Natural Health Products and Pregnancy – Safe or Stay Away?

by | Oct 5, 2019 | Pregnancy Health

So, you’re pregnant! And, the inner dialogue may have gone something like this – almost regardless of your circumstance:
Wow. Wooooooow. WOAH. Shit. Wait. Crazy. Yup. I can do this. Can I do this? We can do this. Let me sit down. Yup. Check again. Yup. I’m pregnant. I AM PREGNANT…I’m….pregnant…There is a human growing inside me. Amazing. Eek.
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You have a lot of things to think about – too many things, so I won’t list them here in an effort to avoid inducing panic attacks but I do hope to provide you with some helpful resources to illuminate a need to sift through the masses of online natural health information – much of which, as with all things on the internet, is not totally accurate.
There seem to be two main schools of thought around supplementation/medication etc. while pregnant and they have one thing in common – FEAR. My suggestion – let go of the fear, it doesn’t serve you. Get a trusted group of health care professionals that really know their stuff – professionals who base their decision making on sound evidence and not fear (yes, even doctor make decisions based on fear!) and keep positive.
Why does this need to be addressed?
  • 37% of pregnant women don’t comply with existing prescriptions due to uncertainties around drug use while pregnant (PMID: 7889024)
  • More specifically, 15% of women using antidepressants who then get pregnant discontinue their use during the pregnancy despite receiving evidence-based reassurance of their safety. Why discontinue? Perceived risk to the newborn child, of course. (PMID: 15951622)
  • A research study done by Motherisk showed that pregnant mothers assigned an unrealistically high risk to medications not known to be teratogenic (PMID: 8494274)
*PMID means Pub Med I.D. and the number corresponds to a study on the topic of discussion
WIKI: Teratology
The study of abnormalities of physiological development. It is often thought of as the study of human congenital abnormalities, but it is much broader than that, taking in other non-birth developmental stages, including puberty; and other non-human life forms, including plants. The related term developmental toxicities includes all manifestations of abnormal development by toxic substances. These may include growth retardation, delayed mental development or other congenital disorders without any structural malformations.
My point here is that, there is a false perception that Natural = Safe
I’m hoping this post will help anyone still under that impression reconsider.
And for those of you about to stop reading because you’re thinking – this doesn’t apply to me, I’m not pregnant…think again! The rate of unintentional pregnancy in the US is 49%….the number is similar in Canada (PMID:16772190) – that said, the risk of accidental exposure to a teratogen during pregnancy is almost inevitable. If we all knew just a little bit more, we can reduce our individual risk by making informed decisions.
I’ve used a “stop light” rating system below. Green, go. Yellow, caution. Red, do not use.
This information, along with the safety “rating” of many other Natural Health Products (NHPs) used to be easily obtained by calling Motherisk and asking about your NHP of concern however, with changes in funding this service is no longer available.
ALWAYS CONSULT A MEDICAL PROFESSIONAL BEFORE STARTING ANY NEW HEALTH PRODUCT, SUPPLEMENT OR MEDICATION – WHETHER YOU ARE PREGNANT OR NOT
Go Green (SAFE) – these NHPs are known to be safe in pregnancy
Cranberry (safe while breast feeding as well)
Echinacea (safe while breast feeding as well)
Fish Oils
Garlic (safe while breast feeding as well)
Ginger (not well researched for use while breast feeding)
Horsechestnut (not well researched for use while breast feeding)
Korean Ginseng (safe while breast feeding as well)
Lactobacillus sp. (in many probiotics)
Milk Thistle (not well researched for use while breast feeding)
Raspberry (not well researched for use while breast feeding)
Senna
Siberian Ginseng (not well researched for use while breast feeding)
St. John’s Wort  (cautioned for use during breast feeding)
Tumeric  (safe while breast feeding as well)
Valerian (not well researched for use while breast feeding)
YELP Yellow  (CAUTION) – these NPHs require more caution when used in pregnancy
Aconite (also cautioned during breast feeding)
Alfalafa (also cautioned during breast feeding)
Aloe (also cautioned during breast feeding)
Ashwaghanda (not well researched for use while breast feeding)
Black Cohosh  (also cautioned during breast feeding)
Blazing Star  (also cautioned during breast feeding)
Calendula (not well researched for use while breast feeding)
Chasetree (also cautioned during breast feeding)
Coffee (also cautioned during breast feeding)
Damiana (not well researched for use while breast feeding)
Dong Quai (not well researched for use while breast feeding)
Ephedra (also cautioned during breast feeding)
Evening Primerose (safe while breast feeding)
False Unicorn (not well researched for use while breast feeding)
Fennel  (also cautioned during breast feeding)
Fenugreek (safe while breast feeding)
Feverfew (not well researched for use while breast feeding)
Flax (safe while breastfeeding)
Gentian  (also cautioned during breast feeding)
Ginko (not well researched for use during breast feeding)
Green Tea  (also cautioned during breast feeding)
Guggul (not well researched for use while breast feeding)
Hawthorn (not well researched for use while breast feeding)
Kava  (also cautioned during breast feeding)
Lemon Balm  (also cautioned during breast feeding)
Licorice (also cautioned during breast feeding)
Nettle (also cautioned during breast feeding)
Quercetin 5-HTP
Red Clover (also cautioned during breast feeding)
Rye Ergot (also cautioned during breast feeding)
Soy Isoflavones
Squaw Vine (not well researched for use while breast feeding)
Vitamin A
Wild Yam (not well researched for use while breast feeing)
Yarrow  (also cautioned during breast feeding)
Run from Red (UNSAFE) – these NPHs are strictly contraindicated during pregnancy
Barberry (also contraindicated during breast feeding)
Blue Cohosh (cautioned during breast feeding)
Borage (safe during breast feeding)
Calamus (also contraindicated during breast feeding)
Deadly Nightshade  (also cautioned during breast feeding)
Foxglove  (also cautioned during breast feeding)
Goldenseal (also contraindicated during breast feeding)
Juniper  (also cautioned during breast feeding)
Oregon grape (also contraindicated during breast feeding)
Parsley  (also cautioned during breast feeding)
Pennyroyal (also contraindicated during breast feeding)

