Many women are looking to avoid unnecessary pharmaceuticals as much as possible. The reality is many of the pharmaceuticals on the market are not known to be absolutely safe in pregnancy . We get new data all the time showing us that things that we thought were safe are not necessarily. Two big screw ups examples are thalidomide and DES which were both used during pregnancy to prevent miscarriage and to control morning sickness. The result was devastating severe deformities and increased risk of cancers in the babies exposed. The medications typically used today do not reach this magnitude but shed light on the need for increased scrutiny for the medications that are being prescribed to pregnant women. Yet at the same time there are so many meds that are currently used that are being pulled for use in pregnant women or there’s a lot of unknown surrounding their use. For example ibuprofen or tylenol which have classically be considered okay for pregnancy are now not recommended. Currently, there is a huge grey area regarding antidepressants use in pregnancy. There is a lot of varying opinions but the reality is whether they are safe or not is still up for debate yet they continue to be used.

Herbs have been traditionally used for thousands of years. Certain herbs traditionally used to relieve the minor discomforts of pregnancy may be safer and gentler than over the counter pharmaceuticals but the problem is little is known scientifically about the risk of herbs during pregnancy. This is not because they are not valuable but rather there is little financial incentive to do the research. Research in herbal medicine occurs either when there is a potential drug that can be marketed, there’s a herbal company that can afford to fund the study, or someone is academically interested and receives a grant. The lack of scientific proof of whether herbs work or don’t has more to do with the lack of research available. Ethical constraints of experimenting on pregnant women also restricts the amount of research that is available. A lot of what we know is either from the research that is available or from retrospective studies (looking back at women who had been found to be taking a herb then data is gathered on the pregnancy outcomes, health of the baby etc.). Empirical, pharmacological, historical and observational evidence is also used to determine safety and efficacy of botanical medicine. Even in the herbs that have known safety profiles, issued have arised due to mislabeling and adulteration (substituting one herb for another, often cheaper herb). It is really important to be diligent when sourcing herbs. Make sure the company you are purchasing from is reputable and doing really good analytics on their products to know what is actually in it.

Just because herbal medicine is natural does not mean it is safe, especially in pregnancy. A strong knowledge and awareness is critical for herbs to be used safely.  Keep in mind lack of proof of harm doesn’t mean it is safe and just because it was used traditionally doesn’t mean it is safe either.  Herbs like pharmaceuticals should have very very limited use in the first trimester when the baby is still forming its parts (unless medically indicated and when there is not a more effective and safer pharmaceutical option available). One must take into consideration the severity of the symptom and the available safety data of the individual herb in order to determine if the use of this herb is reasonable or is a medical approach better, safer and more appropriate?