Herbs and the Childbearing Cycle

Notes and Slides

Welcome to the Intensive!

I'm so glad that you'll be joining us. This is fascinating material, and I hope you'll leave with a deeper understanding of how herbs can support people who are in these life stages. On this page, you'll find information and resources for each of our four classes. If you're not registered for the intensive yet, you can sign up here.


Before the Series: Review

I'd love for everyone to come to the first class with a basic understanding of the menstrual cycle. It may have been a while since you last reviewed this info, so I've included a quick quiz here so that you can make sure you've got the key concepts. If you need  a refresher, I've included a short video below. You can also find a written review of the menstrual cycle in the free, open-access OpenStax A&P textbook.


Supporting Materials for Individual Classes

Class 1: Herbal Support for Fertility and Preconception


References (click to open)

Boivin, J., Griffiths, E., & Venetis, C. A. (2011). Emotional distress in infertile women and failure of assisted reproductive technologies: Meta-analysis of prospective psychosocial studies. BMJ (Clinical Research Ed.), 342, d223.

Domar, A. D., Rooney, K. L., Wiegand, B., Orav, E. J., Alper, M. M., Berger, B. M., & Nikolovski, J. (2011). Impact of a group mind/body intervention on pregnancy rates in IVF patients. Fertility and Sterility, 95(7), 2269–2273. https://doi.org/10.1016/j.fertnstert.2011.03.046

Dong, Y., Cai, Y., Zhang, Y., Xing, Y., & Sun, Y. (2017). The effect of fertility stress on endometrial and subendometrial blood flow among infertile women. Reproductive Biology and Endocrinology: RB&E, 15(1), 15. https://doi.org/10.1186/s12958-017-0236-7

Dumesic, D. A., Oberfield, S. E., Stener-Victorin, E., Marshall, J. C., Laven, J. S., & Legro, R. S. (2015). Scientific Statement on the Diagnostic Criteria, Epidemiology, Pathophysiology, and Molecular Genetics of Polycystic Ovary Syndrome. Endocrine Reviews, 36(5), 487–525. https://doi.org/10.1210/er.2015-1018

Fontana, R., & Della Torre, S. (2016). The Deep Correlation between Energy Metabolism and Reproduction: A View on the Effects of Nutrition for Women Fertility. Nutrients, 8(2). https://doi.org/10.3390/nu8020087

GASKINS, A. J., & CHAVARRO, J. E. (2018). Diet and Fertility: A Review. American Journal of Obstetrics and Gynecology, 218(4), 379–389. https://doi.org/10.1016/j.ajog.2017.08.010

Gore, A. C., Chappell, V. A., Fenton, S. E., Flaws, J. A., Nadal, A., Prins, G. S., Toppari, J., & Zoeller, R. T. (2015). EDC-2: The Endocrine Society’s Second Scientific Statement on Endocrine-Disrupting Chemicals. Endocrine Reviews, 36(6), E1–E150. https://doi.org/10.1210/er.2015-1010

Hekmatdoost, A., Vahid, F., Yari, Z., Sadeghi, M., Eini-Zinab, H., Lakpour, N., & Arefi, S. (2015). Methyltetrahydrofolate vs Folic Acid Supplementation in Idiopathic Recurrent Miscarriage with Respect to Methylenetetrahydrofolate Reductase C677T and A1298C Polymorphisms: A Randomized Controlled Trial. PLoS ONE, 10(12). https://doi.org/10.1371/journal.pone.0143569

Joseph, D. N., & Whirledge, S. (2017). Stress and the HPA Axis: Balancing Homeostasis and Fertility. International Journal of Molecular Sciences, 18(10). https://doi.org/10.3390/ijms18102224

Kempegowda, P., Melson, E., Manolopoulos, K. N., Arlt, W., & O’Reilly, M. W. (2020). Implicating androgen excess in propagating metabolic disease in polycystic ovary syndrome. Therapeutic Advances in Endocrinology and Metabolism, 11, 2042018820934319. https://doi.org/10.1177/2042018820934319

Korsmo, H. W., Jiang, X., & Caudill, M. A. (2019). Choline: Exploring the Growing Science on Its Benefits for Moms and Babies. Nutrients, 11(8). https://doi.org/10.3390/nu11081823

Legro, R. S., Dodson, W. C., Kunselman, A. R., Stetter, C. M., Kris-Etherton, P. M., Williams, N. I., Gnatuk, C. L., Estes, S. J., Allison, K. C., Sarwer, D. B., Diamond, M. P., Schlaff, W. D., Casson, P. R., Christman, G. M., Barnhart, K. T., Bates, G. W., Usadi, R., Lucidi, S., Baker, V., … Dokras, A. (2016). Benefit of Delayed Fertility Therapy With Preconception Weight Loss Over Immediate Therapy in Obese Women With PCOS. The Journal of Clinical Endocrinology and Metabolism, 101(7), 2658–2666. https://doi.org/10.1210/jc.2016-1659

Mun, J. G., Legette, L. L., Ikonte, C. J., & Mitmesser, S. H. (2019). Choline and DHA in Maternal and Infant Nutrition: Synergistic Implications in Brain and Eye Health. Nutrients, 11(5). https://doi.org/10.3390/nu11051125

