By Linda Woolven
Web Exclusive

mortar and pestle with herbs
For centuries, herbs have been used around the world to treat problems related to pregnancy. Vitamins and minerals also have a role to play in helping pregnant women with some of the more serious problems that conventional medicine has no help for, like toxemia. Let's take a look at how certain herbs and vitamins can make pregnancy safer and more enjoyable.

Supreme Tonic for Pregnancy
Red raspberry has been called the "herb supreme" for pregnancy. A wonderful tonic that helps to prepare the uterus for birth, relaxing and relieving cramps, it is so effective that many women actually report pain-free or virtually pain-free labors thanks to red raspberry leaf tea.

Red raspberry is rich in iron and calcium (which pregnant women need more of), potassium, and vitamins B, C, and E. It has been shown to help with morning sickness and postpartum depression, to prevent bleeding at birth and hemorrhaging, to return the uterus to normal more quickly after birth, and to encourage breast milk. British scientists have recently identified an active ingredient and confirmed raspberry leaf's use as a pregnancy tonic. It is safe and without side effects. Red raspberry leaves are usually infused as a tea and consumed three times a day.

Preventing Neural Tube Defects
Folic acid has been shown to prevent neural tube defects (NTDs) such as spina bifida. NTDs, which occur in one out of every thousand births, result when the bones fails to form over the brain or spinal cord. Supplementing with folic acid in early pregnancy can reduce the incidence of NTDs by as much as 48 to 80 percent. 1

NTDs occur very early in pregnancy, and it is therefore extremely important that women who could get pregnant take at least 400 mcg of folic acid a day, and 1mg of folic acid if they are pregnant or planning to become pregnant. Since many women do not know that they are pregnant at first, it is probably safer for sexually active women to take the full gram throughout the childbearing years. Women with a history of having babies with neural tube defects should take 4 mg of folic acid daily. Epileptic women should not take folic acid, because it may increase seizure activity.

According to a study published in 1992, a multivitamin with at least 800 mcg of folic acid a day could prevent neural tube defects in women without a history of them. 2 In 1991 The Lancet reported that, among women who had previously had babies with neural tube defects, 4 mg of folic acid for the first trimester prevented 72 percent of neural tube defects. 3 At least five other similar studies exist. 4

Obviously, eating right during pregnancy is as important as taking supplements. The best place to find folic acid is in deep-green, leafy vegetables. It was once thought that fortifying food with folic acid would prevent NTDs, but recent research has found that NTD rates are no lower now than before fortification, because the amounts used are too low. Most disturbing is the fact the NTD rates are actually slightly up since fortification began. 5

Recent studies show that high levels of the toxic compound homocysteine in pregnant women predispose their babies to NTDs. 6 Folic acid may prevent the elevation of homocysteine during the first trimester of pregnancy. An elevated homocysteine level is also now believed to be one of the most important factors in predicting who is at risk for heart disease.

Morning Sickness
One of the most common problems that women experience during pregnancy is morning sickness, frequently due to low hydrochloric acid (HCl) levels during the first three months. Supplementing with betain and HCl can significantly relieve the problem. During the last three months, however, HCl levels are often too high, and supplementing with HCl and betain should be stopped.

There are also many safe and effective herbs that can be used during pregnancy for nausea. Herbalists like Rosemary Gladstar, author of Herbal Healing for Women (Fireside, 1993) and Amanda McQuade Crawford, author of Herbal Remedies for Women (Prima Publishing, 1997) suggest peppermint, slippery elm, chamomile flowers, lemon balm, small amounts of dandelion root, and ginger. Ginger has a long history of relieving all kinds of motion sickness and nausea, including morning sickness. It can be taken as a tea or as a pill in dosages up to 250 mg four times a day.

