Herbal Supplements in Pregnancy: What’s Safe and What’s Not

More than 1 in 4 pregnant women take herbal supplements. Not because they’re reckless, but because they’re told these are "natural" and therefore safe. The truth? It’s not that simple. While some herbs like ginger have solid research backing their use, others carry hidden risks - and most have almost no reliable data at all. If you’re pregnant and wondering whether that chamomile tea or raspberry leaf capsule is okay, you’re not alone. And you’re not wrong to be unsure.

What Herbal Supplements Are Actually Used During Pregnancy?

Ginger tops the list. Around 28% of pregnant women in Catalonia, Spain, use it - mostly for nausea. And for good reason. Multiple studies show that doses under 1,000 mg per day reduce vomiting and nausea as effectively as some prescription meds, without the same side effects. It’s one of the few herbs with enough evidence to be recommended by major medical groups.

Chamomile comes next. Often used for sleep or anxiety, it’s in teas, tinctures, and capsules. But here’s the catch: some studies link it to higher risks of preterm birth and low birth weight. Others show no effect. The inconsistency isn’t because the science is messy - it’s because almost no one has studied it properly in pregnant women.

Raspberry leaf is another big one. Many midwives and doulas recommend it starting in the third trimester to "tone the uterus" and ease labor. But the American Academy of Family Physicians says it may increase the chance of cesarean delivery when used to try to induce labor. And it’s not just about timing - there’s no standard dose. One capsule might have 500 mg. Another might have 1,200 mg. That’s a problem when you’re trying to avoid uterine overstimulation.

Cranberry supplements are popular for preventing urinary tract infections (UTIs), which are common in pregnancy. They might help a little, but they’re not as reliable as antibiotics like nitrofurantoin. And there’s a red flag: some women report spotting in the second or third trimester after taking them. No one knows why. No one’s studied it enough to say if it’s a real risk or a coincidence.

Why Is There So Little Safety Data?

Here’s the harsh reality: pregnant women are almost never included in clinical trials. Not because researchers are ignoring them - but because they’re afraid of harming the baby. So when a company makes a ginger supplement, they don’t need to prove it’s safe for pregnancy. They just need to say it’s "natural." That’s it.

The FDA doesn’t require herbal supplements to be tested for safety or effectiveness before they hit store shelves. That means two bottles of "raspberry leaf extract" from different brands could contain wildly different amounts of active ingredients - or even unlisted herbs, heavy metals, or pharmaceuticals. One 2023 FDA review found that 20% to 60% of herbal products had contamination or mislabeling issues.

Even the name "supplement" is misleading. Unlike prenatal vitamins - which are regulated as dietary supplements with strict ingredient limits - herbal products are treated like food. That’s why you can buy a bottle labeled "For Pregnancy" with no warning labels, no dosage guidelines, and no proof it does what it claims.

What’s the Real Risk?

Most herbs aren’t dangerous if used carefully. But some can be. Rosemary, for example, is fine as a seasoning in food. But in medicinal doses - like in capsules or concentrated teas - it can stimulate contractions. The American Pregnancy Association calls oral use "possibly unsafe." Topical use? Unknown. That’s the pattern: we know what happens when you eat it, but not when you take it as a pill.

Then there are herbs with clear red flags: pennyroyal, blue cohosh, black cohosh, and high-dose sage. These are linked to uterine contractions, fetal distress, and even miscarriage. Yet they’re still sold online with labels like "natural labor support" or "uterine tonic." No warnings. No disclaimers.

Even "safe" herbs can interact with medications. Ginger can thin the blood - a problem if you’re on aspirin or have a bleeding disorder. Chamomile might interfere with sedatives or antidepressants. And if you’re taking iron supplements for anemia (common in pregnancy), some herbs can block absorption.

Why Do Women Still Use Them?

Because they’re told it’s better than medicine. A Spanish study found that women who used herbal products were far more likely to believe that natural remedies are safer than prescription drugs. That belief is strong - and it’s fueled by social media, family advice, and wellness blogs.

Forty-two percent of women in that same study started using herbs without telling their doctor. They got advice from their mom, a Facebook group, or a YouTube video. Reddit threads from early 2024 show how confused people are. One post asking "Is chamomile tea safe?" got 142 comments. Only 37% said they’d consult a provider. The rest relied on anecdotal experience.

And let’s be honest - doctors don’t always help. Many don’t ask about herbal use. They assume it’s harmless. Or they don’t know enough to give good advice. A 2023 survey found that 68% of OB-GYNs felt underprepared to discuss herbal supplements with patients. That’s a gap - and it’s dangerous.

What Should You Do?

If you’re pregnant and using any herbal product - even if it’s just a tea - talk to your provider. Not your aunt. Not your doula. Not your Instagram health coach. Your doctor or midwife. Bring the bottle. Show them the label. Ask: "Is this safe for me right now?"

Here’s what to avoid:

• Any herb marketed to "induce labor," "cleanse the uterus," or "boost fertility" during pregnancy
• Supplements with no ingredient list, no manufacturer name, or no batch number
• Products bought from unregulated online sellers (especially Amazon, Etsy, or Instagram shops)
• Herbs you’ve never used before - especially in the first trimester

Here’s what’s likely okay, with your provider’s approval:

• Ginger - up to 1,000 mg per day for nausea
• Cranberry capsules - for UTI prevention, if you’ve had them before and aren’t spotting
• Raspberry leaf - only after 32 weeks, and only if you’ve discussed it with your provider

And if you’re not sure? Skip it. Pregnancy isn’t the time to experiment with untested substances. There’s no rush. You don’t need to "optimize" your pregnancy with herbs. You just need to stay healthy.

What’s Changing?

There’s some hope. In September 2023, the National Institutes of Health launched a $12.7 million study to track herbal use in pregnancy across the U.S. They’re following 5,000 women from early pregnancy through birth to see what, if anything, affects outcomes. That’s the kind of data we’ve needed for decades.

The FDA also issued warning letters in early 2024 to three companies making false claims about pregnancy-safe herbal products. That’s a start. But until herbal supplements are held to the same standards as drugs - and until doctors are trained to ask about them - the risk will stay high.

For now, the safest rule is simple: if you didn’t get it from your doctor, don’t take it. Not because everything is dangerous. But because we just don’t know enough to say what’s safe.