Henry M. Hess and Richard K. Milter
2.19.1 The safety of herbs during pregnancy 485
2.19.2 Counseling a pregnant woman about herbs 486
2.19.3 General concepts regarding the use of herbs during pregnancy 488
2.19.4 Herbs used as foods 489
2.19.5 Essential oils that are safe during pregnancy 489
2.19.6 Herbs frequently used during pregnancy 490
2.19.7 Herbs controversially used during pregnancy 491
Plants and plant extracts have been used for medicinal purposes since before recorded time. Many pharmaceutical agents have their origins in plant-based compounds. In a trend towards returning to the "natural", and believing that such agents are safer, patients worldwide are more and more frequently consulting natural therapists and taking herbs to enhance their nutrition, slay healthy, and treat their illnesses. Women taking herbs can and do get pregnant. They take herbal therapies to ensure that they are healthy prior to and during their pregnancy, and also to treat medical conditions during their pregnancy. A 2003 study of 578 pregnant women in the United States showed that 45 percent of respondents used herbal medicines (Glover 2003).
2.19.1 The safety of herbs during pregnancy
The difficulties in evaluating the safety and risk of herbal therapies are known, and are faced by everyone who takes or is considering
taking herbs. These concerns are enhanced in pregnant women, and risks are even more difficult to evaluate. The problems of determining the safety of herbs in this context are as follows:
■ There are few published clinical trials or investigations of these substances establishing the efficacy and/or toxicity of the preparations at specific doses.
■ There are limited standards for the preparation and for the established amounts of specific ingredients in the products marketed, and there are few regulating bodies that certify the products sold or doses used (for example, the US Food and Drug Administration (FDA), the European Medicines Agency (EMEA) and the European Evaluation Food Safety Authority (EFSA)). The German Commission E does provide some oversight on selected herbal products (Blumenthal 2003, 1998).
■ There are differing health claims made by the agcncies in Europe, the United States, and other countries around the world.
a Some of the products available worldwide may contain (and in some instances have been shown to contain) unknown contaminants such as lead and/or arsenic from the agricultural or manufacturing processes. These could have devastating effects on the pregnant woman. m It is always important to know the potential side effects of anything we take, and this is even more significant during pregnancy. The fetus is growing rapidly, and is vulnerable to substances that affect cellular growth and division. In addition, certain herbs and natural substances can affect the muscle tone and circulation of the uterus, and some can act as uterine stimulants, abortifacients or teratogens (Low Dog 2005).
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