Motherwort for Birth and Postpartum Recovery – A Complete Guide

I was captivated when I first read the story of a young Swedish mother from the 16th century. She lived in a green valley, in a crowded town surrounded by two rivers. When she gave birth to her baby, both of them tragically passed away afterwards. Archaeologists found them buried together when they excavated her town, Nya Lödöse. In the area of her stomach, hundreds of seeds and calyxes were found. More than a tablespoon, in an otherwise empty stomach.

We do not know her name, or that of her newborn. We do not know whether the herb was given to her by a midwife, or that she took it herself. Perhaps her mother had taught her. What we do know is that someone knew about its effects. A woman in that ancient village was growing Motherwort intentionally in her domestic garden. She understood that this plant had something extraordinary to offer a birthing woman. 

This article is about that specific plant, Motherwort. I had to find out what the women in that birth space knew, and what science had come to say about it four centuries later. The young mother inspired me to write an extensive academic thesis on Motherwort as part of my herbal certification. This article translates my thesis into an easy-to-read, but thorough essay for mothers. It is focused entirely on birth and postpartum.

Before we dive in, it is important to mention that Motherwort can refer to several different species across different continents. The relevant ones are Leonurus cardiaca, the European species, and Leonurus japonicus, its Asian counterpart. Although they share their name, their compound profiles are not identical. Distinguishing between the two is very important for understanding the research, because in several cases therapeutic effects have been attributed to the wrong plant. This article is about the European plant only: Leonurus cardiaca.

Motherwort (Leonurus cardiaca) 

 What’s in a name?

The botanical name of Motherwort is Leonurus cardiaca. It’s a combination of the Greek words leon (lion) and oura (tail), translating into lion’s tail. This likely refers to the shape of the flowers that curl upwards, although some have linked it to the shape of the leaves. Cardiaca means ‘belonging to the heart’. Both the lion’s tail and the heart reference are found in many languages. 

Most profound though is the reference to the word mother. In Old English, wurt was the term used for an herb, translating Motherwort into ‘herb for the mother’. We find this in many other languages, such as German (Wild Mutterkraut), Latvian (sirds matere) and Polish (serdecznik pospolity). Traditional Chinese Medicine calls the close relative Leonurus japonicus Yu Mi Cao, meaning ‘good for the mother’. Although these sound beautiful, they are not poetic names. They are literal descriptions of how this herb was traditionally being used.

Traditional use

We will never be able to get a complete overview of traditional use, because herbal medicine was an oral tradition. Women simply passed on their knowledge to each other as an extension of their daily lives. This means that I am limited to books written mainly by male doctors, who reported what they observed in their community. Motherwort made her first appearance in an herbal book in 1485. Does this mean that this was the first year women were using Motherwort as support? I hope the young mother from Sweden reminds you that it doesn’t, as she most certainly did not read the German herbal book.

There are other archaeological findings hinting on medicinal use, spread throughout the centuries like small seedlings. Roman pottery from 1 A.D. found in France contained several inscriptions with the image of Motherwort. Archaeologists have speculated that this means the plant had great significance for the commissioner of the pottery. It wouldn’t be farfetched to imagine that he witnessed a profound effect in his wife using the plant during birth or postpartum. This particular type of Roman pottery was a status symbol, used during dinner parties. Who knows - the beautiful bowls might have been the ancient equivalent of what some would now call a push present.

Roman pottery with inscriptions of Motherwort leaves and flowers

Now onto the herbal books, where women’s healing practices were first documented. How common the use of Motherwort was becomes clear from the words of German doctor Hieronymus Bock in 1548: “Mutterkraut is known to almost every woman”. I must admit that I feel a little sting when I read these words – if only that would still be true. If I skip ahead in his text to the part relevant for birth, he writes: “When mutterkraut is steeped in good white wine for a night / chopped up before that / and extracted in a glass jar / it is more powerful / will apparently ease the ailments of women and mothers”. Although he does not specify what ailments this may be, it was a common way in that period to refer to menstruation, birth and postpartum. An English doctor around the same time is a little more specific, when he writes ‘brings women their illness’. This clearly points to use of Motherwort as a stimulant for menstruation. Many other similar texts follow, such as: ‘A well prepared extract is good for women who suffer from discomfort after giving birth’ (1554), and ‘good for them that are in hard travail with child’ (1644). 

