• ]]>Breastfeeding Support]]>, ]]>Herbs and Supplements to Avoid During Pregnancy and Breastfeeding]]>, ]]>Nausea and Vomiting of Pregnancy]]>, ]]>Preeclampsia]]>
• Anemia ]]>Anemia]]> : Iron (If Deficient)
• Hemorrhoids ]]>Citrus Bioflavonoids]]>, ]]>Oxerutins]]>
• Prevention of Neural Tube Defects and Other Birth Defects ]]>Folate]]>, ]]>Multivitamin/Multimineral]]>
• Varicose Veins ]]>Citrus Bioflavonoids]]>, ]]>Gotu Kola]]>, ]]>Horse Chestnut]]>, ]]>Oxerutins]]>
• Assisting or Initiating Childbirth ]]>Acupuncture]]>, ]]>Aromatherapy]]>, Castor Oil, ]]>Hypnotherapy]]>, ]]>Massage]]>, ]]>Proteolytic Enzymes]]>, ]]>Red Raspberry]]>
• Bladder Infections ]]>Vitamin C]]>
• Constipation ]]>Dandelion]]>, Fiber Supplements, ]]>Flaxseed]]>, ]]>Glucomannan]]>, Lactulose
• Diabetes in Pregnancy ]]>Chromium]]>, ]]> Vitamin B 6]]>
• Gingivitis ]]>Folate]]>
• Jaundice of Pregnancy ]]>S-Adenosylmethionine (SAMe)]]>
• Leg Cramps ]]>Calcium]]>, ]]>Magnesium]]>, ]]> Vitamin B 1]]> Plus ]]> Vitamin B 6]]>
• Prevention of Low Birth Weight B Vitamins, ]]>Calcium]]>, ]]>Fish Oil]]>, ]]>Folate]]>, ]]>Iron]]>, ]]>Magnesium]]>, ]]>Vitamin D]]>, ]]>Zinc]]>
• Prevention of Miscarriage ]]> Vitamin B 12]]>
• Prevention of Prematurity ]]>Calcium]]>, ]]>Fish Oil]]>, ]]>Iron]]>, ]]>Magnesium]]>, ]]>Zinc]]>
• Support of Healthy Mental Function in Infant ]]>Fish Oil]]>
Pregnancy is a time of dramatic transitions. Body systems that once sustained a single human now support two. Organs, blood vessels, body chemistry, and even the solid supporting structures of a woman's body all go through changes; in the meantime, the fetus's body grows from a tiny bundle of cells to a full-sized baby.
It's no wonder that women feel the desire for remedies to help with these transitions. Since ancient times, women have tried herbs and other natural treatments to ease discomfort or assist with pregnancy, childbirth, and breastfeeding. However, pregnancy is also a circumstance when the potential risk of any treatment rises dramatically. Seemingly benign medications—even natural ones—have been found to cause birth defects or increase the risk of complications. Some traditional remedies, such as ]]>blue cohosh]]> for labor stimulation, must be discarded for safety reasons.
Thorough study is needed before any treatment can be considered absolutely safe in pregnancy—and in many cases this research may never been done due to insurmountable ethical consideration regarding the safety of the fetus. It's important to talk with your doctor before deciding to use any treatment, whether it is natural or conventional.
Principal Proposed Natural Treatments
Many natural treatments have shown promise for conditions related to pregnancy. In this section, we discuss those with the most scientific support. However, treatments for nausea and vomiting of pregnancy]]> and ]]>preeclampsia]]> are not discussed here; instead, they are addressed in separate articles. ]]>Breastfeeding support]]> also has an article of its own.
Note: The safety of the following treatments has not been confirmed, except for nutrients such as vitamins and minerals, for which appropriate dosages for pregnancy have been established. For more information on potentially harmful natural treatments, see ]]>Herbs and Supplements to Avoid During Pregnancy and Breastfeeding]]> .
Increased pressure from the expanding abdomen and other factors can lead to pooling of fluid in the legs, a condition called venous insufficiency (closely related to varicose veins).
Venous insufficiency/varicose veins occur outside pregnancy as well, and a wide variety of natural treatments have shown promise in their treatment, including buckwheat, ]]>butcher’s broom]]> , ]]>citrus bioflavonoids]]> , ]]>gotu kola]]> , ]]>horse chestnut]]> , ]]>oligomeric proanthocyanidins (OPCs)]]> , and red vine leaf. These are discussed in the ]]>Venous Insufficiency]]> article.
