Miscarriage

**Definition:**
Loss of the products of conception before the fetus is viable.

**Etiology:**
Physicians generally define spontaneous abortion as before the 20th week of pregnancy, or of a fetus with a weight of less than 500 gm; definitions do vary, however. It is estimated that between 10-15% of pregnant women will spontaneously abort their fetus: many times the fetus is grossly deformed, absent, or has genetic abnormalities that make it incompatible with life. Therefore, it is theorized that a spontaneous abortion may be a natural selection process for rejecting those fetuses that are biologically unfit for life. Most spontaneous abortions occur within the first trimester; these are often due to fetal maldevelopment. Spontaneous abortions in the second trimester seem to be due more to maternal factors such as: incompetent cervix; congenital or acquired abnormalities of the uterine cavity; hypothyroidism; DM; chronic nephritis; acute infection; trauma to the pelvic region; or severe emotional shock. Early abortions are those that occur before 12 weeks. Late abortions are those that occur from the 12-20th week. Spontaneous abortions may be threatened (bleeding and/or cramping in the uterus within the first 20 weeks of pregnancy), inevitable (intolerable pain or bleeding that is threatening the mother's well-being); incomplete (only part of the conception is passed) or complete (all products of conception have passed, the uterus is normal sized, and the cervix is closed). A habitual aborter is a woman who has had 3 or more consecutive spontaneous abortions.

**Nutrition:**
therapeutic foods: • increase foods rich in organic sources of Sodium • increase foods rich in Iron, Vitamin C and Vitamin E • chicken, chicken egg yolk • increase foods that nourish Xue (Blood) and tonify the Spleen and Stomach; bland foods; foods that tonify the Kidney specific remedies: » threatened miscarriage: take 30 g of raisins and 15 g of red dates, add water, steam and serve (Yin-fang and Cheng-jun, p. 88)

avoid: • hot sauces, spicy foods, fried foods, fatty foods, rich foods, salty foods, coffee, caffeine, sweet foods and sugar, alcohol, cow's milk and other dairy products, white bread, refined foods, processed foods, catarrh-forming foods: tofu, meat, ice cream, cold foods

**Botanicals**
• Chamaelirium luteum (Helonias): reproductive tonic, stimulates depressed uterine and ovarian function; prevents threatened abortion and is best begun before conception and continued through the 1st trimester in those with a history of miscarriage. Specifically indicated for sense of fullness and distension in the uterus (Priest and Priest, pp. 104-105; Weed, p. 27; Felter, p. 404; Mitchell, p. 78) • Dioscorea villosa: contains phytosterols to maintain a pregnancy when a woman's hormones are inadequate. 2-4 oz. of decocted root every 30 min. useful when a crisis threatens, effect noted with several doses (Weed, pp. 27-28) • Lobelia inflata (toxic): powerful anti-spasmodic for muscular rigidity and uterine contractions; a dose of 60 drops can relax the uterus (Felter, pp. 455, 460) • Mitchella repens: diminishes nervous irritation and helps prevent miscarriage in those with previous history (Felter, p. 480) • Viburnum opulus: for expulsive, spastic uterine pains radiating to back and thighs (Felter, p. 694) • Viburnum prunifolium: for uterine debility, spasms, threatened abortion; sedates uterus and halts contractions (Felter, pp. 694-699; Weed, pp. 27, 150; Priest and Priest, pp. 106-107)