Nowak, I., Bylińska, A., Wilczyńska, K., Wiśniewski, A., Malinowski, A., Wilczyński, J. R., Radwan, P., Radwan, M., Barcz, E., Płoski, R., Motak-Pochrzęst, H., Banasik, M., Sobczyński, M., & Kuśnierczyk, P. (2017). The methylenetetrahydrofolate reductase c.c.677 C>T and c.c.1298 A>C polymorphisms in reproductive failures: Experience from an RSA and RIF study on a Polish population. PLoS ONE, 12(10). https://doi.org/10.1371/journal.pone.0186022

Obeid, R., Holzgreve, W., & Pietrzik, K. (2013). Is 5-methyltetrahydrofolate an alternative to folic acid for the prevention of neural tube defects? Journal of Perinatal Medicine, 41(5), 469–483. https://doi.org/10.1515/jpm-2012-0256

Pietrzik, K., Bailey, L., & Shane, B. (2010). Folic acid and L-5-methyltetrahydrofolate: Comparison of clinical pharmacokinetics and pharmacodynamics. Clinical Pharmacokinetics, 49(8), 535–548. https://doi.org/10.2165/11532990-000000000-00000

Rooney, K. L., & Domar, A. D. (2018). The relationship between stress and infertility. Dialogues in Clinical Neuroscience, 20(1), 41–47.

Rotterdam ESHRE/ASRM-Sponsored PCOS consensus workshop group. (2004). Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Human Reproduction (Oxford, England), 19(1), 41–47.

Sargis, R. M., Heindel, J. J., & Padmanabhan, V. (2019). Interventions to Address Environmental Metabolism-Disrupting Chemicals: Changing the Narrative to Empower Action to Restore Metabolic Health. Frontiers in Endocrinology, 10. https://doi.org/10.3389/fendo.2019.00033

Sharma, R., Biedenharn, K. R., Fedor, J. M., & Agarwal, A. (2013). Lifestyle factors and reproductive health: Taking control of your fertility. Reproductive Biology and Endocrinology: RB&E, 11, 66. https://doi.org/10.1186/1477-7827-11-66

Stilley, J. A. W., Birt, J. A., & Sharpe-Timms, K. L. (2012). Cellular and molecular basis for endometriosis-associated infertility. Cell and Tissue Research, 349(3), 849–862. https://doi.org/10.1007/s00441-011-1309-0

Venn, B. J., Green, T. J., Moser, R., & Mann, J. I. (2003). Comparison of the effect of low-dose supplementation with L-5-methyltetrahydrofolate or folic acid on plasma homocysteine: A randomized placebo-controlled study. The American Journal of Clinical Nutrition, 77(3), 658–662. https://doi.org/10.1093/ajcn/77.3.658

Resources (click to open)

Class 2: Herbal Support during ART

References (click to open)

Ainehchi, N., Khaki, A., Farshbaf-Khalili, A., Hammadeh, M., & Ouladsahebmadarek, E. (2019). The Effectiveness of Herbal Mixture Supplements with and without Clomiphene Citrate in Comparison to Clomiphene Citrate on Serum Antioxidants and Glycemic Biomarkers in Women with Polycystic Ovary Syndrome Willing to Be Pregnant: A Randomized Clinical Trial. Biomolecules, 9(6). https://doi.org/10.3390/biom9060215

Cahill, D. J., Fox, R., Wardle, P. G., & Harlow, C. R. (1994). Multiple follicular development associated with herbal medicine. Human Reproduction (Oxford, England), 9(8), 1469–1470. https://doi.org/10.1093/oxfordjournals.humrep.a138731

Chiu, Y.-H., Karmon, A. E., Gaskins, A. J., Arvizu, M., Williams, P. L., Souter, I., Rueda, B. R., Hauser, R., Chavarro, J. E., & EARTH Study Team. (2018). Serum omega-3 fatty acids and treatment outcomes among women undergoing assisted reproduction. Human Reproduction (Oxford, England), 33(1), 156–165. https://doi.org/10.1093/humrep/dex335

Einarsson, S., Bergh, C., Friberg, B., Pinborg, A., Klajnbard, A., Karlström, P.-O., Kluge, L., Larsson, I., Loft, A., Mikkelsen-Englund, A.-L., Stenlöf, K., Wistrand, A., & Thurin-Kjellberg, A. (2017). Weight reduction intervention for obese infertile women prior to IVF: A randomized controlled trial. Human Reproduction (Oxford, England), 32(8), 1621–1630. https://doi.org/10.1093/humrep/dex235

El Refaeey, A., Selem, A., & Badawy, A. (2014). Combined coenzyme Q10 and clomiphene citrate for ovulation induction in clomiphene-citrate-resistant polycystic ovary syndrome. Reproductive Biomedicine Online, 29(1), 119–124. https://doi.org/10.1016/j.rbmo.2014.03.011

Espino, J., M, M., G, L., Á, O., C, R., Ab, R., & I, B. (2019, August 23). Impact of Melatonin Supplementation in Women with Unexplained Infertility Undergoing Fertility Treatment. Antioxidants (Basel, Switzerland); Antioxidants (Basel). https://doi.org/10.3390/antiox8090338

Fernando, S, Em, W., B, V., N, L., N, H., M, W., M, L., A, L., C, R., K, L., P, T., & L, R. (2018, September 19). Melatonin in Assisted Reproductive Technology: A Pilot Double-Blind Randomized Placebo-Controlled Clinical Trial. Frontiers in Endocrinology; Front Endocrinol (Lausanne). https://doi.org/10.3389/fendo.2018.00545

