Is Black Cohosh Safe To Induce Labor?

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Black cohosh is a flowering plant species native to the eastern region of North America (1). You may have heard of the use of black cohosh for labor induction and may be wondering if it is true. Although there isn’t much research suggesting the positive effects of black cohosh in inducing labor, it is sometimes used for this purpose.

According to some studies, this method of inducing labor was used by almost 45% of midwives to induce labor in pregnant women (2). However, it is advised not to disturb the natural process and timing of labor to avoid unforeseen complications for the mother and the baby.

Read on to know more about black cohosh, including its use, benefits, and possible side effects that might follow if not used under proper supervision.

In This Article

What Is Black Cohosh?

Black cohosh may act as a uterine tonic. It is believed to trigger uterine activity or contractions and stimulate labor and childbirth. According to the research reports published in June 1999, 45% of the midwives have used blue and black cohosh for inducing labor in pregnant women (3).

protip_icon Point to consider
Black cohosh can cause mild side effects such as stomach upset, rash, vaginal bleeding, and weight gain (9). Thus, its unguided use during pregnancy must be avoided.

How To Use Black Cohosh To Induce Labor?

If you are considering inducing labor and parturition with black cohosh, you must have a word with your doctor first. It is essential you are well informed and do everything under supervision to stay safe and healthy.

Here are some things you ought to know:

  • If you take black cohosh before your term, you may be in danger. You can also put at risk the health of your baby. So, be very careful and try this herbal medicine only under the supervision of your doctor.
  • You need five drops of black cohosh to promote the ripening of your cervix. This may regulate contractions and induce your labor.

    You can add black cohosh drops to your coffee and tea and drink them twice daily.

    Image: Shutterstock

  • You can add the drops to your coffee and tea and drink them twice daily.
  • If you do not find any changes in your cervical, you can increase your intake to 10 drops. If you experience any side effects, you must discontinue taking it and contact your midwife or doctor immediately.
  • You can take black cohosh capsules from the 38th week of your pregnancy. Each of the capsules generally contains 500 mg of black cohosh.
  • You can repeat the process after an hour if you find no changes.
  • You can add the black ones with the blue variants for increased effectiveness. A combination of the two herbs can help induce your labor pains.


protip_icon Did you know?
Black cohosh is often used alone or in combination with other herbs to induce labor. The labor-inducing formula prepared by mixing black cohosh with herbs is known as “partus preparatus” or mother’s cordial (10).

Induction Of Labor

To be on the safer side, it is always better not to indulge in any practices that disrupt the natural process. You must avoid any techniques until you reach the 40th week of your pregnancy.

  • Last few weeks of your pregnancy are crucial for the development of the brain of your baby.

    The fetus' brain develops fully in the final stages of pregnancy

    Image: Shutterstock

  • Your baby may experience fetal distress and suffer from developmental delays if your pregnancy is cut short by even a week.
  • Thus, whether you are thinking of using black cohosh or anything else to induce labor and promote delivery, you must have a discussion with your doctor first.

Warnings:

Since it is all about you and your unborn baby, you cannot afford to take even the smallest of risks. If you use black cohosh, you must be well aware of the risk factors associated with it. Here are the common ones you should keep in mind:

  • The FDA does not recommend use of any types of herbal supplements in pregnancy (4).
  • You cannot be sure that the products you purchase shall contain all the ingredients listed on the label.
  • Black cohosh must be avoided if you are suffering from liver disorders or breast cancer, states the National Institutes of Health (5).

    Avoid black cohosh if you are suffering from any liver disorder

    Image: Shutterstock

Frequently Asked Questions

1. What happens if I take too much black cohosh in pregnancy?

Excess black cohosh in pregnancy can negatively impact maternal health by leading to hyponatremia (decreased sodium levels), per a study published in the National Library of Medicine (6). Changes in mental health status, seizures, and coma are a few complications associated with hyponatremia (7).

2. Does black cohosh make me sleepy while pregnant?

A random controlled trial on postmenopausal women found that black cohosh improved sleep in those who complained of insomnia (8). However, not much is known about the effect of black cohosh on pregnant women. Therefore, it is safe to seek a doctor’s advice before its use.

3. How long does it take for black cohosh to induce labor?

The exact amount of time black cohosh takes to induce labor may vary from one woman to another. Generally, the safety and efficacy of black cohosh in inducing labor are not extensively researched. Hence, it is essential to consult a healthcare provider before using black cohosh for labor induction.

4. Can black cohosh be a natural alternative to medical induction methods, and are there any benefits to doing so?

Midwives sometimes use black cohosh as a natural alternative to medical procedures to induce and augment labor. However, it is worth noting that black cohosh’s safety and efficacy for labor induction or augmentation are not well established. Therefore, it is essential to use black cohosh only under medical guidance (11).

5. When should I not take black cohosh?

Ohio-based physician Dr. Kevin Huffman suggests, “For most individuals, black cohosh can be safe at recommended doses, but it should be avoided during pregnancy because it might trigger uterine contractions and lead to miscarriage. Similarly, those with liver disease or a history of liver discomfort should avoid black cohosh, as it may worsen these conditions.”

