if you're studying for a big herbology test like finals year-ends Clinic entrance exams or boards you'll probably want to be familiar with which herbs are contraindicated during pregnancy so instead of giving you a big list to memorize let's briefly discuss why certain errors might be contraindicated during pregnancy and hopefully that will make some of these herbs easier to remember when you get to your test so generally speaking there are three reasons why an herb might be contraindicated during pregnancy it may be toxic it may have a strong action of invigorating blood or it may have a strong downward nature or descending action so first let's look at toxicity toxic herbs tend to have a very strong or harsh effect and of course this is bad when you're pregnant so let's think about which of our herbs are toxic in nature well an obvious place to start is the category harsh expellents these are herbs that strongly drive out water through the large intestine they cause you to pass water anally and pretty much all of these herbs are toxic in nature that's why they tend to have a smaller dosage and that's why they're pretty much all contraindicated during pregnancy soy and bado are all contraindicated during pregnancy one of our most commonly used toxic herbs is jerfutza remember jerfutza is aconite and it also goes by the names month hood or wool Spain because it was originally used to poison wolves so obviously if you use it to poison wolves you should probably not give it to pregnant people and this also applies to our other forms of aconite Church in the transform phlegm category we also learned which is especially useful for treating wind phlegm so notice that all of these herbs have jur in the name which means they've been processed or prepared so these herbs are toxic in the raw form but we prepare them or process them in certain ways to reduce their toxicity but we still don't use them in cases of pregnancy notice one that's missing from this list is gerbancha now gerbanchop is usually listed as being toxic but it's actually not contraindicated during pregnancy in fact Bond shot is often used to treat morning sickness or no nausea and vomiting during pregnancy so it's actually specifically used during pregnancy and not contraindicated so Bond shot is toxic in its raw form but but by the time we process it and cook it in decoction it's considered safe to use so dirty and nanching is out but durabancha is okay some other obviously toxic ones are our insects choanchier and wugong from the extinguished wind category these are Scorpion and centipede so they're obviously toxic don't give it to pregnant people and finally we have Leo Huang which is sulfur now this is from the category substances for topical application so it's mentally used externally if you're going to use it internally you have to be really careful with the dose because 10 to 20 grams can put you in a coma so it's definitely toxic and don't use it with pregnancy after that herbs with a strong action of invigorating blood tend to be contraindicated during pregnancy the idea here is these herbs create a lot of movement and if we create too much movement that can move the baby right out and cause a miscarriage and here it might be worth remembering that when it comes to invigorating blood we actually have different levels of intensity for more mild action we say harmonize the blood for a moderate action we say Quicken the blood or transform stasis and for a strong action we say break the blood orbensky says breaks up blood stasis so for herbs with a more mild action of invigorating blood these might actually be okay to use or it might say use caution during pregnancy but for strong herbs that break the blood those are definitely contraindicated during pregnancy remember here we're talking about out treating fixed abdominal masses or breaking up accumulations so that is obviously not something you want to do when you're dealing with a pregnant patient so when you look at the category herbs that invigorate blood most of these herbs are contraindicate during pregnancy or we at least say use caution during pregnancy but those ones that break the blood and treat abdominal masses are definitely contraindicated but then remember that we do have some herbs outside of this category that also have additional actions of invigorating blood so mudon P cools the blood but it also invigorates blood to my from the drain dampness category also breaks up blood and pu Huang cat tail pollen is in the stop bleeding category and it also has an action of invigorating blood and this one we say that the raw form is contraindicated because it can cause uterine contractions and finally herbs with a strong downward action or descending nature also tend to be contraindicated during pregnancy again if we're creating a lot of downward Movement we might inadvertently move the baby down and out and cause a miscarriage so one group of herbs we might look at is the purgative category which is part of the downward draining category so because of their strong downward action all of these herbs are contraindicated during pregnancy but then we have other ones like matrician and Shogun from the heat toxicity category matrician is kind of interesting Penske describes this one as having a slippery nature now I don't think he ever actually elaborates on what it means for an herb to be slippery but I'm just imagining the baby slipping right out when you don't want it to who Joe is a little bit weird this is from the warm the interior category but it's just pepper which it doesn't sound like it should be that bad but we do describe it this one as having a strong descending action we say it drives Chi downward in cases of vomiting fluids or food stagnation but I'm assuming this is referring to larger dosages used in decoction because I'm pretty sure pregnant people still put pepper on their food and they turn out just fine guayabon and the Aja are turtle shells from the tonifayun category they have a strong anchoring function for Yin deficiency with young rising and I think of anchoring like moving downward and then we have shushion and Neo Huang from the aromatic substances that open the orifices category with shushyang we say it hasten's delivery and facilitates the downward passage of stillborn horns and with these when we say open the orifices that really means open the sensory orifices or open the heart orifices but I also think about this as opening the lower Yin orifices and just having Things fall out so a few things to point out here one sometimes going from the books it can be really difficult to tell if an herb is really strictly contraindicated during pregnancy or if it's just use caution during pregnancy for one thing different sources sometimes say different things both in terms of our classical sources and our modern textbooks but also Penske is just kind of sometimes ambiguous about this he'll say things like relatively contraindicated during pregnancy or use great caution and only when necessary so for those I'm just going to say they're contraindicated the other thing to point out is on a test you may or may not get questions that are just like which of the following herbs is contraindicated during pregnancy I think what tends to be more likely is you would get a case study where a patient is pregnant and also has a certain condition and then it will ask which herbs would you prescribe or which herbs would you add to the formula and in that situation you would know that you should cross out any answer that has these contraindicated herbs in it so that might be the way you see it come up on a test and that's why knowing these herbs is important and when it comes to herbs where we use caution during pregnancy we're kind of dealing with the same situations the herbs are either slightly toxic they invigorate blood or have a dispersing nature or they have a descending action like a lot of our herbs that regulate chi have a descending function they move rebellious cheek downwards so we use caution during pregnancy but here we could add a number four which is some herbs we just know through historical or empirical use that they cause uterine contractions or they hasten delivery and therefore they should be used cautiously during pregnancy for example chant way was historically used to promote labor and promote the expulsion of the residue of the birthing process so use caution during pregnancy or church expels retained placenta so use caution during pregnancy or we have things like shanja Hawthorne Berry which can cause fetal death in large doses so large doses of shanja are contraindicated but when it comes to herbs where you use caution during pregnancy that list is much longer so if you want I made a handout you can download it's actually several handouts put together it has the list of herbs that are contraindicated during pregnancy a combined list of cautions and contraindicated herbs during pregnancy some information about the 18 incompatible herbs and the 19 antagonisms some Basics about drug herb interactions and herbs of special cooking instructions so these are all topics that show up on the nccm boards as well as year-ends and Clinic entrance exams so it's good to look over if you want to get it there's a link below where you can enter your email address and I'll send you the handout as well as some other resources that will help you study for your herbology exams I have a lot of videos handouts and practice tests scattered throughout the YouTube channel and the website tcmc study.net so I'll send you links to those as well so that's it for this one if you want to review some other topics that tend to come up on herbology exams check out these videos and I'll see you in the next one foreign [Music]