Fernando, Shavi, Wallace, E. M., Rombauts, L., White, N., Hong, J., Vollenhoven, B., Lolatgis, N., Hope, N., Wong, M., Lawrence, M., Lawrence, A., Russell, C., Leong, K., Thomas, P., & da Silva Costa, F. (2020). The effect of melatonin on ultrasound markers of follicular development: A double-blind placebo-controlled randomised trial. The Australian & New Zealand Journal of Obstetrics & Gynaecology, 60(1), 141–148. https://doi.org/10.1111/ajo.13074

Firns, S., Cruzat, V. F., Keane, K. N., Joesbury, K. A., Lee, A. H., Newsholme, P., & Yovich, J. L. (2015a). The effect of cigarette smoking, alcohol consumption and fruit and vegetable consumption on IVF outcomes: A review and presentation of original data. Reproductive Biology and Endocrinology : RB&E, 13. https://doi.org/10.1186/s12958-015-0133-x

Firns, S., Cruzat, V. F., Keane, K. N., Joesbury, K. A., Lee, A. H., Newsholme, P., & Yovich, J. L. (2015b). The effect of cigarette smoking, alcohol consumption and fruit and vegetable consumption on IVF outcomes: A review and presentation of original data. Reproductive Biology and Endocrinology: RB&E, 13, 134. https://doi.org/10.1186/s12958-015-0133-x

Hossein-Rashidi, B., & Nemati, M. (2017). Effects of Vitex agnus-castus extract on the secretory function of pituitary-gonadal axis and pregnancy rate in patients with premature ovarian aging (POA). Journal of Herbal Medicine, 10, 24–30. https://doi.org/10.1016/j.hermed.2017.10.003

Hu, K.-L., Ye, X., Wang, S., & Zhang, D. (2020). Melatonin Application in Assisted Reproductive Technology: A Systematic Review and Meta-Analysis of Randomized Trials. Frontiers in Endocrinology, 11, 160. https://doi.org/10.3389/fendo.2020.00160

Kadogami, D., Y, N., & Y, M. (2020, September). Use of a vaginal probiotic suppository and antibiotics to influence the composition of the endometrial microbiota. Reproductive Biology; Reprod Biol. https://doi.org/10.1016/j.repbio.2020.07.001

Kamel, H. H. (2013). Role of phyto-oestrogens in ovulation induction in women with polycystic ovarian syndrome. European Journal of Obstetrics, Gynecology, and Reproductive Biology, 168(1), 60–63. https://doi.org/10.1016/j.ejogrb.2012.12.025

Kim, H.-K., Ko, D.-H., Lee, W., Kim, K.-R., Chun, S., Song, J., & Min, W.-K. (2019). Body fluid concentrations of bisphenol A and their association with in vitro fertilization outcomes. Human Fertility (Cambridge, England), 1–9. https://doi.org/10.1080/14647273.2019.1612104

Koedooder, R., Singer, M., Schoenmakers, S., Savelkoul, P. H. M., Morré, S. A., de Jonge, J. D., Poort, L., Cuypers, W. J. S. S., Beckers, N. G. M., Broekmans, F. J. M., Cohlen, B. J., den Hartog, J. E., Fleischer, K., Lambalk, C. B., Smeenk, J. M. J. S., Budding, A. E., & Laven, J. S. E. (2019). The vaginal microbiome as a predictor for outcome of in vitro fertilization with or without intracytoplasmic sperm injection: A prospective study. Human Reproduction (Oxford, England), 34(6), 1042–1054. https://doi.org/10.1093/humrep/dez065

Kong, Y., Liu, Z., Shang, Q., Gao, Y., Li, X., Zheng, C., Deng, X., & Chen, T. (2020). The Disordered Vaginal Microbiota Is a Potential Indicator for a Higher Failure of in vitro Fertilization. Frontiers in Medicine, 7, 217. https://doi.org/10.3389/fmed.2020.00217

La Vecchia, I., Paffoni, A., Castiglioni, M., Ferrari, S., Bortolus, R., Ferraris Fusarini, C., Bettinardi, N., Somigliana, E., & Parazzini, F. (2017). Folate, homocysteine and selected vitamins and minerals status in infertile women. The European Journal of Contraception & Reproductive Health Care: The Official Journal of the European Society of Contraception, 22(1), 70–75. https://doi.org/10.1080/13625187.2016.1263292

Li, Y., L, F., Y, Y., H, S., S, W., Y, G., & Y, S. (2019, April 12). Higher melatonin in the follicle fluid and MT2 expression in the granulosa cells contribute to the OHSS occurrence. Reproductive Biology and Endocrinology : RB&E; Reprod Biol Endocrinol. https://doi.org/10.1186/s12958-019-0479-6

Looman, A., C, van den B., A, G., Rak, S., R, H., Jmt, K. G., Mgj, B., Cl, L.-E., Lde, W., Ejm, F., & Em, B.-B. (2018, July 25). Supplement Use and Dietary Sources of Folate, Vitamin D, and n-3 Fatty Acids during Preconception: The GLIMP2 Study. Nutrients; Nutrients. https://doi.org/10.3390/nu10080962

López-Moreno, A., & Aguilera, M. (2020). Probiotics Dietary Supplementation for Modulating Endocrine and Fertility Microbiota Dysbiosis. Nutrients, 12(3). https://doi.org/10.3390/nu12030757

Mínguez-Alarcón, L., & Gaskins, A. J. (2017). Female exposure to endocrine disrupting chemicals and fecundity: A review. Current Opinion in Obstetrics & Gynecology, 29(4), 202–211. https://doi.org/10.1097/GCO.0000000000000373

