The Use of Botanicals During Pregnancy and Lactation
SOURCE: Alt Ther in Health and Med 2009 (Jan); 15 (1): 54-58 ~ FULL TEXT
Tieraona Low Dog, MD
Arizona Center for Integrative Medicine,
University of Arizona Health Sciences Center, Tucson
Women are the largest consumers of healthcare, and this extends to their utilization of complementary and alternative medicine (CAM). Researchers have attempted to uncover the reasons why women turn to CAM in general and to botanical medicine in particular. Desire to have personal control over their health has been cited as the strongest motive for women to use herbal medicine. Second was dissatisfaction with conventional treatment and its disregard for a holistic approach, as well as concerns about the side effects of medications. 
These concerns may explain, in part, the fact that many women use herbal remedies during pregnancy. A survey of 578 pregnant women in the eastern United States reported that 45% of respondents had used herbal medicines,  and a survey of 588 women in Australia revealed that 36% had used at least 1 herbal product during pregnancy.  Women probably feel comfortable using herbal remedies because of their perceived safety, easy access, and the widespread availability of information about them (ie, Internet, magazines, books).
While it is true that many botanicals are mild in both treatment effects and side effects, the data regarding safety during pregnancy are very limited. Given the small sample sizes in clinical trials studying botanicals in pregnant women, only large differences in measures of pregnancy outcomes would likely be detected. For example, if an herb were thought to increase the rate of spontaneous abortion from 6% to 7%, a sample size of more than 19,000 women would be needed (to actually demonstrate that effect). It is highly unlikely that there will be any studies of a botanical (or any drug for that matter) with this large a sample size. (more…)