Overview

Essential oils are naturally occurring oils made by steam distillation or cold pressing the flowers, roots, seeds, fruit, or bark of plants. These concentrated extracts retain the essence of the plant’s fragrance. Essential oils have long been a part of complementary and alternative medicine in aromatherapy, topical application, or ingestion. Natural remedies, like essential oils, are an attractive alternative for expecting mothers who wish to avoid chemicals or pharmaceuticals and utilize more natural remedies. Most information on essential oils comes from the marketing of the companies that manufacture them or their representatives. There are a lot of claims that essential oils can treat everything from common discomforts to severe illnesses. It can be challenging to determine which claims are valid and which may be exaggerated. This article examines the safety of essential oils during pregnancy and the evidence of their effectiveness in treating pregnancy symptoms and improving your birth experience. Plus, tips for buying essential oils.

Listen Now

Article and Resources

Essential Oils

Essential oils are naturally occurring oils made by steam distillation or cold pressing the flowers, roots, seeds, fruit, or bark of plants. These concentrated extracts retain the essence of the plant’s fragrance. Essential oils have long been a part of complementary and alternative medicine in aromatherapy, topical application, or ingestion. They can also be used in manufacturing fragrances, cosmetics, household and personal care products, or as food additives.

How Essential Oils Work 

Essential oils contain terpenes, esters, oxides, alcohols, phenols, ketones, and aldehydes. These components are responsible for the desired effects like anti-inflammatory, calming, antiseptic, or aromatic. The molecules in essential oils are tiny, which allows them to be absorbed easily by your body. 

Your olfactory system, or your sense of smell, is directly connected to your brain. When you smell something, like essential oil, the receptors in your nasal cavity transmit information to your limbic system, sometimes called the emotional brain. Plus, part of your limbic system is your hypothalamus which influences the pituitary gland that secretes hormones responsible for many functions like thyroid function, sleep cycles, and blood pressure. Essential oils are thought to work by interacting directly with the hypothalamus, which can influence neurochemistry throughout the body. 

Your autonomic nervous system has two parts, your sympathetic and parasympathetic nervous systems. Your sympathetic nervous system is your fight-or-flight response. It makes your heart beat faster and stronger, opens your airways so you can breathe more easily, and inhibits digestion. Your parasympathetic nervous system is your rest and digest system. It stimulates digestion, activates metabolic processes, and helps you to relax. There is a balance to these systems, and if you spend too much time in a sympathetic state, you are constantly in a fight or flight mode. Activating your parasympathetic system has a calming effect on your body and promotes a rest and digest state. Essential oils can also work by stimulating your parasympathetic nervous system. 

Essential Oil Uses

There are an infinite number of uses for essential oils. There are single oils and blends which contain multiple oils for a particular purpose, like uplifting your mood or helping you sleep. If you are into essential oils or have a friend who is, you have likely heard the phrase, “there is an oil for that.” There is oil or a blend of oils for just about anything. Whether or not there is actual evidence to back up the efficacy is another topic that we will be diving into in this article.

There are a few different ways you can use essential oils. Aromatically is any way in which you smell an essential oil. This can be directly from the bottle, in a diffuser, or a bath. Another way you can use essential oils is topically by applying them on your skin. Most often, oils are diluted with a carrier oil before they are applied topically. A carrier oil is vegetable oil, like grape seed, olive, coconut, or almond.

You can also use essential oils internally. Methods of ingestion include diluting with a carrier oil in a capsule, adding to water, or cooking. This is the most controversial way to use oils, especially when you are pregnant. Many sources advise against ingesting oils ever.

There are also many household uses of essential oils, like using them in homemade cleaning products, soaps, lotions, or other personal care products.

Regulation

Many essential oils are labeled GRAS (generally recognized as safe) by the Food and Drug Administration. This designation applies to use as food additives only. Inclusion on the GRAS list doesn’t mean they are safe for any use in any amount or that they are effective for the claims of their use. 