COMMON NATURAL HEALTH PRODUCTS USED IN PREGNANCY & WHAT YOU NEED TO KNOW

GETTING PREGNANT

ECHINACEA
  • There was some concern years ago based on a study (PMID:11074744) looking at echinacea use in pregnant women and an increased number of spontaneous abortions, however the difference between he two groups has no statistical significance
  • There is however, preliminary research suggesting that high dose echinacea might reduce sperm & ova fertility (PMID: 10079411) – Take Home? If you are trying desperately to get pregnant, high dose echinacea might upset your fertility temporarily but otherwise while you are pregnant the research says its safe
ST. JOHN’S WORT
  • This herb is often used as a “natural antidepressant”
  • The research: there were no major difference in major malformations and no difference in life birth rates and prematurity between groups
  • St. John’s Wort seems to inhibit sperm motility and viability – suggesting a spermicidal (sperm-killing) effect (PMID:10079411)
  • That said, if you are trying to conceive, you may won’t to look at other options until your little one has had a chance to implant properly.
CoQ10
  • Suggested for use when trying to conceive, stop once pregnant and restart during second trimester
  • Improved oocyte and embryo quality (PMID: 19732879)
  • Reduces risk of pre-eclampsia (PMID: 19154996)
  • Also beneficial for energy levels, decreasing cholesterol, heart benefits, high blood pressure, anti-aging, anti-cancer
PROBIOTICS
  • As if anyone needed another reason to take a probiotic…
  • Woman with increased vaginal lactobacilli have increased conception rates and decreased early pregnancy loss (PMID: 12839628)
  • Absence of lactobacilli was identified as an independent risk factor and a predictor for preterm delivery at <33 weeks (PMID: 12530101)
  • Reduces atopic (skin) disease  like psoriasis and eczema which is linked to childhood asthma(PMID: 11297958, PMID: 17208601, PMID:
  • And for those of you are probiotic sceptics because you know they interact with the immune system and you have concerns about how they may interact with vaccination – there was a study conducted that showed no difference in antibody responses to either, tetanus or Haemophilus influenza type b (Hib) vaccination versus placebo (PMID: 16925686)