Mokhtari, F., Akbari Asbagh, F., Azmoodeh, O., Bakhtiyari, M., & Almasi-Hashiani, A. (2019). Effects of Melatonin Administration on Chemical Pregnancy Rates of Polycystic Ovary Syndrome Patients Undergoing Intrauterine Insemination: A Randomized Clinical Trial. International Journal of Fertility & Sterility, 13(3), 225–229. https://doi.org/10.22074/ijfs.2019.5717

Moran, L. J., Tsagareli, V., Noakes, M., & Norman, R. (2016). Altered Preconception Fatty Acid Intake Is Associated with Improved Pregnancy Rates in Overweight and Obese Women Undertaking in Vitro Fertilisation. Nutrients, 8(1). https://doi.org/10.3390/nu8010010

Pacchiarotti, A., G, C., G, A., & A, P. (2016). Effect of myo-inositol and melatonin versus myo-inositol, in a randomized controlled trial, for improving in vitro fertilization of patients with polycystic ovarian syndrome. Gynecological Endocrinology : The Official Journal of the International Society of Gynecological Endocrinology; Gynecol Endocrinol. https://doi.org/10.3109/09513590.2015.1101444

Shahin, A. Y., & Mohammed, S. A. (2014). Adding the phytoestrogen Cimicifugae Racemosae to clomiphene induction cycles with timed intercourse in polycystic ovary syndrome improves cycle outcomes and pregnancy rates—A randomized trial. Gynecological Endocrinology: The Official Journal of the International Society of Gynecological Endocrinology, 30(7), 505–510. https://doi.org/10.3109/09513590.2014.895983

Shen, J., Kang, Q., Mao, Y., Yuan, M., Le, F., Yang, X., Xu, X., & Jin, F. (2020). Urinary bisphenol A concentration is correlated with poorer oocyte retrieval and embryo implantation outcomes in patients with tubal factor infertility undergoing in vitro fertilisation. Ecotoxicology and Environmental Safety, 187, 109816. https://doi.org/10.1016/j.ecoenv.2019.109816

Showell, M. G., Mackenzie-Proctor, R., Jordan, V., & Hart, R. J. (2017). Antioxidants for female subfertility. The Cochrane Database of Systematic Reviews, 7, CD007807. https://doi.org/10.1002/14651858.CD007807.pub3

Sun, H., Y, L., D, L., C, Z., X, Z., L, F., F, M., & W, Q. (2019, September 2). Mediterranean diet improves embryo yield in IVF: A prospective cohort study. Reproductive Biology and Endocrinology : RB&E; Reprod Biol Endocrinol. https://doi.org/10.1186/s12958-019-0520-9

Tamura, H., Jozaki, M., Tanabe, M., Shirafuta, Y., Mihara, Y., Shinagawa, M., Tamura, I., Maekawa, R., Sato, S., Taketani, T., Takasaki, A., Reiter, R. J., & Sugino, N. (2020). Importance of Melatonin in Assisted Reproductive Technology and Ovarian Aging. International Journal of Molecular Sciences, 21(3). https://doi.org/10.3390/ijms21031135

Wise, L. A., Wesselink, A. K., Tucker, K. L., Saklani, S., Mikkelsen, E. M., Cueto, H., Riis, A. H., Trolle, E., McKinnon, C. J., Hahn, K. A., Rothman, K. J., Sørensen, H. T., & Hatch, E. E. (2018). Dietary Fat Intake and Fecundability in 2 Preconception Cohort Studies. American Journal of Epidemiology, 187(1), 60–74. https://doi.org/10.1093/aje/kwx204

Xu, Y., Nisenblat, V., Lu, C., Li, R., Qiao, J., Zhen, X., & Wang, S. (2018). Pretreatment with coenzyme Q10 improves ovarian response and embryo quality in low-prognosis young women with decreased ovarian reserve: A randomized controlled trial. Reproductive Biology and Endocrinology: RB&E, 16(1), 29. https://doi.org/10.1186/s12958-018-0343-0

Resources (click to open)

Class 3: Herbal Support during Pregnancy

References (click to open)

Amzajerdi, A., Keshavarz, M., Montazeri, A., & Bekhradi, R. (2019). Effect of mint aroma on nausea, vomiting and anxiety in pregnant women. Journal of Family Medicine and Primary Care, 8(8), 2597–2601. https://doi.org/10.4103/jfmpc.jfmpc_480_19

Cheang, K. I., Nguyen, T. T., Karjane, N. W., & Salley, K. E. S. (2016). Raspberry Leaf and Hypoglycemia in Gestational Diabetes Mellitus. Obstetrics and Gynecology, 128(6), 1421–1424. https://doi.org/10.1097/AOG.0000000000001757

Cuzzolin, L., Francini-Pesenti, F., Verlato, G., Joppi, M., Baldelli, P., & Benoni, G. (2010). Use of herbal products among 392 Italian pregnant women: Focus on pregnancy outcome. Pharmacoepidemiology and Drug Safety, 19(11), 1151–1158. https://doi.org/10.1002/pds.2040

Dickson, B., Mansfield, C., Guiahi, M., Allshouse, A. A., Borgelt, L. M., Sheeder, J., Silver, R. M., & Metz, T. D. (2018). Recommendations From Cannabis Dispensaries About First-Trimester Cannabis Use. Obstetrics and Gynecology, 131(6), 1031–1038. https://doi.org/10.1097/AOG.0000000000002619