Only one natural treatment, oxerutins, has been studied in a ]]>double-blind]]> trial enrolling pregnant women with venous insufficiency. ]]>1]]> In this study of 69 women, researchers found oxerutins more effective than ]]>placebo]]> .
For more information, see the full ]]>Oxerutin]]> article.
A double-blind study enrolling 97 pregnant women found oxerutins (1,000 mg daily) significantly better than placebo at reducing the pain, bleeding, and inflammation of hemorrhoids. ]]>13]]> Evidence for citrus bioflavonoids is limited to one ]]>open trial]]> . ]]>12]]> Other natural treatments for varicose veins are often recommended for hemorrhoids as well, although research on their use for this condition in pregnancy is lacking.
For more information, see the article on ]]>Hemorrhoids]]> .
Anemia is common during pregnancy, usually due to deficiency in iron. However, iron supplements can be hard on the stomach, thereby aggravating morning sickness. One study found evidence that a fairly low supplemental dose of iron—20 mg daily—is very nearly as effective for treating anemia of pregnancy as 40 mg or even 80 mg daily, and is less likely to cause gastrointestinal side effects. ]]>112]]> (Interestingly, 20 mg daily is lower than the amount contained in standard prenatal vitamins.)
Pregnant women who are not anemic should not take more than the recommended daily allowance of iron in pregnancy, as excess iron intake may be harmful both for pregnant women and their unborn children. ]]>14-16]]>
Interestingly, one study suggests that ]]>iron]]> plus ]]>folate]]> is more effective for the treatment of iron-deficiency anemia in pregnancy than iron alone, even in women who do not appear to be folate-deficient. ]]>17]]>
Prevention of Neural Tube Defects and Other Birth Defects
]]>Folate]]> supplements can help prevent a serious and common type of birth defect known as neural tube defects (NTDs). ]]>18-20]]> Folate, or folate plus ]]>multivitamin/multimineral supplements]]> , may help prevent other birth defects as well, including cleft palate and anomalies of the heart and urinary tract. ]]>108]]>
Other Proposed Natural Treatments
Other natural remedies have been recommended for treating discomforts and complications of pregnancy or decreasing risks to the baby.
Castor bean oil was noted by the ancient Egyptians to stimulate labor, and it is still used by some conventional physicians and midwives to induce contractions—for example, if labor does not occur spontaneously after the water has broken. A recent controlled trial in 100 pregnant women compared oral castor oil to no treatment and found that 57.7% of those given castor oil began labor within 24 hours, compared to only 4.2% of those without treatment. 23]]> Other preliminary studies also suggest that castor oil may help. ]]>24,25]]> Unfortunately, castor oil is a strong laxative, and diarrhea is a nearly universal effect—not a particularly pleasant experience during childbirth.
In addition, considering how common this treatment is, research on its safety and effectiveness is surprisingly scant. One case of a potentially fatal complication linked to use of castor oil has been reported, though some have questioned whether the castor oil was responsible. ]]>25,26]]> In addition, an ]]>observational]]> study of South African women found that those self-treating with castor oil and/or other traditional herbs had a higher incidence of meconium (fetal feces) in the amniotic fluid, a sign of fetal distress. ]]>27]]>
]]>Acupuncture]]> has shown some promise for reducing pain in labor, but the quality of most of the supporting evidence is relatively poor. ]]>28,29,94]]> In one study, sterile water injections were found to be more effective than acupuncture for lower back pain and relaxation during labor. It is unclear whether or not the patients in the study knew which treatment they were receiving at the time. ]]>115]]> And, in one placebo-controlled trial, real acupuncture was no better than sham acupuncture in relieving pelvic pain prior to labor. ]]>119]]>
A study of 45 pregnant women found that women who received acupuncture on the mathematically calculated birth “due date” gave birth sooner than those who did not. ]]>30]]> However, this trial used a no-treatment control group instead of sham acupuncture, making its results unreliable. Another study suggested that the use of acupuncture may help stimulate normal term labor. ]]>107]]> On the other hand, a third study of 106 women with premature rupture of membranes (“water breaking” too early) ]]>113]]> found that acupuncture did not effectively speed up delivery. It should be noted that none of these 3 studies used sham (fake) acupuncture as a control, making their results unreliable. However, in a subsequent trial that attempted to address this problem, real acupuncture administered for 2 days prior to a planned induction of labor (artificial stimulation of labor) was no better than sham acupuncture at preventing the need for induction or shortening the time of labor. ]]>120]]>
Two studies suggest that acupuncture and associated therapies can help "turn" a breech presentation. ]]>96,97]]> In 2008, researchers published a review of 6 randomized controlled trials that investigated acupuncture-like therapies (moxibustion, acupuncture, or electro-acupuncture) applied to a specific point (BL 67). They concluded that these therapies were effective at decreasing the incidence of breech presentations at the time of delivery. ]]>118]]> Again, however, not all of these studies employed a sham acupuncture group for comparison.
