Introduction: Use of herbal medicine by pregnant women is reported globally. There is limited data on reasons for use and safety of herbal medicines used during pregnancy. This study aimed at finding the prevalence, factors associated with, and reasons for use of herbal medicine by pregnant women in an urban tertiary hospital in Uganda, Mulago Hospital Methods: In this cross-sectional survey, 520 postpartum women participated. Data on demographic characteristics, self-reported use/non-use of herbal medicine in the just ended pregnancy, and reasons for the use of herbal medicine were collected in an interviewer-administered questionnaire. Using modified Poisson regression model, factors associated with use of herbal medicine in pregnancy were determined Results: Prevalence of herbal medicine use in pregnancy was 69.8 %( 363/520). Herbal medicine was used for reasons like gaining energy, widening the pelvis to prevent caesarean section, and easing delivery. Women who strongly agreed that herbal medicine is safe in pregnancy (PR=1.1 95%CI=1.01.00-1.21); women of low parity (PR=1.22, 95%CI=1.08-1.39); women advised by family members (PR=1.64, 95%CI=1.04-2.59); and those who used herbal medicine in past pregnancies (PR=3.23, 95%CI=2.23-4.67) were more likely to use herbal medicine in pregnancy Conclusions: This study indicates that herbal medicine is widely used during pregnancy by pregnant women at Mulago National Referral Hospital. The medicine is used mainly to gain energy, ease delivery, and prevent caesarean sections. Further research is to understand women’s perception of the delivery modes offered at Mulago hospital is recommended

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