Facchinetti, F., Pedrielli, G., Benoni, G., Joppi, M., Verlato, G., Dante, G., Balduzzi, S., & Cuzzolin, L. (2012). Herbal supplements in pregnancy: Unexpected results from a multicentre study. Human Reproduction (Oxford, England), 27(11), 3161–3167. https://doi.org/10.1093/humrep/des303

Gallo, M., Sarkar, M., Au, W., Pietrzak, K., Comas, B., Smith, M., Jaeger, T. V., Einarson, A., & Koren, G. (2000). Pregnancy outcome following gestational exposure to echinacea: A prospective controlled study. Archives of Internal Medicine, 160(20), 3141–3143. https://doi.org/10.1001/archinte.160.20.3141

Gaskins, A. J., Rich-Edwards, J. W., Williams, P. L., Toth, T. L., Missmer, S. A., & Chavarro, J. E. (2018). Pre-pregnancy caffeine and caffeinated beverage intake and risk of spontaneous abortion. European Journal of Nutrition, 57(1), 107–117. https://doi.org/10.1007/s00394-016-1301-2

Gunn, J. K. L., Rosales, C. B., Center, K. E., Nuñez, A., Gibson, S. J., Christ, C., & Ehiri, J. E. (2016). Prenatal exposure to cannabis and maternal and child health outcomes: A systematic review and meta-analysis. BMJ Open, 6(4), e009986. https://doi.org/10.1136/bmjopen-2015-009986

Haider, B. A., & Bhutta, Z. A. (2017). Multiple-micronutrient supplementation for women during pregnancy. The Cochrane Database of Systematic Reviews, 4, CD004905. https://doi.org/10.1002/14651858.CD004905.pub5

Heitmann, K., Havnen, G. C., Holst, L., & Nordeng, H. (2016). Pregnancy outcomes after prenatal exposure to echinacea: The Norwegian Mother and Child Cohort Study. European Journal of Clinical Pharmacology, 72(5), 623–630. https://doi.org/10.1007/s00228-016-2021-5

Herrell, H. E. (2014). Nausea and vomiting of pregnancy. American Family Physician, 89(12), 965–970.

Ho, M., Chang, Y.-Y., Chang, W.-C., Lin, H.-C., Wang, M.-H., Lin, W.-C., & Chiu, T.-H. (2016). Oral Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14 to reduce Group B Streptococcus colonization in pregnant women: A randomized controlled trial. Taiwanese Journal of Obstetrics & Gynecology, 55(4), 515–518. https://doi.org/10.1016/j.tjog.2016.06.003

John, L. J., & Shantakumari, N. (2015). Herbal Medicines Use During Pregnancy: A Review from the Middle East. Oman Medical Journal, 30(4), 229–236. https://doi.org/10.5001/omj.2015.48

Khorasani, F., Aryan, H., Sobhi, A., Aryan, R., Abavi-Sani, A., Ghazanfarpour, M., Saeidi, M., & Rajab Dizavandi, F. (2020). A systematic review of the efficacy of alternative medicine in the treatment of nausea and vomiting of pregnancy. Journal of Obstetrics and Gynaecology: The Journal of the Institute of Obstetrics and Gynaecology, 40(1), 10–19. https://doi.org/10.1080/01443615.2019.1587392

Kolding, L., Pedersen, L. H., Henriksen, T. B., Olsen, J., & Grzeskowiak, L. E. (2015). Hypericum perforatum use during pregnancy and pregnancy outcome. Reproductive Toxicology (Elmsford, N.Y.), 58, 234–237. https://doi.org/10.1016/j.reprotox.2015.10.003

Lete, I., & Allué, J. (2016). The Effectiveness of Ginger in the Prevention of Nausea and Vomiting during Pregnancy and Chemotherapy. Integrative Medicine Insights, 11, 11–17. https://doi.org/10.4137/IMI.S36273

Lowensohn, R. I., Stadler, D. D., & Naze, C. (2016). Current Concepts of Maternal Nutrition. Obstetrical & Gynecological Survey, 71(7), 413–426. https://doi.org/10.1097/OGX.0000000000000329

Matthews, A., Haas, D. M., O’Mathúna, D. P., & Dowswell, T. (2015). Interventions for nausea and vomiting in early pregnancy. The Cochrane Database of Systematic Reviews, 9, CD007575. https://doi.org/10.1002/14651858.CD007575.pub4

Moussally, K., & Berard, A. (2012). Exposure to specific herbal products during pregnancy and the risk of low birth weight. Alternative Therapies in Health and Medicine, 18(2), 36–43.

Muñoz Balbontín, Y., Stewart, D., Shetty, A., Fitton, C. A., & McLay, J. S. (2019). Herbal Medicinal Product Use During Pregnancy and the Postnatal Period: A Systematic Review. Obstetrics and Gynecology, 133(5), 920–932. https://doi.org/10.1097/AOG.0000000000003217

Nordeng, H., Bayne, K., Havnen, G. C., & Paulsen, B. S. (2011). Use of herbal drugs during pregnancy among 600 Norwegian women in relation to concurrent use of conventional drugs and pregnancy outcome. Complementary Therapies in Clinical Practice, 17(3), 147–151. https://doi.org/10.1016/j.ctcp.2010.09.002

Olsen, P., Williamson, M., Traynor, V., & Georgiou, C. (2018). The impact of oral probiotics on vaginal Group B Streptococcal colonisation rates in pregnant women: A pilot randomised control study. Women and Birth: Journal of the Australian College of Midwives, 31(1), 31–37. https://doi.org/10.1016/j.wombi.2017.06.012