The FDA does not regulate essential oils, but the FDA intervenes when essential oil manufacturers make marketing claims that oils treat or prevent diseases. The FDA considers anything marketed as intended for use in the diagnosis, cure, mitigation, treatment, or prevention of disease to be a drug that would require approval by the FDA. The FDA has issued numerous warning letters (like this) to essential oil manufacturers requiring they cease claims that their essential oils treat or cure illnesses or diseases. The Federal Trade Commission can regulate advertising claims, which could apply to those used by essential oil companies. No regulatory agency oversees or approves essential oils sold to consumers.

Using Essential Oils Safely

Despite the lack of regulatory oversight, manufacturers have an incentive for consumers to use essential oils safely. Risks of using essential oils can include skin irritation, allergic reaction, photosensitivity, eye irritation, throat irritation, nausea, and dizziness. It is important to read the entire label on the essential oil bottle and heed any warnings about how to use it, especially regarding dilution. Essential oils are very concentrated, and you should use them with care. For example, it is estimated that one drop of peppermint essential oil is equivalent to 25-30 cups of peppermint tea.

Special Considerations During Pregnancy

Of course, you are much more mindful of the products and chemicals you are exposed to when pregnant. According to the website of one of the largest essential oil companies on using oils during pregnancy: As with any medical condition, we strongly recommended that prior to using essential oils, you seek the advice and recommendation of a competent, trained health care advisor who is experienced in essential oil usage. Also, on the listing for every essential oil product, there is a caution: If you are pregnant, nursing, taking medication, or have a medical condition, consult a health professional prior to use. These types of disclaimers are typical of the industry. 

Many sources recommend avoiding essential oils in the first trimester. This period is considered the most sensitive period of your baby’s development. The first trimester is also when the majority of miscarriages happen.

There are some changes specific to pregnancy that may affect how you react to using essential oils. 

Skin Sensitivity

Your skin is more sensitive during pregnancy. This is something to keep in mind if you use any oils topically. Topical dilution is generally 1% (3 drops of essential oil per tablespoon of carrier oil). You may want to dilute them even more and test on a small area first to ensure you don’t have an adverse reaction. Your skin may also be more sensitive to sun exposure, especially if you are experiencing melasma. Citrus oils can further increase your skin’s sun sensitivity. See this episode for more information on how pregnancy changes your skin.

Heightened Sense of Smell

When you are pregnant, you have a heightened sense of smell. You may be able to use less essential oil to get the desired effects from aromatherapy. Some scents may be a total turn-off, especially if you are experiencing morning sickness. You may want to limit the use of a diffuser to shorter times. 

Essential Oils Thought to be Safe

Without an agency that regulates safety, it is challenging to determine which oils are safe during pregnancy, especially when most essential oil companies instruct you to consult a health professional before use. The National Association for Holistic Aromatherapy is a non-profit organization focused on education around aromatherapy, and they release guidelines on the safety of oils during pregnancy. The organization states that the following properly diluted essential oils are used commonly in practice and present no hazard:

• Benzoin (Styrax tonkinensis)
• Bergamot (Citrus bergamia)
• Black pepper (Piper nigrum)
• Chamomile German (Chamomilla recutita)
• Chamomile Roman (Chamaemelum nobile)
• Clary (Salvia sclarea)
• Cypress (Cupressus sempervirens)
• Eucalyptus (Eucalyptus smithii)
• Frankincense (Boswellia carteri)
• Geranium (Pelargonium graveolens)
• Ginger (Zingiber officinale)
• Grapefruit (Citrus paradisi)
• Juniper (Juniperus communis)
• Lavender (Lavandula angustifolia)
• Lemon (Citrus limon)
• Mandarin (Citrus reticulata)
• Marjoram Sweet (Origanum majorana)
• Neroli (Citrus aurantium amara flos)
• Petitgrain (Citrus aurantium var amaraol)
• Rose Otto (Rosa centifolia)
• Sandalwood (Santalum album)
• Sweet Orange (Citrus sinensis)
• Tea Tree (Melaleuca alternifolia)
• Ylang Ylang (Cananga odorata)

Essential Oils to Avoid

NAHA also notes that care should be taken with oils that contain high levels of phenols, ethers, and aromatic aldehydes, as they can sometimes irritate the skin due to their molecular shape. This includes the following:

