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Herbal Induction

Safe Use of Herbs to Induce Labor

Know which herbs are safe to use for herbal induction of labor. Compare herbs commonly used for inducing labor. Herbs should be taken in correct amounts if used to induce labor.

Blue Cohosh

Blue cohosh (Caulophyllum thalictroides) is often recommended for herbal induction of labor in a non-laboring woman or to facilitate contractions during a long labor.

Risks of Blue Cohosh in Pregnancy

Unfortunately, there were two serious cases of heart failure in the late 1990's in neonates whose mothers took blue cohosh to induce labor. In both cases, the infants had to be ventilated. Both survived, but one had continued impaired cardiac function at two years of age. The mother of this child took three times the dose recommended by her midwife. The dosage taken by the other woman was not reported.

Many herbalists and midwives have steered away from blue cohosh since these reports were published. While it is to be granted that only two cases out of the unknown thousands of laboring women who have taken blue cohosh is small; the severity of these infants’ condition make it less desirable.

Blue cohosh should always be avoided in a pregnant woman who is not at term since it is reported to cause abortion or preterm labor from its uterine stimulating effect. No other human studies have shown detriment to the fetus, though birth defects have been seen in animal studies.

Use of Blue Cohosh for Inducing Labor

Some midwives continue to use blue cohosh in certain instances, as it appears to be an effective uterine stimulant. The tincture has been administered at a rate of five drops every four hours.

Considering potential risks, it would be advisable to use only at the end of pregnancy and only with the supervision of a practitioner experienced with its use.

Red Raspberry

Red raspberry (Rubus idaeus) is a favorite herb of midwives and mothers alike. It can be used safely throughout the pregnancy, labor, and breastfeeding.

It should not be taken in large, ultra doses prior to term since it has been shown to cause uterine contractions.

Reported risks of Red Raspberry

Due to its possible estrogen effects, red raspberry should not be used by women with reproductive cancers, uterine fibroids or endometriosis. It should be used with care by diabetic patients or others monitoring their glucose levels since it can lower blood glucose.

Studies with Red Raspberry

One retrospective study done in Australia indicated shorter labors, decreased incidence of post-date pregnancies, and reduction in artificial rupture of membranes, cesareans, and instrument deliveries in women who used red raspberry leaf supplements compared to those who did not.

A randomized study done later by some of the same researchers had different results. The outcomes of women who had taken 1.2 grams of raspberry leaf tablet were compared to women in the control group who had not. There was a shorter second stage and decrease in forceps delivery for women who had taken raspberry leaf tablets. No significant differences were found in the length of first stage, leading the authors to question the appropriate dosage level.

Red Raspberry for Herbal Induction

Red raspberry tea is commonly used by women instead of the tablets. In labor, one half cup of dried leaves can be added to one quart of water after it has boiled, and steeped for 30 minutes. The mother can drink one half cup to one full cup per hour.

Black Cohosh

Black Cohosh (Cimicifuga racemosa) is not the same as Blue Cohosh. It too has a uterine stimulating effect.

Uses of Black Cohosh

Black Cohosh has been used to induce labor at term or to increase contractions of a woman whose labor is long.

Black cohosh is also used for the treatment of hot flashes in menopausal women; with some research validating the effectiveness for this usage and some concluding it is not effective for hot flashes.

Risks of Black Cohosh

The most serious side effects of black cohosh have been seen with large doses above manufacturers recommendations. These include seizures, slow heart beat, and vision changes. None of these lead to permanent disability. Dizziness, headache, nausea, sweating, upset stomach, and vomiting have been reported with regular use of black cohosh.

In labor, midwives have reported precipitous labor and hyperstimulated contractions. Black cohosh should be avoided in pregnancy before term to prevent prematurity or abortion.

It should not be taken by someone with alcohol in their system, as it potentiates the effect of the alcohol. It should not be taken by those with liver disease due to potential toxicity. Due to its estrogen-like effects, it should not be taken by women with reproductive cancers, or with uterine fibroids or endometriosis. It may also interfere with hormone replacement therapy or oral contraceptives in non-pregnant women.