Parsons, M., Simpson, M., & Ponton, T. (1999). Raspberry leaf and its effect on labour: Safety and efficacy. Australian College of Midwives Incorporated Journal, 12(3), 20–25. https://doi.org/10.1016/s1031-170x(99)80008-7

Peprah, P., Agyemang-Duah, W., Arthur-Holmes, F., Budu, H. I., Abalo, E. M., Okwei, R., & Nyonyo, J. (2019). “We are nothing without herbs”: A story of herbal remedies use during pregnancy in rural Ghana. BMC Complementary and Alternative Medicine, 19(1), 65. https://doi.org/10.1186/s12906-019-2476-x

Sharifzadeh, F., Kashanian, M., Koohpayehzadeh, J., Rezaian, F., Sheikhansari, N., & Eshraghi, N. (2018). A comparison between the effects of ginger, pyridoxine (vitamin B6) and placebo for the treatment of the first trimester nausea and vomiting of pregnancy (NVP). The Journal of Maternal-Fetal & Neonatal Medicine: The Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians, 31(19), 2509–2514. https://doi.org/10.1080/14767058.2017.1344965

Simpson, M., Parsons, M., Greenwood, J., & Wade, K. (2001). Raspberry leaf in pregnancy: Its safety and efficacy in labor. Journal of Midwifery & Women’s Health, 46(2), 51–59. https://doi.org/10.1016/s1526-9523(01)00095-2

Sridharan, S., Archer, N., & Manning, N. (2009). Premature constriction of the fetal ductus arteriosus following the maternal consumption of camomile herbal tea. Ultrasound in Obstetrics & Gynecology, 34(3), 358–359. https://doi.org/10.1002/uog.6453

Stanisiere, J., Mousset, P.-Y., & Lafay, S. (2018). How Safe Is Ginger Rhizome for Decreasing Nausea and Vomiting in Women during Early Pregnancy? Foods (Basel, Switzerland), 7(4). https://doi.org/10.3390/foods7040050

Szutorisz, H., & Hurd, Y. L. (2018). High times for cannabis: Epigenetic imprint and its legacy on brain and behavior. Neuroscience and Biobehavioral Reviews, 85, 93–101. https://doi.org/10.1016/j.neubiorev.2017.05.011

Viljoen, E., Visser, J., Koen, N., & Musekiwa, A. (2014). A systematic review and meta-analysis of the effect and safety of ginger in the treatment of pregnancy-associated nausea and vomiting. Nutrition Journal, 13, 20. https://doi.org/10.1186/1475-2891-13-20

Wolf, H. T., Hegaard, H. K., Huusom, L. D., & Pinborg, A. B. (2017). Multivitamin use and adverse birth outcomes in high-income countries: A systematic review and meta-analysis. American Journal of Obstetrics and Gynecology, 217(4), 404.e1-404.e30. https://doi.org/10.1016/j.ajog.2017.03.029

Yang, S., Reid, G., Challis, J. R. G., Kim, S. O., Gloor, G. B., & Bocking, A. D. (2015). Is There a Role for Probiotics in the Prevention of Preterm Birth? Frontiers in Immunology, 6. https://doi.org/10.3389/fimmu.2015.00062

Yavari Kia, P., Safajou, F., Shahnazi, M., & Nazemiyeh, H. (2014). The effect of lemon inhalation aromatherapy on nausea and vomiting of pregnancy: A double-blinded, randomized, controlled clinical trial. Iranian Red Crescent Medical Journal, 16(3), e14360. https://doi.org/10.5812/ircmj.14360

Resources (click to open)

Class 4: Herbal Support during the Postpartum Period

References (click to open)

Alvarenga, M. B., Francisco, A. A., de Oliveira, S. M. J. V., da Silva, F. M. B., Shimoda, G. T., & Damiani, L. P. (2015). Episiotomy healing assessment: Redness, Oedema, Ecchymosis, Discharge, Approximation (REEDA) scale reliability. Revista Latino-Americana De Enfermagem, 23(1), 162–168. https://doi.org/10.1590/0104-1169.3633.2538

Asgharikhatooni, A., Bani, S., Hasanpoor, S., Mohammad Alizade, S., & Javadzadeh, Y. (2015). The effect of equisetum arvense (horse tail) ointment on wound healing and pain intensity after episiotomy: A randomized placebo-controlled trial. Iranian Red Crescent Medical Journal, 17(3), e25637. https://doi.org/10.5812/ircmj.25637

Chang, S.-M., & Chen, C.-H. (2016). Effects of an intervention with drinking chamomile tea on sleep quality and depression in sleep disturbed postnatal women: A randomized controlled trial. Journal of Advanced Nursing, 72(2), 306–315. https://doi.org/10.1111/jan.12836

Chen, S.-L., & Chen, C.-H. (2015). Effects of Lavender Tea on Fatigue, Depression, and Maternal-Infant Attachment in Sleep-Disturbed Postnatal Women. Worldviews on Evidence-Based Nursing, 12(6), 370–379. https://doi.org/10.1111/wvn.12122

De Angelis, C., Di Stadio, A., Vitale, S., Saccone, G., Angelis, M. C. D., Zizolfi, B., & Di Spiezio Sardo, A. (2020). Use of calendula ointment after episiotomy: A randomized clinical trial. The Journal of Maternal-Fetal & Neonatal Medicine: The Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians, 1–5. https://doi.org/10.1080/14767058.2020.1770219