• Oregano (Origanum compactum)
• Thyme (Thymus vulgaris ct thymol)
• Savoury (Satureia montana)
• Clove (Syzygium aromaticum)
• Cinnamon (Cinnamomum camphora)
• Cumin (Cumimum cyminum)
• Aniseed (Pimpinella anisum)
• Fennel (Foeniculum vulgare)
• Anise star (Illicium verum)
• Sweet birch (Betula lenta)
• Wintergreen (Gaultheria procumbens)

NAHA also recommends avoiding the following oils during pregnancy, labor, and breastfeeding:

• Aniseed (Pimpinella anisum)
• Basil ct. estragole (Ocimum basilicum)
• Birch (Betula lenta)
• Camphor (Cinnamomum camphora)
• Hyssop (Hyssopus officinalis)
• Mugwort (Artemisia vulgaris)
• Parsley seed or leaf (Petroselinum sativum)
• Pennyroyal (Mentha pulegium)
• Sage (Salvia officinalis)
• Tansy (Tanacetum vulgare)
• Tarragon (Artemisia dracunculus)
• Thuja (Thuja occidentalis)
• Wintergreen (Gaultheria procumbens)
• Wormwood (Artemisia absinthium)

There is an in-depth review on the maternal reproductive toxicity of some essential oils, including the essential oils the NAHA advises using with caution or to avoid during pregnancy. It also covers some additional oils that are not commonly used.

Using Essential Oils During Pregnancy, Birth, and While Breastfeeding

There are a lot of purported benefits of essential oils to treat pregnancy symptoms, alleviate pain or improve your birth experience, and aid you in the postpartum period. These suggestions are compiled from multiple sources, and a discussion of the evidence on efficacy is included when applicable.

Essential oils are not a panacea. While there may be some evidence for their use in relieving some symptoms, these are one intervention. In most cases, your best shot at reducing symptoms or improving discomfort will be when you utilize more than one intervention or remedy. For many of these topics, there are separate full episodes of the podcast that examine other evidence-based treatments to consider.

There is a difference between someone who regularly uses essential oils and is comfortable with them, and knows how their body reacts and someone who does not have experience using essential oils. If you are new to essential oils and want to start incorporating them, you can always start slow, with minimal amounts. Then slowly increase the use if you find them helpful and have no adverse reactions. 

Essential Oils to Treat Pregnancy Symptoms

One of the most significant concerns during pregnancy is whether substances you are exposed to cross the placenta to your baby. Natural remedies, like essential oils, are an attractive alternative for expecting mothers who wish to avoid chemicals or pharmaceuticals and utilize more natural remedies. It is thought that all essential oils do cross the placenta. For oils to exercise caution with or avoid, there is evidence that many cross the placenta and can impact your baby. There is also the opinion from advocates of essential oils that crossing the placenta is a positive thing and can benefit your baby. Some expecting mothers choose to use fewer oils during pregnancy or limit their use, limiting the amount crossing the placenta and exposing their babies.

Morning Sickness

Morning sickness affects 60-80% of expecting mothers. This is most common in the first trimester, can start as early as one to two weeks after conception, and usually goes away after 12 weeks or when you are beginning the second trimester. Hyperemesis gravidarum is a severe morning sickness requiring hospitalization or treatment with IV fluids and affects .3-2% of all pregnancies. The oils most commonly recommended for morning sickness are lavender, ginger, peppermint, spearmint, and citrus oils like lemon, grapefruit, lime, and orange. Citrus oils can increase sun sensitivity when applied topically.

Some studies examine the efficacy of peppermint and lemon oils in treating nausea in pregnancy. A single-blind clinical trial examined aromatherapy with peppermint oil on the severity of nausea and vomiting during pregnancy. This study used sweet almond oil as the placebo and found the severity of nausea within seven days after the intervention had a decreasing trend in both groups and was not statistically significant for either oil. A double-blinded, randomized, controlled clinical trial examined the effects of smelling lemon essential oil as soon as a participant felt nauseous. The researchers observed a more significant decrease in morning sickness with the inhalation of lemon oil than with the placebo on the second and fourth days of the study. One study combined lemon and peppermint essential oils. Nausea and vomiting intensity was significantly decreased in the treatment group versus the placebo on days two, three, and four.

