The Pregnancy-Contraindicated Herb List

Several categories of herbs are contraindicated or used only with great caution in pregnancy. This lesson catalogs them.

Strongly contraindicated (avoid entirely)

**Pennyroyal (Mentha pulegium and Hedeoma pulegioides).** Pulegone toxicity. Historically used as abortifacient; multiple deaths reported from attempts at this use. Strictly avoid in any form.

**Mugwort (Artemisia vulgaris) at clinical doses.** Uterine stimulant. Avoid medicinal use; small amounts in food are typically not concerning.

**Wormwood (Artemisia absinthium).** Thujone toxicity. Avoid.

**Tansy (Tanacetum vulgare).** Uterine stimulant and thujone-containing. Avoid.

**Rue (Ruta graveolens).** Strong uterine stimulant. Historically used as abortifacient. Avoid.

**Blue cohosh (Caulophyllum thalictroides).** Cardioactive in fetus. Specific traditional use only at very end of labor by experienced midwives. Avoid otherwise.

**Pulsatilla / pasque flower (Anemone pulsatilla).** Toxic; uterine effects. Avoid medicinal use.

**Pennyroyal essential oil.** Highly toxic. Strictly avoid.

**Most strong cathartic herbs:** Senna, cascara sagrada, buckthorn. Avoid; safer options exist for pregnancy constipation.

**Goldenseal (Hydrastis canadensis).** Uterine stimulant. Avoid in pregnancy.

**Comfrey internally.** Hepatotoxic pyrrolizidine alkaloids; concern for fetus. Avoid internal use.

**Stinging nettle root.** Effects on testosterone and DHT; theoretical concern. Avoid as supplement.

**Excessive licorice (high glycyrrhizin).** Can cause maternal hypertension. Limit consumption.

**Most strong essential oils internally.** Most essential oils are not for internal use during pregnancy. External use at appropriate dilution may be okay; varies by oil.

Use with caution in pregnancy

Some herbs are commonly used in pregnancy but with specific considerations:

**Raspberry leaf (Rubus idaeus).** Generally considered safe in second and third trimester (some sources say all of pregnancy); avoided by some practitioners in first trimester. Use as tea is typical.

**Ginger.** Generally safe and useful for nausea. Limit to therapeutic doses (1 g daily of dried ginger or modest amounts of fresh). Some sources recommend avoiding in late pregnancy due to mild antiplatelet effect.

**Chamomile.** Generally safe in modest doses. Some sources recommend caution at large doses in early pregnancy.

**Peppermint.** Modest doses fine for nausea; avoid excessive amounts.

**Echinacea.** Conflicting research. Modest amounts for short-term acute use during cold/flu generally considered acceptable in pregnancy; coordinate with provider.

**Some adaptogens.** Ashwagandha — caution; some sources avoid in pregnancy. Holy basil — generally avoid in pregnancy.

The reason for caution

Many herbs are contraindicated for one or more of these reasons:

**Uterine stimulant effects.** Could potentially cause uterine contractions, theoretically risking miscarriage or preterm labor.

**Hormonal effects.** Could affect fetal hormonal development.

**Cardioactive effects.** Could affect maternal or fetal cardiac function.

**Hepatotoxic effects.** Could affect maternal liver and reach fetus.

**Strong central nervous system effects.** Could affect maternal mental status and reach fetus.

**Insufficient safety data.** Some herbs simply haven't been well-studied in pregnancy.

A working framework

For any herb you're considering for a pregnant client:

1. **Verify it's not on the contraindicated list.** The list above isn't exhaustive; consult a current reference.

2. **Verify the specific safety for the trimester.** Some herbs are okay later in pregnancy that aren't okay in first trimester.

3. **Verify the dose is within safe range.** Even "safe" herbs can be problematic at heroic doses.

4. **Verify quality and source.** Especially for pregnant clients, source from reputable suppliers; avoid adulteration concerns.

5. **Document everything.** Specific herb, dose, frequency, duration, reason for use, coordination with provider.

Safe-list herbs for pregnancy

Despite the long contraindicated list, several herbs are generally considered safe and useful in pregnancy:

**For nausea:** - Ginger (small amounts) - Peppermint tea - Lemon (juice or peel)

**For constipation:** - Slippery elm - Marshmallow root - Adequate fiber and hydration

**For sleep:** - Chamomile (modest amounts) - Lemon balm - Possibly oat straw

**For nutrition:** - Nettle leaf (tea) - Red raspberry leaf (second and third trimester) - Alfalfa - Dandelion leaf

**For colds:** - Elderberry syrup (homemade with reasonable doses) - Echinacea (short-term) - Honey and lemon

**For skin:** - Calendula topically - Sea buckthorn oil topically - Cocoa butter topically

**For mood:** - Lemon balm - Modest chamomile - Adequate nutrition and rest

**For lactation preparation (third trimester):** - Modest raspberry leaf - Modest oat straw

Working with traditional knowledge

Many herbal traditions have specific pregnancy practices — particular herbs valued for fertility, pregnancy, or labor preparation. Some are well-established; some are riskier than commonly thought.

**General principles:** - Traditional knowledge is valuable; not all traditional uses are safe - Cross-reference traditional uses against current safety literature - Avoid herbs that traditional knowledge values but current safety data questions - Coordinate with prenatal care providers

What to carry forward

If you support pregnant clients, ensure you have access to current safety references. The Botanical Safety Handbook (McGuffin et al.) is excellent. Specific pregnancy-herb references include "Botanical Medicine for Women's Health" by Romm.

Next lesson, generally safe herbs through pregnancy.