**Chinese Formulae**
» aftermath of miscarriage: • Tang Kuei and Evodia (Wen Jing Tang) plus blue citrus (qing pi) and cyperus (xiang fu): persistent bleeding after miscarriage: take daily during menstrual flow only (Hsu, 1980, p. 588; Yeung, p. 242; Dharmananda, 1986, p. 323; Bensky and Barolet, p. 324) » threatened miscarriage: • Gelatin and Artemesia Four C.; Tang Kuei and Gelatin C. (Jiao Ai Tang) plus dried ginger (gan jiang); An Tai Wan (patent): Chong Mo Cold and Xu (Deficiency) with break-through bleeding: prevents miscarriage or premature delivery by arresting uterine bleeding ; minus cnidium (chuan xiong) plus white atractylodes (bai zhu), eucommia (du zhong) and loranthus (sang ji sheng) if low back pain. (Gelatin and Artemesia: Hsu, 1980, p. 417; Dharmananda, 1986, p. 322; Tang Kuei and Gelatin: Hsu, 1980, p. 576; Yeung, p. 137; Bensky and Barolet, p. 345; An Tai Wan: Zhu, p. 281) • Shih San Tai Pao Wan (patent): during first trimester for fatigue, anemia, nausea and threatened miscarriage (Fratkin, p. 219) • Tang Kuei Four C. (Si Wu Tang) plus artemisia (ai ye) and gelatin (e jiao): Liver Xue Xu (Blood Deficiency): dizziness, blurred vision, lusterless complexion, generalized muscle tension, periumbilical and lower abdominal pain (Hsu, 1980, p. 433; Yeung, p. 220; Dharmananda, 1986, p. 106; Bensky and Barolet, p. 248) • Ba Zhen Yi Mu Wan: Qi Xu (Deficiency) with Xue Xu (Blood Deficiency) with Xue Yu (Blood Stasis): reduced appetite, weak extremities, soreness in the lower back, abdominal distention, restless fetus syndrome (threatened miscarriage) (Bensky and Barolet, p. 260) • Tai Shan Pan Shi San: Spleen Qi Xu (Deficiency) with Xue Xu (Blood Deficiency): for women with history of miscarriage who wish to become pregnant: take once a week from the second to the fourth or fifth month of pregnancy; pale face, fatigue, loss of appetite, pale tongue (Yeung, p. 227; Bensky and Barolet, p. 261) • Bao Tai Zi Sheng Wan: Spleen Qi Xu (Deficiency): reduced appetite, diarrhea, weakness, weight loss, threatened miscarriage (Bensky and Barolet, p. 241) • Tang Kuei and Peony C. (Dang Gui Shao Yao San) plus cardamon (sha ren), eucommia (du zhong), dipsacus (xu duan), artemesia (ai ye) and scute (huang qin): Liver Invading Spleen with Xue Xu (Blood Deficiency): history of previous miscarriage or difficulty conceiving, continuous cramping pain in abdomen that is not severe, slight edema of the lower limbs (Flaws, 1983, p. 34, Hsu, 1980, p. 585; Yeung, p. 77; Dharmananda, 1986, p. 177; Bensky and Barolet, p. 251) » habitual miscarriage: • Tai Shan Pan Shi San: Spleen Qi Xu (Deficiency) with Xue Xu (Blood Deficiency): for women with history of miscarriage who wish to become pregnant: take once a week from the second to the fourth or fifth month of pregnancy; pale face, fatigue, loss of appetite, pale tongue (Yeung, p. 227; Bensky and Barolet, p. 261) • Ginseng and Astragalus C. (Bu Zhong Yi Qi Wan) (available as patent) plus eucommia (du zhong) and cuscuta (tu si zi): Spleen Qi Xu (Deficiency) with Spleen Qi Sinking: recurrent miscarriage, loose stools, weak limbs, shiny pale complexion (Ginseng: Hsu, 1980, p. 255; Yeung, p. 51; Dharmananda, 1986, p. 186; Bensky and Barolet, p. 241; patent: Zhu, p. 270; Fratkin, p. 171) • Tang Kuei and Peony C. (Dang Gui Shao Yao San) plus cardamon (sha ren), eucommia (du zhong), dipsacus (xu duan), artemesia (ai ye) and scute (huang qin): Liver Invading Spleen with Xue Xu (Blood Deficiency): history of previous miscarriage or difficulty conceiving, continuous cramping pain in abdomen that is not severe, slight edema of the lower limbs (Flaws, 1983, p. 34, Hsu, 1980, p. 585; Yeung, p. 77; Dharmananda, 1986, p. 177; Bensky and Barolet, p. 251)

**Acupuncture**
after assessing the person and palpating, consider these patterns: Xue Xu (Blood Deficiency); Heat in the Xue (Blood); Qi Xu (Deficiency); Kidney Qi Xu (Deficiency); Liver Qi Stagnation; traumatic injury or accident; Xue Yu (Blood Stasis); dysfunction of the Ren Mai (Conception Vessel) and/or Chong Mai (Penetrating Vessel) » therapeutic notes: • treatment with acupuncture is not an adequate substitute for emergency medical intervention in the event that complications appear likely • if you are unsure about contraindications, check the list of "forbidden and caution points" in the materia medica regarding appropriateness during pregnancy • therapeutic intention, point selection and technique will vary considerably if the fetus is considerable viable or if the primary goal has become expelling the fetus to save the mother from complications; if the pregnancy is no longer viable, see also "retained placenta" under "labor pains" for points that will assist in expelling a non-viable fetus » illustrative combinations: • St-25 and Sp-6 (D): "sometimes used to treat threatened abortion" (Liu, p. 398) • UB-15 and UB-18 (-): reduce Heat in the Xue (Blood) • UB-20, CV-3 and Sp-9 (-): resolve Damp-Heat in the Lower Warmer and Xue (Blood) • UB-23 and UB-28 (+): benefit Kidney • GV-4, CV-4, and St-36 (+ and D): tonify Kidney Yang and Qi; nourish the weak • Lu-7 and Kd-6 open and regulate the Ren Mai (Conception Vessel) which nurtures the fetus and nourishes the Uterus • Sp-6, UB-23 and Kd-3 (+): reinforce Kidney and nourish Yin (Finkelstein, p. 27; Flaws, 1989, p. 88) • Kd-5 and Kd-7: stabilize and consolidate Kidney Qi (Finkelstein, p. 53) • Kd-5, CV-4 and Kd-7: consolidate Kidney Qi (Finkelstein, p. 53)