FIRST-THIRD TRIMESTER

FOLIC ACID
  • Folate is especially importantant for pregnant woman who suffer from epilepsy, insulin dependant diabetes, or obesity (BMI >35 kg/m2), have a person history or family history of neural tube defects, are Sikh (high risk ethnic group), or have lifestyle issue considerations such as: variable diet, no consistent birth control use, or use of teratogenic substances (alcohol, tobacco, recreational drugs, etc.)
  • Visit THIS website and scroll down to find out which foods are rich in folate
  • Ideally folate supplementation should be started before you have baby on board…but where that isn’t possible – consult your doctor as soon as you know you’re pregnant!
B6
  • First-line treatment for morning sickness (PMID: 15051578, PMID: 2047064, PMID: 7573262)
  • The “PILL” depletes B6 so many women who come off the pill just in time to get pregnant, planned or not, experience worse morning sickness than women who are either never on the pill or who come off the pill for several months prior to getting pregnant. Replenish your B6 ladies!
  • May also decrease dental decay
  • May prevent cardiovascular malformations (PMID: 15357625)
  • Protects the placental vascular bed (PMID: 13836053), leading to higher birth and placental weights…babies who’s mothers were supplementing B6 in their 3rd trimester were found to have increased in vitro oxygen affinity (P50) (PMID: 6624427)
GINGER
  • Downside – can take 1-4 days to work…that’s too long for my liking but I wanted to include it for your consideration
  • Ginger capsules are available but can be large and hard to swallow when you want to throw-up…
  • Tea Option: Boil Ginger Tea or Ginger Root, add honey to taste
  • Ipicax: a homeopathic I have heard used successfully for pregnancy endured nausea and vomiting….despite the fact that I’m not big on homeopathics
VITAMIN E
  • One case control study showed that the babies born to women who supplemented additional vitamin E had higher levels of chronic heart disease. This study wasn’t well conducted though…the amount of vitamin E is not known (PMID: 19187473)
  • Vitamin E doesn’t appear to have any additional benefits beyond what’s included in a prenatal so why risk it?! – those are my thoughts anyways.
  • Vitamin E can in fact be dangerous when taken by women suffering from preeclampsia and using Vitamin C.
WIKI: Pre-eclampsia or Preeclampsia 
A disorder of pregnancy characterized by high blood pressure and large amounts of protein in the urine. Though present in the majority of cases, protein in the urine need not be present to make the diagnosis of preeclampsia. It involves many body systems and evidence of associated organ dysfunction may be used to make the diagnosis when hypertension is present. This includes the presence of a low blood platelet count (thrombocytopenia), impaired liver function, the development of new kidney dysfunction, fluid accumulation in the lungs (pulmonary edema), and/or new-onset brain or visual disturbances. If left untreated, preeclampsia can develop into eclampsia, the life-threatening occurrence of seizures during pregnancy. Preeclampsia is associated with multiple maternal and fetal adverse effects.

DELIVERY

RASPBERRY
  • Used by midwives in a variety of applications: nausea, vomiting, fertility,  dysfunctional labour, cervical ripening
  • Seen to shorten the second stage of labour (delivery!) by 9 minutes and lower the rate of forceps delivery (PMID: 11370690)
  • Mothers in this study were more likely to experience spontaneous rupture or membranes and higher proportion of mothers raspberry group developed pregnancy-induced hypertension/preeclampsia vs. the control group
  • Women taking raspberry were less likely to receive an artificial rupture of their membranes, requiring a C-section, forceps or vacuum birth (PMID: 10754818)
  • Summary: the way raspberry works is unclear, but we know that raspberry has a stimulatory or spasmodic effect on the uterus. The effects are dose and tissue dependant. My instincts, coupled with a lack of solid human data, tells me to proceed with caution!
CASTOR OIL
  • Who hasn’t heard of using castor oil to induce contractions… but, what do we really know about it?
  • First, let me make it clear as day that castor oil is only ever used to induce labour and it has no other application in pregnancy. It should not be used for any abdominal applications you may have used it for before getting pregnant or for stretch marks for that matter…
  • Drastically increases the chances of delivery 24 following consumption (PMID: 10631825)
  • May lead to a more tumultuous labor due to increased cramping and diarrhea associated with ingesting castor oil
  • How does it work? Castor oil induces labour by producing hyperaemia (increased blood flow) in the intestinal tract, which causes reflex stimulation of the uterus
  • May increase prostaglandin production
BLUE COHOSH
  • Traditionally used in Native American culture to induce labour
  • The therapeutic dose is very narrow and therefore is never recommended for “at home” use
  • Midwives use Blue Cohosh in a variety of applications: labour induction, dysfunctional labour, prolonged latent phase, post-term pregnancy, labour augmentation & cervical ripening
  • I’ve reviewed the research – the way Blue Cohosh works is more complicated than anything worth posting on this blog but please inquire with me if you would like to know more. All in all, there are many unknowns when it comes to Blue Cohosh – too many for me to feel comfortable administering it to someone carrying a child…
EVENING PRIMEROSE OIL (EPO)
  • Midwives have used EPO for applications such as: cervical ripening, labour induction, post-term pregnancy
  • Results of a quasi-experimental design (PMID: 10380450) showed that EPO did not shorten gestation, does not decrease overall length of labour & increases the incidence of prolonged rupture of membranes, oxytocin augmentation, arrests of descent, and vacuum extraction
  • Despite the points above, surveys have shown that midwives are having success with EPO…How? It would seem they are giving it in combination with other NHPs – alone however, EPO doesn’t seem to be working