Herbs in Pregnancy

Herbs

We’ve written in the past about a pregnant woman’s lowered immunity. Good nutrition, sanitation habits, rest, and exercise all help to strengthen the pregnant woman’s immune system—yet she will inevitably be exposed to viruses and other immune challenges. Pharmaceutical remedies may prove too strong or be contraindicated in pregnancy, so we wondered about herbal remedies. What herbs are safe in pregnancy and what herbs should be avoided? We turned to an herbalist with training in the use of herbs during pregnancy and postpartum to find the answers. *

Before receiving clinical training in Herbal Medicine for Women, Julie Pettler worked as a physical therapist. Later, while teaching her young children at home, Julie built a large garden in her yard and began to keep bees. As her love of gardening grew, so did her fascination with the power of herbs—herbs that grow naturally and herbs that can be cultivated—to treat common ailments. “I study history, science, anatomy, and human health [as an herbalist],” Julie says. “Sometimes I walk barefoot through my yard to gather dandelion greens to add some bitter to my diet. Sometimes I order a strong tincture to stimulate a client’s lymphatic system.” In her current herbalist practice, she combines her love of teaching with her love of plants by leading workshops on foraging, herbal medicine making, the holistic use of plants for health and well-being, and the history and science of plant medicine. Studying herbs for women’s health combined another of her passions: advocacy for pregnant women and evidence-based childbirth.

We started the conversation by asking Julie when the pregnant woman can use herbs during pregnancy. “Herbs may be used for general nutritional support during pregnancy, such as with the use of pregnancy “teas,” and confidently used to address common mild discomforts such as nausea, itchy skin (topical use), and heartburn,” she says. “If a more serious issue arises during pregnancy, herbs may be considered in consultation with a knowledgeable practitioner.”

Julie offered a list of categories of herbs traditionally avoided in pregnancy. “Stimulating laxatives, such as Cascara sagrada, [and] aloe and rhubarb should not be used during pregnancy.” She suggests instead non-stimulating bulk laxatives such as flax or psyllium. Tansy, Mugwort, wormwood, and yarrow stimulate menstrual flow and should not be used. Julie points out that the literature on the safety of herbs in pregnancy is often conflicting, so she suggests a conservative approach to the use of herbal remedies.

The following are some of her suggestions for use in pregnancy:

Nausea

Nausea is a common complaint among pregnant women, in particular in the early months. Julie recommends ginger. “It’s the most studied herb for nausea in pregnancy,” she says. “And the studies support the traditional use of ginger.” Ginger can be taken as a tea (simply shaving fresh ginger into a teacup and steeping it in hot water, can create the tea), as ale in the form of ginger ale with real ginger, in capsule form, or as a candy.

Colds and Flus

For immune support, Julie recommends Echinacea initially, at the first sign of a cold or a flu. “It can be combined with elderberry for extra immune support,” she says. “If a cold or flu sets in, Echinacea should be discontinued. Many times though, the use of Echinacea will prevent illness.” Echinacea is best used for a short duration and can be taken in tincture form every few hours for two-three days.

Pregnancy Tea for Uterine Support

Pregnancy teas support and tone the expanding uterus in the second and third trimesters. Julie recommends equal parts Red Raspberry Leaf, Nettle Leaf, Oat Straw, and Alfalfa (measuring one cup combined). Using one quart of boiling water, cover and steep the herbs overnight to make the nourishing tea.

Postpartum

Julie suggests using herbs for after pains and for healing and antiseptic support of the perineal tissue. Antispasmodic herbs include chamomile, catnip, motherwort, and cramp bark, and can provide relief from after pains. Sitz baths, warm compresses, or peri-rinses to support the perineum postpartum can be made using comfrey leaves, calendula flowers, lavender flowers, sage leaf, yarrow blossoms, and rosemary.

A longitudinal study in 2001 on the use of pharmaceutical medications in pregnancy concluded that 91% of conventional medications had not been proven safe in pregnancy; physicians had inadequate information on the safety of medications in pregnancy. The World Health Organization studied the safety of vaccines in pregnancy and reached a similar conclusion—there are not enough studies conducted on pregnant women for obvious ethical reasons.

Most pregnant women have healthy pregnancies despite the lowered immunity. Herbs can provide a safe and low-risk option for women wanting to boost their immune systems when they’ve been exposed to a cold or flu, when they are preparing for birth, and during the early trimesters for nausea or in the postpartum period when their bodies are healing. “I love that the plants are simultaneously simple and complex,” Julie says. “I love the ways herbs can nudge our bodes toward health by nourishing us and supporting all of our body systems. This is an excellent time to slow down and embrace the healing power of plants.”