**Homeopathy**
• Aconitum napellus: due to dreadful dreams such as sight of robbers, fire, drowning; use 200C • Apis mellifica: premature labor, esp. with eclampsia; stinging pains in ovaries • Arnica montana: due to a false step or carrying heavy weight or other physical overexertion, shocks, falls, bruises, concussions; may be pain with or without flow or flow with or without pain • Camphora: leukorrhea, colds in chest or head or catarrhal discharges • Caulophyllum thalictroides: habitual abortion from uterine debility • Ipecacuanha: acute bleeding with continuous flow of bright red blood, colic, cutting pain in abdomen; violent pressure on uterus • Gelsemium: due to mental excitement; pain extends from abdomen upwards to back • Opium: from a severe, sudden fright • Kali carbonicum: at 2-3 months; sharp pelvic pain extending into thighs, back aches as if broken • Pulsatilla: timid, chilly, thirstless, flow intermittent • Sabina: habitual every second/third month; discharge of dark blood; pain in small of back and genitals. • Sepia: 5th-7th month; feeble, delicate patient; leukorrhea and constipation • Viburnum prunifolium: esp. in 8th month

**Subtle Support**
• notes: A, A#, B, C, C#, D, E, F, G, G# • chords: A minor, C minor, D minor, D# minor, tonic (Gimbel, p. 116)

**Mind/Body**
Found to be associated with the following: » history of patient's mother having serious illness or major emotional problem during or immediately after pregnancy with patient » starting life as an unwanted infant » history of serious childhood illness » death of parent or parental divorce before patient was 10 years old » parental concern if menstruation was delayed past 15 years old; can make child feel abnormal » history of abdominal surgery » history of sexual molestation » unconscious guilt from past TAB, SAB, stillbirth, or delivery of abnormal child » unconscious hostility toward husband or husband's family » history of severe menstrual cramps (Rossi and Creek, p. 309) • Fear; fear of the future; inappropriate timing; not now - later. (Hay, 1984, p. 175) • Kidney ~ Shen stores Jing (Essence) and governs birth, growth, reproduction, development, and aging; houses the Zhi (Will); expresses ambition and focus; provides the "Fire of Life" through its Yang functions; provides the nourishing and stabilizing qualities of Yin and Water that balance the Yang and the Fiery qualities; manifests through the reproductive function, particularly the internal aspects of the reproductive organs, and governs the process of passing on life to offspring; and displays the effects of overwork, aging, chronic debilitation, and extreme stress. » Healthy expressions are gentleness, groundedness, and endurance. » Kidney Xu (Deficiency) signs include indecisiveness; confused speech; dreams of trees submerged under water; cold feet and legs; abundant sweating (Seem, p. 28); fearfulness; apathy; chronic fatigue; discouragement; scatteredness; lack of will; negativity; impatience; difficult inhalation; low sex drive; lumbago; sciatica; and musculoskeletal irritation and inflammation, especially when worse from touch. » Intense or prolonged fear depletes the Kidney. Often chronic anxiety may induce Xu (Deficiency) and then Fire within the Kidney. (Maciocia, p. 250) Overwork, parenting, simple aging, and a sedentary or excessively indulgent lifestyle all contribute significantly to Kidney Xu (Deficiency). • Liver ~ Gan is the home of the Hun (Ethereal Soul); it relates to decisiveness, control, and the principle of emergence; stores and cleanses the Xue (Blood); maintains smooth flow of Qi and Xue (Blood); controls the muscles, ligaments, and tendons, especially the contractility of the muscles and moistening of the sinews; has an intimate relationship with the Lower Warmer; and reflects emotional harmony and movement. » Healthy expressions are kindness, spontaneity, and ease of movement. » Liver Xu (Deficiency) signs include frigidity; pain in thighs, pelvic region, and throat; ready tendency to "the blahs" (Seem, p. 28); timidity; depression; irritability; vertigo; pruritus; dry eyes, skin, and/or tendons; asthma; aching at the waist; hernia; and difficulty raising head up and down. Liver Xue Xu (Blood Deficiency) predisposes to Xue Yu (Blood Stasis) and Xue (Blood) Heat. » Liver Qi Stagnation reflects and accentuates emotional constraint as the Liver's function of facilitating smooth flow in the body is constricted. Stagnation is associated with frustration, irritability, tension, and feeling stuck. With time this pattern tends to produce a gloomy emotional state of constant resentment, repressed anger or depression, along with tightness in the chest, frequent sighing, abdominal tension or distension, and/or a feeling of a lump in the throat with difficulty in swallowing. (Maciocia, p. 216) Xue Yu (Blood Stasis) often begins with Qi Stagnation. • Spleen ~ Pi governs digestion and manifests in the muscle tissues; transforms food into Qi and Xue (Blood); governs the Xue (Blood); maintains upbearing; and relates to the ability to assimilate, stabilize, and feel centered and balanced. » Healthy expressions are fairness, openness, deep thinking, and reminiscence. » Spleen Xu (Deficiency) signs include slightness (deficient "form"); abundant elimination; morning fatigue; cold, wet feet (Seem, p. 28); abdomen taut and distended like a drum; craving for sweets; flatulence; nausea; mild edema; memory failure; heavy feeling in legs; pale lips; loose stools; and muscular weakness. » The excessive use of the mind in thinking, studying, concentrating, and memorizing over a long period of time tends to weaken the Spleen and may lead to Xue Yu (Blood Stasis). This also includes excessive pensiveness and constant brooding. (Maciocia, p. 241) Likewise, inadequate physical exercise and excess consumption of sweet and Cold foods will also deplete the Spleen. Environmentally, the Spleen is highly susceptible to attack from external Dampness and Cold.
 * Chinese psychophysiology: **

