Blue Cohosh and Birth Defects
Q: I recently read a small article in Fit Pregnancy magazine that
says blue cohosh can cause birth defects, according to a recent study
done at Lehman College of City University of New York. Have you heard
anything about this? It went on to say that a woman who took the herb
during labor gave birth to an infant who later developed heart
failure. I have encouraged women to take the cohoshes during early
labor and I myself took the herbs during labor and I would like to
know if this is a new finding.

A: I have never heard about blue cohosh causing birth defects. It
seems unlikely since it's only given in the last weeks of pregnancy.
I do know a lot about the supposed newborn heart failure that was
attributed to blue cohosh--it was a single case study written up in
Pediatrics in either 1998 or 99. That was MY client, and there is
*no* proof, or even any evidence, that blue cohosh caused her baby's
heart problem. It's only an association--they couldn't figure out
what else might have caused this highly unusual problem, which almost
killed the baby, so they blamed it on the mom's use of blue cohosh
during weeks 37-38 of pregnancy. She took capsules (not a terribly
potent form of the herb) for about two weeks, then quit for several
days before going into labor. She had a precipitous labor and birth,
baby did well initially, then crashed quickly and severely at about
30 minutes of age or so. Neither the mom nor I believe the blue
cohosh had anything to do with it or we would be seeing *many* more
babies with heart failure, given how commonly the herb is used to
initiate labor. Thousands of women have used the cohoshes without any
known ill effect, but this one published case is scaring the
beejeebies out of everyone, even though it's purely speculative!

About 12 years ago a friend took lots of cohosh (I'm not sure if it
was black or blue) to abort an unwanted pregnancy and was
unsuccessful. Her baby was born with tetralogy of Fallot, a heart
condition incompatible with life, and had to have open heart surgery
at less than one year of age. She always wondered if it could be
attributed to the cohosh. Maybe it was the amount she took to abort
that was dangerous and small doses wouldn't hurt.

Medscape this week published an article that stated that "there are
no known pathologic conditions for which black cohosh is
contraindicated. Until recently, the herb was not recommended for use
during pregnancy or lactation; according to Newall et al,[1] black
cohosh binds to uterine estrogen receptors. However, more recent
studies clearly demonstrate that black cohosh does not bind to
estrogen receptors and therefore does not have an estrogenic
effect."[16]. Even if it were shown to cause fetal anomolies or
malformations, using this herb at term should not be a problem, as
the fetus is already fully developed. And it has been used by
midwives for years with no untoward effects.
To see this entire (very interesting) article go to:
-Chava Weiman

Alternative Medicine--Black Cohosh
Jeremy L. Pettit
[Clinician Reviews 10(4):117-118, 121, 2000. (c) 2000 Clinicians Publishing
Group and Williams & Wilkins]

Reprinted from Midwifery Today E-News (Vol 2 Issue 22 June 2, 2000)
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