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TCM in Pregnancy: Why Herbs and Some Techniques Need Special Caution

Why Chinese herbs, moxibustion and other TCM practices need special caution in pregnancy, what reviews found about acupuncture and herbs, and why to ask your maternity provider first.

Content last updated . This page has not been medically reviewed.

Acupuncture, moxibustion and acupressure

  • Acupuncture. A systematic review of 105 studies found that when adverse events were reported, those judged related to acupuncture were mild or moderate, and total incidence was 1.9%. Only about a quarter of studies gave detailed adverse event data. [9] A separate review found adverse event reporting in pregnancy trials was generally poor. [10] For acupuncture in general, see acupuncture side effects and precautions.
  • Moxibustion. A 2012 Cochrane review found limited evidence for moxibustion to turn a breech baby. [11] A newer Cochrane update is covered on Moxibustion for Breech Presentation. A review of adverse events reported premature birth, premature rupture of the membrane and bleeding in pregnant women. [12] See moxibustion for breech presentation and who should avoid moxibustion, cupping and gua sha.
  • Acupressure. The NHS says there is some evidence that pressure on the wrist, with a band or the fingers, may relieve morning sickness. [3] A review of 13 trials of acupressure in labor found moderate evidence of reduced pain and a shorter first stage, with no adverse events reported in the limited studies. [13] See acupressure points in Chinese medicine.
  • Gentle movement. NCCIH advises pregnant women to talk to their provider before starting tai chi, qigong or any exercise program. [1]

Talking with your provider

Surveys pooled in a 2024 review found 34.4% of pregnant women used herbal medicine and only 27.9% of users told their providers, often because they thought it harmless. [14] Telling your care team helps them watch for problems. See telling your doctor about TCM use, therapies in pregnancy and pregnancy and breastfeeding safety.

Frequently asked questions

Are Chinese herbs safe during pregnancy?

Not as a general statement. Some herbs have toxic or abortive potential, especially early in pregnancy, and for many the safety is unknown. [4] [5] Ask your maternity provider and a pharmacist.

Can I use acupuncture while pregnant?

A review found few mild or moderate adverse events when it was correctly applied, but reporting was limited. [9] Choose a trained practitioner, say you are pregnant, and check with your midwife.

Is moxibustion safe in pregnancy?

Evidence for turning a breech baby is limited, and reports include premature birth, premature rupture of the membrane and bleeding. [11] [12] Use only under your maternity provider's guidance.

Does acupressure help morning sickness?

The NHS says there is some evidence it may help. [3] Call your midwife or GP if you cannot keep fluids down for 24 hours.

Should I tell my doctor about herbs?

Yes. Only 27.9% of pregnant herbal users in a review disclosed use, yet disclosure was linked with better maternal and child outcomes. [14]

More details: evidence, limits and cautions

The details behind this page: cautions, limits of the evidence and where sources disagree. Open any note to read it.

Start here if you are pregnant
Check with your midwife, obstetrician or doctor before using any Chinese herb, patent medicine, tea or technique during pregnancy, and tell any TCM practitioner you see that you are pregnant or could be. NCCIH advises that if you are pregnant or nursing, you should be especially sure to consult your health care provider before using TCM. [1] The NHS says herbal medicines should not be taken if you are pregnant or breastfeeding. [2]

Seek urgent care (in the US, call 911) for heavy bleeding, severe abdominal pain or any sign that something is wrong with you or your baby. In the UK, the NHS advises calling your midwife, GP or 111 if you cannot keep food or fluids down for 24 hours or you vomit blood. [3] If you may have swallowed something harmful, US Poison Help is 1-800-222-1222; see Poisoning: what to do first.

