Diuretics During Pregnancy: What Is Allowed, What Traditional Medicine Says

Swollen feet, heavy legs, and the feeling of having gained weight overnight – water retention is a common experience for many pregnant women. Especially in the second and third trimesters, expectant mothers often complain about this typical accompanying phenomenon. At the same time, the question of what is even allowed during this special phase of life is often accompanied by uncertainty. Conventional medicine advises caution, and rightly so. But traditional healing methods – above all the inherited knowledge of Hildegard of Bingen – have developed answers over centuries that are gaining importance again today. This article sheds light on why water retention occurs during pregnancy, what traditionally passed-down plants can contribute, and which limits must definitely be observed. Products for women's health

Why water retention occurs during pregnancy

The pregnant body is a marvel of adaptation. To optimally supply the growing child, a pregnant woman's blood volume increases by up to 50 percent. Added to this are hormonal changes, especially the increased progesterone level, which softens the vessel walls and influences fluid distribution in the tissue. The result: fluid more easily passes from the blood vessels into the surrounding tissue and accumulates there. This process is physiologically normal within certain limits and is part of the body's natural preparation for birth and breastfeeding.

The ankles, lower legs, hands, and occasionally the face are particularly affected. The swelling is often less in the morning and increases throughout the day – a classic sign that these are position-dependent edemas favored by gravity. Warm temperatures, prolonged standing or sitting, and a salt-rich diet can increase the extent. For most women, these complaints are annoying but harmless. Nevertheless, sudden, severe swelling – especially in the face and hands – combined with headaches or high blood pressure should always be medically evaluated, as they may indicate preeclampsia.

Mild to moderate water retention during pregnancy is a normal accompanying phenomenon affecting an estimated 80 percent of all pregnant women – in most cases, it is not a sign of illness but an expression of profound physical adjustment.

Traditional healing did not view this condition in isolation but always in the context of the overall well-being of the expectant mother. Gentle herbal medicine, dietary adjustments, and lifestyle rhythms played a central role – a perspective that still holds validity today. Hildegard of Bingen products

What traditional healing – and Hildegard of Bingen – have passed down

Hildegard of Bingen (1098–1179) is considered one of the most important natural healers of the Middle Ages. In her works “Physica” and “Causae et Curae,” she described in detail the properties of plants, stones, and foods and their effects on the human body. Her worldview was holistic: humans were seen as part of nature, and health arose from the balance of the so-called Viriditas – the green life force that permeates all living things. For pregnant women, Hildegard recommended a particularly mindful lifestyle focused on rest, light food, and selected herbs.

“Hildegard of Bingen wrote in her ‘Physica’ about fennel: ‘However one eats fennel, it makes a person cheerful and gives pleasant warmth.’ The appreciation for this plant ran throughout the monastic medicine of the Middle Ages.” – From: Hildegard of Bingen, Physica (12th century), preserved in the writings of the Benedictine Abbey.

In monastic medicine, which was strongly based on Hildegard’s legacy, the condition of a pregnant woman with water retention was accompanied by gentle, warming herbs. Cooling, strongly diuretic, or bitter-aggressive plants were considered unsuitable. Instead, herbs traditionally known as compatible and balancing were used. Nettle, fennel, and parsley root – in moderate amounts – appear in historical records as typical companions for women in the second half of pregnancy. Monastic medicine always emphasized the principle of gentleness: nothing should be forced, everything should be supported carefully.

What particularly distinguishes Hildegard and the herbal tradition that followed her is the principle of individual constitution. Not every plant suits every woman. Hildegard distinguished between fiery, phlegmatic, and melancholic temperaments – and accordingly recommended different herbal approaches. This constitution-based thinking is very much alive today in naturopathy and is also found in modern holistic therapy concepts. BitterKraft Original

Traditional herbs in focus: What is historically known as supportive

Not all herbs known for natural diuretic effects are suitable during pregnancy. Some traditionally highly valued plants – such as lovage, juniper berries, or highly concentrated parsley extracts – are avoided during pregnancy for good reason, as they have historically been associated with labor-inducing or uterus-stimulating properties. It is all the more important to look closely at which herbs tradition has classified as compatible.

What lies behind the traditional herbs?

Monastic medicine distinguished between “driving” herbs (strong, fast, not always compatible) and “supportive” herbs (gentle, balancing, long-term). For pregnant women, almost exclusively the latter were recommended. Warmth, gentleness, and the absence of aggressive active substances were central selection criteria. Hildegard herself repeatedly emphasized in her writings that restraint with strongly acting remedies is advisable during pregnancy.

These herbs are traditionally known as supportive for pregnant women:

• Nettle (Urtica dioica): Valued for centuries in European folk medicine, nettle is traditionally described as a mineral-rich herb. In monastic medicine, it was considered balancing and used as tea or in food – in normal amounts as part of the daily diet.
• Fennel (Foeniculum vulgare): Explicitly positively mentioned by Hildegard of Bingen, fennel is regarded in traditional medicine as a warming, gentle herb. As tea in usual amounts, it has long been part of European pregnancy support.
• Birch leaves (Betula pendula): Traditionally used for generations in Northern European folk medicine, birch leaves are considered a gentle supportive herb. Birch leaf tea is historically known in many cultures as an everyday beverage.
• Dandelion (Taraxacum officinale): Known in European herbal medicine since the Middle Ages, dandelion – leaves and root – was traditionally valued as part of spring and herbal cuisine. As salad or mild tea, it has a long history in folk medicine.
• Horsetail (Equisetum arvense): Known in monastic medicine as a mineral-rich herb, horsetail was traditionally appreciated for its balancing properties. However, its use during pregnancy should always be in consultation with a specialist.

