This sheet is about exposure to berberine in pregnancy and while breastfeeding. This information is based on published research studies. It should not take the place of medical care and advice from your healthcare provider. 

What is berberine?

Berberine is an ingredient found in many plant species, including goldthread, huang lian, Oregon grape, and barberry. It has been used to treat many conditions, such as diarrhea, diabetes, and high cholesterol. It has also been used for weight loss.   

Berberine is available as a supplement sold over the counter. In general, it is suggested to speak with your healthcare provider before taking any supplements. Many supplements are not recommended for use during pregnancy unless your healthcare provider has prescribed them to treat a medical condition. This is because they are not well-regulated or studied for use in pregnancy. For more detail on supplements, please see the fact sheet at https://mothertobaby.org/fact-sheets/herbal-products-pregnancy/. 

I take berberine. Can it make it harder for me to get pregnant?

It is not known if berberine can make it harder to get pregnant. There is some information to suggest berberine might increase fertility and pregnancy rates in people with polycystic ovary syndrome (PCOS). 

Does taking berberine increase the chance of miscarriage? 

Miscarriage is common and can occur in any pregnancy for many different reasons. It is not known if berberine can increase the chance of miscarriage. One study suggests that berberine might cause uterine contractions. As there can be many causes of miscarriage, it is hard to know if a medication, the medical condition being treated, or other factors (such as age, health, other exposures) are the cause of a miscarriage. 

Does taking berberine increase the chance of birth defects? 

Birth defects can happen in any pregnancy for different reasons. Out of all babies born each year, about 3 out of 100 (3%) will have a birth defect. We look at research studies to try to understand if an exposure like berberine might increase the chance for birth defects in a pregnancy.  

It is not known if using berberine can increase the chance of birth defects. The research on berberine is limited to one report looking at 218 pregnancies exposed to huang lian (which contains berberine). Of those, three babies had nervous system defects, and three had defects in their genitals. 

Does taking berberine in pregnancy increase the chance of other pregnancy-related problems?

Studies have not been done to see if berberine can increase the chance of pregnancy-related problems such as preterm delivery (birth before week 37) or low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth). 

Berberine can change how bilirubin (a yellowish pigment that is made during the breakdown of red blood cells) binds to serum albumin (the main protein in blood plasma). This can cause a buildup of bilirubin in the brain, which can lead to brain damage and other issues. While information on this is very limited, one author suggests avoiding herbs and products that contain berberine during pregnancy. 

Does taking berberine in pregnancy affect future behavior or learning for the child?  

Studies have not been done to see if berberine can increase the chance of behavior or learning issues for the child. 

Breastfeeding while taking berberine:

Berberine can pass into breastmilk, but it is not known how much. It may raise the risk of bilirubin buildup in a baby’s brain, which can lead to brain damage and other problems, especially in newborns. Also, because berberine is a supplement, it is not recommended for use during breastfeeding unless your healthcare provider has prescribed it to treat a medical condition. Be sure to talk to your healthcare provider about all your breastfeeding questions.  

If a man takes berberine, could it affect his fertility or increase the chance of birth defects?

Studies have not been done in humans to see if berberine could affect men’s fertility (ability to get a partner pregnant) or increase the chance of birth defects. In general, exposures that fathers or sperm donors 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/.  

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This sheet is about exposure to the HPV vaccine during pregnancy and while breastfeeding. This information is based on published research studies. It should not take the place of medical care and advice from your healthcare provider.  

What is HPV?

Human papillomavirus (HPV) is the most common infection that is passed by skin-to-skin sexual contact. There are over 200 different kinds of HPV. At least 50% of all sexually active people have been exposed to at least one type of HPV. Most people will have no symptoms of HPV infection and no related health problems. However, some types of HPV do cause health problems, like genital warts. Others can cause cancer of the cervix and vagina, the penis, the mouth/throat, and the anus.  

What is the HPV vaccine? 

The HPV vaccine protects against infection with some types of HPV that cause cancer and genital warts. Gardasil®9, which protects against 9 of the HPV virus types, is the brand name of the HPV vaccine currently available in the United States. The vaccine is approved for people between 9 and 45 years of age but it provides the most protection when given before becoming sexually active. The vaccine is given in either two or three doses (series). Gardasil®9 does not contain a live virus. This means it is noninfectious and cannot give a person HPV. Noninfectious vaccines in general are considered a low concern for pregnancy. MotherToBaby has a general fact sheet on vaccines here: https://mothertobaby.org/fact-sheets/vaccines-pregnancy/.  

