May 9, 2001 (Chicago) -- Pregnant? How about a little ginger tea to settle your stomach? Maybe some St. John's Wort to keep the blues away? After all, what could be more natural than some of nature's remedies while you are pregnant?
That type of sales pitch, which more often than not comes from a friend or relative, is worrying some obstetricians. And they are worried for a variety of reasons.
Herbal medicine and pregnancy was on the agenda at the recent American College of Obstetricians and Gynecologists annual clinical meeting held here. A presentation by Paul Gibson, MD, made it apparent that many pregnant women are using herbal remedies, without their doctor's knowledge -- and that could be risky.
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Gibson, who recently completed a postdoctoral fellowship at Brown University in Providence, R.I., specializes in medical disorders of pregnant women. He says, "my focus has been medication use during pregnancy, so I became interested in the use of herbs and alternative medicines during pregnancy."
As he started to explore the topic, though, Gibson discovered that there was very little data about herbal medicine and pregnancy so he conducted a study where he questioned 242 pregnant women about their use of nontraditional medications.
"Only 7.4% of these women said they had ever been asked about their use of herbal medicines," says Gibson. But when he asked, 9.1% of the women said they were using herbal medicines and 7.5% said they "used them at least once a week. That's a pretty significant usage," says Gibson.
He found that women who used the medicines before they became pregnant were more likely to be users during pregnancy. The most common substances used were garlic, aloe, chamomile, peppermint, ginger, echinacea, pumpkin seeds, and ginseng.
Gibson says the herbal remedies were more popular among white women than among other racial groups. Herbal remedies also were more appealing to women with some college education than they were to women with less education.
Gibson says that many women don't consider herbal remedies to be medicine and when they are pregnant these women usually don't report their use of these substances to their obstetricians. He tells WebMD that this is worrisome because even "herbs or vitamin supplements have the potential for side-effects or interactions with other medications."
The problem is compounded by the fact that herbal medications are not regulated, says Stanley Zinberg, MD, vice president of the American College of Obstetricians and Gynecologists. "We have no idea how much of substance is in a given bottle because the manufacturers are not regulated. There is no good control over these products."
Michael T. Mennuti, MD, professor of ob-gyn at the University of Pennsylvania in Philadelphia, tells WebMD that in some cases herbal remedies may not "even contain the substance that it claims is in the bottle. It may contain the concentration stated on the label or it may have a higher concentration or none of the substance."
Mennuti says that obstetricians and other doctors know that so-called natural remedies are becoming more popular but he says that too often obstetricians are ignorant about their own patients' use. "We need to ask the questions and I guess we need to ask very specific questions," he says.
Zinberg agrees with Gibson that some women don't think of herbal medicines as medicine so they are unlikely to volunteer information about use. "They think what could be wrong with something natural but they don't realize that just putting a natural label on something doesn't guarantee safety," he says.
The take home message for pregnant women is pretty clear, says Gibson: even if your doctor doesn't ask, tell him or her about any herbal preparations that you are taking.