Morning sickness is a very common disorder, occurring in 50 – 80% of all pregnant women (Smith 2002). Symptoms associated with morning sickness can range from not only nausea, vomiting, retching, but excess salivation, cravings, food aversions, intense hunger, heartburn, burping/belching, smell, pica (desire to eat something inedible), tiredness and fatigue (West 2001). Symptoms are unpleasant, but transitory and usually end by about the 4th month. In fact morning sickness is a misnomer as symptoms are by no means contained to the first part of the day. For some women symptoms can be constant and can last throughout the duration of the pregnancy.
In a few cases, the symptoms can become so all consuming that leading a normal life becomes nearly impossible. This is called Hyperemesis Gravidarum (HG). It is defined as ‘a condition of excessively severe and protracted sickness and vomiting occurring as one of the complications of pregnancy’ and occurs in approximately 3-10 pregnancies out of a thousand and can cause severe dehydration in the mother and child. 30 years ago HG was lethal and has taken the lives of such well known people as Charlotte Bronte. Today HG is a serious condition but fortunately one which is rarely fatal (Whale 2001).
The causes of morning sickness are unknown although there are a number of inconclusive theories: high levels of HCG (a hormone that is generated by the cells that eventually become the placenta), a maladaptive reaction to oestrogen, or progesterone and its inhibitory effect on the gut. Other factors that may contribute to HG include obesity, nulliparity (never having completed a pregnancy beyond miscarriage/termination), and non-smoking (Whale 2001). Betts (2003) lists fatigue and high stress levels can increase the risk of morning sickness, as can emotional factors like anxiety and fear. Some studies have looked at thyroid dysfunction, liver dysfunction and the association of Helicobacter pylori with HG (Whale 2001).
Orthodox treatment includes anti-emetics and fluid administration. Many women are reluctant to take pharmaceutical medications during pregnancy and so Traditional Chinese Medicine (TCM) can offer a real alternative to alleviate symptoms.
“Women now have an additional option to manage their morning sickness” (Smith 2002).
TCM is an entire healthcare system that has been established for over 2000 years and includes the therapies of Acupuncture, Chinese Herbal Medicine and dietary therapy. There has been a plethora of research into the effectiveness of acupuncture for treating morning sickness and the results are positive (Smith 2002, Habek 2004, Betts 2006). One of the most researched acupuncture points is Pericardium 6 - Neiguan – inner pass, which harmonises the stomach and alleviates nausea and vomiting (Deadman 1998). It is located on the inside of the forearm, about 2 inches above the wrist crease, in between the central tendons. This is one of the points that is likely to be used with morning sickness, in fact ‘sick bands’ can be worn over this point to provide constant stimulation. There are a number of different patterns in TCM that may give rise to morning sickness. In broad terms these can either be from a deficient or overburdened digestive function, an element of cold or heat within the stomach, an abundance of phlegm or emotional instability. Each patient will be individually diagnosed according to their constitution and symptoms and a personalised point prescription and, if appropriate, a herbal formula will be administered.
There are a number of home remedies that women may find helpful to alleviate symptoms although what works for one does not necessarily work for another as each woman will exhibit her own pattern. Ginger is possibly one of the best anti-emetics known (Whale 2001), perhaps due to its rich source of zinc (West 2002) or in TCM its ability to warm and settle the stomach. An indication that ginger may be useful is if warming foods are preferable and help alleviate nausea. Peppermint may also be useful as it aids digestion, breaks down fats (Whale 2001) and in TCM cools the stomach and regulates the liver. An indication that peppermint may be useful is if cooling foods are preferable and help alleviate nausea. These herbs can be taken as teas and are a good way of keeping hydrated. Even slight dehydration will make the nausea more intense. Soups are a useful way of taking on fluids. Bland flavours like potato, vegetable or chicken broths are most tolerated.
Snacks are an important way of maintaining blood sugar levels and literally help to keep the nausea anchored in the stomach. Depending on your constitution hot or cold foods and dairy products may need to be avoided. Generally sugary foods should be avoided as should fatty junk food as they only cause more congestion within the digestion. Citrus fruits and juices may cause increased nausea by aggravating the stomach. High protein snacks (nuts) before bed and a carbohydrate snack (toast, crackers) on waking may be useful. Certain foods will definitely increase the nausea and it is important that women take into account what is best for them.
Tiredness inevitably increases the feelings of nausea and so rest is imperative. Stress is another contributory factor and must be avoided as much as possible. It is important to stick to a routine of regular appropriate snacks/meals, regular bed times and enough rest.
There are a number of reassuring facts to remember when experiencing this disorder:
The vast majority of babies born to even severely hyperemetic women are completely normal and healthy.a ‘normal’ pregnant woman has a 15% chance of miscarrying/stillbirth while the hyperemetic woman has a greatly reduced chance of 3%the blood flow of an hyperemetic woman is twice that of a ‘normal’ pregnant woman (this is the way the body compensates for the lack of nutrient intake)It is true what they say: (in most cases) the sicker you are the better off your baby isTHERE IS AN END TO THE DISORDER! (Whale 2001)
References
Betts D (2006) A Review of Research in to the Application of Acupuncture in Pregnancy. Journal of Chinese Medicine 80 February 50-55
Betts D (2003) Harmonising the Penetrating Vessel in the treatment of Morning Sickness. Journal of Chinese Medicine 72 June 36-41
Deadman P & Al-Khafaji M (1998) A Manual of Acupuncture. Journal of Chinese Medicine Publications, UK.
Habek D (2005) Success of acupuncture and acupressure of the Pc 6 acupoint in the treatment of hyperemesis gravidarum. Research in Complementary and Natural Classical Medicine. 11:20-23. (Research Abstract from European Journal of Traditional Chinese Medicine, Vol 4, No 1, 2005)
Smith C (2002) Acupuncture Fights Morning Sickness. http://news.bbc.co.uk/1/hi/health/1842196.stm
West Z (2001) Acupuncture in Pregnancy and Childbirth. Churchill Livingstone.
Whale M (2001) Morning Sickness and Hyperemesis Gravidarum. Register of Chinese Herbal Medicine News. Autumn 17-24.
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