Motherisk update: Taking St. John's wort during pregnancy

Question. A 23-year-old patient of mine has been taking St John's wort for postpartum depression for about 2 years. She is now planning her second pregnancy. Is she or her fetus at risk if she continues to take the herbal therapy? Answer. Despite the widespread availability and use of St John's wort and extensive research on the herb, there are almost no data on reproductive safety. At this stage, therefore, St John's wort cannot be recommended as safe therapy during pregnancy.