Barbara Roberts, Homeopath

Morning Sickness

I recently did a few posts about the menstrual cycle. It’s only fitting that we move into pregnancy.

Early pregnancy is maintained by a high human chorionic gonadotrophin (hCG) level, which signals the corpus Luteum to continue producing progesterone. hCG levels are what a pregnancy test used to detect pregnancy, they usually rise through the first trimester and then decline after that. The placenta takes over producing progesterone towards the end of the first trimester and increases this until mid to late third trimester. Estrogen also rises throughout pregnancy, and peaks in the third trimester when it is involved with the formation of the milk ducts.

The most common complaint of early pregnancy is nausea and vomiting. This ranges from mild morning sickness, to the severe clinical hyperemesis. Hyperemesis gravidarum is a difficult condition to get under control- and is usually best treated with more than one modality. I have personal experience with hyperemesis, and while homeopathy helped, it was in conjunction with medication, nutrition and acupuncture. Milder forms of morning (or all day) sickness respond well to Homeopathy.

Some homeopathic remedies to consider for morning sickness include-

Pulsatilla – can be a remedy for all day sickness, or nausea in afternoons and evenings. They are not thirsty, but can crave many foods, although those foods may not be “safe” to eat without bringing them back up. Pork and pork fat (eating, smelling, seeing, or even talking about) may make it worse or bring on vomiting. Emotionally they can be sensitive and tearful and need comfort and support.

Sepia – nausea with an empty, “all gone” feeling in the stomach. Emotionally can feel worn out and irritable- especially with family. Nausea is worst first thing in the morning and is not helped by eating, instead can vomit afterwards. Odours May make it worse and she may lose her taste for many foods, or they may taste salty. Can crave vinegary foods.

Ipecac – constant, unrelenting nausea felt all day and evening after eating. Even after vomiting she may feel nauseous. There can be excess salivation and dry retching, or forcible vomiting.

Nux Vomica – nausea especially worse in the morning, with dry retching and the feeling that if they could just vomit they would be fine. Stomach feels sensitive, may be crampy and they can be constipated. They are often irritable and impatient and have a driven personality, so being held up by this nausea is extremely annoying.

Cocculus – nausea that starts as soon as you wake up. Worse with the smell, sight or even thought of food, and they have no appetite. Also chilly and get tired easily, with flagging energy (and worse nausea) in the afternoon. Worse for travel- motion sickness- and lack of sleep will also aggravate.

Remember with Homeopathy it is the “peculiar, rare and strange” (PRS) symptoms that can lead to a remedy. In my first pregnancy along with the nausea and vomiting I had a persistent sour taste in my mouth. This narrowed the number of potential remedies down significantly and Lactic Acid, which has nausea immediately on waking, better for eating, and a sour taste in the mouth, did make things a little more bearable.

Other important things to consider-

Fatigue- this generally makes morning sickness worse. Personally I think this is part of the reason my first pregnancy was better than the other two, because I could sleep when I needed to. It can be hard to get enough when you are juggling family and other commitments but if you are considering staying up late for. Netflix marathon, my advice is to skip that and go to bed.

Dehydration- this makes nausea and vomiting worse (which is ironic when it is the vomiting that has caused the dehydration, then the dehydration causes the vomiting). This is the reason why IV rehydration for hyperemesis can improve things for a short period of time (unfortunately not in all cases). So if you are feeling nauseous consider whether your fluid intake is adequate, including whether you are getting electrolytes. Using an electrolyte replacement or simply adding a pinch of sea salt or Himalayan salt to your water may help. Thirstlessness is also a symptom of various remedies, particularly Pulsatilla (see above).

Eating regularly. There is some suggestion that peaks and troughs of blood sugar levels may contribute to nausea, and anecdotally many women will tell you they’re ok if they eat every hour, or similar. The food which you can tolerate varies greatly between women, so it will take some experimentation to find an eating schedule and range of foods that suit you best. Carbohydrates foods will cause a quicker rise in blood sugar, but this is also rapidly dealt with and doesn’t last. If you are needing to eat frequently, try and follow up some carbohydrate with protein and fat once the initial nausea has reduced to create a more stable blood sugar level.

Acupressure/Acupuncture. Some women find the “sea-bands” acupressure bands helpful for nausea and vomiting. A qualified acupuncturist can also be enormously beneficial, and often won’t just use the Nei-Kuan point on the inside of the wrist, but ones elsewhere as well to increase the effect. (I remember having ones in my feet, calves and chest as well as the wrists.) Acupuncture does require a trained professional so ask around and get recommendations for someone in your area!

Herbal remedies- ginger is commonly used, and has a carminative action. (This is actually first line in some medical guidelines!) The dose is around 250mg four times daily or up to 2g in 24 hours in divided doses. If you have reflux or heartburn ginger can make this worse.

Peppermint tea is sometimes recommended also.

Supplements- Vitamin B6 (pyridoxine) often helps, and can be prescribed by your midwife or doctor. 25mg three or four times a day is usually prescribed but this can be up to 200mg a day in divided doses.

Also consider if your pregnancy multivitamin is contributing to your nausea. Some women find these a problem, it may be reduced by switching to taking it in the evening, trying a different brand or it may be best to stop for a while and take the bare minimum of folic acid/folate and iodine.

Aromatherapy- I have no qualifications in this area and would strongly advise consulting a qualified aromatherapist who has completed a professional qualification before using essential oils in pregnancy (or around children or animals). Essential oils are powerful and should not be used without advice. Do not take essential oils orally.

Medication also has its place. There are a number of drugs used and this list does not include all that you may be prescribed. Please talk to your midwife, doctor or pharmacist to get more information.

Doxylamine – this is considered first line in some hyperemesis guidelines but is not often used in New Zealand (and not funded). It is a sedating antihistamine and 25mg taken at night will give an antiemetic effect through the next day.

Cyclizine, and Promethazine (also sedating antihistamines) and Prochlorperazine (a phenothiazine) are also used three or four times a day, but can cause sedation.

Metoclopramide is commonly used, 10mg three or four times a day.

For more severe vomiting, especially if the above options have been ineffective Ondansetron may be used, 4-8mg two or three times a day.

If you are feeling nauseous and/or vomiting and it is affecting your ability to get on with life then try some of the above options and ask for help. It is especially hard when you are trying to keep a pregnancy to yourselves until past the first trimester, but with severe morning sickness this may not be possible- I told people around 6-8 weeks because it was pretty obvious anyway!

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