Evidence supporting the use of: Blue cohosh
For the health condition: Afterbirth Pain

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Synopsis

Source of validity: Traditional
Rating (out of 5): 2

Blue Cohosh (Caulophyllum thalictroides) has a long history of use in traditional North American herbal medicine, particularly among Native American groups and midwives, to support childbirth and address postpartum concerns such as afterbirth pain (the uterine cramping that occurs as the uterus returns to its pre-pregnancy size). Traditionally, it was used as an emmenagogue, parturient, and uterine tonic. Historical texts and herbal compendia from the 19th and early 20th centuries, such as King’s American Dispensatory and the Eclectic Materia Medica, describe Blue Cohosh as helpful in easing uterine muscle spasms and reducing afterbirth pain. The presumed mechanism is based on the presence of alkaloids and saponins, which were thought to have a mild antispasmodic and uterine-stimulating effect. However, modern scientific studies specifically evaluating Blue Cohosh for afterbirth pain are lacking, and safety concerns (including reports of neonatal toxicity and adverse cardiovascular effects) have led to caution against its use during and after pregnancy. The evidence for its efficacy is thus primarily traditional and anecdotal, rather than grounded in contemporary clinical research. Overall, Blue Cohosh’s use for afterbirth pain is justified by tradition, but there is minimal scientific validation, and its safety profile is questionable.

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