Other Natural Treatments
One double-blind, placebo-controlled trial evaluated the effects of ]]>red raspberry]]> in 192 pregnant women. ]]>32]]> Treatment (placebo or 2.4 g of raspberry leaf daily) began at 32 weeks of pregnancy and was continued until the onset of labor. The results failed to show any statistically meaningful differences between the groups. Red raspberry did not significantly shorten labor, reduce pain, or prevent complications.
]]>Blue cohosh]]> is a toxic herb and should not be used. One published case report documents profound heart failure in a baby born to a mother who used blue cohosh to induce labor. ]]>33]]> Severe medical consequences were also seen in a child whose mother took both black and blue cohosh. ]]>34]]>
]]>Hypnotherapy]]>]]>82-85]]> and ]]>massage therapy]]>]]>86-88]]> have shown some promise for assisting labor. In a large controlled trial (more than 600 participants), ]]>lavender oil]]>]]>aromatherapy]]> failed to improve pain after childbirth. ]]>89]]>
For a discussion of homeopathic approaches to pregnancy support, see the childbirth support article in the in the ]]>Homeopathy Database]]> .
]]>Constipation]]> frequently occurs during pregnancy, for reasons that are not entirely clear.
Fiber supplements, such as psyllium seed, are commonly recommended for the treatment of constipation in pregnancy because of their apparent safety. ]]>Flaxseed]]> is another high-fiber seed, and alternative practitioners often recommend it. However, flaxseed contains estrogen-like substances that might pose hazards to the fetus; one study found an effect on reproductive organs and function in baby rats whose mothers ate large amounts of flaxseed during pregnancy. ]]>35]]>
Other natural remedies for constipation during pregnancy include ]]>dandelion root]]>]]>36]]> and a combination of ]]>glucomannan]]> and lactulose. ]]>37]]> However, there is no meaningful evidence to indicate that they are effective.
Note : Avoid use of powerful laxatives, including natural remedies such as buckthorn, cascara, rhubarb, castor bean oil, and senna, as these can induce uterine contractions. ]]>36]]> (See the ]]>Assisting Childbirth]]> section above.) The traditional remedy ]]>yellow dock]]> , though milder, might warrant similar caution. ]]>36,38]]>
Pregnant women sometimes experience painful leg cramps. A double-blind study of 73 women with this symptom found that ]]>magnesium]]> was significantly more effective than placebo in decreasing their distress. ]]>39]]>
]]>Calcium]]> has also been studied for this problem, but research so far gives little indication that it helps. ]]>40-42]]> A combination of vitamins ]]> B 1]]> and ]]> B 6]]> has also been suggested for leg cramps, but evidence that it helps remains minimal. ]]>43]]>
Prevention of Prematurity
Interesting though not entirely consistent evidence suggests that use of ]]>fish oil]]> or its constituents by pregnant women might help prevent premature births. ]]>50,51,90,99,110]]> Double-blind studies have evaluated the minerals ]]>calcium]]> , ]]>52-54]]>]]>zinc]]> , ]]>55-58]]> and ]]>magnesium]]>]]>59-61]]> for this purpose as well, but the results have been mixed. A number of trials suggest that anemia is linked to prematurity; however, evidence as to whether ]]>iron supplements]]> can help remains inconclusive. ]]>54,62]]> Several studies have evaluated ]]>folate]]> but did not find it effective for preventing premature birth. ]]>63]]>
One study failed to find ]]>vitamin C]]> helpful for preventing premature birth. ]]>95]]> However, another study found that vitamin C (100 mg/day after 20 weeks of pregnancy) helped prevent early rupture of the chorioamniotic membrane ("the water breaking"). ]]>100]]> Another study found that use of vitamin E (400 IU daily) and vitamin C (500 mg/day) after premature water breaking helped hold off delivery by several days. ]]>101]]>
Prevention of Low Birth Weight
Babies born below a specific weight (5-½ pounds)—called low birth weight—are at greater risk for complications.
