Background: Use of herbal medicine during pregnancy and labour is often associated with obstetric complications including uterine rupture and fetal distress, but little is known about its advantages. Particularly, in-depth information on the perceptions of rural women in Malawi about the use of herbal medicine during pregnancy and labour is underreported. Knoweldge of women’s views and perceptions on use of herbal medicine would help determine potential inclusion of the suitable herbal medicine in women and reproductive health services. Aims: To explore the perceptions of women on potential use of herbal medicine during pregnancy and labour in rural Malawi. Methods: We employed a crossesctional survey on study participants (women), purposively identified (parity≥2) from four villages (Kagona, Champsinja, Mthupi and Manja) of Traditional Authority Malili, in Lilongwe rural district, Malawi. Qualtitative data was collected through four Focus Groups of 6-8 women in each group that were conducted in each village. Data analysis was performed using content analysis inductive approach. Results: A total of 28 women of reproductive age 20 and above; 20-24 (32.14%), married (75%), average of 3 deliveries (57.14%), primary school education (75.0%), and Christians (92.86%) were recruited and interviewed. Two main themes emerged from the narratives: (1) herbal medicine is beneficial: (i) hastens labour, (ii) prevents pregnancy complications and illnesses, and (2) herbal medicine is risky: (i) leads to caesarean delivery, (ii) leads to ruptured uterus and death, (iv) leads to birth asphyxia, and still births. Conclusion: Perceptions among rural women on use of herbal medicine during pregnancy and labour are deep routed on cultural and personal experiences. Health education on health related dangers associated with use of herbal medicine among rural women in Malawi can help prevent associated pregnancy and labour complications and improve maternity care. Further research is warranted to explore accessibility and community pathway systems for herbal medicine use during pregnancy and labour among the pregnant women.

Background Globally, use of herbal medicine during pregnancy and labour is often associated with adverse obstetric outcomes such as uterine rupture and fetal distress. However, in rural Malawi, information on the perceptions of women about the use of herbal medicine during pregnancy and labour is underreported despite the practice. Understanding women’s views and perceptions on use of herbal medicine during pregnancy and labour is therefore critical for understanding the basis of their practice and for setting up maternal and neonatal health care interventions to alleviate any possible pregnancy and labour complications. Aims To explore the perceptions of women on the use of herbal medicine during pregnancy and labour in rural Malawi. Methods We employed a qualitative descriptive (QD) study on the purposively identified participants (women with parity $$\ge 2$$ ≥ 2 ), residing in four villages (Kagona, Champsinja, Mthupi and Manja) of Traditional Authority Malili, in Lilongwe rural district, Malawi. Qualitative data was collected through four Focus Groups of 6–8 women in each group that were conducted in each village. Data analysis was performed inductively, using reflexive thematic analysis approach. Results A total of 28 women of reproductive age 20 and above; 20–24 (32.14%), married (75%), average of 3 deliveries (57.14%), primary school education (75.0%), and Christians (92.86%) were recruited and interviewed. Two main themes emerged from the narratives: (1) perceived benefits of using herbal medicine: (i) hastens labour, (ii) prevents pregnancy complications and (iii) prevents and treats illnesses, and (2) perceived risks of using herbal medicine: (i) perceived maternal risks, (ii) perceived fetal risks. Conclusion In rural Malawi, the practice of using herbal medicine during pregnancy and labour is perceived as both risky and beneficial to women. These perceptions are shaped by the exposure to either personal or other people’s experiences, hence the continued practice. Therefore, inclusion of health education topics on maternal complications due to use of herbal medicine among women can help reduce maternal and neonatal mortality rates in rural Malawi. Further research is also warranted to explore accessibility and community pathway systems for herbal medicine use during pregnancy and labour among the pregnant women.