**Integrative Therapies**
The causes for miscarriage vary. They are related to the condition of the uterus, the mother's state of health, and the fetus's condition. Some miscarriages are a natural result of an abnormally developed fetus.

The first step in preventing miscarriages is to optimize the health of the mother.

THE PROPER DIET WILL INCLUDE: 1. A diet rich in vegetables, fruits, proteins, and whole grains. The protein needs during pregnancy are very high, so be sure to include chicken, fish, and soy products in the diet on a daily basis. 2. Avoid artificial colors, flavors, and preservatives commonly found in processed foods, as these are known to be associated with a higher rate of miscarriages. If you need more information on an appropriate diet, refer to the article entitled "Pregnancy".

THE FOLLOWING SUPPLEMENTS CAN BE TAKEN : 1. Calcium – 1,000 milligrams a day. 2. Magnesium – 500 milligrams a day. 3. A multivitamin specific for pregnancy – Follow the manufacturer's directions, but be sure it is a brand that contains no sugar or artificial ingredients.

NOW, ABOUT THE HERBS USED TO HELP PREVENT MISCARRIAGE: Traditionally these herbs have been used for conditioning the uterus and preventing contractions during early pregnancy. 1. Raspberry Leaf Tea – This can be used throughout the pregnancy. Put 1 tablespoon of the leaves in 1 cup of boiling water. Steep for 15 minutes. Drink 2 to 3 cups a day. 2. A mixture of the following herbs can be used in capsule form or as a tincture, which is a liquid herbal extract. Mix equal parts of the following: Angelica, Cramp Bark, Blazing Star, Black Cohosh, and Squaw Vine. Take 2 capsules 2 times a day or 1 teaspoon of the tincture 3 times a day. If used as a tincture, pour a small amount of boiling water over the mixture to boil off the alcohol.

HOMEOPATHY: From the following homeopathic medicines, choose the one that best matches your symptoms. Dissolve 3 pellets under the tongue. • Sabina 12C: For pain in the pubic area and a tendency to miscarriage, especially in the third month. Taken 2 times a day through-out the first half of pregnancy. • Viburnum 6C: For the tendency to miscarriage with cramps. Take 3 times day for 1 month. Note: A wide range of homeopathic medicines can be helpful for women who are at risk for or have experienced a miscarriage. Consultation with a health care professional trained in homeopathic prescribing will usually be the best way to select the correct medicine.

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Recommended Minerals
-Iodine