A recent meta-analysis of 7 controlled studies looked at the effects of ]]>calcium]]> supplementation on birth weight. ]]>64]]> These studies predominantly focused on preventing hypertension and/or preeclampsia in the mother, both of which can result in low-birth-weight babies. Overall, calcium appeared to decrease the percentage of babies weighing less than 5 pounds 8 ounces. ]]>64]]> However, other analysts looking at a somewhat different group of studies came to the opposite conclusion. ]]>65,66]]>
Quite a few double-blind studies have examined ]]>zinc]]>]]>58,67-72]]> as well as ]]>magnesium]]>]]>59,60,73]]> for preventing low birth weight, with mixed results. Results have been similarly mixed in other controlled trials of ]]>folate]]>]]>61,74]]> and ]]>fish oil]]> or one of its fatty acids. ]]>50,65,75]]>]]>Vitamin D]]> and ]]>B vitamins]]> have also been proposed, but so far evidence of their usefulness is weak. ]]>54,76]]>
Several decades ago, ]]>iron]]> was believed to be helpful in preventing low birth weight. However, a recent large-scale unblinded study of well-nourished women found that routine iron supplements in pregnancy had no effect on birth weight. ]]>77]]> In addition, as previously noted, iron supplementation in pregnant women who are not anemic may not be good for either mother or baby.
Other Uses of Natural Treatments
A common problem in pregnancy is an increased tendency toward swollen or bleeding gums—a condition known as gingivitis. Two, small, double-blind studies suggest that ]]>folate]]>mouthwash may help. However, folate supplements do not appear to be especially effective against gingivitis. ]]>44,45]]>
A condition called intrahepatic cholestasis may occur during pregnancy, causing jaundice and other complications. Preliminary evidence suggests that the supplement ]]>s-adenosylmethionine (SAMe)]]> might be helpful for preventing this. ]]>48,49,103-105]]>
One placebo-controlled study of 30 women suggests that the mineral ]]>chromium]]> may be useful for gestational diabetes, the term for ]]>diabetes]]> that occurs during pregnancy. ]]>46]]>]]> Vitamin B 6]]> has also been proposed for this condition, but evidence in support of its effectiveness is minimal. ]]>47]]>
A small preliminary study found that ]]>fish oil]]> was significantly more effective than placebo at alleviated postpartum depression. ]]>117]]> However, two other studies failed to find either fish oil or one of its chief components, docosahexaenoic acid (DHA), helpful for preventing perinatal (including postpartum) depression. ]]>98,116]]>
Herbs and Supplements to Avoid During Pregnancy
For information on this important topic, see Herbs and Supplements to Avoid During Pregnancy and Breastfeeding]]> .
3. Unkauf M, Rehn D, Klinger J, et al. Investigation of the efficacy of oxerutins compared to placebo in patients with chronic venous insufficiency treated with compression stockings. Arzneimittelforschung. 1996;46:478-482.
8. Cesarone MR, Laurora G, De Sanctis MT, et al. The microcirculatory activity of Centella asiatica in venous insufficiency. A double-blind study [translated from Italian]. Minerva Cardioangiol. 1994;42:299-304.
10. Guilhou JJ, Fevrier F, Debure C, et al. Benefit of a 2-month treatment with a micronized, purified flavonoidic fraction on venous ulcer healing. A randomized, double-blind, controlled versus placebo trial. Int J Microcirc Clin Exp. 1997;17(suppl 1):21-26.
17. Juarez-Vazquez J, Bonizzoni E, Scotti A. Iron plus folate is more effective than iron alone in the treatment of iron deficiency anaemia in pregnancy: a randomized, double blind clinical trial. BJOG. 2002;109:1009-1014.
18. Laurence KM, James N, Miller MH, et al. Double-blind randomised controlled trial of folate treatment before conception to prevent recurrence of neural-tube defects. Br Med J (Clin Res Ed). 1981;282:1509-1511.
21. Kurtzweil P. How folate can help prevent birth defects. Food and Drug Administration website. Available at: http://www.fda.gov/fdac/features/796_fol.html . Accessed August 22, 2000.
31. McFarlin BL, Gibson MH, O'Rear J, et al. A national survey of herbal preparation use by nurse-midwives for labor stimulation. Review of the literature and recommendations for practice. J Nurse Midwifery. 1999;44:205-216.
40. Hammar M, Berg G, Solheim F, et al. Calcium and magnesium status in pregnant women. A comparison between treatment with calcium and vitamin C in pregnant women with leg cramps. Int J Vitam Nutr Res. 1987;57:179-183.
42. Hammar M, Larsson L, Tegler L. Calcium treatment of leg cramps in pregnancy. Effect on clinical symptoms and total serum and ionized serum calcium concentrations. Acta Obstet Gynecol Scand. 1981;60:345-347.