I got the HPV vaccine. Can it make it harder for me to get pregnant? 

There is no evidence to suggest that getting the HPV vaccine would make it harder to get pregnant in the future. Since the HPV vaccine is noninfectious, there is no recommended waiting period before trying to get pregnant. Pregnancy testing is not needed to get the HPV vaccine. However, the Centers for Disease Control and Prevention (CDC) recommends that if you find out that you are pregnant before you get all the doses, wait until after pregnancy to finish the vaccine series. 

Does getting the HPV vaccine increase the chance of miscarriage? 

Miscarriage is common and can occur in any pregnancy for many different reasons. Information from several studies (including one study looking at over 5000 pregnancies exposed to the HPV vaccine during pregnancy) does not suggest an increased chance of miscarriage. 

One study suggested a possible increased chance of miscarriage when receiving the HPV vaccine in the first trimester of pregnancy. However, it is not known if these findings are due to the HPV vaccine or other factors. 

Does getting the HPV vaccine increase the chance of birth defects? 

Birth defects can happen in any pregnancy for different reasons. Out of all babies born each year, about 3 out of 100 (3%) will have a birth defect. We look at research studies to try to understand if an exposure, like the HPV vaccine, might increase the chance of birth defects in a pregnancy. In over 4,000 pregnancies in which an HPV vaccine was given shortly before or during pregnancy, no increased chance of birth defects was found. 

Does getting the HPV vaccine increase the chance of other pregnancy-related problems? 

Getting the HPV vaccine has not been shown to increase the chance of other pregnancy-related problems, such as preterm delivery (birth before week 37) or low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth). 

Does getting the HPV vaccine affect future behavior or learning for the child?   

Studies have not been done to see if the HPV vaccine can increase the chance of behavior or learning issues for the child. Based on what is known about noninfectious vaccines, getting the HPV vaccine is not expected to increase the chance of behavior or learning issues for the child.   

Breastfeeding and the HPV vaccine:

The CDC notes that the HPV vaccine can be given to a person who is breastfeeding. Be sure to talk to your healthcare provider about all your breastfeeding questions.

If a man gets the HPV vaccine, could it affect his fertility or increase the chance of birth defects?

There is no evidence to suggest that the HPV vaccine could affect men’s fertility (ability to get a partner pregnant) or increase the chance of birth defects. HPV infection in men can reduce fertility and HPV vaccination can protect against this. HPV can be spread by sexual intercourse to a partner who is pregnant. People who are pregnant and have partners with HPV should talk with their healthcare provider. For more general information on paternal exposures, please see the MotherToBaby fact sheet at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.      

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This sheet is about exposure to docusate sodium in pregnancy and while breastfeeding. This information is based on published research studies. It should not take the place of medical care and advice from your healthcare providers.

What is docusate sodium?

Docusate sodium is a stool softener that has been used to treat constipation (when a person passes less than three bowel movements a week or has trouble with bowel movements). Docusate sodium is found in many products and has been sold under many different brand names. Some brand names are Colace®, Correctol®, Docusate®, Surfak®, and Soflax®.

Sometimes when women find out they are pregnant, they think about changing how they take their medication, or stopping their medication altogether. However, it is important to talk with your healthcare providers before making any changes to how you take this medication. Your healthcare providers can talk with you about the benefits of treating your condition and the risks of untreated illness during pregnancy.

I take docusate sodium. Can it make it harder for me to get pregnant?

It is not known if docusate sodium can make it harder to get pregnant.

Does taking docusate sodium increase the chance of miscarriage?

Miscarriage is common and can occur in any pregnancy for many different reasons. Studies have not been done to see if docusate sodium increases the chance for miscarriage. In general, very little docusate sodium is expected to get into the blood stream; which makes it unlikely it would reach the developing pregnancy.

Does taking docusate sodium increase the chance of birth defects?

Birth defects can happen in any pregnancy for different reasons. Out of all babies born each year, about 3 out of 100 (3%) will have a birth defect. We look at research studies to try to understand if an exposure, like docusate sodium, might increase the chance of birth defects in a pregnancy. When used as directed, docusate sodium is unlikely to increase the chance of birth defects above the background risk.

Does taking docusate sodium in pregnancy increase the chance of other pregnancy-related problems?

When used in recommended doses, docusate sodium is unlikely to cause problems during pregnancy, such as preterm delivery (birth before week 37) or low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth).

