Tanya Smith

Acupuncturist and Traditional Chinese Medicine Practitioner

Cultivate the soil before planting the seed

Ugh, Morning Sickness…

Why medication may not be the best choice and what to do instead

 

It’s awful to see people in early pregnancy struggling with nausea and vomiting. Nausea and vomiting in pregnancy (NVP), often termed pregnancy sickness, occurs in the first trimester in up to 80% of pregnancies (Gadsby et al., 1993). Symptoms range from mild nausea (often accompanied by aversions to certain foods) to frequent vomiting and hyperemesis.

Clearly it is a significant issue for pregnant women, but the reason for pregnancy sickness is not well understood and there is no reliable treatment for it.

Health care professionals are constantly seeking better and more effective treatment for pregnancy sickness. A drug (called Diclectin) was released in 1983 and has been promoted widely for use in early pregnancy. However, more recent research has begun to question if it’s really more effective than placebo. Some questions have even come up about the drugs safety for the developing fetus.

 

For all of the controversy about this medication, including the politics and big money involved in Diclectin, read this Maclean’s article.

 

According to the Maclean’s article, “Canada remains the only country to recommend prescription pyridoxine-doxylamine (Diclectin) as a front-line nausea and vomiting of pregnancy treatment. The American College of Obstetricians and Gynecologists first recommends over-the-counter vitamin B6. Britain’s National Institute for Health and Care Excellence advises ginger, acupressure and antihistamines if women ask for treatment.”

Happily, the 2016 clinical care recommendations from the Society of Obstetricians and Gynecologists of Canada (SOGC) have been amended to include ginger and acupressure as lifestyle measures that can be recommended clinically before medication is prescribed.

The recommendations are in order of increasing intervention and read as follows:

      1. Women experiencing nausea and vomiting of pregnancy may discontinue iron-containing prenatal vitamins during the first trimester and substitute them with folic acid or adult or children’s vitamins low in iron.
      1. Women should be counselled to eat whatever pregnancy-safe food appeals to them and lifestyle changes should be liberally encouraged. I find people in early pregnancy who are ordinarily very healthy eaters, are often concerned that they are not getting everything they need to build a healthy baby because they suddenly can’t stomach vegetables. One of my clients called it the beige diet! Please rest assured that the baby will get everything it needs to build a healthy body.

        Get the good stuff in the ways that you can. One way I really like is bone broth used in soups or in place of water when cooking rice or quinoa. Skip the veggies for now with an intention to add them back in when you start to feel better. Make sure to eat protein or fat with every meal and snack – it helps to balance blood sugar and alleviate nausea.Lifestyle changes may also include more sleep, saying no to extra activities or exercise for now. The more you can listen to your body and respond to what it needs, the more relief you may experience from the NVP.

      1. Ginger may be beneficial in improving the symptoms of nausea and vomiting of pregnancy. Ginger can be taken as a tea (boil fresh ginger in water, strain and enjoy). If too much liquid is difficult to take in, ginger can be taken as a supplement in a capsule, candied ginger or ginger chews (I like this one Chimes)
      1. Acupressure may help some women in the management of nausea and vomiting of pregnancy. (For those that are still skeptical, the SOGC indicates that the evidence for using acupressure for NVP was obtained from at least one properly randomized controlled trial and there is good evidence to recommend it as a clinical preventive action.)The advantage to using acupressure/acupuncture for nausea and vomiting in pregnancy is that there are no one-size-fits-all points for nausea. We will take the time to diagnose what type of NVP you are experiencing and use points to re-balance your body and reduce symptoms. This makes treatment more effective for you.
      1. Mindfulness-based cognitive therapy as an adjunct to pyridoxine (Vit B6) therapy may be beneficial.
      1. Pyridoxine (Vit B6) alone or doxylamine/pyridoxine (Diclectin) combination therapy is recommended as first line in treating nausea and vomiting of pregnancy due to their efficacy and safety.

If you are experiencing nausea and vomiting in early pregnancy, rest assured that there are many things you can try to get some relief!

 

 

 

 

 

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