use noncommercial sites (e.g. NIH, FDA, USDA) rather than depending on information from the herbal product company or any other commercial website ending with “.com”.
  • 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.
  • Ask your healthcare provider if the supplement you are considering would be helpful for you.

What if the father of the baby takes herbal products?

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 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 https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/pdf/.

References Available Upon Request