Other natural remedies have been recommended for treating discomforts and complications of pregnancy or decreasing risks to the baby.
Assisting Childbirth
Castor Oil
Castor bean oil was noted by the ancient Egyptians to stimulate labor, and it is still used by some conventional physicians and midwives to induce contractions—for example, if labor does not occur spontaneously after the water has broken. A recent controlled trial in 100 pregnant women compared oral castor oil to no treatment and found that 57.7% of those given castor oil began labor within 24 hours, compared to only 4.2% of those without treatment.
23
Other preliminary studies also suggest that castor oil may help.
24,25
Unfortunately, castor oil is a strong laxative, and diarrhea is a nearly universal effect—not a particularly pleasant experience during childbirth.
In addition, considering how common this treatment is, research on its safety and effectiveness is surprisingly scant. One case of a potentially fatal complication linked to use of castor oil has been reported, though some have questioned whether the castor oil was responsible.
25,26
In addition, an
observational
study of South African women found that those self-treating with castor oil and/or other traditional herbs had a higher incidence of meconium (fetal feces) in the amniotic fluid, a sign of fetal distress.
27
Acupuncture and Acupressure
A number of studies, including a 2011 review of 13 trials, found evidence that
acupuncture
is helpful in reducing labor pain.
28,29,94,109,221,224
In a study involving 212 women in active labor, researchers found that, in countries where epidural anesthesia is not available, acupuncture can help to reduce pain compared to standard care early in labor.
217
Not all of the evidence to support the use of acupuncture to treat labor pain has been high-quality, though.
28,29,94
And there have been some studies that have contradicted this conclusion. For example, in one study, sterile water injections were found to be more effective than acupuncture for lower back pain and relaxation during labor. It is unclear whether or not the patients in the study knew which treatment they were receiving at the time.
115
And, in a placebo-controlled trial, real acupuncture was no better than sham acupuncture in relieving pelvic pain prior to labor.
119
A carefully conducted review of 10 randomized controlled trials involving 2,038 woman was unable to uncover consistent evidence of acupuncture's effectiveness for labor pain either alone or in combination with other treatments.
122
In one study involving 60 women, postoperative acupuncture or electro-acupuncture reduced pain within the first 2 hours (but no longer) and demand for pain medication within the first 24 hours after cesarean section.
121
And in a study involving 105 women giving birth to their first baby, there was no difference in the need for pain relief between the women receiving real or sham acupuncture.
218
A study of 45 pregnant women found that women who received acupuncture on the mathematically calculated birth “due date” gave birth sooner than those who did not.
30
However, this trial used a no-treatment control group instead of sham acupuncture, making its results unreliable. Another study suggested that the use of acupuncture may help stimulate normal term labor.
107
On the other hand, a third study of 106 women with premature rupture of membranes (“water breaking” too early)
found that acupuncture did not effectively speed up delivery.
113
It should be noted that none of these 3 studies used sham (fake) acupuncture as a control, making their results unreliable.
However, in a subsequent trial that attempted to address this problem, real acupuncture administered for 2 days prior to a planned induction of labor (artificial stimulation of labor) was no better than sham acupuncture at preventing the need for induction or shortening the time of labor.
120
Two studies suggest that acupuncture and associated therapies can help "turn" a breech presentation.
96,97
In 2008, researchers published a review of 6 randomized controlled trials that investigated acupuncture-like therapies (moxibustion, acupuncture, or electro-acupuncture) applied to a specific point (BL 67). They concluded that these therapies were effective at decreasing the incidence of breech presentations at the time of delivery.
118
Again, however, not all of these studies employed a sham acupuncture group for comparison.
According to a small, randomized trial, acupuncture may also help to reduce pain after labor in women undergoing an episiotomy.
225
Other Natural Treatments
One double-blind, placebo-controlled trial evaluated the effects of
red raspberry
in 192 pregnant women.
32
Treatment (placebo or 2.4 g of raspberry leaf daily) began at 32 weeks of pregnancy and was continued until the onset of labor. The results failed to show any statistically meaningful differences between the groups. Red raspberry did not significantly shorten labor, reduce pain, or prevent complications.
