The Naturopathic view - Miscarriage

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Judith Fiore,ND
Fall 2005

Nutrition

For many couples who have experienced a miscarriage, becoming pregnant can bring on the worry that miscarriage could happen again. For those who have endured recurrent miscarriages, pregnancy is a time of fear and trepidation, and any slight twinge can induce an emotional rollercoaster.

The best time for a woman with a history of miscarriage to see a naturopathic doctor is long before conception is attempted. It is best to have at least three months of treatment in advance of pregnancy. Depending on the case, I may suggest contraception for six months or longer. A naturopathic approach takes time, because the body needs time to heal and change. Three months is considered the minimum, since each new follicle and each new sperm has a journey of approximately three months until maturity.

The treatments that are typically considered are nutrition, homeopathy, acupuncture, physical therapies and herbal medicine. A naturopathic doctor may consider one or more of these treatments, and may also include other treatments not mentioned in this article. You may also consider seeing a practitioner who is focused in one particular area of treatment, such as a homeopath or acupuncturist. Whatever route you choose, it is important that you have a therapist who is sensitive to the issue of miscarriage and comfortable discussing the physical and emotional concerns that may arise.

A healthy diet should be made up of an abundance of fruits, vegetables, whole grains (brown rice, millet, quinoa, barley, oatmeal and whole-grain breads) and quality protein foods (chicken, lean beef, eggs, fish, legumes and beans, yogurt, cottage cheese and nuts – except peanuts). Fish should be preferably wild caught and eaten once per week on average. To ensure that you are getting your omega-3 essential fatty acids (which are important for the development of the brain, eye and spine in utero), take fish oil (liquid or capsule form) every day. I don’t recommend the 3-6-9 formulas, since we get plenty of omega-6 and omega-9 fats from our regular diet. You should also enjoy moderate amounts of monounsaturated oils such as olive and canola oils.

The foods to avoid or limit are caffeine (coffee, tea, pop – both diet and regular), white flour products, saturated fats, sugars and sweets (including all artificial sweeteners), and processed foods. Often I will ask my patients to remove all alcohol, sugar, and caffeine from the diet. Even decaffeinated beverages are discouraged. Depending on your history, I may also ask you to avoid dairy products or gluten grains, or both. There could be a number of reasons for this, but a primary concern is the health of the immune system and its possible implication in recurrent miscarriage.

In addition, I think it wise to avoid any foods that may harbour the bacteria Listeria monocytogenes. It usually has no effect on healthy people, but in pregnant women it can lead to miscarriage or stillbirth. High risk foods that often contain Listeria are cold foods such as paté, deli meats, pre-mixed salads, soft-serve ice cream, soft cheeses (Brie, ricotta, blue vein and Stilton), smoked seafood - and any leftovers kept in the fridge for more than 12 hours. Listeria can be killed by cooking; so you can eat soft cheeses or smoked salmon if cooked in a quiche or pie.

Another issue is salmonella poisoning. This can trigger miscarriage or pre-mature birth, and is usually traced to undercooked poultry and meats, and raw eggs. The foods that are made with raw eggs include hollandaise sauce, mayonnaise and Caesar salad dressing. Raw meats and seafood, such as carpaccio, sushi and sashimi should also be avoided during pregnancy.

As for supplemental nutrition, it is wise to have a good quality prenatal multi- vitamin that doesn’t contain sugar, fillers and other artificial ingredients, and has at least 1 mg (1000 mcg) of folic acid. I have yet to see a prenatal formula that doesn’t have the required amount of folic acid, and unless you have taken or are taking medications (pharmaceuticals can deplete folic acid and B vitamins), often a prenatal vitamin is sufficient. If you do need to take extra folic acid, take a supplement that has the combination of folic acid, B6 and B12. I also suggest 1000 mg per day of calcium and 500 per day of magnesium in the form of a calcium-magnesium supplement, and check to see that the daily amount of selenium is between 200 and 400 mcg. All of these supplements have been studied for their role in preventing miscarriage.

Homeopathic medicine has been part of alternative therapies for over 200 years, and is gaining in popularity here in North America. In Great Britain and Europe, homeopathy is a respected and widely used therapy. It is estimated that the majority of European homeopathic practitioners are medical doctors.

I explain homeopathy as being a mode of healing similar to acupuncture. It induces energetic shifts, and because of this energetic approach to treatment, is completely safe to use during pregnancy. (Please note: homeopathy is not herbal medicine.) Homeopathic re-medies, when carefully chosen, can help to prevent future miscarriage, and are successful in roughly 70% of threatened miscarriage cases. It is important to acknowledge that homeopathy will not prevent miscarriage if the pregnancy is not viable. In those cases, homeopathic medicine can be used to ease the woman’s discomfort and calm her. Many times, homeopathy can also help the woman to avoid a D and C (dilation and curettage).

There are a large number of homeopathic remedies that are considered by naturopathic doctors and homeopaths. It is always best to consult with an experienced practitioner before taking these remedies. In general, though, there is one homeopathic remedy, Sabina 12CH, that can be taken as a preventative once per week for the first 20 weeks of pregnancy, and also every four hours in case of a threatened miscarriage. However, keep in mind that this is a general recommendation, and may not be the best approach for everyone.