*Always consult with your healthcare practitioner before using herbs in pregnancy

The Fourth Trimester

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photo credit: Birthing Beautiful Communities

When a newborn emerges from the womb, it leaves behind a warm, dark, and physically stimulating environment that includes the mother’s heartbeat, the sounds of children or other adult voices, and the rocking, jostling, and rhythmic steps of the mother moving about. Upon birth, a baby will turn toward the familiar sound of its mother’s voice. We teach new parents to lay the baby down in quiet rooms, away from noise and the hustle and bustle of life, away from the mother’s familiar heartbeat, but what if what they really need is more of what they experienced in the womb?

The concept of a fourth trimester was first communicated by British childbirth educator and author, Sheila Kitzinger, in 1975: “There is a fourth trimester to pregnancy, and we neglect it at our peril. It is a transitional period of approximately three months after birth, particularly marked after first babies, when many women are emotionally highly vulnerable, when they experience confusion and recurrent despair, and during which anxiety is normal and states of reactive depression commonplace.” And other anthropologists like Jean Liedloff, author of The Continuum Concept, have studied multiple cultures or indigenous populations, looking for answers for problems faced by mothers and babies during the fourth trimester and beyond.

The fourth trimester concept embraces the idea that human babies are born three to four months earlier than developmentally ready. With evolution, the human brain has grown larger, but the woman’s pelvis has not. Thus, babies are born when their skulls are approximately eleven centimeters and before they have the muscle control to hold up their heads or roll over.

A friend who recently had her first baby remarked that while she had probably over-prepared for the birth, she hadn’t prepared at all for the first three months. Women no longer live and work in the same environments; we don’t see parenting up close with our communities or do as much caring for younger children as we once did when families were larger and life was more communal. We’ve moved into the workplace, attending college at large numbers, and waiting until our thirties (on average) to have children.

The transition from baby-in-the-womb to baby in the room can be just as jarring for today’s new mother as for the baby.

Buzzwords and parenting trends come and go, but the needs of the baby and new mother remain constant. During the fourth trimester, the mother faces: changing hormones, physical and sometimes emotional recovery from the birth, an initial unusually heavy period, soreness, moodiness, sleep deprivation, feeding and caring challenges with the baby, and, frankly, a world turned topsy-turvy. First time mothers are adjusting to the fact that every decision they make—even slipping into the bathroom to shower—impacts another person. Essentially, her life is no longer focused on her own wants and desires. More than men, women’s lives are greatly disrupted and reshaped by the arrival of a child, especially in the first months after the baby’s birth.

Both mom and baby are thrust into a new world, requiring adjustments, time, and a steep learning curve. If it’s a first baby, the learning curve is steep, but even consecutive babies create a learning curve, given personality and developmental differences baby to baby.

didymos-baby-sling-baby-carrier-baby-brightThe concept of the fourth trimester helps during this vulnerable time of change—looking at the early months through the eyes of the newborn, with empathy, helps the new parents in terms of setting expectations and making decisions. For instance, babywearing, especially with cloth wraps, can soothe even the fussiest of babies. The baby returns to the familiar warmth, heartbeats, and movement of its mother in the wrap. Wrapped securely, mothers can grocery shop, take care of older children, walk around the house, prepare food, or rest on the couch while the baby naps in its familiar cocoon. Some physicians and development specialists recommend swaddling to achieve a similar sense of security, but it remains more controversial in terms of neurological and motor development, especially if done for extended periods of time. One of my favorite wraps is the Didymos, but there are many types and styles of wraps on the market today and a mother might find that different styles are better for certain situations. For instance, for a quick errand at the store, a ring style sling might be easier to use. And babywearing can be a lifesaver with colicky babies.

Looking through the lens of the fourth trimester, it’s easy to see why a baby might nurse at uneven intervals; in the womb, the baby received nutrition continuously and in synch with the baby’s development. In the same way, a baby will nurse more when it’s making big developmental leaps, cutting teeth, or going through a growth spurt—as well as when it’s upset, scared, or angry. The media (books, TV shows, movies) often portrays sleep as something to be managed, when in reality, the baby knows what it needs and the sooner the new mother (and father) accept a more flexible approach to feeding/nursing, the easier the fourth trimester becomes. Full nights of sleep WILL return, but to expect full nights of sleep when the baby is young is contrary to its needs and development.

