As Dr. Yuan says below, most cases of difficult birth end up as cesarean sections. In this case, the woman had an allergy to any type of drugs which made both Pitocin and surgery unavailable as viable options. This case and the one in the last post make me think of how much wisdom Chinese medicine carries that should not be lost. With the advent of high technology in the world of birthing, there is a risk much of this could be lost.
Kai Gu San (Open the Bones Powder) modified to treat difficult birthing by Dr. Yuan Ming-Zhong
Ms. Guan, age 29
Main Complaint: Ms. Guan’s water had broken on March 4, 1982 and so she entered the obstetric ward of the hospital. On March 5, she passed some blood which spontaneously stopping on the afternoon of March 6. She was not aware of any fetal movements. On March 8th, the obstetrician did a check up and saw that her pelvis was relatively small. The fetal heart tones were low. They wanted to do a caesarian section but Ms. Guan had an allergy to both the anesthesia and to antibiotics so she was unable to have surgery. She also had an allergy to Pitocin so a Traditional doctor was consulted.
Check up: Her complexion was yellowish, her emotional state was keyed up, she sweat from her forehead at times and her tongue was red with white moss. Her pulse was deep and slightly slippery and fast.
Diagnosis: Serious difficult labor
Treatment Method: Open the bones to hasten labor
Formula: Modified Kai Gu San
Dang Gui 30
Chuan Xiong 24
Zhi Gui Ban 30
Yi Mu Cao 30
Simmer in water two times. Divide into 2 doses and drink on an empty stomach. Her family was advised to take the utmost care in observing her, carefully recording her responses to the herbs so that necessary adjustments could be made.
On the afternoon of March 8th, at 2:00 she began the herbs. At 4:00 she began to have lower abdominal pain and the desire to move her bowels. She went to the toilet twice. In the evening at 8:00 she again took the herbs and had lower abdominal pain. Compared to the afternoon, the pain was lighter. After taking the herbs again at 2:00 a.m. on the 9th, she had stronger lower abdominal pain and the urge to move her bowels which she did 3 times. That evening after taking the herbs she had light abdominal pain. On the 10th she reacted to the herbs in the same way as before. Each time she took the herbs she had abdominal pain (Uterine Contractions) about two hours later. However, the interval between contractions was still too long and the exam showed that she was not opening. On the afternoon of the 10th she was given two doses of herbs. I decided to give her two packages in one day, which meant giving her one dose every 6 hours. After each dose there was lower abdominal labor pains for several minutes and the interval in between contractions was a half hour. This came with an urge to move her bowels and urinate. The abdominal pain became more intense and the urge to move her bowels was constant. On the 11th, after taking the herbs, the pain became stronger with a bearing down feeling. Intermittently the contractions were very strong and urgent. At 3:00 in the afternoon of the 12th the interval between contractions was still ½ an hour. By 4:00 it had become more frequent with the interval between contractions at every 1-2 minutes and by 5:00 the interval was half a minute. Each contraction was lasting 4-5 minutes. At this time the cervix was 3 fingers dilated and by 10:00 that evening, it was 10 fingers dilated. At midnight she gave birth to a baby boy.
Due to the fact that this woman’s pelvic bones were small, after the birth a 2-centimeter fracture was discovered. This affected the woman’s gait. I gave her Liu Wei Di Huang Tang with Xu Duan, Gu Sui Bu, Zi Ran Tong, Bu Gu Zhi and Mu Gua. After 9 packages of this she was cured.
Difficult birth is a serious pathology. These days, when there is a difficult birth a cesarean section is usually performed and there is very little use of Chinese herbs for this. In this case however, due to the patient’s allergy to western drugs, surgery was not an option. Instead I used modified Kai Gu San (Open the Bones Powder) and the result was good.
Kai Gu San (Open the Bones Powder) is from the Yī Zōng Jīn Jiàn (Golden Mirror of the Medical Tradition) – Essential Tricks of the Trade for Gynecology. The original formula includes Dang Gui, Chuan Xiong, Gui Ban and Fu Fa Hui (?). For this case, I removed the Fu Fa Hui and added Yi Mu Cao. Dang Gui and Chuan Xiong nourish and move the blood. In small dosages they will calm the fetus while in large doses, they will induce uterine contractions and promote birth. Yi Mu Cao is able to increase uterine contractions. Gui Ban nourishes Yin Qi so as to open the bones. When used together, these herbs are effective for opening the bones and hastening labor. The Ji Yin Gang Mu (A Compendium of Female Disorders) argues that Yin Qi deficiency is the cause of the joining bones not opening. This is why Kai Gu San uses Gui Ban. It is also said that another cause of difficult birth is small joining bones.
Chinese medicine can be effective for difficult birth. However, if the pelvic bones are small, it can be difficult for the baby to be delivered and this is also difficult to treat.