If you are experiencing morning sickness, you may try aromatherapy with peppermint, spearmint oil, or citrus oil like lemon, grapefruit, lime, or orange. You can also try combining mint and citrus oil. You may see more significant effects with prolonged use on subsequent days.

Fatigue

Fatigue is common during pregnancy, especially in the first and third trimesters. This is primarily due to increased levels of progesterone. In addition, your body increases blood volume, and your blood pressure is lower. You increase your metabolism and lower your blood sugar. Your body is going through many changes, and all those changes take energy.

Peppermint and citrus essential oils like lemon and orange are recommended for fatigue. A meta-analysis of nineteen studies, including 1381 non-pregnant participants, examined the efficacy of lavender, citrus, and mixed essential oils on fatigue. They found that aromatherapy is effective in relieving fatigue in adults who suffer from chronic diseases, such as cancer, arthritis, hypothyroidism, diabetes, renal disease, and so on. However, several trials showed that aromatherapy did not ameliorate fatigue. 

Getting adequate sleep and taking care of your health may help with fatigue. Sometimes the best thing you can do is not fight fatigue. Relax, rest, take a nap, or go to bed early.

Relaxation and Sleep

Pregnancy can be a time of additional stress as you are experiencing many physical changes and preparing for birth and a new baby. As a result, many expecting mothers may find it difficult to relax. Plus, many issues in pregnancy can negatively impact your sleep. Getting in a comfortable position is more challenging as your belly grows. Nasal congestion or snoring can disrupt your sleep. You may also experience leg cramps or restless leg syndrome.

There are many essential oil blends geared toward sleep and relaxation. Common essential oils recommended for these purposes include lavender, chamomile, and bergamot.

There is evidence that essential oils can decrease stress. Many studies ask participants to complete questionnaires to assess emotional outcomes. Still, these leave a lot of room for individual interpretation and may not always be the most accurate for research. In one study, researchers measured cortisol, a stress hormone in saliva, before and after aromatherapy. This was a small study of 22 men, but the researchers found that aromatherapy with lavender and rosemary oils decreased cortisol levels. A very small (13 participant) randomized controlled trial examined aromatherapy with essential oils as a possible solution to decrease stress in pregnancy. Participants used lavender, petitgrain, and bergamot essential oils, which contain high quantities of linalool and linalyl acetate. Using questionnaires and pulse rate, they found that the essential oils helped with fatigue, had relaxing effects, and improved mood. There is also evidence on essential oils and sleep. A randomized controlled clinical trial found neroli (Citrus aurantium) essential oil significantly improved sleep quality in pregnant women with sleep disorders one month after the intervention.

So many changes in pregnancy can lead to increased stress or trouble sleeping. Using aromatherapy with essential oils could be a part of your relaxation protocol or bedtime routine. Using essential oils will not eliminate stress and make up for lost sleep. Understanding your stress response and learning about evidence-based tools to manage stress will minimize the adverse effects for you and your baby and positively impact your mental health. There are also many evidence-based and simple steps to improve the quantity and quality of your sleep. For more in-depth information, see the episodes on evidence-based tips to improve your sleep and troubleshoot sleep issues during pregnancy. You will get the best results by combining multiple strategies to target stress and sleep.

Mood (Pregnancy and Postpartum) 

During pregnancy, Hormones impact more than your physical health. They also affect your mental health by making your moods and emotions swing all over the place. Many essential oils are recommended to improve your mood, including frankincense, neroli, citrus oils like orange and grapefruit, and many blends. Your olfactory system or sense of smell is directly connected to the limbic system in your brain, which controls your basic emotions. It is thought that this is the mechanism by which essential oils can improve your mood.

There is evidence from human and animal studies, as discussed in this review, that essential oils can positively affect your mood. If you enjoy the smell of some oils and are comfortable using them in aromatherapy, there is no downside to trying them to lift your spirits. This could also be applicable after you have your baby postpartum. If there were an oil proven to improve your mood, everyone would use it. Again, this is one tool to have in your toolbox in addition to other interventions.

Headaches 

Many expecting mothers experience headaches and migraines during pregnancy, affecting sleep, mood, nutrition intake, and overall quality of life. If you want to avoid taking pain medication, you may try to alleviate a headache with essential oils. Commonly recommended essential oils for headaches include grapefruit, ylang-ylang, peppermint, lavender, rosemary, chamomile, and eucalyptus.