Labor Induction with Black Cohosh

It is available in tablet form, as an extract, or tincture. Manufacturers recommend different maximum daily amounts depending on the quantity of active ingredient present.

A tea can be made of 2 grams of the dried chopped root of the plant, which can be added to boiling water and steeped for 10 minutes; then drained.


Pennyroyal (Mentha pulegium) is also used as a uterine stimulant. No research was found for the use of dried Pennyroyal for labor.

Herb or Oil?

The Pennyroyal herb should not be confused with the essential oil. The herb is dried from the leaves. The essential oil from Pennyroyal is steam expressed and contains pulegone, a substance toxic to the liver and kidneys. Pennyroyal oil should not be taken internally by anyone.

Risks of Pennyroyal

Both the herb and the oil of Pennyroyal can cause uterine contractions and start labor. Pennyroyal has been used to self-induce abortions, with toxic effects to the woman. Four deaths and 18 injuries have been reported with this use. Therefore, it should never be used in pregnancy before term. There are two reports in the literature of injury to older infants who were given mint tea brewed from fresh home grown plants. Mint tea is given in some population groups during illness, and in this case the variety of mint plant used was Mintha pulegium which contained the pulegone in the essential oil that was steam extracted in the home brew. Both infants developed multiple organ failure.

Use of Pennyroyal for Herbal Induction

Pennyroyal is considered safer as a tea from dried leaves. One to two teaspoons of the dried herb is sometimes steeped for 10-15 minutes in one cup of water that was boiled prior to adding the herb.

In short, Pennyroyal has potential complications if used by an unknowledgeable person. Only the herb should be used, and only when obtained from a reputable source and used according to instructions from an experienced practitioner.


Another supplement that has been used for herbal induction is 5-W. This is a combination of five different herbs that are used as uterine stimulants that have been combined in tablet form. The five herbs are: Blue Cohosh, Red Raspberry, Squaw Vine, Dong Quia, and Butchers Broom.

The herbs Blue Cohosh and Red Raspberry are discussed above. Squaw Vine (Mitchella repens) was an herb used by Native Americans at the end of pregnancy to prepare for birth. No research on this herb was found.

Dong Quai (Angelica sinensis) has been shown to cause unpredicatable uterine contractions in animal studies.

Butcher’s Broom (Ruscus aculeatus) has a mild diuretic action. It also can increase blood pressure, so its use should be monitored more carefully if someone has high blood pressure.

Use of 5-W for Herbal Induction

The 5-W tablets have been used for preparation for birth in the last five weeks of pregnancy. The recommended use is 2 capsules, three times a day for the last five weeks of pregnancy. Since they are sold in bottles of 100 tablets, two bottles would be needed if they are taken for five weeks.

Some midwives recommend that a woman take one tablet a day for a full week when she is 36 weeks pregnant. At 37 weeks she should take two capsules a day; three tablets per day at 38 weeks, four tablets per day at 39 weeks and five tablets a day at 40 weeks. 5-W has also been used when the membranes have ruptured without the spontaneous onset of labor. Four pills per hour are recommended every hour until labor contractions are established.

It has been verbally reported by one midwife who uses 5-W that the majority of women with ruptured membranes will begin contractions within four hours of starting the herb. No scientific research on 5W was found.

Other Risks of Herbal Inductions

In addition to the risks stated above, there is another risk to herbal inductions or other any method of inducing labor. Labor started before 37 weeks results in a preterm delivery and many babies need to go to NICU because their lungs are not fully developed. Any later in pregnancy a preterm delivery may result from labor induction. Currently guidelines are to not induce until after 39 weeks.

Safe Use of Herbs In Pregnancy

This series on herbs for pregnancy and childbirth will help you use herbal preparations safely.

  • Are Herbs Safe?
  • Pregnancy Herbs: 7 Guidelines for Safe Use
  • 6 Ways to Use Herbal Medicines

  • Return from Herbal Induction to the Better Childbirth Outcomes HOME PAGE.

    By Karen Newell Copyright 2003 - 2012 Better Childbirth Outcomes - All Rights Reserved
    Camp Hill, Pennsylvania, USA