Herbal Supplements in Pregnancy: What’s Safe and What’s a Risk

More than 1 in 3 pregnant women take herbal supplements. Not because they’re reckless, but because they’re told it’s natural, gentle, and safe. The problem? Herbal supplements in pregnancy aren’t regulated like drugs. They don’t go through safety testing. And for most of them, we simply don’t know what they do to a developing baby.

What Are People Actually Taking?

Ginger tops the list. Around 28% of pregnant women in Catalonia use it - mostly for morning sickness. And for good reason. Studies show it works. Doses under 1,000 mg a day are linked to less nausea, with no clear risk to the baby. It’s one of the few herbs with solid evidence backing it up.

Next comes chamomile. Used for sleep and calming nerves. But here’s the catch: some research links it to higher chances of preterm birth and low birth weight. Other studies say it’s fine. The data is messy. And that’s the story with most herbal supplements.

Raspberry leaf is another big one. Many women start taking it in the third trimester, believing it tones the uterus and makes labor smoother. But a 2023 review by the American Academy of Family Physicians found it’s tied to a higher rate of cesarean sections when used to try to induce labor. That’s not a small risk. And it’s not well understood.

Cranberry supplements are popular for preventing urinary tract infections (UTIs). They might help - but they’ve also been linked to spotting in the second and third trimesters. Spotting doesn’t always mean danger, but it’s a red flag that needs checking.

And then there’s rosemary. If you’re using it as a spice in food, you’re fine. But if you’re drinking rosemary tea or taking capsules, you’re risking uterine stimulation. The American Pregnancy Association calls oral medicinal doses “possibly unsafe.” Topical use? Unknown.

Why Don’t We Know More?

Pregnant women are almost never included in clinical trials. Not because researchers are careless - but because they’re trying to protect the baby. That’s ethical. But it leaves a massive gap. Less than 10% of all medicines approved since 1980 have enough data to say they’re safe during pregnancy. Herbal supplements? Even worse.

The FDA doesn’t require herbal products to prove safety or effectiveness before they hit the shelf. That means two bottles of “organic raspberry leaf tea” from different brands can have wildly different amounts of active compounds. One might be strong enough to trigger contractions. The other might be harmless. You won’t know until it’s too late.

Independent testing has found that 20% to 60% of herbal supplements contain ingredients not listed on the label. Sometimes it’s just fillers. Other times, it’s powerful herbs or even prescription drugs slipped in. One woman in Australia took a “natural anxiety blend” and ended up in the hospital because it contained a banned sedative.

Herbal vs. Conventional: The Real Trade-Offs

It’s easy to think herbal = safer. But that’s not always true.

Ginger is a rare win. It’s as effective as some anti-nausea pills, with fewer side effects. That’s why doctors often recommend it first.

But for UTIs, cranberry supplements are hit or miss. Antibiotics like nitrofurantoin have known risks in the third trimester - but they also have decades of data. Cranberry? You get a maybe, plus the risk of spotting. Is that worth it?

Prenatal vitamins? They’re tested. They’re standardized. You know exactly what’s in them. Herbal supplements? You’re guessing.

And then there’s the cultural side. In Spain, 48% of pregnant women used herbal products - higher than the global average of 29%. Why? Many believed herbal remedies were better than conventional medicine. That’s a powerful belief. But belief isn’t evidence.

Who’s Taking Them - And Why?

The women using these supplements aren’t outliers. They’re moms-to-be trying to do the right thing. They’re reading blogs, asking friends, scrolling Reddit threads. One Reddit post from early 2024 had 142 comments. 78% of commenters said they were unsure if their herbal tea was safe. 63% were still drinking it.

In Catalonia, 42% of women started using herbal supplements without telling their doctor. They got advice from family (38%), social media (29%), or Google (24%). Not from a midwife. Not from an OB-GYN. That’s the problem.

The timing matters too. Ginger use spikes in the first trimester - when nausea is worst. Raspberry leaf use jumps in the third trimester - when women start thinking about labor. That’s not random. It’s targeted. But targeting doesn’t mean safety.

What Experts Say - And Why You Should Listen

The American College of Obstetricians and Gynecologists (ACOG) says this plainly: “Don’t take any herbal product without talking to your provider first.”

Cleveland Clinic’s stance is even stronger: “Pregnant women should avoid most herbal supplements.” Why? Because some can trigger contractions. Others interfere with blood thinners or blood pressure meds. And you won’t know until you’re in labor - or worse.

The FDA warns that the strength and purity of herbal products can change between batches. One bottle might be fine. The next might be dangerous. There’s no quality control.

And here’s the kicker: even traditional knowledge doesn’t guarantee safety. Just because a herb was used for centuries doesn’t mean it’s safe for every pregnancy. Bodies change. Doses change. And we’re not studying the long-term effects on children.

What Should You Do?

If you’re pregnant and taking herbal supplements - stop. Just stop. Don’t panic. But do talk to your doctor.

Here’s what to ask:

• “Is this supplement safe for me right now?”
• “What’s the evidence for this?”
• “Could this interact with my prenatal vitamins or other meds?”
• “Is there a better, proven alternative?”

If you’re using ginger for nausea - keep going. But tell your provider. Keep the dose under 1,000 mg a day. Don’t double up with ginger tea, capsules, and candy.

If you’re thinking about raspberry leaf - don’t start it unless your provider says it’s okay. And never use it to try to induce labor. That’s not a home remedy. That’s a medical risk.

If you’re using cranberry for a UTI - talk to your doctor. Antibiotics might be the safer choice, even with their own risks. Untreated UTIs can lead to preterm birth. That’s a bigger danger than a short course of antibiotics.

The Bigger Picture

The U.S. market for herbal supplements hit $85 billion in 2023. About 4.7% of that is aimed at pregnant women. That’s billions of dollars spent on products with little to no proof they’re safe.

The NIH just launched a $12.7 million study to fix this. It’ll take years. In the meantime, you’re the one making the call.

And if you’re a provider? Ask. Always ask. Don’t assume your patient isn’t using herbs. Don’t assume they know the risks. Make it part of every prenatal visit. Write it down. Track it.

Because the truth is this: pregnancy is already full of unknowns. You don’t need to add more.

What’s the Bottom Line?

Some herbal supplements might be safe. Ginger is the best example. But most? We just don’t know. And that’s not a risk worth taking.

You don’t need to avoid everything. But you do need to stop guessing. Talk to your provider. Bring the bottle. Show them the label. Ask for evidence. If they can’t give you a clear answer - don’t take it.

Your baby’s safety isn’t about what’s natural. It’s about what’s known.