Postpartum hemorrhage (PPH) is excessive blood loss within 24 hours of delivery. The definition is > 500 mL of blood loss in a vaginal birth, > 700 mL in assisted delivery or > 1000 mL if a C-section. PPH is a leading cause of maternal mortality throughout the world and occurs in 2% of all pregnancies.
The purpose of this study was to determine if an extract of Shepherd’s Purse would affect PPH. Historically, it has been used to treat hemorrhages and heavy menstrual bleeding.
Women were in the maternity ward in Iran and were ages 20-35 with a history of less than 3 pregnancies, no C-section, had a single fetus with head first delivery, with a gestational aged between 37 and 42 weeks, with a normal duration of labor and no third or fourth degree tears with labor. A total of 100 women met the inclusion criteria and were enrolled in the study.
A Shepherd’s Purse alcohol tincture of the dry aerial parts of the plant was 
given in a dose of 10 drops following delivery (each drop contained 50 mg of the extract) and was to be held under the tongue for 1 minute. Women were randomly assigned to the treatment group or the placebo group. All women received an infusion of oxytocin and Ringer’s solution in addition to the drops of herb or placebo. Blood products of pads/drapes/ gauze was weighed. In the end, there were 50 women in each group. There was a significant difference between the two groups, in the amount of blood lost and patient satisfaction. The Shepherd’s Purse group had on average 76.9 mL of blood loss vs. 112.64 mL of blood loss in the placebo group.
Commentary: It appears the Shepherd’s Purse alcohol extraction drops were effective in reducing postpartum blood loss. A decline in heavy bleeding was also seen in a study done in 2016 in women with heavy menses. The problem with this study is that all patients did receive oxytocin as well, which reduces bleeding, and the amount of bleeding was normal in most of the women. In essence, we do not know what the results would be without oxytocin and in women who actually did have postpartum hemorrhage.
I have used Shepherd’s Purse in women with heavy menses for over 3 decades, and I do find it an important botanical for that purpose. However, the studies on ginger and heavy menses are more robust and compelling so I always use that as well.
Reference: Ghalandari S, Kariman N, Sheikhan Z, et al. Effect of hydroalcoholic extract of Capsella bursa pastoris on early postpartum hemorrhage: A clinical trial study. J Altern Complement Med 2017;23 (10): 794-799