There are studies on essential oils for migraines and headaches, but most do not include pregnant participants. For example, a placebo-controlled clinical trial found that lavender essential oil may be an effective and safe treatment modality in the acute management of migraine headaches. You may consider using the recommended essential oils listed above or any essential oil that promotes relaxation. See this episode for evidence-based diet and lifestyle changes to relieve headaches and migraines and the safety of pain-relieving medications during pregnancy and breastfeeding.

Additional Pregnancy Symptoms

For any symptom or discomfort you experience during pregnancy, you can likely find a recommendation for an essential oil to treat it. Articles online promote essential oils for frequent urination, heartburn, stretch marks, varicose veins, etc. These symptoms have well-understood mechanisms that cause them, which are common during pregnancy. For example, you urinate more frequently in pregnancy due to increases in hormones, producing additional fluids, your kidneys are more efficient, and as your uterus grows, it can put more pressure on your bladder. There is no essential oil that will stop these processes. Plus, these changes are a necessary part of growing a healthy human.

Essential Oils During Labor and Birth 

Essential oils are becoming increasingly popular for use in labor to reduce anxiety, reduce pain, alleviate nausea, or improve your birth room environment.

A randomized controlled trial on aromatherapy in childbirth offered participants five options of essential oils, including Roman chamomile, clary sage, frankincense, lavender, and mandarin. The essential oil most frequently used was lavender, chosen by 45% of the participants. No maternal adverse effects associated with aromatherapy application were reported, and there were no related neonatal ill effects. Researchers found no differences in induction rates, mode of delivery (vaginal, cesarean, assisted), use of oxytocin, length of labor, or Apgar scores.

In a study of over 8,000 women who used various essential oils during labor, more than half of the mothers rated them as helpful, and 14% found them unhelpful. The mothers’ midwives in the study rated 50% of aromatherapy administrations as helpful. For oils used for anxiety, Rose was found to be the most helpful. In this group, the mothers who used essential oils had higher rates of spontaneous vaginal delivery and lower rates of epidural use. To alleviate pain, lavender was most common, followed by frankincense. Lavender was rated as helpful by 54% of women and frankincense by 64% of women. Similar to those using aromatherapy for anxiety, there were higher rates of spontaneous vaginal delivery and lower rates of epidural use. Peppermint oil was used to treat nausea and vomiting. Of those who had an epidural (which can cause nausea), 44% found it helpful, 17% responded that it was not helpful, and 39% saw no difference. Of the participants who did not have an epidural, 54% found it helpful, 11% did not find it helpful, and 35% found no difference. For use to augment contractions, clary sage was most commonly used. Clary sage was only rated helpful by 36% of mothers. 

A randomized controlled trial evaluated neroli oil (Citrus aurantium) in labor. As labor progressed, pain and anxiety increased in all participants, but the increase was milder in the group that used aromatherapy with neroli oil than in the control group. A randomized clinical trial found that orange essential oil reduced anxiety during labor more than the placebo. There is a correlation between anxiety and pain. Anxiety stimulates the sympathetic nervous system and releases stress-related hormones, which can increase labor pain severity and even labor duration.

A systematic review of 33 studies evaluated the effects of essential oils on anxiety and pain during labor. The most popularly used essential oil in the studies was lavender, either as a single essential oil or in combination with others. Most of the included studies confirmed the positive effect of aromatherapy in reducing labor pain and anxiety. Other oils used were rose (Rosa damascene), chamomile (Chamaemelum nobile), peppermint (Mentha piperita), sweet orange (Citrus sinensis), neroli (Citrus aurantium), Frankincense (Boswellia thurifera), Clove (Eugenie aromatica), jasmin (Jasmine officinale) and geranium (Pelargonium graveolens).

One study examined changes in oxytocin after aromatherapy with clary sage. Oxytocin is responsible for contractions, and clary sage is thought to help with contractions in labor. This study measured oxytocin levels from saliva and did find higher levels of oxytocin after inhaling the essential oil. However, the aromatherapy with clary sage did not cause uterine contractions. This was a small pilot study, and researchers were evaluating whether it would be worth it to do a full-scale, larger study. Results were mixed, but perhaps with a full-scale study, we would have clearer results on whether clary sage is effective during labor.