Principle of traditional healing: During pregnancy, the rule “as little as necessary, as gentle as possible” applies – no herb or plant should be used without consulting a midwife or a naturopathically trained professional.

An important aspect that traditional healing always emphasized: the method of preparation makes the difference. A mild tea from birch leaves is something completely different from a highly concentrated extract. Folk medicine knew teas, porridges, baths, and compresses – each form of administration had its own intensity and application area. Anyone considering traditional herbs during pregnancy today should always do so in close consultation with a midwife or doctor. Products for women's health

Nutrition, lifestyle rhythm, and gentle everyday measures

Traditional healing was never just herbal medicine – it was always also an art of living. Hildegard of Bingen devoted at least as much attention to nutrition as to medicinal plants in her writings. For pregnant women, she recommended a light, nutrient-rich diet with plenty of fresh vegetables, whole grains, and sufficient fluids. This may sound intuitively contradictory – drink more with water retention? But in fact, good fluid intake can help the body balance its own system. Hildegard especially recommended warm drinks and steamed vegetables, as she considered “cold foods” to be burdensome elements.

From today’s perspective, additional gentle everyday measures complement the picture usefully: elevating the legs, regular exercise such as walking or swimming, contrast showers according to Kneipp’s tradition (if medically safe), and consciously reducing very salty meals. Monastic medicine was also well aware of the salt issue – Hildegard advised moderate salt use and emphasized that excessive salt consumption “dries out and simultaneously bloats” the body, a paradox similarly described by modern nutritional medicine. The connection between sodium intake and water balance was thus intuitively known even in the Middle Ages.

“Traditional concepts like monastic medicine according to Hildegard of Bingen have emphasized for centuries the value of a balanced lifestyle with sufficient rest, exercise, and simple diet – principles that are also considered in modern holistic health concepts for pregnant women.” – Summary from the history of naturopathy, Haug Verlag, Munich.

Particularly noteworthy is the importance of lifestyle rhythm – a concept easily lost in today’s hectic pace. Hildegard spoke of the “discretio” virtues: the right measure in everything. Too much rest paralyzes, too much activity exhausts. For pregnant women, this meant specifically: moderate exercise, sufficient sleep, conscious recovery phases, and avoiding extreme stress. The body, according to monastic medicine, needs space to find its own order. Sleep and relaxation products This conviction is surprisingly current today, in a time of increasing research on the effects of sleep and stress regulation on fluid balance.

Limits of naturopathy: When medical evaluation is absolutely necessary

As valuable as traditional plant knowledge is – it has clear limits that must be taken especially seriously during pregnancy. Water retention is not always harmless. If swelling suddenly increases significantly, occurs unilaterally (which may indicate thrombosis), or is accompanied by headaches, visual disturbances, upper abdominal pain, or high blood pressure, these are warning signs requiring immediate medical evaluation. Preeclampsia – formerly called pregnancy poisoning – is a serious condition that cannot and must not be treated with home remedies.

No herb in the world, however traditionally healing it may be, replaces the monitoring by a midwife or gynecologist during pregnancy. Naturopathy is intended as a complement – not a substitute for medical care.

Traditional healing itself was very aware of this limit. Hildegard of Bingen and her contemporaries in the monasteries were not competitors of the physicians of their time – they complemented their work. Monastic medicine saw itself as care for everyday life, for chronic complaints, and for prevention. In acute, serious conditions during pregnancy, the experienced midwife or doctor was always consulted. This humility is a hallmark of good naturopathy – then as now.

Those interested in herbal support during pregnancy are well advised to consult a midwife with naturopathic training or an experienced naturopath. Especially with herbal teas, it applies: not everything natural is automatically safe during pregnancy. Some herbs highly valued outside pregnancy – such as sage, large amounts of rosemary, yarrow, or ginger in extract form – are not recommended for pregnant women, especially in the first trimester, by experts. Consulting a professional here is not a sign of uncertainty but of responsibility toward oneself and the unborn child. Products for women's health

Bitter herbs, liver, and the holistic view during pregnancy

An aspect often overlooked in the discussion about water retention is the importance of a well-functioning metabolism for overall fluid balance. In traditional healing – and especially with Hildegard of Bingen – the liver played a central role as the “hearth of the body.” It was considered the seat of vitality and a key organ for the quality of blood and bodily fluids. If this “hearth” is not sufficiently nourished, it was believed that sluggishness and stagnation could spread in the body – what we might today describe as a less efficient metabolism.

Bitter herbs in monastic medicine:

Hildegard of Bingen valued bitter herbs such as wormwood, gentian, and galangal as cornerstones of her healing kitchen. In monastic medicine, bitter substances were seen as invigorating for the entire organism – not in a pharmacological sense, but as stimulants for life force. For pregnant women, however, strongly bitter herbs were considered too intense; instead, milder bitter plants like dandelion or light artichoke leaves, which have been regarded as more compatible for centuries, were used.

The idea of supporting the body in its natural order – through nutrition, exercise, sleep, gentle herbs, and rituals – is the heart of Hildegard medicine. Bitter herbs hold a special place because they were traditionally seen as stimulants for the organism’s vitality. For pregnant women, this means choosing not the strongest remedies but the gentlest companions tailored to the individual condition. BitterKraft Original Liver products from Bitterkraft

Those curious about the potential of traditional herbal medicine to support pregnancy complaints are advised to be accompanied by a knowledgeable person and to use the rich heritage of monastic medicine as a source of inspiration – not as a recipe book to be blindly followed, but as a living tradition of wisdom that sees the person in their entirety. Because that was Hildegard’s deepest conviction: a person is not a problem to be solved but a being to be accompanied, nourished, and strengthened in their power. Hildegard of Bingen products