Using more than the recommended amount of docusate sodium can lower the levels of magnesium in a person’s blood. There is one reported case of low magnesium levels in a newborn that was linked to overuse of docusate sodium by the woman who was pregnant. The baby’s main symptom was jitteriness, which went away by age 2 days. There have been no reported problems linked to the use of recommended amounts of docusate sodium in pregnancy.

Does taking docusate sodium in pregnancy affect future behavior or learning for the child?

Studies have not been done to see if prenatal exposure to docusate sodium could cause behavior or learning issues for the child.

Breastfeeding while taking docusate sodium:

The use of docusate sodium while breastfeeding has not been studied. Docusate sodium is not well-absorbed from the gastrointestinal tract and is unlikely to be found in breastmilk in large amounts. There was 1 case report of diarrhea in an infant who was exposed to docusate sodium along with another medication called danthron through breastmilk. There have been no other reports of problems in children exposed to docusate sodium during breastfeeding. If you suspect the baby has any symptoms (such as diarrhea), contact the child’s healthcare provider. Be sure to talk to your healthcare provider about all your breastfeeding questions.

If a man takes docusate sodium, could it affect fertility (ability to get a woman pregnant) or increase the chance of birth defects?

Studies have not been done to see if docusate sodium could affect male fertility or increase the chance of birth defects above the background risk. In general, exposures that men 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/.

Please click here for references.

This sheet is about exposure to depot medroxyprogesterone acetate in pregnancy and while breastfeeding. This information is based on published research studies. It should not take the place of medical care and advice from your healthcare provider. 

What is depot medroxyprogesterone acetate? 

Depot medroxyprogesterone acetate is the injectable (given by shot) form of a lab-made hormone called medroxyprogesterone acetate. It has been used to prevent pregnancy (as birth control). Depot medroxyprogesterone acetate can also be used to treat some problems linked to a woman’s period (menstrual disorders) and, at high doses, can be used to treat certain types of cancer. This fact sheet will cover the use of the depot medroxyprogesterone acetate shot for birth control. Depot medroxyprogesterone acetate is sold under the brand name Depo Provera®. 

Depot medroxyprogesterone acetate is not the same as oral birth control pills (pills taken by mouth), which contain other hormones.  

I am taking depot medroxyprogesterone acetate, but I would like to stop taking it before becoming pregnant. How long does the drug stay in my body? 

The time it takes the body to metabolize (to process) medication is not the same for everyone. In healthy non-pregnant adults, it takes 120 to 200 days, on average, for most of the depot medroxyprogesterone acetate to be gone from the body. 

I take depot medroxyprogesterone acetate. Can it make it harder for me to get pregnant? 

Depot medroxyprogesterone acetate is a form of birth control and is expected to lower the chance of getting pregnant.  

After stopping depot medroxyprogesterone acetate, fertility (ability to get pregnant) might be lower for some time. Most of the time, this side effect is temporary, and fertility will return to normal levels after stopping depot medroxyprogesterone.   

Does taking depot medroxyprogesterone acetate increase the chance of miscarriage? 

Miscarriage is common and can occur in any pregnancy for many different reasons. Use of depot medroxyprogesterone acetate is not expected to increase the chance of miscarriage. 

Does taking depot medroxyprogesterone acetate increase the chance of birth defects?  

Birth defects can happen in any pregnancy for different reasons. Out of all babies born each year, about 3 out of 100 (3%) will have a birth defect. We look at research studies to try to understand if an exposure, like depo medroxyprogesterone acetate, might increase the chance of birth defects in a pregnancy. Most studies have not found a higher chance of birth defects with exposure to depot medroxyprogesterone acetate. 

Does taking depot medroxyprogesterone acetate in pregnancy increase the chance of other pregnancy-related problems? 

It is not known if depot medroxyprogesterone acetate can increase the chance of other pregnancy-related problems, such as preterm delivery (birth before week 37) or low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth). Two studies reported a link to low birth weight while another study did not. Studies have not been done to see if depot medroxyprogesterone acetate can increase the chance for preterm delivery or other pregnancy-related problems.  

Does taking depot medroxyprogesterone acetate in pregnancy affect future behavior or learning for the child? 

Studies have not been done to see if depot medroxyprogesterone acetate can increase the chance of behavior or learning issues for the child.  

Breastfeeding while taking depot medroxyprogesterone acetate: 

Depot medroxyprogesterone acetate passes into breast milk in small amounts. Taking depot medroxyprogesterone acetate while breastfeeding is not expected to negatively affect a child’s long-term growth and development.  