In the meantime, what makes sleep easier? Many families find that co-sleeping or using a side basinet works well. If breastfeeding, the mother gets more sleep when the baby is close by. And regular sleep/arousal cycles are healthy for infants and decrease the risk of SIDS. Every baby will sleep on its own when it’s ready. Managing expectations about sleep is just as important as managing the baby’s care. Attitudes should match development, not external schedules or sleep rules. These guidelines for safe co-sleeping can be helpful. Never sleep with an infant if the accompanying parent(s) have been using drugs or alcohol, as they may impair instincts and awareness. Dr. McKenna, an anthropologist and infant sleep researcher, cautions against co-sleeping when the mother is unable to breastfeed. In that instance, having the infant in the room in the early days will allow the parents to respond quickly to the baby’s needs. To learn more, check out McKenna’s Behavioral Sleep Laboratory at Notre Dame.

More and more research, as well as community programs, is focused on the concept of the fourth trimester. The University of North Carolina has a team of investigators looking at ways to improve outcomes during the first months of motherhood and infancy. Mothers and babies need support during those tender first months and health professionals are beginning to realize the importance of timely health encounters to reduce the incidents of post-partum depression, breastfeeding problems, and other maternal health issues. As women, we no longer live communally, but we can create a sense of community and support with our care providers, support groups (La Leche League or new parent groups for example), extended family, and friends who are already mothers.

Midwives see the care of the mother from a holistic perspective. From pregnancy to birth to postpartum, the midwife educates and supports the mother. It’s just as important that a new mother reach out to her midwife or care provider when feeling overwhelmed or unsure. Like the baby, the new mother is going from a constant environment—one in which she did things a certain way—to a completely changed environment. Support from other seasoned mothers and from health providers can be crucial to moving successfully through the final trimester and first months of motherhood.

(Locally, check out the Premier Birth Center postpartum support group, which meets every month in Winchester).

Natural Ways to Boost the Pregnant Immune System

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Pregnant women are more at risk for acquiring infection or viruses given the altered immune state that accompanies pregnancy. Most care providers and health agencies agree that the flu is a risk in late pregnancy and recommend certain types of flu vaccines. But there are also natural ways to aid the pregnant immune system.

Habits


Regular Exercise

Gentle exercise cleanses the lymph system and flushes bacteria out of the lungs. When the body heats up with exercise, it helps the body to fight infection. Breathwalking, yoga, swimming, and Tai Chi are gentle forms of exercise that are beneficial for pregnant women.

Sleep

The importance of sleep cannot be stressed enough. The body resets with sleep and a healthy immune system relies upon its restorative aspects. It can be hard to get comfortable in the third trimester when the baby gains the most weight just before birth. Sleeping on your side with a pillow between the legs is one of the most comfortable positions for sleep for the pregnant woman. Heartburn can also be a problem late in pregnancy. Be sure to eat small meals in the evening or drink tea with cinnamon or ginger or peppermint. If you find your sleep is interrupted at night, try to fit in a nap during the day.

Diet

A strong diet during pregnancy helps not only with immunity, but also with the size of the baby, which in the end can ensure an easier delivery. Check out our post on the optimal pregnancy diet and tips for eating healthy.

Hydration

Most midwives will tell you that hydration is key to a healthy pregnancy. Taking in enough fluids helps to flush your lymph system and keep your kidneys and bladder healthy, and water helps to form the placenta and the amniotic sac. Dehydration during pregnancy can lead to serious pregnancy complications, including neural tube defects, low amniotic fluid, inadequate breast milk production, and even premature labor. These risks, in turn, can lead to birth defects due to lack of water and nutritional support for the baby. Aim for at least eight 8-ounce glasses of water a day.

Hand washing

Be sure to wash your hands regularly. Anti-bacterial soaps are not recommended, but washing with regular soap is a good habit to develop while pregnant and when handling your newborn, postpartum. The most effective hand washing method involves lathering the backs of your hands, between your fingers and under your nails. Be sure to wash your hands after attending a group gathering or playing with young children.

Immune Boosters


Vitamin C

A master immune booster, Vitamin C helps immune cells mature; has an antihistamine effect; controls excesses of stress hormones, which suppress immunity; is antiviral and antibacterial; and raises interferon levels, an antibody that coats cell surfaces. In addition to Vitamin C supplements, the following foods contain the vitamin: papaya, bell peppers, strawberries, oranges, grapefruit, broccoli, pineapple, kale, kiwi, or Brussels sprouts.

Tumeric

Tumeric is the food that keeps on giving. Research has shown that it’s a better inflammatory than many OTC anti-inflammatory medications and equal to low dose steroids. High in antioxidants, anti-cancer by nature, good for digestion, and excellent at controlling inflammation, turmeric offers many immune benefits. You can add turmeric to smoothies, drink turmeric tea, or add turmeric to your favorite dishes.

