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Birth: Preventing hemorrhage

Herbs can enhance the birth experience, and can help keep a home birth at home by reducing the likelihood that medical intervention will be needed.

When I gave birth to my daughter at home, I had a supply of motherwort to make a tea from after the baby was born, to reduce the likelihood of hemorrhage.  I also had a tincture made from fresh shepherd's purse, to be used only in case of emergency; the herb has a reputation for stopping uterine bleeding as effectively as the synthetic oxytocin used by the medical professions.  And I had some black haw, which I used to soothe my afterpains.

None of these herbs have been tested in a laboratory or clinical setting.  In using them, I chose to trust that they had been used by birthing women for centuries because they are safe and effective.

Here is a short literature review on shepherd's purse for preventing postpartum hemorrhage.  This review was included in Midwifery Today's e-news  in February, 2001. 


Shepherd’s Purse (Capsella bursa-pastoris)

Rachel Emma Westfall, copyright 2001.

Shepherd’s purse is a small, herbaceous, annual or biennial plant, native to Europe.  It is in the family Brassicaceae (USDA, NRCS, 1999).

 Shepherd’s purse is common in disturbed soils throughout the temperate world, and is cultivated as food and medicine in many regions (Blumenthal et al., 2000).  The whole young plant is a delicious pot herb or salad green, and is a good source of calcium (Weed, 1986).

 Shepherd’s purse has been used medicinally since the Middle Ages (Phillips and Foy, 1990).  It is valued for its ability to stop bleeding.  The Eclectic publication “King’s American Dispensatory” refers to the plant’s applications for chronic hemorrhages and menorrhagia (Felter and Lloyd, 1992).  It is particularly useful for childbirth hemorrhage and excessive menstruation because it stimulates uterine contractions as well as promoting vasoconstriction of the capillaries, stimulating prothrombin production, and tightening tissue structure (Newell et al., 1996).  It is also valuable for treating varicose veins (Bartram, 1998) and bleeding hemorrhoids (Belew, 1999).  It was used in the First World War to stem hemorrhage when nothing else was available (Blumenthal et al., 2000).  The British Herbal Pharmacopoeia (1996) attributes shepherd’s purse with the ability to stimulate smooth muscle and treat hemorrhage.

 The active constituents of shepherd’s purse include diosmin, the flavonoid rutin, oxalic acid, and tannic acid (Duke, 1992a).   According to Duke (2000), the organic acids and rutin are hemostatic, and diosmin has been attributed with capillary strengthening and antimetorrhagic properties.

 Though shepherd’s purse has a long history of use in treating postpartum hemorrhage and excessive menstrual bleeding, clinical studies have not been conducted (Blumenthal et al., 2000).   Because of its purported ability to cause uterine contraction, it is contraindicated in pregnancy and labour, and is used only after the placenta is delivered (Belew, 1999; Campion, 1996).  Excessive doses can cause heart palpitations (McGuffin et al., 1997).  There are no other known contraindications, and frequent dosing is believed to be safe (Belew, 1999).

 Shepherd’s purse is a popular herb in contemporary midwifery.   When discussing postpartum hemorrhage, the authors of some articles prescribe shepherd’s purse and Pitocin (oxytocin) interchangeably (McLean, 1998; Toepke, 1998).  Apparently, it is a matter of personal preference on the part of the midwife.  Goldstein (1995) notes that shepherd’s purse is gentler than Pitocin, resulting in less postpartum cramping.   Pitocin is not hemostatic; it stems postpartum bleeding by encouraging the uterus to clamp down.

 Most herbalists recommend a tea or tincture made from the whole fresh plants, including the flowers and seeds.  The tincture loses its potency after a year or two (Belew, 1999).  A typical dose is two drops of tincture under the tongue or one dropperful (about 1 mL) in 30 mL of water as needed (Goldstein, 1995).  Its action is very quick; Susun Weed (1986) reports that a dropperful of tincture under the tongue can stop postpartum hemorrhage in five to thirty seconds.

References

Bartram T.  Bartram’s Encyclopedia of Herbal Medicine.UK: Robinson, 1998.

Belew C.  “Herbs and the childbearing woman.”  Journal of Nurse Midwifery 1999; 44:231-252.

Blumenthal M, Goldberg A, Brinckmann J, editors.  Herbal Medicine- Expanded Commission E Monographs.   Texas: American Botanical Council, 2000.

British Herbal Pharmacopoeia.  British Herbal Medicine Association, 1996.

Campion K.  Holistic Herbal for Mother and Baby.  London: Bloomsbury, 1996.

Duke JA. Dr. Duke’s Phytochemical and Ethnobotanical Databases (www.ars-grin.gov/cgi-bin/duke/).   Agricultural Research Service: USA, 2000.

Duke JA.  Handbook of Phytochemical Constituents of GRAS Herbs and Other Economic Plants.  Florida: CRC Press, 1992a.

Felter HW, Lloyd JU.  King’s American Dispensatory, 1898 version.  Oregon: Eclectic Medical Publications, 1992.

Goldstein L.  “Remedies… to file for future reference.”  Birthkit, Dec 1, 1995.

McGuffin M, Hobbs C, Upton R, Goldberg A.  Botanical Safety Handbook.  Boca Raton: CRC Press, 1997.

McLean MT.  “Hemorrhage during pregnancy and childbirth.”  Midwifery Today 1998; December 1.

Newell CA, Anderson LA, Phillipson JD.  Herbal Medicines; A Guide for Health Care Professionals.   London: Pharmaceutical Press, 1996.)

Phillips R, Foy N.  The Random House Book of Herbs.  New York: Random House, 1990.

Toepke McLean, M.   “Hemorrhage during pregnancy and childbirth.”  Midwifery Today 1998; December 1.

USDA, NRCS.  The PLANTS Database (http://plants.usda.gov/plants).   National Plant Data Center: Baton Rouge, 1999.

Weed S.  Wise Woman Herbal for the Childbearing Year.  New York: Ash Tree Publishing, 1986.

 

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