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Blue Cohosh Survey

Easy Steps to a Safer Pregnancy - View e-book or Download PDF - FREE!
An interactive resource for moms on easy steps they can take to reduce exposure to chemical toxins during pregnancy.

Other excellent resources about avoiding toxins during pregnancy

These are easy to read and understand and are beautifully presented.

For a .doc version of this survey, please e-mail the author, avivajill@aol.com

Blue Cohosh Survey

Aviva Romm and Tieraona Low Dog

Biographical Information about the Survey Authors

Aviva Romm, CPM, RH(AHG) has been a midwife since 1985 and is the author of The Natural Pregnancy Book, Natural Health After Birth, Natural Healing for Babies and Children, and Vaccinations: A Thoughtful Parents’ Guide, among others. She is the President of the American Herbalists Guild and an entering first year medical student. Aviva teaches widely on the use of herbs for women and children.

Tieraona Low Dog, MD is Director of Botanical Medicine and Clinical Asst. Professor for the University of Arizona School of Medicine, Program in Integrative Medicine in Tucson, AZ.  She serves on the Advisory Board for the National Institute’s of Health National Center for Complementary and Alternative Medicine and is Chair of the United States Pharmacopoeia Dietary Supplements/Botanicals Expert Panel.  Dr. Low Dog is the author of Women’s Health:  Complementary and Integrative Medicine and has published numerous articles on women’s health in peer-reviewed journals.

The use of blue cohosh (Caulophyllum thalictroides)* as a partus preparator and labor stimulant is well known amongst midwives. Research identifying potentially toxic compounds and published case reports of neonatal harm presumably due to maternal ingestion of blue cohosh have led to new questions about the safety of this herb. As midwives and herbalists, it is for the benefit of our clients that we gain a better understanding of the relative clinical safety of this herb and the volume of actual use amongst pregnant women, and for our own benefit to determine whether this herb is safe to recommend. We hope you will take approximately 15 minutes to complete this survey, which is part of a preliminary data collection process we are undertaking to evaluate the safety of blue cohosh use in pregnancy.

As midwives, we fully recognize the need for anonymity. This survey is entirely anonymous; there will be no identifying features connecting survey respondents to their responses.

* (Please note that this is a survey about blue cohosh (Caulophyllum thalictroides), not black cohosh (Cimicifuga syn. Actaea racemosa).



Aviva Romm and Tieraona LowDog
1931 Gaddis Rd
Canton, GA 30115

Or Email to: avivajill@aol.com

Return by:  July 20, 2005



1. Specify your profession: (circle all relevant options)
a. Certified Professional Midwife
b. Certified Nurse Midwife
c. CM or LM
e. Family or General Practitioner
f. Nurse-Practitioner
g. Childbirth educator or Doula
h. ND or herbalist
i. OTHER: (specify)

2. How many births do you attend per year?
a. 0-10
b. 10-25
c. 25-50
d. 50-100
e. 100-500
f. >500

3. In what setting do you practice? (Circle all relevant options)
a. Homebirth
b. Private practice
c. Hospital or Birthing Center
d. Other (please specify)

4. What do you consider post-dates pregnancy?
a. Any time after term (40 weeks)
b. After 41 weeks
c. After 42 weeks

5. What is the induction rate in your practice?
a. 0-10%
b. 10-20%
c. 20-30%
d. >50 %

6. What is the most common reason for induction in your practice? (Circle all relevant options)
a. Postdates pregnancy
b. Premature rupture of membranes (PROM)
c. Obstetric pressure on mother/ midwife to induce labor by a certain date

7. What is the most common form of induction in your practice?
a. Prostaglandin-based (i.e., Cytotech, prosgel)
b. Pitocin
c. “Stripping membranes”
d. Herbal (i.e., blue cohosh, castor oil)
e. Other?

8. Have you ever used blue cohosh for labor induction?  (circle one)        YES   NO

9. What is the most common reason for blue cohosh use in your practice? (Circle all relevant options)
a. As a uterine tonic during late pregnancy
b. To induce labor
c. For postdates pregnancies
d. For stalled labor
e. As an abortifacient
f. Other

10. Have you ever mentioned, suggested, or recommended the use of blue cohosh during prior to 38 weeks pregnancy? (circle one)       YES   NO

If yes, check one:

11. Have you ever mentioned, suggested, or recommended the use of blue cohosh during labor? (circle one)  YES   NO

If yes, check one:

12. What is your training in the use of herbal medicines? (Circle all relevant options)
a. No training
b. Self-study (books, magazines, journal articles)
c. Formal school (specify)
d. Distance learning (specify)
e. Professional in-service training
f. Other

13. How did you learn about the use of blue cohosh? (Circle all relevant options)
a. Word of mouth
b. Books/articles
c. Professional training

14. In what form do you typically use blue cohosh? (Circle all relevant options)
a. Pills or capsules
b. Tincture/ alcohol extracts
c. Tea
d. Other

15. Do you generally recommend blue cohosh in combination with other herbs?
(circle one)        YES      NO

If yes, can you list some of the other herbs? _____________________________________


16. Is there any particular brand(s) of blue cohosh product you suggest?

If yes, Why? _______________________________________________________________

17. If you recommend blue cohosh, what dose information do you provide?



18. Do you consider blue cohosh safe for use when taken for several weeks during late- pregnancy? (circle one)        YES   NO

19. Have you found blue cohosh to be an effective labor stimulant?  (circle one)  YES  NO

20. Do you consider blue cohosh safe when used as a uterine stimulant during labor?
(circle one)        YES     NO

21. Have you seen any of the following adverse outcomes with the use of blue cohosh? (Circle all relevant options)

a. Meconium at birth
b. Fetal bradycardia
c. Fetal tachycardia
d. Need for resuscitation at birth
e. Increased postpartum bleeding

If other, please describe briefly:


Thank you for taking the time to help us with this important research. We value your participation and  will publish the results in the midwifery community when the project is complete.

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