Garlic

Garlic is a powerful natural antibiotic. One clove is powerful enough to combat infection, with its five milligrams of calcium, 12 milligrams of potassium, and more than 100 sulfuric compounds. It’s most powerful raw. If you feel a cold coming on or feel flu-like, try a raw garlic “shot:” one minced garlic clove in a small amount of water, chased by more water. Or, if you’re really ambitious, consider a shot of raw garlic, ginger, carrots, and lemon for a quick immune boost. Raw pesto is a wonderful way to get your raw garlic – toss on pasta or slather on a piece of toast or use in place of tomato sauce on pizza.

Healthy Fats

It’s important to obtain adequate essential fatty acids (EFAs) from the diet during pregnancy and lactation. DHA supplements, an Omega-3 fatty acid, based on cultured microalgae are available in many natural food stores. EFAs boost the pregnant woman’s immune system, support endocrine function and normal function in tissues, and lessen inflammation.

Linoleic and alpha-linolenic, key components of EFAs, cannot be synthesized in the body and must be obtained from food. Omega-6 fats are derived from linoleic acid and are found in leafy vegetables, seeds, nuts, grains, and vegetable oils (corn, safflower, soybean, cottonseed, sesame, sunflower). Most diets provide adequate amounts of this fatty acid, and therefore planning is rarely required to ensure proper amounts of omega-6 fatty acids. A less common omega-6 fatty acid, gamma-linolenic acid (GLA), has been shown to have anti-inflammatory effects along with other disease-fighting powers. GLA can be found in rare oils such as black currant, borage, and hemp oils.

Research suggests that fatty acids are needed for fetal growth and fetal brain development. The EFAs are important for infants as they ensure proper growth and development and normal functioning of body tissues. Increased omega-3 fatty acid intake in the immediate post-natal period is associated with improved cognitive outcomes. It’s important that the mother’s diet contain a good supply of omega-3s because infants receive essential fatty acids through breast milk.

Zinc

The body requires zinc for production, repair, and functioning of DNA – the basic building blocks of cells. Beans, nuts, breads, seeds, dairy, and some cereals provide zinc. Too much zinc is not beneficial, so if you consider taking zinc supplements, be sure to talk to your midwife or doctor first.

Vitamin D

Vitamin D supplementation during pregnancy and breastfeeding is generally recommended. Vitamin D plays a key role in the process of priming T cells to be ready to attack invaders and to fight infection. Sunshine, oily fish, and eggs are good sources of Vitamin D. If eating fish, it’s recommended to limit the servings to 12 ounces a week because of the exposure to methylmercury in most fish.

Almonds

Almond skin contains naturally occurring chemicals that help white blood cells detect viruses and even help to keep them from spreading. Almonds contain healthy fats, fiber, iron, protein, and magnesium. Almond butter is high in protein and good fats. It’s a good substitute for peanut butter and can be served on apples, crackers, or bread.

Chicken Soup

The old adage is true: eating chicken soup boosts the immune system. The broth and vegetables combine to provide anti-inflammatory benefits. Chicken soup decreases the duration and intensity of colds and flu by inhibiting the migration of white blood cells across the mucous membrane, which, in turn, can reduce congestion and ease cold symptoms.

Yogurt or Kefir

A healthy gut is an important building block of a healthy immune system. Yogurt and even better, Kefir, are full of probiotic benefits. Buy plain yogurt or kefir and add fruit-juice sweetened jam or fresh fruit and honey to avoid the high sugar content of commercial flavored brands.

Hot Lemon Water with Honey

Fresh lemon juice is an immune powerhouse, filled with Vitamin C, vitamin B6, vitamin E, folate, niacin thiamin, riboflavin, pantothenic acid, copper, calcium, iron, magnesium, potassium, zinc, phosphorus and protein. Squeeze the juice of one fresh lemon into a teacup, fill the rest of the cup with hot tea water, and sweeten with raw honey. This drink is especially soothing when you have a sore throat, cold, or sinus issues.

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Proper hydration, healthy diet, moderate exercise, and sleep are the building blocks of a healthy pregnancy. The basic prenatal multi-vitamin offers a lot of immune enhancing properties (don’t take a generic multi-vitamin as they often contain Vitamin A, which is contraindicated for pregnancy.) Experiment with some of these immune boosting tips, but most of all enjoy your pregnancy and let your midwife or physician know if you have any questions about immunity in pregnancy.

