RH Herb Safety & Contraindications 3 — Questions and Answers
Question 1: Which of the following herbs is absolutely contraindicated during pregnancy due to uterine-stimulating (oxytocic) properties?
- Ginger (culinary doses)
- Blue cohosh (Correct answer)
- Red raspberry leaf (third trimester)
- Chamomile (tea)
Correct answer: Blue cohosh
Blue cohosh (Caulophyllum thalictroides) contains caulosaponin and methylcytisine, which strongly stimulate uterine contractions and are associated with serious adverse outcomes in pregnancy.
Question 2: Pennyroyal (Mentha pulegium) is contraindicated in pregnancy primarily because it:
- Raises blood pressure
- Is a potent abortifacient (Correct answer)
- Causes neural tube defects
- Blocks iron absorption
Correct answer: Is a potent abortifacient
Pennyroyal's active compound pulegone is a potent abortifacient and hepatotoxin; its use in pregnancy has caused maternal deaths and is absolutely contraindicated.
Question 3: Which herb is generally considered safe in culinary amounts during pregnancy but should be avoided in medicinal doses due to uterine-stimulating effects?
- Nettle leaf
- Ginger
- Sage (Correct answer)
- Oat straw
Correct answer: Sage
Sage (Salvia officinalis) in medicinal doses contains thujone and has uterine-stimulating properties; small culinary use is considered safe but therapeutic doses are avoided in pregnancy.
Question 4: A breastfeeding mother asks about using peppermint tea. The main safety concern related to lactation is:
- It increases milk supply
- Large amounts may reduce milk production (Correct answer)
- It causes infant jaundice
- It raises maternal blood pressure
Correct answer: Large amounts may reduce milk production
Menthol in large quantities may reduce milk supply (antilactogenic effect), so breastfeeding mothers are advised to use peppermint in moderation.
Question 5: Motherwort (Leonurus cardiaca) is contraindicated during pregnancy because it:
- Causes fetal cardiac defects
- Stimulates uterine contractions (Correct answer)
- Blocks folate absorption
- Causes maternal hypertension
Correct answer: Stimulates uterine contractions
Motherwort contains alkaloids that stimulate uterine smooth muscle, making it contraindicated in pregnancy but useful post-partum for uterine involution.
Question 6: Which herb is high in pyrrolizidine alkaloids (PAs) and is contraindicated during pregnancy and in children under 6?
- Comfrey (Correct answer)
- Calendula
- Lemon balm
- Elderflower
Correct answer: Comfrey
Comfrey (Symphytum officinale) contains hepatotoxic pyrrolizidine alkaloids that are especially harmful to the developing fetal liver and are contraindicated in pregnancy.
Question 7: Why is black cohosh (Actaea racemosa) considered contraindicated or used with caution during pregnancy?
- It contains caffeine
- It has emmenagogue and potential uterine-stimulating effects (Correct answer)
- It blocks vitamin K absorption
- It causes gestational diabetes
Correct answer: It has emmenagogue and potential uterine-stimulating effects
Black cohosh has emmenagogue properties and may stimulate uterine contractions; it is contraindicated in the first two trimesters, though sometimes used cautiously in late pregnancy under supervision.
RH Herb Safety & Contraindications 3
Which of the following herbs is absolutely contraindicated during pregnancy due to uterine-stimulating (oxytocic) properties?