49. Nicastri PL, Diaferia A, Tartagni M, et al. A randomised placebo-controlled trial of ursodeoxycholic acid and S-adenosylmethionine in the treatment of intrahepatic cholestasis of pregnancy. Br J Obstet Gynaecol. 1998;105:1205-1207.
53. Crowther CA, Hiller JE, Pridmore B, et al. Calcium supplementation in nulliparous women for the prevention of pregnancy-induced hypertension, preeclampsia and preterm birth: an Australian randomized trial. FRACOG and the ACT Study Group. Aust N Z J Obstet Gynaecol. 1999;39:12-18.
66. Bucher HC, Guyatt GH, Cook RJ, et al. Effect of calcium supplementation on pregnancy-induced hypertension and preeclampsia: a meta-analysis of randomized controlled trials. JAMA. 1996;275:1113-1117.
71. Hunt IF, Murphy NJ, Cleaver AE, et al. Zinc supplementation during pregnancy: effects on selected blood constituents and on progress and outcome of pregnancy in low-income women of Mexican descent. Am J Clin Nutr. 1984;40:508-521.
74. Bulstra-Ramakers MT, Huisjes HJ, Visser GH. The effects of 3g eicosapentaenoic acid daily on recurrence of intrauterine growth retardation and pregnancy induced hypertension. Br J Obstet Gynaecol. 1995;102:123-126.
90. Smuts CM, Huang M, Mundy D, et al. Plasse T, Major S, Carlson SE. A randomized trial of docosahexaenoic acid supplementation during the third trimester of pregnancy. Obstet Gynecol. 2003;101:469-479.
91. Helland IB, Smith L, Saarem K, et al. Maternal supplementation with very-long-chain n-3 fatty acids during pregnancy and lactation augments children's IQ at 4 years of age. Pediatrics. 2003;111:E39-E44.
95. Steyn PS, Odendaal HJ, Schoeman J, et al. A randomised, double-blind placebo-controlled trial of ascorbic acid supplementation for the prevention of preterm labour. J Obstet Gynaecol. 2003;23:150-155.
99. Knudsen VK, Hansen HS, Osterdal ML, et al. Fish oil in various doses or flax oil in pregnancy and timing of spontaneous delivery: a randomised controlled trial. BJOG. 2006 Mar 27. [Epub ahead of print]
101. Borna S, Borna H, Daneshbodie B, et al. Vitamins C and vitamin E in the latency period in women with preterm premature rupture of membranes. Int J Gynaecol Obstet. 2005 May 19. [Epub ahead of print]
103. Binder T, Salaj P, Zima T, et al. Ursodeoxycholic acid, S-adenosyl-L-methionine and their combinations in the treatment of gestational intrahepatic cholestasis (ICP)]. Ceska Gynekol. 2006;71:92-98.
110. Olsen SF, Osterdal ML, Salvig JD, et al. Duration of pregnancy in relation to fish oil supplementation and habitual fish intake: a randomised clinical trial with fish oil. Eur J Clin Nutr. 2007 Feb 7. [Epub ahead of print]
111. Ochoa-Brust GJ, Fernandez AR, Villanueva-Ruiz GJ, et al. Daily intake of 100 mg ascorbic acid as urinary tract infection prophylactic agent during pregnancy. Acta Obstet Gynecol Scand. 2007;86:783-787.
113. Selmer-Olsen T, Lydersen S, Morkved S. Does acupuncture used in nulliparous women reduce time from prelabour rupture of membranes at term to active phase of labour? A randomised controlled trial. Acta Obstet Gynecol Scand. 2007 Oct 25. [Epub ahead of print]
117. Su KP, Huang SY, Chiu TH, et al. Omega-3 fatty acids for major depressive disorder during pregnancy: results from a randomized, double-blind, placebo-controlled trial. J Clin Psychiatry. 2008 Mar 18.
118. van den Berg I, Bosch JL, Jacobs B, et al. Effectiveness of acupuncture-type interventions versus expectant management to correct breech presentation: A systematic review. Complement Ther Med. 2008;16:92-100.
119. Elden H, Fagevik-Olsen M, Ostgaard HC, et al. Acupuncture as an adjunct to standard treatment for pelvic girdle pain in pregnant women: randomised double-blinded controlled trial comparing acupuncture with non-penetrating sham acupuncture. BJOG. 2008;115:1655-1668.
Last reviewed April 2009 by EBSCO CAM Review Board]]>
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
Copyright © 2007 EBSCO Publishing All rights reserved.