Some midwives have used black cohosh to induce labor, which is known to stimulate the uterus to contract. However, it is recommended to seek your doctor’s opinion before using any herbs, natural remedies, or alternative medications to stimulate labor since the effects may not be tolerable for all women. In addition, it is recommended to let the labor occur at its pace to avoid complications. Black cohosh use is not regulated by the food and drug administration, so you may look for the ingredients in the products to avoid risks. Also, this herb should not be used in pregnant women with liver problems or breast cancer.

Infographic: Why Black Cohosh May Be Unsafe

Black Cohosh has been used for its postulated ability to induce labor; however, there are concerns about its safety, mainly when used in high doses or for long periods. So, learn about its possible adverse effects before taking it, and consult your doctor before consuming any herbal supplement during pregnancy.

side effects of black cohosh (infographic)

Illustration: Momjunction Design Team

Key Pointers

  • Black cohosh is commonly used to induce uterine contractions.
  • It can be consumed in the form of capsules or mixed with beverages.
  • Taking black cohosh before the due date can pose a risk to the health of both the mother and the baby.
  • Consulting a doctor prior to consuming black cohosh is recommended to prevent any complications.
black cohosh to induce labor_illustration

Image: Stable Diffusion/MomJunction Design Team


Gain valuable insights on the safe use of black and blue cohosh to induce labor. Get expert advice on recommended doses and strategic timing for best results.

References

MomJunction's articles are written after analyzing the research works of expert authors and institutions. Our references consist of resources established by authorities in their respective fields. You can learn more about the authenticity of the information we present in our editorial policy.
  1. Actaea racemosa.
    https://plants.ces.ncsu.edu/plants/actaea-racemosa/
  2. Safety and Efficacy of Black Cohosh During Pregnancy and Lactation.
    https://www.herbalgram.org/resources/herbclip/issues/bin_331/review44895/
  3. B L McFarlin et al.; (1999); A national survey of herbal preparation use by nurse-midwives for labor stimulation Review of the literature and recommendations for practice.
    https://pubmed.ncbi.nlm.nih.gov/10380441/
  4. Medicine and Pregnancy.
    https://www.fda.gov/consumers/free-publications-women/medicine-and-pregnancy
  5. Black Cohosh.
    https://ods.od.nih.gov/factsheets/BlackCohosh-HealthProfessional/
  6. Matthew J. Blitz et al; (2016); Severe Hyponatremia Associated with Use of Black Cohosh during Prolonged Labor and Unsuccessful Home Birth;
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4794442/
  7. Hyponatremia;
    https://my.clevelandclinic.org/health/diseases/17762-hyponatremia
  8. K Jiang et al; (2015); Black cohosh improves objective sleep in postmenopausal women with sleep disturbance;
    https://pubmed.ncbi.nlm.nih.gov/26000551/
  9. Black Cohosh.
    https://pubmed.ncbi.nlm.nih.gov/26000551/
  10. Safety and Efficacy of Black Cohosh During Pregnancy and Lactation.
    https://pubmed.ncbi.nlm.nih.gov/26000551/
  11. Severe Hyponatremia Associated with Use of Black Cohosh during Prolonged Labor and Unsuccessful Home Birth.
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4794442/#:~:text=Black%20cohosh%2C%20a%20homeopathic%20remedy
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Dr. Karla S. Sanchez-Banos is a board-licensed Ob/Gyn in Mexico, specializing in Adolescent Gynecology. She is also trained in Gynecological Endocrinology, granted by AMEGIN (Gynecological Endocrinology Mexican Association).

Read full bio of Dr. Karla S. Sanchez-Banos
  • Dr Kevin Huffman
    Dr Kevin HuffmanMD Dr. Kevin Huffman is a doctor of osteopathic medicine and a board-certified bariatric physician. He is the founder of AmBari Nutrition, a platform for weight loss and dieting products. Dr. Huffman has treated more than 10,000 patients over three decades and is the founder & president of the American Bariatric Consultants.
    Dr. Kevin Huffman is a doctor of osteopathic medicine and a board-certified bariatric physician. He is the founder of AmBari Nutrition, a platform for weight loss and dieting products. Dr. Huffman has treated more than 10,000 patients over three decades and is the founder & president of the American Bariatric Consultants.
Rebecca is a pregnancy writer and editor with a passion for delivering research-based and engaging content in areas of fertility, pregnancy, birth, and post-pregnancy. She did her graduation in Biotechnology and Genetics from Loyola Academy, Osmania University and obtained a certification in ‘Nutrition and Lifestyle in Pregnancy’ from Ludwig Maximilian University of Munich (LMU).

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Swati Patwal
Swati PatwalM.Sc. (Food & Nutrition), MBA
Swati Patwal is a clinical nutritionist, a Certified Diabetes Educator (CDE) and a toddler mom with more than a decade of experience in diverse fields of nutrition. She started her career as a CSR project coordinator for a healthy eating and active lifestyle project catering to school children.

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Aneesha holds a Bachelor's degree in Biotechnology from USTM, Meghalaya and Master’s degree in Applied Microbiology from VIT, Vellore. With two years of experience, she has worked on different research projects in the field of Food Sciences.

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