Many of us are aware of the studies showing that acupuncture combined with IVF almost doubles success rates. More recently, a study by the Reproductive Medicine and Fertility Center in Colorado Springs has shown that acupuncture improves treatment outcomes of IVF: 51% of acupuncture patients achieved pregnancy, compared to 36% without acupuncture. It also showed that the women who received acupuncture had only an 8% rate of miscarriage; the women who didn’t receive the treatment had a miscarriage rate of 20%.

Acupuncture, as part of the system of Traditional Chinese Medicine (TCM), has been used to treat a wide range of conditions for over 4,000 years. It is especially helpful for both men and women with fertility problems. At its simplest, we know that acupuncture increases blood flow to the ovaries in women. If you increase circulation to an area of the body, it has better function because it is receiving more nutrients than it normally would. By nourishing a woman’s reproductive organs, healing and balance are restored and a woman’s fertility improves.

Aside from nutrition, I consider acupuncture to be one of the most effective treatments in my practice. I encourage you to consider this type of therapy as one of the best ways for you to prevent miscarriage. Acupuncture can also be used when there is threatened miscarriage. I have seen at first hand how it can stop contractions and bleeding, and allow the pregnancy to continue. However, as with homeopathy, if the pregnancy is not viable, then the acupuncture will not prevent pregnancy loss.

Herbal medicine has existed for as long as there have been plants growing on our planet, which means it far outdoes the history of acupuncture. There are many herbs that are used to prevent miscarriage. When using herbs, it is best to take them for at least three months before attempting conception. As a precaution, it is important to stop the herbal medicines as soon as pregnancy occurs.

Unless you are seeing a naturopathic doctor or qualified herbalist, it is usually advised that you drink the herbs in the form of teas that will detoxify and tone your reproductive system. Some herbs often used in this way are False Unicorn Root, Black Cohosh, Motherwort and Red Raspberry Leaf. For all of these herbs, be sure to stop taking them once you know you are pregnant. Another note of caution: if you are beginning medical fertility treatment, it is extremely important that you stop taking all forms of herbal teas, tinctures and tablets as soon as you begin your fertility drugs. A drug-herb interactionsometimes occurs, and therefore it is always best to not mix the two.

I have included this category because physical therapies typically help improve circulation, and so, like acupuncture, can be an effective way to prevent miscarriage.

Massage and chiropractic care are excellent therapies to consider. A Registered Massage Therapist (RMT) is your best bet for quality treatment, and a Doctor of Chiropractic (DC) will provide you with safe and effective care. If you don’t yet have a therapist, ask friends and family about their RMTs and DCs, or you can check with their provincial associations. If you live in a large city, you may be able to find RMTs and DCs who are focused on women’s health, including (in some cases) prenatal care.

Two physical therapies that I regularly advise patients on are castor oil packs and hydrotherapy.

Castor oil packs involve externally (not internally) applying castor oil via a flannel pack to the abdomen, with either a hot water bottle or heating pad placed on top for warmth. The pack should remain in place for at least 30 minutes. Castor oil packs increase circulation and lymphatic activity; they have also been observed to dissolve scar tissue. However, they should be used only during the first half of the cycle, unless conception is being avoided (if so, they are safe to use during the second half of the cycle as well).

Hydrotherapy can be used at any point in the cycle. You alternate three minutes of heat with one minute of cold applied to the lower abdomen. Repeat this se-veral times, always ending with cold. This simple therapy increases circulation to the abdominal cavity.

I was speaking with one of my patients about this article. She had experienced miscarriage, but has also been through a successful pregnancy, and now has a young daughter. I asked her what she wanted to know about naturopathic medicine regarding this subject. She answered that the most important thing was to receive reassurance that there were natural therapies that could change her outlook and not be afraid, the next time she was pregnant, that there is life after miscarriage.

My patient also had thoughts about the fact that after a miscarriage, because there isn’t a body, you’re not really allowed to mourn as you need to. “There are a lot of hopes and dreams invested in this tiny bit of life the minute the pregnancy test shows positive,” she said, “but when you miscarry, it’s OK to cry for a day or two, and then you’re suddenly supposed to get back to work and carry on as if nothing had happened.” This lack of sympathy from most people seemed to upset her the most. Even her own mother told her to “take it in stride and move on.”

The loss of a pregnancy really signifies the loss of a child that a woman has held inside her womb. For women who are struggling with their fertility, this is not a little bump along the road of her life; it’s a major accident. It can take weeks, months, even years to heal. My own mother experienced the tragedy of miscarriage a total of 12 times. She never really got over it. You could hear the pain and bitterness in her voice any time it came up. When I first became pregnant, my mother did not jump for joy, instead she cautioned, “Let’s wait and see what happens,” and (an even more telling statement) “Don’t tell anyone else until you’re at least four months along.”

In this article, I hope I have encouraged you to not give up hope, to recognize that there are natural therapies that can make the difference in your dream of having a child. Live well, take courage and support from others who know what path you are taking, and I hope each day brings you the strength you need to move forward. u

About the author: Dr. Judith Fiore, ND, is a registered Naturopathic Doctor who owns and operates the Naturopathic Centre for Reproductive Health in Toronto, Ontario. Her practice is focused entirely on fertility care for individuals and couples with fertility concerns. Her office can be reached through her website, www.naturalfertility.ca, or by calling 416 231-4477.