The safety of ashwagandha in pregnancy and lactation has been questioned in the popular literature and some other sources.¹⁰ These theoretical concerns appear to be based on ashwagandha’s alkaloid, specifically nicotine, content.¹¹ Alkaloids, as a family, are known for their ability to affect the central nervous system and their potential to cause toxicity. Although ashwagandha’s adaptogenic effects are attributed to its steroidal lactones, known as withanolides, it contains numerous other constituents, including an array of alkaloids such as nicotine.¹² These alkaloids are concentrated in the leaves, with only small amounts being present in the root, which is by far the most commonly used part of the plant. Alcohol extracts contain the highest amounts of alkaloids.¹³

In a study in rats, ashwagandha demonstrated no maternal or fetal toxicities, even at high doses.¹⁴ Its many historical uses include improving fertility, bringing on pregnancy, preventing miscarriage, and promoting lactation.¹⁵ Nonetheless, there are also reports of its use to induce abortion, although there is no information about the parts or doses used for this purpose.¹⁶

Given its long and broad history of use, the toxic potential of ashwagandha appears to be very low when used in typical amounts. Nevertheless, ashwagandha’s safety during pregnancy and lactation has not been rigorously studied and therefore cannot be confirmed.