Why herbs need special caution
  • Many herbs are not well studied in pregnancy. A 2022 systematic review of 35 articles reported that some medicinal plants have toxic, teratogenic (able to cause birth defects) and abortive potential, particularly in the first trimester. [4]
  • Traditional textbooks and animal studies are not a reliable guide. One re-evaluation concluded that for most Chinese medicinals, neither safety nor risk during pregnancy can be definitively ascertained, and that standard materia medica textbooks contain unreliable information on pregnancy risk. It also found two widely cited animal studies had serious flaws, so alarming animal results should not be taken at face value either. [5]
  • Some herbs are listed as restricted. A review compared herbal medicines that TCM and traditional Indonesian medicine say pregnant women should avoid, drawing on government reports and databases. [6] Ask your provider rather than relying on a list you find online.
  • Reviews of human use are mixed and cautious. A 2026 review of 111 studies found that adjusted observational studies did not show a clear increase in major adverse outcomes overall, while some individual herbs, including licorice (Glycyrrhiza) and Coptidis Rhizoma, were linked to possible risks in limited studies. [7] The authors advise caution for products without strong data. [7]
  • Quality problems matter too. NCCIH notes some Chinese herbal products were contaminated with heavy metals, pesticides or undeclared drugs. [1] See Chinese herbal products: quality and interactions.
Herbs studied for a pregnancy problem
Some trials tested herbs for threatened miscarriage in a clinical setting. A 2023 review of 57 trials (5,881 patients) found higher continuation of pregnancy when herbs were added to standard medical treatment, with low to moderate quality evidence. [8] That is promising but limited, and it describes supervised treatment of a specific problem, not general use of herbs during pregnancy.
References
  1. NCCIH. Traditional Chinese Medicine: What You Need To Know. Read 2026-10-22.
  2. NHS. Herbal medicines and complementary therapies. Read 2026-10-22.
  3. NHS. Vomiting and morning sickness. Read 2026-10-22.
  4. Balarastaghi S et al. Potential benefits versus hazards of herbal therapy during pregnancy: a systematic review. Phytother Res (2022). PubMed record. Read 2026-10-22.
  5. Wiebrecht A et al. Safety aspects of Chinese herbal medicine in pregnancy: re-evaluation of experimental data of two animal studies and the clinical experience. Complement Ther Med (2014). PubMed record. Read 2026-10-22.
  6. Jun P et al. Traditional Chinese Medicine and Traditional Indonesian Medicine: a comparative review of herbal medicines restricted in pregnancy. Chin J Integr Med (2021). PubMed record. Read 2026-10-22.
  7. Chen C et al. Benefits and risks of herbal medicine use during pregnancy on offspring outcomes: a systematic review and meta-analysis. Pharmacol Res (2026). PubMed record. Read 2026-10-22.
  8. Xie H et al. Chinese herbal medicine for threatened miscarriage: an updated systematic review and meta-analysis. Front Pharmacol (2023). PubMed record. Read 2026-10-22.
  9. Park J et al. The safety of acupuncture during pregnancy: a systematic review. Acupunct Med (2014). PubMed record. Read 2026-10-22.
  10. Clarkson CE et al. Adverse event reporting in studies of penetrating acupuncture during pregnancy: a systematic review. Acta Obstet Gynecol Scand (2015). PubMed record. Read 2026-10-22.
  11. Coyle ME et al. Cephalic version by moxibustion for breech presentation. Cochrane Database Syst Rev (2012). PubMed record. Read 2026-10-22.
  12. Park JE et al. Adverse events of moxibustion: a systematic review. Complement Ther Med (2010). PubMed record. Read 2026-10-22.
  13. Chen Y et al. Acupressure for labor pain management: a systematic review and meta-analysis of randomized controlled trials. Acupunct Med (2021). PubMed record. Read 2026-10-22.
  14. Im HB et al. Patient-physician communication on herbal medicine use during pregnancy: a systematic review and meta-analysis. BMJ Glob Health (2024). PubMed record. Read 2026-10-22.
Education, not medical advice. This page is for general information. It does not diagnose or treat any condition and is not a substitute for care from a qualified health professional. Natural does not automatically mean safe. Ask a clinician or pharmacist before changing your care, especially if you take medication, are pregnant or breastfeeding, or have a health condition.