Effati-Daryani, F., Mohammad-Alizadeh-Charandabi, S., Mirghafourvand, M., Taghizadeh, M., Bekhradi, R., & Zarei, S. (2018). Effect of Lavender cream with or without footbath on sleep quality and fatigue in pregnancy and postpartum: A randomized controlled trial. Women & Health, 58(10), 1179–1191. https://doi.org/10.1080/03630242.2017.1414101

Eghdampour, F., Jahdie, F., Kheyrkhah, M., Taghizadeh, M., Naghizadeh, S., & Hagani, H. (2013). The Impact of Aloe vera and Calendula on Perineal Healing after Episiotomy in Primiparous Women: A Randomized Clinical Trial. Journal of Caring Sciences, 2(4), 279–286. https://doi.org/10.5681/jcs.2013.033

Hajhashemi, M., Ghanbari, Z., Movahedi, M., Rafieian, M., Keivani, A., & Haghollahi, F. (2018). The effect of Achillea millefolium and Hypericum perforatum ointments on episiotomy wound healing in primiparous women. The Journal of Maternal-Fetal & Neonatal Medicine: The Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians, 31(1), 63–69. https://doi.org/10.1080/14767058.2016.1275549

Harrison-Hohner, J., Coste, S., Dorato, V., Curet, L. B., McCarron, D., & Hatton, D. (2001). Prenatal calcium supplementation and postpartum depression: An ancillary study to a randomized trial of calcium for prevention of preeclampsia. Archives of Women’s Mental Health, 3(4), 141–146. https://doi.org/10.1007/s007370170011

Jahdi, F., Khabbaz, A. H., Kashian, M., Taghizadeh, M., & Haghani, H. (2018). The impact of calendula ointment on cesarean wound healing: A randomized controlled clinical trial. Journal of Family Medicine and Primary Care, 7(5), 893–897. https://doi.org/10.4103/jfmpc.jfmpc_121_17

LaCross, A., Groff, M., & Smaldone, A. (2015). Obstetric anal sphincter injury and anal incontinence following vaginal birth: A systematic review and meta-analysis. Journal of Midwifery & Women’s Health, 60(1), 37–47. https://doi.org/10.1111/jmwh.12283

Lakhan, S. E., Sheafer, H., & Tepper, D. (2016). The Effectiveness of Aromatherapy in Reducing Pain: A Systematic Review and Meta-Analysis. Pain Research and Treatment, 2016, 8158693. https://doi.org/10.1155/2016/8158693

Lepez, T., Vandewoestyne, M., & Deforce, D. (2013). Fetal microchimeric cells in autoimmune thyroid diseases: Harmful, beneficial or innocent for the thyroid gland? Chimerism, 4(4), 111–118. https://doi.org/10.4161/chim.25055

Leung, B. M., Kaplan, B. J., Field, C. J., Tough, S., Eliasziw, M., Gomez, M. F., McCargar, L. J., & Gagnon, L. (2013). Prenatal micronutrient supplementation and postpartum depressive symptoms in a pregnancy cohort. BMC Pregnancy and Childbirth, 13, 2. https://doi.org/10.1186/1471-2393-13-2

Mahmudi, G., Nikpour, M., Azadbackt, M., Zanjani, R., Jahani, M., Aghamohammadi, A., & Jannati, Y. (2015). The Impact of Turmeric Cream on Healing of Caesarean Scar. The West Indian Medical Journal, 64(4), 400–406. https://doi.org/10.7727/wimj.2014.196

Mantovani, G., Isidori, A. M., Moretti, C., Di Dato, C., Greco, E., Ciolli, P., Bonomi, M., Petrone, L., Fumarola, A., Campagna, G., Vannucchi, G., Di Sante, S., Pozza, C., Faggiano, A., Lenzi, A., & Giannetta, E. (2019). Selenium supplementation in the management of thyroid autoimmunity during pregnancy: Results of the “SERENA study”, a randomized, double-blind, placebo-controlled trial. Endocrine, 66(3), 542–550. https://doi.org/10.1007/s12020-019-01958-1

Marzouk, T., Barakat, R., Ragab, A., Badria, F., & Badawy, A. (2015). Lavender-thymol as a new topical aromatherapy preparation for episiotomy: A randomised clinical trial. Journal of Obstetrics and Gynaecology: The Journal of the Institute of Obstetrics and Gynaecology, 35(5), 472–475. https://doi.org/10.3109/01443615.2014.970522

Mokhber, N., Namjoo, M., Tara, F., Boskabadi, H., Rayman, M. P., Ghayour-Mobarhan, M., Sahebkar, A., Majdi, M. R., Tavallaie, S., Azimi-Nezhad, M., Shakeri, M. T., Nematy, M., Oladi, M., Mohammadi, M., & Ferns, G. (2011). Effect of supplementation with selenium on postpartum depression: A randomized double-blind placebo-controlled trial. The Journal of Maternal-Fetal & Neonatal Medicine: The Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians, 24(1), 104–108. https://doi.org/10.3109/14767058.2010.482598

Molazem, Z., Mohseni, F., Younesi, M., & Keshavarzi, S. (2014). Aloe vera gel and cesarean wound healing; a randomized controlled clinical trial. Global Journal of Health Science, 7(1), 203–209. https://doi.org/10.5539/gjhs.v7n1p203

Nikpour, M., Shirvani, M. A., Azadbakht, M., Zanjani, R., & Mousavi, E. (2014). The effect of honey gel on abdominal wound healing in cesarean section: A triple blind randomized clinical trial. Oman Medical Journal, 29(4), 255–259. https://doi.org/10.5001/omj.2014.68

