Threatened or recurrent miscarriage and Chinese medicine

Chinese medicine has a very long history of treating threatened or recurrent miscarriage. For centuries and dating back to the last millennia, they have been using certain formulas based on the constitution of the patient to prevent pregnancy loss. With modern development and research, as well as empirical observation in gynaecology departments of Chinese medicine, the treatment of miscarriage has reached an incredible sophistication.

There are certainly many causes for recurrent miscarriage, including mechanical and genetic reasons. For instance, some women have a uterine septum that may be preventing the proper development and enlargement of the placenta. This is sometimes a common and missed diagnosis by their gynaecologist, as not all ultrasounds can detect this abnormality. Other times, there are genetic issues with the developing embryo, and women are generally told that this is the most likely cause. However, all possibilities should be investigated where there are repeated miscarriages. We must also remember that an association to a particular factor does not establish causality. For instance, there is also strong evidence showing that a lack of immunological tolerance can also be correlated with failed implantations or miscarriage. This area however may be overshadowed by more readily investigated hormonal causes.

In otherwise normal pregnancies, where there is bleeding or pressure in the lower abdomen either early in pregnancy or later in term, modern medical practice can sometimes do very little but to monitor and recommend bed rest. As far as bed rest goes, I find that most women are given a passive advice when this is a crucial issue and could determine the pregnancy outcome.

Chinese medicine can be very effective in holding the pregnancy. This could be either earlier on where the hormone levels are too low, or the constitution of the patient is too weak. Or it could be later on in pregnancy, where there is bleeding and a concern for pre-term birth.

Even when I treat women for fertility issues, I often use a combination of herbs during the premenstrual phase that are aimed to benefit fertilization. Interestingly, some of these herbs are used for threatened miscarriage as well. This is because many of these herbs are aimed at strengthening the constitutional vigour and hormonal pattern. In TCM terms they are herbs that nourish the essence, calm the foetus and benefit the conception and penetrating vessel. Some are for tonifying “kidney yang” and “qi” to hold the pregnancy, and some have immune modulating function. In that effect, I gear the treatments with the following aims:
1. Strengthen the body and reproductive function to improve fertility.
2. Promote implantation and benefit pregnancy
3. Maintain the pregnancy and the health of mother and child

If there are genetic abnormalities with the foetus that are causing the body to reject the pregnancy then the herbs will not prevent the miscarriage. The herbs are to normalize imbalances and strengthen constitution that can lead to miscarriage if left untreated.

Although I use acupuncture in my treatments for threatened or recurrent miscarriage, it is only an adjunct to herbal medicine. There is sufficient evidence to demonstrate the benefits of acupuncture. However, herbal medicine is the standard of treatment. I find that acupuncture can have positive results, but ideally we want to use everything at our disposal to treat such a serious condition.

In a treatment, generally acupuncture is administered first. And while you are resting comfortably in the treatment room, an herbal formula is prepared for you to take home.

Written by Sarkis Makarians