2.7. Red raspberry leaf (Rubus idaeus)

Red raspberry leaf is known as garden raspberry leaf. The deciduous raspberry plant produces it [48].

#### 2.7.1. Benefits of red raspberry

Red raspberry leaf has mineral rich nutritive and uterine tonic to promote an expedient labour with minimal bleeding. It can also be used as an astringent to diarrhoea. In a study based on two clinical trials, there was positive association with red raspberry use and astringency in the case of diarrhoea. Daily recommended dose is 1.5–5 g [23–24]. Traditionally, red raspberry leaf has been used in late pregnancy to shorten the duration of labour and to reduce complications of pregnancy. Pregnant women should consult a doctor or a pharmacist for advice before using red raspberry leaf in pregnancy in a tea or infusion [49]. Red raspberry fruit is not believed to pose risk to the mother or to the baby during pregnancy. Some women take it as a labour aid during the last 2 months before delivery, whereas others take it throughout the pregnancy. In a randomized clinical trial, 192 women at 32 weeks of gestation received 1.2 g of raspberry leaf tablets twice daily. The study reported no adverse effects to mothers or infants. The active treatment with raspberry leaf shortened the second stage of labour and lowered the rate of forceps delivery. A retrospective observational study conducted on 108 pregnant women showed that 57 women who ingested raspberry leaves were less likely to have an artificial rupture of membranes or to require caesarean section, forceps or vacuum birth than 51 controls [50–51]. Women have used red raspberry leaves for painful periods in pregnancy, morning sickness, to prevent miscarriage, easing labour and delivery and enriching breast milk [52].

2.9. Clary sage (Salvia officinale)

relaxed during contractions [56–57].

2.9.2. Untoward effects of clary sage

2.10. Anise (Pimpinella anisum)

exposure is relatively low [58].

2.10.2. Untoward effects of anise

2.11. Green tea (Camellia sinensis)

the concern that they might trigger early labour [58].

Green tea is mostly consumed in Middle East.

2.10.1. Benefits of anise

anise (Illicium verum) Chinese star anise [58].

2.9.1. Benefits of clary sage

Clary sage is a plant native to Italy, Syria and Southern France and grows in dry soil. The

Herbal Medicine Use during Pregnancy: Benefits and Untoward Effects

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It is recommended that clary sage only be used from 37 weeks onwards. It may be used to induce labour if the body is ready to go into labour. It may stimulate the release of oxytocin in pregnant women [56]. Using clary sage is highly recommended during labour to help contractions to intensify and become more effective in pulling up the horizontal uterine muscles to open the cervix and move the baby down into the pelvis and into the birth canal. The simplest and most common way to use clary sage during labour is to put a few drops on to dry cloth; the mother will inhale the aroma when she needs it to help herself become more calm and

Large doses best avoided for concern of potential miscarriage and abortifacient effect [47].

Anise is known as aniseed. There are two types of anise: anise (Pimpinella anisum) and star

Orally, anise is used for dyspepsia, flatulence, rhinorrhoea (runny nose) and as an expectorant, diuretic, and appetite stimulant. Anise is also used to increase lactation and facilitate birth. Topically, anise is used for lice, scabies and psoriasis treatment. Using anise during pregnancy is likely safe when used orally in amounts commonly found in food. There is insufficient reliable information available about safety of anise when taken orally in medicinal amounts during pregnancy [59]. Anise used in small amounts in herbal tea is safer in pregnancy because

When used topically, anise in combination with other herbs can cause localized pruritis. In allergic patients, inhaled or ingested anise can cause rhino conjunctivitis, occupational asthma and anaphylaxis [59]. Essential oil and concentrated anise should be avoided in pregnancy for

essential oil is distilled from the flowers and flowering tips [56].

#### 2.7.2. Untoward effects of red raspberry

The untoward effect of red raspberry needs further investigations.
