Herbal Products and Pregnancy: Safety, Risks, and Abortifacient Concerns

When used for abortion or fertility regulation, herbs or herbal preparations may cause significant side effects. Liver damage, breathing difficulties, and death can occur after use of herbal products for intentional miscarriage or contraception. Recent social media content has included conversations about the use of herbal preparations to affect fertility or induce abortion, but many of these posts have ignored the potential safety issues associated with these products.

What are Abortifacients?

Abortifacients are products or substances that are used to terminate a pregnancy. In June 2022, the United States Supreme Court published a landmark decision stating that the Constitution does not protect the right for women to undergo abortion. Since then, many news articles and social media posts have discussed alternative methods of abortion and fertility regulation, including abortifacients. However, while there are medications that are approved by the United States Food and Drug Administration for pregnancy termination, there is no abortifacient list.

Home remedies for abortion and “D.I.Y.” abortions are not recommended. A June 2022 piece in Rolling Stone mentions “herbal abortion” as trending on TikTok, referencing herbs some people believe can induce abortion. Herbal products have been used for centuries to control fertility, provide contraception, or facilitate abortion. Pennyroyal, blue and black cohosh, and quinine are plant-based products known for their abortifacient (abortion-inducing) activity, but there are many other herbs that can also affect pregnancy outcome or fertility.

Highly Toxic Herbal Substances

Ruta graveolens (Common Rue)

Ruta graveolens (“common rue”) is a shrub-like plant found in Mediterranean countries. This plant has been used in many countries, including England, France, and Brazil, to stimulate menstruation and induce abortion. When used by humans, it is reported to cause abortion within a day of consumption, but it can also result in severe maternal toxicity including vomiting, liver damage, and anemia. In severe cases, tremors, respiratory distress, and death have occurred. The use of Ruta graveolens to induce abortion or miscarriage is not approved or recommended.

Abrus precatorius (Jequirity Bean)

The Jequirity bean or rosary pea is the seed of the Abrus precatorius plant. Powdered Abrus seeds have been used as oral contraceptive agents by Central African tribes, and a paste made from the seeds is also used as a vaginal suppository to induce abortion in some countries. Despite their intriguing and colorful appearance, Abrus precatorius seeds contain a highly poisonous and potent toxin called abrin. Similar to ricin, abrin interferes with normal cellular function and causes cell death. Abrin is even more lethal than ricin, and there is no antidote available.

Medicinal Herbs and Pregnancy Safety

Women commonly use medicinal herbs during pregnancy; the National Birth Defects Prevention Study found that 9.4% of 4239 women reported herbal use during pregnancy, primarily in the first trimester. The herbs most commonly used by pregnant women have not been found to increase malformations.

• Ginger root: Commonly used for morning sickness, it has been tested in numerous clinical trials in doses up to 1 g/day and appears to be both effective and safe.
• Raspberry leaf: Teas made from raspberry leaf (Rubus idaeus) are used throughout pregnancy in many cultures; while there is no clinical evidence of benefit, this use appears safe.
• Peppermint and Spearmint: Teas made from these are common folk remedies for morning sickness.

Herbs That Require Caution

Not all herbs are benign. Licorice, an herb that is used medicinally but is consumed most commonly in the form of candy or chewing gum, appears to shorten gestation in humans. Heavy exposure to licorice (more than 500 mg/ glycyrrhizinic acid per week) slightly shortened gestation and more than doubled the risk of delivering a baby before 38 weeks. Furthermore, a study found dose-related cognitive defects and attention problems in those exposed to high levels of licorice in utero.

Maternal use of blue cohosh (Cimicifuga racemosa) in high doses has been associated with cases of stroke heart attack, and hypoxic-ischemic symptoms in exposed infants. Blue cohosh rhizomes contain vasoconstrictors. St. John’s wort (Hypericum perforatum) for depression has not been associated with major malformations, however, it can lower drug concentrations because it can alter some drug-metabolizing enzymes.