Some oils like clary sage and myrrh are thought to stimulate the uterus and consequently are not recommended until you are in labor. Before using any essential oils during labor, discuss them with your doctor or midwife. Hospitals and birth centers may limit essential oils or prohibit using a diffuser. You can put oils on cotton balls and store them in a Ziploc bag. If a particular scent is no longer helpful for you, it is much easier to seal up a bag and open a new one than to clear the air and get a smell out of an entire room. If you plan a water birth, do not add oils to the water. They tend to float on the surface and could irritate your baby’s skin or eyes.

Essential Oils While Breastfeeding

If you are considering using essential oils while breastfeeding, you need to consider the possibility that your baby will come into contact with them if you are using a diffuser or applying them topically. You can also transfer essential oils to your baby through breast milk. Talk to your doctor, midwife, or pediatrician about the safety of essential oils with your baby. For information on how some essential oils could affect breastfeeding, the LactMed database is a fantastic resource. This searchable database includes evidence on levels of such substances in breast milk and your baby’s blood and the possible adverse effects on your baby.

Comparing Brands

The two largest essential oil companies are Young Living and doTERRA. One downside to these sellers is that their oils are significantly more expensive than other brands. Both doTERRA and Young Living are multi-level marketing companies. You need to sign up as a member to get wholesale pricing, which is significantly lower than retail pricing. These companies are based on setting up new members as distributors and encouraging them to recruit more people to sign up, which earns them bonuses or commissions.

In investigating why doTERRA and Young Living are so much more expensive than nearly every other brand, I couldn’t come up with a satisfactory answer. The companies themselves claim that their oils are of higher quality. The doTERRA website states, “Remember, you usually get what you pay for, and essential oils are no different.” There is also a lot of criticism about high prices due to high marketing spending and commissions associated with the MLM model. Some of their products may be available on Amazon but tend to be priced higher than the wholesale prices through Young Living or doTERRA directly.

Tips for Buying Essential Oils

Unfortunately, there is no universal standard for testing the quality of essential oils. This leaves it up to individual companies to impose their quality standards. A term you will often see on labels is therapeutic grade. This is purely a marketing claim, and there is no universal standard essential oil can meet to be labeled therapeutic grade. doTERRA created its quality testing process called CPTG (Certified Pure Therapeutic Grade). This testing process includes eight steps to ensure each batch is pure, unadulterated, and safe for use. Of course, this is proprietary to doTerra, and no other brands have this certification.

Look for 100% pure oil on the label or ingredients. You want to avoid synthetic products labeled “fragrance,” “aromatherapy,” “scented,” or “perfume.”

When looking for specific essential oils, look for the Latin name which lists the Genus and species. For example, there are multiple types of lavender. The most common is Lavandula angustifolia (also known as Lavandula officinalis). Other types of lavender may differ in composition and have different effects.

Some essential oils are certified organic or non-GMO verified. GMOs are not a concern for essential oils, but pesticides could be, and that could be a motivator to buy organic.

When comparing prices, pay attention to the quantity in a bottle. The most common volumes are 5, 10, and 15 ml (0.17, 0.33, or 0.5 oz). If you compare the prices of two brands, make sure they are the same, so you are comparing apples to apples.

Talk to Your Doctor or Midwife

As with so many things during your pregnancy, it is up to you to decide if this is something you are comfortable with. You have to combine knowledge of the risks and benefits with your own experience and the symptoms you are experiencing. Some expecting moms will decide to err on the side of caution and avoid essential oils, and others will swear by them. It is up to you where you fall on that spectrum. 

If you have an aromatherapist, herbalist, or naturopathic doctor to consult, they will likely be knowledgeable about using essential oils. Few midwives and even fewer ObGyns are likely educated about essential oils. Discuss using essential oils with your doctor or midwife is still a good idea. They are your trusted partner during your pregnancy and can help you navigate the safety of essential oils, given the particulars of your pregnancy and the symptoms you are experiencing.

Thank you to the amazing companies that have supported this episode.