A more poetic and elaborate description is found in The Birth of Mankind, from 1540: “It is also to be understanded that many times after the deliverance, happeneth to women other [either] the fever or ague, or swelling or inflation of the body, other tumbling in the belly, or else commotion or settling out of order of the mother or matrix. Cause of the which things is sometimes lack of due and sufficient purgation and cleansing of the flowers [menstrual blood] after the birth, or else contrariwise, overmuch flowing of the same, which sore doth weaken the woman. (...) And ye must take diligent heed that she be exactly and utterly purged. To this be agreeable all such simples which provoke urine and open the veins, making free way for the blood to pass, and send the humours and matter downward, as motherwort (...).

One of the most impressive effects of Motherwort is first mentioned here: its support for both too little bleeding and too much bleeding. Hold that thought, and I will get back to it when we dive into the science.

Image of a birthing stool from the book The Birth of Mankind (1540)

Clearly, Motherwort played a central role for women in supporting their monthly bleed, birth and postpartum. I hold deep reverence for the wisdom of these women, and how they passed it on through their lineage for centuries. At the same time, I’m a modern woman that graduated university in a worship culture of statistics. Let’s move onto what science has to say.

How does it work?

I hate prescriptions. I can’t help it, but they give me such a disempowering feeling. As if the message is “just trust me to take this, because I know what’s best for you”. There wouldn’t be too much of an issue with that, if there wasn’t dozens of expert opinions convincingly arguing opposite things. Instead, I prefer to explain the detailed workings of plants and general physiology. You are the expert on your own body, so I trust you to take this knowledge and be the one who decides if it’s a match for you personally. So, let’s dive into the science.

The exceptional dual effect

Motherwort has been used traditionally in cases that seem to contradict each other. For example, it has been used both to stimulate menstruation, but also to ease menstrual cramping. This can be explained by an exceptional dual effect that was observed in animal studies. In these studies, they isolated the compound stachydrine from Motherwort. It’s a compound that can be extracted in both water (like a tea) and in tinctures. Stachydrine showed a significant effect on uterine smooth muscle. Uterine smooth muscle is the thick middle layer of the uterine wall, also known as myometrium. This is the muscle that generates the forceful contractions needed for childbirth (don’t we all know that one). Now back to the dual effect. Stachydrine has shown that it can stimulate, as well as ease contractions. This suggests that Motherwort can act as a regulator of the uterus, rather than a simple stimulant or relaxant. The direction of the effect seems to be determined by the state of the body. The stimulating direction was compared in an interesting in vitro study, which compared the effect of synthetic oxytocin on uterine contractions with several herbs. Motherwort showed an increase in contractile force of 90% relative to synthetic oxytocin. I would like to emphasize that this study was done on isolated uterine tissue, not in human clinical context. Still, the findings are intriguing. Synthetic oxytocin is the most administered drug to birthing mothers worldwide. It is used to induce labor, to speed up contractions, and to prevent excessive bleeding after birth. Now is not the time to dive into its many side effects, but the finding that a native and abundant European plant might offer equal effects is interesting to say the least. It makes me think back to the young mother in Sweden. I wonder what these women had been observing first-hand without a petri dish.

Graph from the in vitro study comparing several herbs with synthetic oxytocin

Healing of the womb

Motherwort extracts have been observed to improve endothelial cell recovery and support endometrial angiogenesis. Now let’s take that sentence apart, because these are not terms most of us use daily. Endothelial cells are flat cells that form a lining on the interior surface of all vessels. This lining is only a single cell thick, and is crucial for the formation of new blood vessels and initiating healing processes (among many other things). So when would endothelial cells need to recover? Well, each menstruation the endothelial cells of the uterus collapse and are shed with the rest of our menstrual blood. You can image this is even more profound after giving birth. Stachydrine was associated with the recovery of these cells. Then the second part of that sentence: supports endometrial angiogenesis. Angiogenesis is the process of generating new blood vessels. Endometrium refers to the lining of the uterus. So endometrial angiogenesis is the generation of new blood vessels within the lining of the uterus. Both of these effects may explain why Motherwort has traditionally been associated with postpartum recovery. The study used an extract of the full alkaloid spectrum in Motherwort (of which stachydrine mentioned above is one). Although some alkaloids can be extracted in water, only a tincture with the right ratio of water to alcohol will extract the full spectrum.

