Safety during pregnancy and breastfeeding has not been established. Black cohosh may relax the muscular wall of the uterus, and some nurse-midwives in the United States use black cohosh to stimulate labor. There is one report of severe multiorgan damage in a child delivered with the aid of both black cohosh and blue cohosh Caulophyllum thalictroides who was not breathing at the time of birth. The child survived with permanent brain damage. However, blue cohosh is known to have effects on the heart and blood vessels and may have been responsible for these effects.
Black cohosh may also have hormonal effects, and caution is advised during breastfeeding. There is a lack of scientific evidence on the use of black cohosh during breastfeeding.
Tinctures may be ill-advised during pregnancy, due to their potentially high alcohol content.
You should read product labels, and discuss all therapies with a qualified healthcare provider. Natural Standard information does not constitute medical advice, diagnosis, or treatment.