Approximately 50-75% of women will experience nausea and vomiting during pregnancy. It typically starts around 6 weeks gestation and often subsides around 12 weeks at the second trimester mark. It is frequently accompanied by sensitivity to smells, food cravings and aversions, and other symptoms of indigestion.
Morning sickness is due to changes in hormone levels that influence the digestive tract. Smooth muscle relaxes at the stomach and downward motility of the intestinal muscle slows. Risk factors for morning sickness include family history, obesity, stress, multiples, and prior nausea when taking the birth control pill, many of which are linked to elevated circulating estrogen levels.
Hyperemesis gravidarum is an extreme form of morning sickness characterized by continuous nausea and vomiting. Medical intervention is necessary in order to correct hydration and electrolyte levels. Before intravenous therapy was developed for rehydration, this condition could be fatal.
The ultimate goal of treatment is to avoid dehydration and to ensure that mother and baby are obtaining adequate nutrition for growth and development. The benefits of quick and effective treatment for nausea and vomiting cannot be overstated in terms of health outcomes and quality of life during a woman’s pregnancy. Conventional medical treatment in Canada is limited to a single pharmaceutical drug, Diclectin. Diclectin is a combination of 10 mg of doxylamine and 10 mg of vitamin B6 in a delayed-release formulation. Motherisk studies have found that it does not interfere with fetal development.
From a naturopathic perspective, there are a variety of interventions that not only relieve nausea and vomiting in pregnancy, they also optimize the health status of both mother and baby.
Acupuncture is a favourite intervention for nausea and vomiting in pregnancy. It provides rapid relief, often resolving symptoms completely after 2-4 treatments. Needles are inserted gently and are kept to a minimum. There are no negative side effects and safety of acupuncture during pregnancy is well-established with the selection of appropriate points. Acupuncture as an adjunctive therapy for hyperemesis gravidarum is also a great option for women who do not respond well to Diclectin and who would benefit from rapid relief in order to ensure adequate nutritional needs during pregnancy.
To ensure safe and effective treatment, seek out a well-qualified and knowledgeable licensed practitioner including Naturopathic Doctors or Licensed Acupuncturists who use sterile, single-use, fine acupuncture needles and who are comfortable treating women during pregnancy.
Other Natural Options
Diet modifications are a first line option due to extensive health promoting benefits for mother and baby in a variety of ways. Internet wisdom will speak about small, frequent meals. Some women have dietary intolerances that are best to avoid early in pregnancy; others require more protein to stave off nausea. A Naturopathic Doctor assesses and recommends dietary modifications based on individual needs, as every woman’s pregnancy is unique.
Clinical nutrition and herbal medicine is a gentle second line option to try before moving on to harsher treatments, such as prescription drugs. Whether it is peppermint tea, ginger Gravol or a vitamin capsule, most of these are easily accessible over the counter in health food stores and pharmacies. With a few exceptions, nutrients are generally safe in pregnancy in appropriate doses. Herbs are best to avoid unless you and your health care provider are confident in their safety in pregnancy and effectiveness. That being said, there are multiple herbs that can be taken as tea safely that help to soothe feelings of nausea and indigestion.
For those suffering from the discomfort of morning sickness, whether it be a first or fifth pregnancy, natural therapies including acupuncture, nutritional counseling and herbal medicine are a gentle option worth exploring.
~First published in From Belly to Baby magazine Fall 2014