Calming the nervous system

Motherwort has traditionally been used to support calmness. It has been studied from several angles in this regard. The main one is its calming effect on the heart. Motherwort is actually called Hartgespan (tense heart) in my mother tongue. It hurts a little to skip over this big topic, but I will leave the heart for another time. What I do want to speak on though, is the neurological pathway to calmness. In the hours and days after birth, a mother’s nervous system is navigating an extraordinary transition. Progesterone drops extremely fast. This is relevant, because progesterone is an important building block for GABA-A receptor sensitivity. GABA (gamma-aminobutyric acid) is the primary inhibitory neurotransmitter in the central nervous system. Think of it as a brake. It determines how well you tolerate stress and how quickly you can return to a baseline after stress. If that brake works as it should, it is called inhibitory tone. The huge drop in progesterone means that inhibitory tone is significantly reduced. Pair this with the physical aftermath of birth, sleep deprivation and a profound identity change, and the result is often anxiety and hypervigilance. Now let’s bring Motherwort into the equation. Studies have shown that a full extract of Motherwort can bind to GABA-A receptors in animals. It is hypothesized that this binding may support the inhibitory tone, at a time when support derived from progesterone is reduced. Interesting side note is that the same study also used five isolated compounds from Motherwort, and none of them showed this effect. A beautiful testament to the wisdom of nature and using plants as a whole. 

The hormonal changes in postpartum (image created by Perelel)

Most research seems to validate a long history of traditional use. From a scientific point of view though, I need to make some nuances. These effects have not been studied in clinical trials on women, let alone birthing or postpartum women. This does not mean that there is no effect in this specific group - simply that there is no data. The studies I referenced were mostly done in vitro and in vivo, which means in this case that testing was done on live animals or their tissue. It is unlikely that research will move beyond this point, because (recently) pregnant women are not deemed suitable research subjects. 

Contraindications

Pregnancy

You are likely to find pregnancy as a contraindication for Motherwort in every product you’ll see. In the case of Motherwort, this is not just a disclaimer based on a lack of research in pregnant women (which a lot of disclaimers are). It remains true that there are indeed no studies on the effects of Motherwort in pregnant women. But the contraindication in this case is based on observed effects on the uterus in general. Motherwort is classified as an emmenagogue, which means that it encourages the onset of menstruation. Although there are no studies into the specific mechanism behind this, it would likely be a combination of the effects on the uterus and on the nervous system. Motherwort has traditionally been associated with calming effects on the nervous system, which makes it especially suitable for stagnant menstruation in times of emotional anxiety.

Heart medication?

If you dive deep into the contraindications of Motherwort, you may come cross the statement that it can interact with pharmaceuticals in the treatment of heart disease. Personally, I think this claim is blunt and lacks solid foundation. But because I should not be the one deciding how you perceive risk, let me give you the full story. These statements are based on a case from 1999, where it was suggested that Motherwort contributed to heart failure. It concerned a 94-year old woman who had to be hospitalized. In the three days prior, she had been taking spironolactone (a synthetic drug against heart failure) and a combination of several herbs, including Motherwort. It was then suggested that glycosides in Motherwort interacted with the spironolactone, hereby contributing to heart failure. There are several flaws with this conclusion. The dosage of the herbs was unknown, the other herbs could not be ruled out, and there has not been any comparable effect in the long history of Motherwort.

Pain-relief medication?

Then a final consideration is the suggestion that it may have a synergistic effect on hypnotics and analgesics. A Russian researcher made this statement in 1993 and that has been referenced by some. Unfortunately the original source is not available. A possible explanation might be that Motherwort interacts with the cytochrome P450 system, which is a mechanism of detoxification primarily found in the liver. Although this has never been studied with Leonurus cardiaca, it has indeed been studied in Leonurus japonicus. This showed an effect on CYP1A1/1, 2B1/1 and 2E1. These are not involved in the breakdown of hypnotics or analgesics though. It might be an interesting topic to dedicate research to, but so far there is no research (or historical evidence) to support the claim.

How to use it

In traditional herbal medicine, Motherwort was used in the postpartum period to ease afterpains, support the nervous system and promote healing of the womb. It can be integrated in your recovery in several ways. First of all, in the many nourishing dishes I hope you are eating. A traditional postpartum dish from the Hakka is Kacang Ma Chicken, made with dried Motherwort leaves. Another way would be to make an infusion – the herbal term for medicinal tea. An herbal infusion will extract most of the compounds, but will be very bitter in taste. This could be masked by combining it with other herbs or adding honey. 30 grams of dried Motherwort is enough for 1L medicinal tea, which is more than enough for a daily dose. The herbs must steep for at least 15 minutes to be properly extracted. Finally, it could be taken as a tincture. This is the most concentrated form, will have the fastest effects, and the most complete spectrum of all the compounds. It was on my bedside table in postpartum, and I simply added a few drops to the many cups of tea I drank. If you are worried about the alcohol contents while breastfeeding, know that the amount of alcohol in a single dose is less than that of a ripe banana or a serving of kimchi. To be exact, it would be 1/8^th of a teaspoon if you use a tincture with a high percentage of alcohol (which I’d recommend with Motherwort).

Closing words