Even in the severe form of morning sickness called hyperemesis gravidum, ginger is the herb to use. In one study of 30 women with this condition, 250 mg of ginger four times a day reduced the severity of nausea and the number of vomiting attacks in 70 percent of subjects.7

Ginger: Safe or Not Safe?
Recently there have been claims that ginger can cause birth defects and abortions. Actually the controversy results when an isolated compound of ginger is used, rather than ginger as a whole food. Two studies found that the isolated compound may cause birth defects, but ignored the fact that other parts of ginger contain equally powerful antimutagenic properties. In other words, using the whole herb is not a problem. A 1991 review found no reports in the scientific literature of miscarriage or birth defects from ginger.8 Another, more recent review of all the studies on ginger could find no evidence that ginger harmed the mother or the child.9 The FDA considers 5 gram of ginger to be safe as a food, whereas only 1 gram is necessary during even the most severe form of nausea. According to Michael Murray's The Healing Power of Herbs (Prima Publishing, 1995), ginger is safer to use for the nausea and vomiting of pregnancy than the antiemetic drugs, which can cause fetal abnormalities.

Slippery elm is one of the best herbs to use when no food can be kept down. Not only does it soothe and settle the stomach, but it is also highly nutritious and can be eaten freely as a cereal or as a tea for days at a time if need be when no other food can be tolerated.

Preventing Miscarriage
Another problem that many women face during pregnancy is threatened miscarriage. Miscarriage can result from stress, poor diet, toxins, smoking, alcohol, hormonal imbalance, trauma, weak uterine muscles, and other problems. It can also be a natural response to a condition such as fetal abnormality. There are many herbs that can help prevent miscarriages but will not interfere with the natural process of miscarriage when the fetus is damaged or improperly secured.10

Several herbs can be taken in small amounts during pregnancy if there is a risk of miscarriage. The most prominent of these is black haw, which has a long history of use for preventing miscarriage as well as for menstrual problems and as a uterine tonic. In the 19th century it was used to stop miscarriage, and it is still used in Europe today, even to counteract the effect of abortion drugs. In the American South it was well known to slave owners. The slave owners would rape slave women to increase the number of slaves. These women knew of an herb that would bring on a miscarriage; but the slave owners forced the women to drink a strong decoction of black haw to prevent miscarriage.11

Black haw contains several powerful uterine relaxants. It works by reducing the severity of contractions and relieving uterine cramping throughout pregnancy. It does not relax a normal uterus; it only relaxes when the contractions are excessive, and so it does not interfere with the normal contractions of labor. Like aspirin, it contains salicins and thus has pain-killing properties.

Cramp bark, a near relative of black haw, has many of the same components and is used in much the same way. Cramp bark is an antispasmodic. It is especially helpful in preventing miscarriage due to stress or anxiety, and it can be safely used over prolonged time to treat threatened miscarriage without side effects if necessary. Other herbs that have been used in this way include false unicorn root, lobelia, red raspberry, and wild yam.

If a miscarriage occurs in the first few weeks of pregnancy, it may be due to low progesterone levels. If this is the case, wild yam or chaste tree berry, which can raise progesterone levels, may be useful. Other useful nutrients for threatened miscarriage include zinc, vitamin E, and bioflavonoids. Low levels of zinc have been associated with spontaneous abortion and premature delivery. Bioflavonoids are especially useful in women with frequent miscarriages. 12 One recent study found that reduced serum folic acid levels are a risk factor as well.13

Seven percent of all pregnancies suffer from toxemia or preeclampsia, a very serious condition characterized by elevated blood pressure, fluid retention and loss of protein in the urine. Conventional medicine insists there is no way to prevent toxemia and recommends only bed rest.

Good nutrition prior to pregnancy may be the key to preventing toxemia. Calcium, magnesium, and antioxidants also have a role to play in prevention. Magnesium deficiencies during pregnancy have been linked to toxemia. When calcium intake is low, the incidence of high blood pressure during pregnancy is high, and when calcium intake is high, incidence of high blood pressure is low.14 Low antioxidants are also involved. In one study, women with preeclampsia had significantly lower levels of Vitamin C. In severe preeclampsia, vitamin E and beta-carotene are also significantly lower;15 so increasing antioxidants during pregnancy may help. In a double-blind, placebo-controlled study reported in The Lancet, 160 pregnant women at risk for PE were given either a placebo or 1 gram of vitamin C and 400 IU of vitamin E from weeks 16 to 22 until the end of pregnancy. The incidence of preeclampsia was 76 percent lower in the antioxidant group than in the placebo group.16 Vitamins C and E are safe to use during pregnancy.

