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

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The Physiology of Birth

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photo courtesy of Adelaide Birth Photography

Birth is often a mystery—at least that’s what we’re led to believe. But closer examination reveals basic physiological truths that underpin normal birth for both the mother and baby. Certain truisms can indicate risk, such as a pregnant woman’s prenatal nutrition and medical history, but, in the end, birth is a complex orchestration of hormones, proteins, neurology, and basic psychology for the mother. The teasing apart of these elements allows us to understand the perfectly designed biological process of childbirth.

What We Know About the Onset of Labor

There is surprisingly little known about what causes labor. In the beginning of pregnancy, the woman’s immune system is suppressed to insure that the forming embryo implants successfully and the biological process sets in motion. In fact, if a woman’s immune system is too active, miscarriage can occur in the early months. Later in the pregnancy, when the baby is full term and labor begins naturally, though, there is less consensus about the exact cause of labor. Science is only just beginning to understand the onset of labor.

There’s strong evidence the baby may have something to do with initiating labor. When the baby reaches 32 weeks, a surface protein, a soap like substance or surfacent, coats the inside of the baby’s lungs to keep the alveoli open, a critical shift that will allow the baby to breathe outside the uterus. The surfacent consists of six fats and 4 proteins and continues to be produced until around the child’s eighth birthday, when the lungs are fully developed. Eventually one of the proteins, SP-A, is produced in the baby’s maturing lungs in utero. This protein activates immune cells (macrophages) to migrate to the uterine wall, creating a chemical, inflammatory, reaction, which may be the official start of a natural labor. Studies have been done with mice in which the SP-A is blocked; the mice remain pregnant beyond normal gestation. So, in a nutshell, the baby’s development—more importantly, the baby’s maturing lungs that signal when they are ready to breathe outside the uterus—may be the instigator, signaling for labor to begin.

On the mother’s part, hormones play an important role. Prostaglandin is the hormone that softens the cervix and oxytocin increases and triggers contractions. Also at play are estrogen, progesterone, cortisol, and CRH—corticotrophn. When the baby drops in the mother’s pelvis, the hormones assist, and the cervix begins to relax and thin.

The hormones; the baby’s position; and the immune cells, in concert with the uterus, all work together to trigger the full onset of labor. And hormones continue to work to the mother’s advantage as she progresses through the rest of the labor.

Hormones in Undisturbed Labor Defined

Any woman who has had a natural birth or observed a natural birth knows that undisturbed labor is intuitive and powerful, an intricate dance between mother and baby and the people assisting the mother. The mother often knows what she most needs, even in the most complicated of situations, because of the uninterrupted intuitive interplay between mother and baby.

Sarah Buckley, MD, an Australian obstetrician, writes and speaks extensively on the hormones at play in undisturbed birth. The key hormones in birth include oxytocin, beta-endorphin, adrenaline (epinephrine), and noradrenaline (norepinephrine), and are identical to the pattern of hormone release in lovemaking. “As the hormones of love, pleasure and transcendence, excitement, and tender mothering, respectively, these form the major components of an ecstatic cocktail of hormones that nature prescribes to aid birthing mothers of all mammalian species,” Buckley writes in “Gentle Birth, Gentle Mothering.”

The cocktail of hormones build up and peak around the time of birth or soon after and subside and reorganize over the hours and days after the birth. All of these hormones are produced primarily in the hypothalamus and each serve an important function in natural labor: oxytocin, the love hormone, stimulates contractions, and higher levels of oxytocin are also beneficial for contracting the uterus after birth to prevent hemorrhaging; beta-endorphin serves as a stress hormone, more specifically as a pain-reliever that in high amounts can slow the production of oxytocin, thereby helping to modulate the pain of labor; and adrenaline and noradrenaline—fight or flight hormones—rise at the end of labor, giving the mother extra energy for the pushing and initiating the ejection impulse necessary for the final stage of labor.

Karen Strange, CPM, who teaches NRP training from the baby’s perspective, teaches birth workers to observe and expect the laboring mother to “pause” after the baby arrives. Strange teaches that there is a natural sequencing to birth for both mother and baby, and the pause or resting allows them to have a time of integration. Oxytocin, the love hormone, is at its highest in the hour after the birth, and mothers and babies begin the bonding process during that sacred hour. But noradrenaline also plays a role. “Noradrenaline, as part of the ecstatic cocktail, is also implicated in instinctive mothering behavior. Mice bred to be deficient in noradrenaline will not care for their young after birth unless noradrenaline is injected back into their system,” writes Buckley.

Why Environment Matters

Michael Odent, French obstetrician and surgeon, studied the environments for birth in the 1980s. He introduced low lighting, birthing pools, and singing into the birthing rooms at the hospital where he practiced in Paris. Eventually he became involved in home birth and started a research center in London. He found that low lighting, less observation, warm water, and a more homelike environment aided women in labor. Looking at the hormones at play—the very same hormones that are involved in lovemaking—it’s easy to see why a woman’s labor might be aided by the elements he studied. Traditionally women have birthed in a home, or even outside. The hospital environment became a new normal in the 20th century as surgical and other interventions began to rise, an environment Odent refers to as the masculinization of the birth environment.

Buckley writes, “For birth to proceed optimally, this more primitive part of the brain needs to take precedence over our neocortex—our “new” or higher brain—which is the seat of our rational mind. This shift in consciousness, which some have called “going to another planet,” is aided by (and also aids) the release of birthing hormones such as beta-endorphin, and is inhibited by circumstances that increase alertness, such as bright lighting, conversation, and expectations of rationality.”

Finely Tuned Dance

Low lighting, quiet, and support for the increasing irrational and more instinctual feelings of the birthing mother all support undisturbed labor. Midwives are trained to follow the mother. By following her cues and trusting in the complex orchestration of hormones, the healthcare provider receives vital information for understanding how the labor is progressing. What is most important is that the mother feels safe to travel to that other planet and that labor starts naturally and remains undisturbed. Biology most often takes care of the rest.

The physiology of birth includes a finely tuned dance between mother and baby, between immune cells and proteins and the uterine wall, and between the mother and her environment. If birth is treated more like a medical procedure, more like a masculine [refers to culture, not to men specifically] and rational endeavor, the more removed the mother will become from all the benefits nature provides. The physiology of birth, when allowed to proceed uninterrupted in normal birth, provides a hormonal roadmap for a successful birth and bonding.

“Giving birth and being born brings us into the essence of creation, where the human spirit is courageous and bold and the body, a miracle of wisdom.”

-Harriette Hartigan, midwife, author, and photographer

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.