Miscarriage: Case History

This case history illustrates the versatility of herbs for treating miscarriage-related problems. The patient initially presented with a missed abortion, which she went on to complete with herbal support, and then she desired to maintain pregnancy after a history of several miscarriages.

Initial Appointment

Jan is a 30-year-old woman in dire emotional distress having been informed that day by her nurse-midwife that her 10-week-old fetus had died and that her pregnancy was no longer viable. The CNM and obstetrician told her it appeared that the baby had been dead for about 3 weeks, and recommended dilatation and curettage (D&C). Jan was concerned about the procedure, as this was her third miscarriage and she was afraid that the dilatation and curettages might contribute to uterine scarring and cause problems in a future pregnancy, and she desperately wanted to have another child. Jan requested assistance in completing the miscarriage herbally and wanted help, should she become pregnant again, to prevent miscarriage.

Past Medical History

Jan had twins 4 years ago after an uneventful pregnancy, and has been unable to carry a pregnancy to completion since, having had 3 miscarriages. In the year after the birth of the twins, Jan gained 30 pounds (height is 5’8″ and current weight 210 pounds) and had a serious bout of depression for which she took antidepressants for about 1 year, and then discontinued. After a year of not understanding what was wrong with her, she went to an endo-crinologist and was diagnosed with hypothyroidism, for which she was taking Synthroid. Her thyroid condition is well managed and her thyroid tests are normal. Though she has not been experiencing chronic depression, the miscarriages get her really down.

Treatment Protocol: Missed Abortion

The goal is to stimulate uterine contractions and promote the expulsion of the fetus from the uterus. Jan’s cervix was closed and firm at the initial appointment. We discussed giving the protocol a strict time limit of 5 days, after which she agreed to have a dilatation and curettage if the protocol was not effective. Her CNM and obstetrician agreed to support her in this choice.

1. To initiate cervical ripening, Oenothera biennis, in the form of evening primrose oil (evening primrose oil), was given orally as follows: two 500 mg capsules, twice daily, for a total of 2000 mg per day, for 2 days. Also, Jan was instructed to digitally apply 1500 mg evening primrose oil to the cervix. (The woman can do this herself, her partner can do it, or she can go to a midwife for the treatment; although the efficacy of this practice has not been demonstrated by clinical trials.

2. After 24 hours of evening primrose oil as above, Jan began taking an oral administration of the following tincture:

Cotton root bark (Gossypium herbaceum) 40 mL
Black cohosh (Actaea racemosa) 40 mL
Blue cohosh (Caulophyllum thalictroides) 20 mL

Total: 100 mL

Instructions: Beginning in the morning, take 2.5 mL every hour for 4 hours, and then discontinue. She was instructed that if no contractions commenced, she was to repeat the next day as for day 1. If no contractions ensue on day 2, discontinue on the third day, and resume for two more days on days 4 and 5.

3. The client was instructed to keep on hand Angelica archangelica, Hamamelis virginiania, and he-mostatic herbs should bleeding be heavy, and was given strict instructions on when to seek medical care. Contractions began after the first 24 hours of the herbal protocol, and she continued the herbs until miscarriage seemed inevitable. She miscarried within the next 24 hours and was pleased with the results, and relieved to be through this part of her ordeal.

Treatment Protocol: Miscarriage Prevention

Eight months later the client, who has a history of progesterone insufficiency, as well as depression and irritability, became pregnant again. At this point she was placed on the following herbal protocol to prevent miscarriage: Tinctures of:

Chaste berry (Vitex agnus castus) 60 mL
Cramp bark (Viburnum opulus) 30 mL
Wild yam (Dioscorea villosa) 20 mL

Total: 100 mL

Dose: 5 mL three times / day Jan continued this protocol throughout the first trimester of her pregnancy. Late in her pregnancy, she sent a note saying, “I have had a great pregnancy so far.” The client carried this pregnancy to term and gave birth to a healthy baby boy.