Other nutrients that may alleviate this problem are high-potassium diets, which help control the water balance in the body; vitamin B, especially B6, which is a diuretic; spirulina; and dandelion leaf, a diuretic rich in potassium. Nettle and hawthorn have also been used. Hawthorn helps to lower blood pressure and is a diuretic and an antioxidant. Many of these herbs help to support the liver and kidney, which is also important in toxemia.

Bringing on Birth
Blue cohosh, black cohosh, and motherwort are good and safe herbs to when it is time for birth, either because labor has begun or a health professional has determined that it is time. (They should not be used earlier in the pregnancy since they could cause a miscarriage.)

In the last week of pregnancy, black cohosh can help prepare for labor or bring on an overdue labor. It has been used this way by aboriginal healers for years. It stimulates contractions while relaxing tension in the uterine muscles, easing the pain of labor. Blue cohosh also helps to bring on contractions when labor is prolonged or so overdue that it has become risky. Motherwort prepares the uterus for labor and brings on contractions, and eases the birth.

Cramp bark and black haw are also useful during labor. Black haw is a uterine tonic. It quiets uterine muscles and eases the tension that comes with contractions. Cramp bark works by relaxing uterine muscles. Valerian and chamomile flowers can also help to relieve excess spasms.

Hemorrhaging and Tears
If bleeding is a particular problem after delivery, drink an infusion of yarrow or shepherd's purse. For tears, try using comfrey root, externally only, as a compress. This herb is also called knit bone, since it is so effective at healing tissue.

Why not enjoy all that nature has to offer at a time when nature is leading the way, helping your body to do what it is able to do: Give birth more comfortably and safely with a little help from herbs and vitamins?

1. T. Michael and N. D. Murray, Encyclopedia of Nutritional Supplements.

2. A. E. Czeizel and I. Dudas, "Prevention of the First Occurrence of Neural-tube Defects by Periconceptional Vitamin Supplementation," N Engl J Med 327 (1992): 1832-1835.

3. "Prevention of Neural Tube Defects: Results of the Medical Research Council Vitamin Study," Lancet 338 (1991): 131-137.

4. Canadian Medical Association Journal 149, no. 9 (1993): 1239-1243; JAMA 262, no. 20 (1989): 2847-2852; Nutr Rev 50, no. 1 (1992): 22-24; Prenat Diag March 1990, pp. 149-152; Neurology, 42, no. 4 suppl 5 (1992): 32-42.

5. Lancet 354 (1999): 2168.

6. J. B. Ubbink, Nutrition Reviews 53 (1995): 173-175; R. Steegers-Theunissen et al., N Engl J Med 324 (1991): 199-200; A. G. Motulsky, Amer J Human Genetics 58 (1996): 17-20).

7. W. Fischer-Rasmussen et al., Eur J Obstet Gynecol Reprod Biol 38 (1990): 19-24.

8. P. Bergner, Medical Herbalism 3, no. 3 (1991): 7.

9. Fulder and Tenne, "Ginger as an Anti-nausea Remedy in Pregnancy: The Issue of Safety," Herbalgram 38 (1996).

10. Michael Tierra, The Way of Herbs (Pocket Books, 1998).

11. Rosemary Gladstar, Herbal Healing for Women (Fireside, 1993).

12. J. Redman (letter), Med Trib, April 16, 1980.

13. Nelen et al., Obstet Gynecol 95 (2000): 519-524.

14. J. M. Belizan et al., N Eng J Med 325 (1991): 1399-1405.

15. M. S. Mikhail, Am J Obstet Gynecol 171 (1994): 150-157.

16. L. C. Chappel et al., Lancet 354 (1999): 810-816.

Linda Woolven, MH, CAc, is a practicing master herbalist and certified acupuncturist in Toronto. She is the author of a book on PMS, forthcoming from Alive Books, and the co-author, with her husband, Ted Snider, of an herbal CD-ROM called Herbal Guide (Arc Media). Linda and Ted's natural health question-and-answer column appears regularly in the Toronto Star; they also write a natural health newsletter called The Natural Path.