Safety and efficacy of herbal remedies in obstetrics-review and clinical implications

Objective: to review the literature on safety and efficacy of the most commonly used herbs to enable midwives to give evidence-based information to pregnant women. Design: survey and review of the scientific literature. Setting: the survey was performed at the antenatal clinic at Norfolk and Norwich University Hospital between 26 November 2007 and 15 February 2008. Participants: a total of 578 expectant mothers at least 20-weeks pregnant. Measurements and findings: 57.8% of the participants used one or more herbal remedies. The most commonly used herbal preparations during pregnancy were ginger, cranberry, raspberry leaf, chamomile, peppermint and echinacea. Altogether, 14 studies focusing on the safety and/or efficacy of these herbals in human pregnancy were identified. Ten studies of ginger, one of cranberry, two of raspberry leaf and one of echinacea were located. Key conclusions: there is limited documentation on the safety and efficacy of many herbs commonly used during pregnancy. Implications for practice: midwives are important caregivers for pregnant women and should strive to give evidence-based advice on herbal use in pregnancy. If 'traditional use' is the only available information, the pregnant woman should be made aware of this to enable her to make an informed decision about the eventual use. (C) 2009 Elsevier Ltd. All rights reserved.