Blue cohosh
is a toxic herb and should not be used. One published case report documents profound heart failure in a baby born to a mother who used blue cohosh to induce labor.
33
Severe medical consequences were also seen in a child whose mother took both black and blue cohosh.
34
Proteolytic enzymes
may reduce inflammation and discomfort following episiotomy.
79-81
Hypnotherapy
has shown some promise for assisting labor.
82-85
Researchers have also focused on the potential benefits of
massage therapy
.
86-88,226
An analysis of 5 randomized trials, including 326 pregnant women, compared massage therapy with usual care during childbirth.
226
(One study compared massage to music therapy in addition to usual care.) Those in the massage therapy groups reported feeling less labor pain and/or anxiety. These favorable results are limited by the absence of an adequate control group in any of the studies.
Evidence has been mixed regarding whether
aromatherapy
is helpful during childbirth. In a large controlled trial involving more than 600 participants,
lavender oil
failed to improve pain after childbirth.
89
But, a randomized controlled trial involving 251 pregnant women did find evidence that aromatherapy may help reduce the perception of pain during labor and possibly reduce the risk of a newborn needing intensive care.
219
In contrast, a review of 2 randomized trials failed to find a positive effect. In the larger of the two studies, 513 women were randomized to receive aromatherapy (
Roman chamomile
,
clary sage
,
frankincense
, lavender, or mandarin essentials oils) or standard care. Different methods were used to expose the women to the oils, like applying a compress, giving a massage, or using a footbath. There were no differences between the two groups in level of pain, rate of cesarean section, or use of pain medication.
220
For a discussion of homeopathic approaches to pregnancy support, see the childbirth support article in the in the
Homeopathy Database
.
Constipation
Constipation
frequently occurs during pregnancy, for reasons that are not entirely clear.
Fiber supplements, such as psyllium seed, are commonly recommended for the treatment of constipation in pregnancy because of their apparent safety.
Flaxseed
is another high-fiber seed, and alternative practitioners often recommend it. However, flaxseed contains estrogen-like substances that might pose hazards to the fetus; one study found an effect on reproductive organs and function in baby rats whose mothers ate large amounts of flaxseed during pregnancy.
35
Other natural remedies for constipation during pregnancy include
dandelion root36
and a combination of
glucomannan
and lactulose.
37
However, there is no meaningful evidence to indicate that they are effective.
Note
:
Avoid use of powerful laxatives, including natural remedies such as buckthorn, cascara, rhubarb, castor bean oil, and senna, as these can induce uterine contractions.
36
(See the
Assisting Childbirth
section above.) The traditional remedy
yellow dock
, though milder, might warrant similar caution.
36,38
Leg Cramps
Pregnant women sometimes experience painful leg cramps. A double-blind study of 73 women with this symptom found that
magnesium
was significantly more effective than placebo in decreasing their distress.
39
Calcium
has also been studied for this problem, but research so far gives little indication that it helps.
40-42
A combination of vitamins
B
1
and
B
6
has also been suggested for leg cramps, but evidence that it helps remains minimal.
43
Prevention of Prematurity and Miscarriage
Interesting though not entirely consistent evidence suggests that use of
fish oil
or its constituents by pregnant women might help prevent premature births.
50,51,90,99,110
Double-blind studies have evaluated the minerals
calcium
,
52-54zinc
,
55-58
and
magnesium59-61
for this purpose as well, but the results have been mixed. A number of trials suggest that anemia is linked to prematurity; however, evidence as to whether
iron supplements
can help remains inconclusive.
54,62
Numerous studies have investigated the effects of vitamin supplementation on prematurity and/or miscarriage. In a review of several studies,
folate
was not found to be effective for preventing premature birth.
63
One study failed to find
vitamin C
helpful for preventing premature birth.
95
However, another study found that vitamin C (100 mg/day after 20 weeks of pregnancy) helped prevent early rupture of the membranes ("water breaking").
100
Another study suggested that the use of vitamin E (400 IU daily) and vitamin C (500 mg/day) after premature rupture of membranes helped to hold off delivery by several days.
101
Low levels of
vitamin B
12
may increase risk of miscarriage, and B
12
supplements may help.