Olapour, A., Behaeen, K., Akhondzadeh, R., Soltani, F., Al Sadat Razavi, F., & Bekhradi, R. (2013). The Effect of Inhalation of Aromatherapy Blend containing Lavender Essential Oil on Cesarean Postoperative Pain. Anesthesiology and Pain Medicine, 3(1), 203–207. https://doi.org/10.5812/aapm.9570

Payne, J. L., & Maguire, J. (2019). Pathophysiological Mechanisms Implicated in Postpartum Depression. Frontiers in Neuroendocrinology, 52, 165–180. https://doi.org/10.1016/j.yfrne.2018.12.001

Samadi, S., Khadivzadeh, T., Emami, A., Moosavi, N. S., Tafaghodi, M., & Behnam, H. R. (2010). The effect of Hypericum perforatum on the wound healing and scar of cesarean. Journal of Alternative and Complementary Medicine (New York, N.Y.), 16(1), 113–117. https://doi.org/10.1089/acm.2009.0317

Schiller, C. E., Meltzer-Brody, S., & Rubinow, D. R. (2015). The Role of Reproductive Hormones in Postpartum Depression. CNS Spectrums, 20(1), 48–59. https://doi.org/10.1017/S1092852914000480

Schmidt, J. M., & Greenspoon, J. S. (1991). Aloe vera dermal wound gel is associated with a delay in wound healing. Obstetrics and Gynecology, 78(1), 115–117.

Shahrahmani, H., Kariman, N., Jannesari, S., Rafieian-Kopaei, M., Mirzaei, M., Ghalandari, S., Shahrahmani, N., & Mardani, G. (2018). The effect of green tea ointment on episiotomy pain and wound healing in primiparous women: A randomized, double-blind, placebo-controlled clinical trial. Phytotherapy Research: PTR, 32(3), 522–530. https://doi.org/10.1002/ptr.5999

Sheikhan, F., Jahdi, F., Khoei, E. M., Shamsalizadeh, N., Sheikhan, M., & Haghani, H. (2012). Episiotomy pain relief: Use of Lavender oil essence in primiparous Iranian women. Complementary Therapies in Clinical Practice, 18(1), 66–70. https://doi.org/10.1016/j.ctcp.2011.02.003

Slykerman, R. F., Hood, F., Wickens, K., Thompson, J. M. D., Barthow, C., Murphy, R., Kang, J., Rowden, J., Stone, P., Crane, J., Stanley, T., Abels, P., Purdie, G., Maude, R., Mitchell, E. A., & Probiotic in Pregnancy Study Group. (2017). Effect of Lactobacillus rhamnosus HN001 in Pregnancy on Postpartum Symptoms of Depression and Anxiety: A Randomised Double-blind Placebo-controlled Trial. EBioMedicine, 24, 159–165. https://doi.org/10.1016/j.ebiom.2017.09.013

Sparling, T. M., Henschke, N., Nesbitt, R. C., & Gabrysch, S. (2016). The role of diet and nutritional supplementation in perinatal depression: A systematic review. Maternal & Child Nutrition, 13(1). https://doi.org/10.1111/mcn.12235

Vakili, F., Mirmohammadaliei, M., Montazeri, A., Farokhi, M., & Minaee, M. B. (2018). Impact of Hypericum Perforatum Ointment on Perineal Pain Intensity Following Episiotomy: A Randomized Placebo-Controlled Trial. Journal of Caring Sciences, 7(4), 205–211. https://doi.org/10.15171/jcs.2018.031

Vakilian, K., Atarha, M., Bekhradi, R., & Chaman, R. (2011). Healing advantages of lavender essential oil during episiotomy recovery: A clinical trial. Complementary Therapies in Clinical Practice, 17(1), 50–53. https://doi.org/10.1016/j.ctcp.2010.05.006

Vaziri, F., Shiravani, M., Najib, F. S., Pourahmad, S., Salehi, A., & Yazdanpanahi, Z. (2017). Effect of Lavender Oil Aroma in the Early Hours of Postpartum Period on Maternal Pains, Fatigue, and Mood: A Randomized Clinical Trial. International Journal of Preventive Medicine, 8. https://doi.org/10.4103/ijpvm.IJPVM_137_16

Werner, E., Miller, M., Osborne, L. M., Kuzava, S., & Monk, C. (2015). Preventing postpartum depression: Review and recommendations. Archives of Women’s Mental Health, 18(1), 41–60. https://doi.org/10.1007/s00737-014-0475-y

Xue, L., Zhang, J., Shen, H., Ai, L., & Wu, R. (2020). A randomized controlled pilot study of the effectiveness of magnolia tea on alleviating depression in postnatal women. Food Science & Nutrition, 8(3), 1554–1561. https://doi.org/10.1002/fsn3.1442

Zibanejad, S., Miraj, S., & Rafieian Kopaei, M. (2020). Healing effect of Quercus persica and Lawsonia inermis ointment on episiotomy wounds in primiparous women. Journal of Research in Medical Sciences: The Official Journal of Isfahan University of Medical Sciences, 25, 11. https://doi.org/10.4103/jrms.JRMS_251_18

Hi, I'm Camille

I've been in practice as a licensed nutritionist and registered herbalist since 2006, working in OB/Gyn offices, a fertility clinic and private practice. I'm also a professor at the Maryland University of Integrative Health, where I teach physiology and pathophysiology.

If you're enjoying this series, you can stay in touch by signing up for my newsletter for practitioners. I'd love to work with you further in an Herbal Case Observation Group, private mentoring, or in my Monday Mentoring membership group. 

>