According to one health organization, use of depot medroxyprogesterone while breastfeeding is usually not recommended less than 6 weeks after the baby’s birth. But the benefit of using the medication and breastfeeding your baby may outweigh possible risks. Experts in the United States say that depo medroxyprogesterone is acceptable for use in breastfeeding any time after your baby’s birth.  Your healthcare providers can talk with you about using depot medroxyprogesterone acetate and what medication is best for you. Be sure to talk to your healthcare provider about all your breastfeeding questions.  

If a man takes depot medroxyprogesterone acetate, could it affect his fertility or increase the chance of birth defects? 

Studies have not been done to see if depot medroxyprogesterone acetate could affect male fertility (ability to make healthy sperm) or increase the chance of birth defects. In general, exposures that men 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/.  

Please click here for references.  

This sheet is about having herpes zoster (shingles) in a pregnancy or while breastfeeding. This information is based on research studies. It should not take the place of medical care and advice from your healthcare provider. 

What is herpes zoster (shingles)? 

Herpes zoster, commonly known as shingles, is a viral disease caused by the same virus that causes varicella (chickenpox), called varicella-zoster virus.  

Chickenpox happens when a person is first exposed to the varicella-zoster virus. For more information on varicella (chickenpox), please see the MotherToBaby fact sheet: https://mothertobaby.org/fact-sheets/varicella/.  

After someone has recovered from chickenpox, the varicella-zoster virus can stay inactive in the body. If the inactive virus later becomes active again, it causes shingles. Shingles usually presents as a painful rash on 1 side of the face or body. People can also have fever, headache, chills, upset stomach, and nerve pain. Rarely, hearing or vision problems can develop if the shingles outbreak affects the nerves on the face.  

The shingles rash is contagious and people who have not had chickenpox before or have not been vaccinated against chickenpox, can get infected after direct contact with the shingles blisters. If a person who has never had chickenpox becomes infected, they will develop chickenpox, not shingles. The risk of spreading the virus is low if the rash remains covered. A person is no longer contagious once the shingles rash has scabbed over, which usually takes about 7-10 days.  

Can shingles be treated? 

If you are pregnant and develop shingles, talk to your healthcare provider about treatment. Shingles can usually be treated with antiviral medication during pregnancy. Antivirals are most effective when taken as soon as possible after the rash appears.  

I have shingles. Can it make it harder for me to become pregnant? 

Studies have not been done to see if shingles can make it harder to get pregnant.  

Does having shingles increase the chance of miscarriage? 

Miscarriage is common and can occur in any pregnancy for many different reasons. Studies have not been done to see if having shingles can increase the chance of miscarriage.  

Does having shingles increase the chance of birth defects? 

Birth defects can happen in any pregnancy for different reasons. Out of all babies born each year, about 3 out of 100 (3%) will have a birth defect. We look at research studies to try to understand if shingles might increase the chance of birth defects in a pregnancy. There are not a lot of studies that look at how shingles might affect a pregnancy. However, shingles has not been seen to increase the chance of birth defects.  

Does having shingles increase the chance of other pregnancy related problems? 

Studies have not been done to see if having shingles in pregnancy could cause other pregnancy-related problems, such as preterm delivery (birth before week 37) or low birth weight (weighing less than 5 pounds, 8 ounces at birth). Studies of perinatal maternal herpes zoster infection suggest no intrauterine transmission to the fetus.  

Does having shingles in pregnancy affect future behavior or learning for the child?

Studies have not been done to see if having shingles in pregnancy could cause long-term problems in the child.  

Breastfeeding while I have shingles:

The virus that causes shingles has not been found in breast milk. However, it is important to keep the baby from coming into direct contact with the rash or blisters to lower the chances of spreading the virus, which could cause the baby to develop chickenpox. If lesions are present on the areola, the milk should be pumped and discarded until the rash has scabbed over. If you suspect your baby has any symptoms of chickenpox, contact the child’s healthcare provider.  

If you are taking antivirals to treat shingles while breastfeeding, please contact MotherToBaby to learn more about your medications while breastfeeding. Be sure to talk with your healthcare provider about all of your breastfeeding questions. 

If a man has shingles, could it affect his fertility or increase the chance of birth defects?  

Studies have not been done to see if shingles could affect a man’s fertility (ability to get a woman pregnant) or increase the chance of birth defects. In general, exposures that fathers or sperm donors have are unlikely to increase the risk to a pregnancy. However, if a person is not immune to chickenpox and their intimate partner has shingles, there is a risk that the woman who is pregnant could become infected with chickenpox from direct contact with the shingles rash. For more information, please see the MotherToBaby fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/. 

Please click here for references.