93
However, despite this limited evidence of benefit, a more recent review of 28 trials involving over 98,000 pregnancies failed to show that vitamin supplements of any kind (starting at 20 weeks gestation) prevent miscarriage or stillbirth.
216
Prevention of Low Birth Weight
Babies born below a specific weight (5-½ pounds)—called low birth weight—are at greater risk for complications.
A recent meta-analysis of 7 controlled studies looked at the effects of
calcium
supplementation on birth weight.
64
These studies predominantly focused on preventing hypertension and/or preeclampsia in the mother, both of which can result in low-birth-weight babies. Overall, calcium appeared to decrease the percentage of babies weighing less than 5 pounds 8 ounces.
64
However, other analysts looking at a somewhat different group of studies came to the opposite conclusion.
65,66
Quite a few double-blind studies have examined
zinc58,67-72
as well as
magnesium59,60,73
for preventing low birth weight, with mixed results. Results have been similarly mixed in other controlled trials of
folate61,74
and
fish oil
or one of its fatty acids.
50,65,75Vitamin D
and
B vitamins
have also been proposed, but so far evidence of their usefulness is weak.
54,76
Several decades ago,
iron
was believed to be helpful in preventing low birth weight. However, a recent large-scale unblinded study of well-nourished women found that routine iron supplements in pregnancy had no effect on birth weight.
77
In addition, as previously noted, iron supplementation in pregnant women who are not anemic may not be good for either mother or baby.
In a double-blind, placebo-controlled study of 1,877 women, use of combined
vitamin E
and
vitamin C
failed to prove helpful.
102
Other Uses of Natural Treatments
Gingivitis
A common problem in pregnancy is an increased tendency toward swollen or bleeding gums—a condition known as gingivitis. Two, small, double-blind studies suggest that
folatemouthwash
may help. However, folate supplements do not appear to be especially effective against gingivitis.
44,45
Healthy Mental Function in Children
Folate
has also been studied for its possible role in the intellectual development of children. In one trial, researchers compared children whose mothers took daily folate and iron supplements while pregnant with those who did not.
215
At age 7-9, the children whose mothers did take the combination supplement scored higher on intellectual tests. It is unknown whether or not the folate, iron, or both contributed to this benefit, although the study took place in an area where iron deficiency is common (rural Nepal).
Another study involving 38,954 children found that the use of
folate
supplementation during early pregnancy reduced the children’s chance of having a severe language delay at 3 years of age.
223
Intrahepatic Cholestasis
A condition called intrahepatic cholestasis may occur during pregnancy, causing jaundice and other complications. Preliminary evidence suggests that the supplement
s-adenosylmethionine (SAMe)
might be helpful for preventing this.
48,49,103-105
Bladder Infections
A
single-blind
trial found suggestive evidence that vitamin C, taken at a dose of 100 mg daily, might help prevent
bladder infections
in pregnancy.
111
Gestational Diabetes
One placebo-controlled study of 30 women suggests that the mineral
chromium
may be useful for gestational diabetes, the term for
diabetes
that occurs during pregnancy.
46
Vitamin B
6
has also been proposed for this condition, but evidence in support of its effectiveness is minimal.
47
Prevention of Miscarriage
Low levels of
vitamin B
12
may increase risk of miscarriage, and B
12
supplements may help.
93
Depression
A small preliminary study found that
fish oil
was significantly more effective than placebo at alleviating postpartum depression.
117
However, other studies have failed to find either fish oil or one of its chief components, docosahexaenoic acid (DHA), helpful for preventing perinatal (including postpartum) depression.
98,116
For example, a large study involving 2,399 women found that fish oil capsules—a combination of DHA 800 mg/day and eicosapentaenoic acid (EPA) 100 mg/day—did not prevent postpartum depression.
123
Cognitive and Visual Function in Children
Studies have found evidence that the use of
fish oil
or DHA and EPA by pregnant women might help support healthy cognitive and visual function in their children.
91,92,106
Anxiety
A review of 8 randomized controlled trials found some evidence that
mind-body interventions
(eg, hypnotherapy, imagery) may help reduce the
anxiety
many women feel before and during labor.
222