Pregnancy, Childbirth,
and Post-partum Care
One of the true life-changing phases of a woman’s life cycle, pregnancy brings ups and downs, physical changes, emotional challenges, and unimaginable blessings. While many women experience pregnancy without any complications and give birth quickly and easily, other women experience some normal side effects from hormonal changes, or their labors may be difficult for unseen reasons. Supporting the woman and her body, mind and spirit through this transitional time is paramount for the health of mother, father, baby, and siblings. Herbs are the natural supporters to help nourish the body, ease the emotions, and heal illnesses.
Because there are many comprehensive books about herbal remedies for pregnancy, this chapter will be a broad-spectrum introduction to creating herbal formulas for pregnancy, childbirth, and post-partum.
Pregnancy
Professional midwives have long been the go-to experts for information and education about the application of herbal medicine for pregnancy and childbirth. Midwives provide gynecologic and obstetric care even for women pre-conception, and they are often well-versed in how a woman’s body reacts and responds to plant medicines. Pregnancy is not an illness; it is a normal function of a woman’s body that has evolved to carry out this part of the life cycle with strength and vigor. However, just like in the cardiovascular or digestive systems, normal processes are impeded by poor nutrition, environmental or genetic factors, or stressful conditions that put the body’s systems at a disadvantage.
Mineral Supplementation
The baby receives most of its nutrition through the umbilicus and feeds off the food the mother ingests. However, if the diet is lacking or if the mother is low on nutrients, the mother’s body becomes a donation center providing needed minerals for the baby’s growth. This depletion affects the mother’s body now as well as in the future, putting her at risk for osteoporosis.
Herbs and Foods High in Calcium
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raspberry leaf |
nettle |
oatstraw and milky tops |
|
horsetail |
lamb’s quarters |
fennel seeds |
|
sesame seeds |
yogurt |
cheese and milk |
|
fresh steamed greens |
whole grains |
lentils, beans, and chickpeas |
Include vitamin C rich–foods along with calcium-rich foods to aid in absorption, and avoid drinking sodas and even carbonated waters during pregnancy since the phosphorous that contributes to the carbonation can interfere with calcium absorption. Other mineral-rich herbs include red clover, alfalfa, chamomile, and violet leaves, all of which can be brewed together or separately to make healing and nutrient-packed infusions.
Another important mineral for pregnancy is iron; for sources of iron, see the table “iron-rich herbs and foods.”
Morning Sickness
Morning sickness or nausea is a common symptom of pregnancy and is truly misnamed—it lasts not only through the morning but often all day. Most women experience relief of nausea by the second trimester of pregnancy. Causes are believed to include low blood sugar, low hydrochloric acid, vitamin B6 deficiency, and increased levels of hormones in the bloodstream.
Encourage your clients to prepare snacks at the bedside table and eat before even getting out of bed. Also, eating during the night can help keep foods and fluids in the digestive system so that upon arising in the morning, the body does not feel empty and blood sugar levels do not plummet. Suitable foods for the morning include plain crackers, crackers with peanut or almond butter, tiny strips of dry, non-greasy bacon or jerky, celery with nut butters, dried fruit, candied ginger, popcorn, dried seaweed, and toast. Calcium-rich yogurt is also a good standby for early morning eating.
Herbs that have traditionally shown promise and efficacy in treating morning sickness include wild yam, mint and ginger. Wild yam (not the sweet potato) is the famous root of the South American vine that is the source of the pill. Wild yam balances hormonal production, tones the liver, is anti-inflammatory, especially for the pelvic region, and can be used in cases of premenstrual syndrome to great effect. During pregnancy, wild yam can be a useful remedy for nausea, and it combines well with the tart-tasting dong quai (Angelica sinensis or A. archangelica) or the bland-tasting chaste tree berry (Vitex agnus-castus), which can help balance estrogen and progesterone.
Mint has long been a staple in the medicine cabinet for nausea. Peppermint, spearmint, lemon balm, and catnip are all in the Lamiaceae family and are useful for dispelling gas and improving digestive and gastrointestinal function. They are also very useful for the pregnant woman seeking a soothing, calming, and nervine effect in addition to a nausea medication. Mint-family herbs in teas can all help; here are the differences between them:
Make teas of these herbs in small quantities that can be sipped at less-than-acute symptom dosage since their effects on the individual can vary widely. These herbs can also be made into ice cubes to be sucked on, or into concentrated tinctures (dose: ¼ teaspoon every 15–30 minutes until symptoms subside).
