Dissertation (MSc Midwifery)Herbal medicines are defined as plant-derived material or preparations perceived to have therapeutic benefits; they often contain raw or processed ingredients from one or more plants. Plants have been used for medicinal purposes for thousands of years. Herbal medicines are used in pregnancy although there is very little real evidence of safety. Although herbs are natural, not all herbs are safe to take during pregnancy. Some herbal products may contain agents that are contraindicated in pregnancy and labour. Kagera Region of Tanzania is widely known for its anchored traditional use of herbs. However, data on the extent of use of herbal medicines by women during pregnancy in the area remained largely unknown. Thus, this study aimed at assessing the prevalence and predictors of the use of herbal medicines during pregnancy and labor, as well as the immediate obstetric outcomes among post-delivery women in Kagera Region. An analytical cross-sectional study, involving 374 post-delivery women in two-district hospitals and one regional hospital in Kagera Region was conducted. A structured questionnaire was used through face-to-face interview to collect data on experiences of herbal medicine use as well as outcomes of their labor. Data were analyzed using SPSS, Version 26 prevalence and pattern of herbal medicine use, multivariate analysis was used to determine predictors of herbal medicine use to determine the predictors of herbal medicine use. Immediate maternal and fetal outcomes multivariate analysis was used to determine the factor associated with the use of herbal medicine. The prevalence of herbal medicines use during pregnancy and labour in Kagera Region was 85.3% and the prevalence of herbal medicine use during recent delivery was 63.9%. The significant predictors of herbal medicine use during pregnancy were Age below 20 years( AOR=9.809 at 95%CI 2.018-11.669) and Age above 35 years (AOR=25.669 at 95%CI 17.354-39.702)Married (AOR=3.99 at 95%CI 0.714-6.032) Multigravida (AOR=9.284 at 95%CI 4.021-11.039)Those with 5 children and above(AOR=9.531 at 95%CI 5.035-14.060)Those who did not use herbal in previous pregnancy(AOR=0.005 at 95%CI 0.001-0.257)Religion AOR(0.103 at 95%CI 0.081-1.035)Family (AOR=3.033 at 95%CI1.003-7.037) and those with HIV (AOR=3.343 at 95%CI 1.495-7.661).Also the predictors of herbal medicine during current labour were Age below 20 (AOR=2.135 at 95%CI 1.264-6.311)Those with no formal education(AOR=1.497 at 95%CI 0.815-3.091)Prim gravida (AOR=1.879 at 95%CI 0.738-3.320)Religion(AOR=0.014 at 95%CI 0.008-1.011) and HIV (AOR=13.997 at 95% CI 8.039-17.105)Moreover maternal outcome were PPH (AOR=1.228 at 95%CI 0.910-2.156)Rupture of uterus(AOR=1.314 at 95%CI 0.851-2.997) Also fetal outcome were stillbirth(AOR=1.817at95%CI 1.426-2.157) Cord prolapse(AOR=3.107 at 95%CI 1.103-8.747). A large majority of pregnant women in Kagera Region used herbal medicines during their previous and current pregnancy and labour. The analysis revealed that herbal medicines had a high risk of postnatal complications. Thus, health providers need to consider screening pregnant women for herb use during antenatal and delivery care and provide information about any known risks of complications from herbal medicines use.