Abstract / Summary
Abstract Background Herbal medicine use during pregnancy and lactation is common in sub-Saharan Africa despite concerns regarding the safety and efficacy of many medicinal plants. Evidence from Eastern Uganda remains limited. This study determined the prevalence, patterns, and factors associated with herbal medicine use among pregnant and lactating women in Eastern Uganda. Methods We conducted a facility-based cross-sectional study among pregnant and lactating women attending antenatal and postnatal care services at five health facilities in the Teso sub-region of Eastern Uganda between February 1 and 28, 2026. Participants were selected using systematic random sampling. Data were collected using interviewer-administered questionnaires. Factors associated with herbal medicine use were assessed using mixed-effects modified Poisson regression with robust standard errors. Associations are presented as adjusted prevalence ratios (aPRs) with 95% confidence intervals (CIs). Results A total of 671 women participated in the study. The prevalence of herbal medicine use during pregnancy or within six months postpartum was 27.0% (95% CI: 23.7–30.5). Among users, Zanthoxylum chalybeum was the most commonly reported herbal medicine (34.8%), although 43.1% could not identify the specific product used. Most herbal medicines were obtained from family members or friends (51.4%). Concurrent use with conventional medicines was reported by 28.2% of users, while only 9.4% disclosed herbal medicine use to health workers. Herbal medicine use was associated with alcohol use (aPR = 1.56, 95% CI: 1.13–2.15), previous pregnancy-related complications (aPR = 1.35, 95% CI: 1.13–1.60), barriers to healthcare access (aPR = 1.33, 95% CI: 1.09–1.64), and perceived effectiveness of herbal medicine (aPR = 1.91, 95% CI: 1.20–3.05). Conclusions Herbal medicine use is common among pregnant and lactating women in Eastern Uganda. Low disclosure to health workers and concurrent use with conventional medicines raise safety concerns. Routine screening and counseling on herbal medicine use should be integrated into maternal healthcare services.