Childbirth
Parturition, or delivery, is the event of the baby leaving the mother’s body. It’s a powerful transition from pregnancy to the new experience of motherhood, involving a number of issues on both physical and emotional levels.
Supporting Uterine Contractions
At the onset of labor, a number of stimulant herbs have been traditionally used to “induce” the uterus to begin contractions. All throughout the pregnancy, stimulating herbs have been avoided, but now is the time to use them if they are required. These herbs help activate uterine muscle contraction and open the cervix for passage of the baby’s head. Traditional uterine stimulants for delivery include helonias (false unicorn root, Chamaelirium luteum), blue cohosh (Caulophyllum thalictroides), and black cohosh (Actaea racemosa,). All three of these herbs are on the UpS lists (see Glossary E); acceptable substitutes include ginger (Zingiber officinale), peppermint (Mentha ×piperita). These can be taken as homeopathic tablets or as herbal infusions and tinctures, with 5 to 20 drops given every 15 to 20 minutes until contractions are steady, rhythmic, and strong.
Labia preparation
Many women fear the stretching and tearing of the vagina and labia; teaching them to moisturize, stretch, and prepare these tissues can alleviate their fears and reduce the need for episiotomies. The best way to prepare these tissues is to maintain a proper diet throughout pregnancy, to keep hydrated, and to consume omega-3 fatty acid foods. Dry tissues don’t stretch. But for women whose fear of tearing directly hinders her emotional and physical ability to progress through labor, the application of emollient herbal remedies can be the difference between a frightening, painful process and a peaceful delivery. The best methods for moisturizing labia tissues include gently rubbing with an oil infused with mallow, calendula, red clover, or plantain, or with the oil (fresh or from a broken capsule) of evening primrose. This can be repeated throughout labor, if desired.
Transition
Midwives view transition as a perfectly normal part of labor that indicates passage from the active stage of labor to the pushing stage. Transition could aptly be named Supreme Panic or The Changing of the Mind. It is a pivotal stage of labor in which the cervix opens completely and the uterus ends “massage” contractions and begins “expulsion” contractions. Transition has a strong impact on the emotions, causing panic, fear, heightened anxiety, uncertainty, and even anger. But it is the shortest stage of labor, lasting only a few minutes to no more than two hours.
Because transition is such a short phase and it is completely normal, it is rarely medicated. But if the mother is truly frightened, angry, anxious, and confused, it is perfectly safe to soothe her with words, massage, and nervine tonics. Tier 1 and 2 nervine tonics and adaptogens bring the body into a state of emotional balance without being sedative; the best are skullcap (Scutellaria lateriflora), black cohosh (Actaea racemosa), passionflower (Passiflora incarnata), and motherwort (Leonurus cardiaca). Nervines with a notable sedative action include hops (Humulus lupulus) and valerian (Valeriana officinalis).
Hydration
Keeping the body hydrated is an important and sometimes tricky concern during childbirth, as excess pressure on the kidneys and bladder is unwanted though the body must have a continual supply of water. Often the best method for hydrating the mother is to provide frozen chips of water. Frozen chips of raspberry infusion are valuable as these provide a little flavor and the tonic action of raspberry leaf. Keeping the lips protected with a beeswax-based salve is also a good strategy for helping women avoid the “dry lips” feeling of dehydration, making sure the woman has ready access to fresh liquids in addition to use of the ointment.
Tears and Episiotomies: Post-Partum Tissue Care
Caring for vaginal and labial tears is a common practice for midwives and herbalists, and these wounds can be considered normal events for most childbirths. Extreme wounds that require excessive suturing or demonstrate infection should be seen by a health care practitioner. Herbal formulas should include oils with styptic, vulnerary, antimicrobial, emollient, and astringent actions—all to be used externally only, as most of these are not suitable to the newly breastfeeding mother.
Emollient and Vulnerary Herbs for Post-Partum Tissue Care
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raspberry leaf |
comfrey leaf |
mallow root or leaf |
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calendula |
red clover |
plantain |
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sage |
witch hazel |
oak bark |
|
lady’s mantle |
shepherd’s purse |
St. John’s wort |
|
yarrow |
peppermint |
elder leaf or flower |
A combination of any of these herbs can be applied externally as an oil and/or a sitz bath using the following guidelines:
To combine these two methods: Use the sitz-bath method, dry off, and allow the bottom tissues to be exposed to fresh clean air (no pants!) for a short while, and then apply the oil and cover up with light cotton underpants with an absorbent, all-natural pad. Repeat this process throughout the two to three days post-partum to ensure speedy healing of tissues and avoid infection.