Kim Pekin newborn exam

The Whispered Calling to Midwifery

Kim Pekin newborn exam

I think I always wanted to be a midwife, but I just didn’t know what that was until much later in my life. After I became a midwife, I found out my great-grandmother was a midwife, so maybe the calling is something I knew at a cellular level somehow. When I was a little girl, I was fascinated with birth and babies, and just absolutely amazed by pregnancy. All of my Barbie dolls were continuously pregnant or nursing their little babies. I always had a Baby Alive baby doll with me. I dreamed of the day that I’d somehow become a mother myself. I remember my mother bought a copy of Lennart Nilsson’s A Child Is Born back in 1974, when I was 8 years old, and I read it over and over again. I felt so full of awe by seeing the progression of how two individual cells could somehow manage to form a complete human being. It still boggles my mind to this day. Such an amazing miracle!

When I was a teenager, I thought I wanted to be an obstetrician. I didn’t know anything about midwives. It was 1980 at the time, and we were a really mainstream family. I didn’t know anyone who had given birth at home, and I thought that midwives had gone out of existence long ago. My mother quickly talked me out of the idea of becoming an obstetrician saying, “Oh, you don’t want to do that, Kim! You’d be on call all the time and would have to get up in the middle of the night to go to births!” I laugh about it now, because, well, that’s my life, and I wouldn’t have it any other way!

I had my first child in 1989. I was very excited to finally get to experience this miracle of pregnancy and birth myself! I wanted the best possible care, of course, which to me at the time meant hiring an OB/GYN and having a hospital birth. There was no Internet back then, and I knew of no other way. I read a lot of books. Unfortunately, the books I read weren’t the most helpful ones for preparing to have a natural birth, rather they were much more helpful in preparing me to be a compliant patient. I was very naive and thought that if I wanted a natural birth, all I had to do was tell the hospital staff and doctor that’s what I wanted, and they would support my choice. I had no idea that hospitals weren’t really set up that way for birth. I ended up having a very interventive hospital birth, but somehow escaped a c-section. Looking back, it’s truly a miracle that I ended up with a vaginal birth with my first child. I credit a lack of health insurance and a patient doctor with my outcome.

My next two births were highly interventive hospital births, as well. There was a lot of trauma I had to work through with those births. By the time I had my third baby, I had gotten to the point where I felt like my body was broken somehow. I felt like I needed all of those medical interventions in order to give birth. I lacked confidence as a mother, and I lacked confidence in myself and my ability to make good choices for my care. That idealistic young woman who thought having a natural birth was just a choice and not something I’d have to work for, had quietly dissolved into a compliant, timid, defeated person. The joy I had hoped would come from birth was replaced with fear.

I decided with my fourth baby things would be very different. By that time, I had become a La Leche League Leader, and many of my friends had been choosing to give birth at home with midwives. I wondered if I could be “strong enough” to do that too. Could I do it? Did I have it in me? My friends encouraged me to talk with a midwife and learn more.

After that first meeting, I felt like I’d come home. For the first time as a pregnant woman, I felt like my provider had actually listened and heard what I said. I spent over an hour with the midwife, sharing about my previous births, discussing my hopes and fears, and learning more about what midwifery care was all about. She accepted me into her care, and I was on my way!

I worked really hard. My husband and I attended our 12-week Bradley Method Childbirth classes, we read all sorts of books, practiced our relaxation exercises, ate really well, prepared our home, and did everything our midwives recommended we do to prepare ourselves for our home birth. In the end, I had a beautiful, wonderful home birth, with all of my older children, my mother, and my husband in attendance. Afterwards, my midwife whispered in my ear, “See, your body knows just what to do.” She was absolutely right, and it transformed my life. It took a whisper to hear the calling to midwifery.

That home birth was the impetus for great change in my life. I went on to start my own business. I was fearless! I built my own home-based business and had over 500 people selling for me around the country. I published a catalog several times each year. I created my own line of personal care products. None of these things were things I knew how to do before, but I knew that if I could give birth naturally after feeling as defeated as I had felt, I could figure out how to do all of the rest of these things somehow.

My true love was midwifery, though. Midwifery is what helped me to have the confidence in myself to become the person I was meant to be, and I needed to make that my life’s work. The timing was right. I made the decision to close my business, go back to school, and devote my attention full time to becoming a midwife.

Being a midwife allows me to be part of an incredibly transformative journey for a woman and for her whole family. I love seeing women grow in confidence in their ability to grow and birth their babies, and I feel so deeply touched to witness how couples and entire families strengthen their relationship with each other by working together during this special time. Midwives speak of feeling honored and privileged to be part of this, and those are not just words for us. I know, from my own experience, just how meaningful this experience is. I appreciate so much when someone asks me to help them on their journey, and feel deeply honored to be given the opportunity to serve their family. I feel a certain reverence knowing the impact the experience can have upon their life.