Breastfeeding
Generally, breastfeeding does not bring with it any particular diseases or hardships, with most women concerned about only a small handful of issues: producing an acceptable quantity of milk (and drying up the milk when ready), and avoiding or healing mastitis or infections and inflammation in the breast.
Producing and Drying Milk
Herbs that stimulate breast milk production are called galactagogues, and they are generally essential-oil rich and carminative herbs, as well. Their actions stimulate the mammary glands by acting upon the pituitary, particularly through the actions of the chemical compound anethole, which is present in many of the licorice-scented breastfeeding herbs.
The most reliable galactagogues can be taken as teas, candy, tinctures, and capsules, and they are generally made in combinations for flavor and strength. Traditionally, blessed thistle, anise, caraway, dill, fennel seed, mallow, and barley have been used to reliably increase milk production and promote prolactin production. These aromatic herbs are also those very herbs used throughout European history to treat digestive complaints and ease flatulence, making them perform double duty for mothers of infants suffering colic and gas.
To dry up the milk when weaning the baby, mothers turn to astringent herbs. Whereas galactagogues promote prolactin, astringent herbs inhibit prolactin, constrict the mammary ducts, and reduce milk flow and production. Common astringent herbs used for this purpose include sage, yarrow, goldenseal (on the United Plant Savers at-risk list), and to a lesser extent, raspberry. These can be applied topically but are most effective as internal infusions, tinctures, foods, and capsules. Avoid the temptation to squeeze out the milk that is still being produced, as this can stimulate even more production.
Mastitis
Infection in the mammary glands and milk ducts at any point during breastfeeding is, unfortunately, common and painful. Milk ducts may become clogged, resulting in pain, inflammation, redness, and a hard swelling on the infected breast, and infection may set in, which can cause fever. The causes of mastitis are many: compression of the breast (sleeping positions, etc.), cracked nipples leading to infection by Staphylococcus, Streptococcus, or E. coli pathogens, 73 use of a breast pump, and even diabetes or steroid use. Mastitis makes breastfeeding uncomfortable and painful, but more breastfeeding is often exactly the remedy that helps the most. The more frequently a baby nurses, the more likely a plugged duct is to clear.
Anti-inflammatory and antimicrobial herbs are the best choices to directly treat a case of mastitis; there are many folk remedies, indicating this age-old condition was well recognized historically. The topical application of warm cabbage was a common treatment, likely since cabbage was common and because it has the ability to, like plantain, absorb heat from the body.
Herbal Anti-Inflammatories for Topical Use in Mastitis
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plantain |
yarrow |
violet |
|
arnica |
white willow |
vervain |
|
turmeric |
ginger |
cabbage |
Internal anti-inflammatories acceptable during breastfeeding include vervain, valerian, cramp bark, and ginger. Treat concurrent symptoms such as fever, aches, and fatigue with the appropriate herbs (mentioned elsewhere in this book).
Reducing stress to allow for proper let-down of milk is also key. Stress can interfere with the natural hormonal drive to produce breast milk, so anxiolytic herbs and nervine tonics can be very beneficial for the mother whose milk supply won’t start or has diminished. Specific stress relieving herbs appropriate for breastfeeding include skullcap, hops, lemon balm, lavender, motherwort, vervain, chamomile, and oats milky tops. Provide the mother quiet time when she is free from displaying the new baby to relatives; she needs alone time and time with her baby free from distractions, socializing, and the expectations of hosting well-wishers.
For a discussion of post-partum depression and mother’s stress, see chapter six.
Long the territory of midwives, herbal support for the pregnant and nursing mother is being shared with the wider healing community in an effort to make these remedies known and to offer as many options and choices as possible to the mother. Her informed decisions can only be made when she has the support from her caregivers as well as the legal right to choose her own methods of nourishment and treatment, for both herself and her baby. Using herbs during pregnancy, childbirth, lactation, and weaning is a safe and honorable way to support families during these meaningful experiences.
73 Romm (2010), 450.