Just to be clear here, we are talking about mild or moderate feelings of sickness with occasional episodes of vomiting (also known as morning sickness). We are NOT talking about hyperemesis gravidarum, which is a severe pregnancy complication that is characterised by severe vomiting, weight loss and dehydration. If you are being sick frequently and cannot keep food down, tell your midwife or doctor, or contact the hospital as soon as possible to seek medical help.
If you are looking for additional support for morning sickness we would recommend the Instagram page: Pregnancy Sickness Support (@pregnancysicknesssupport) • Instagram photos and videos
Why do some ladies get ‘Morning Sickness’ and others don’t?
Nausea and / or vomiting is thought to affect 50-80% of pregnant ladies (to a varying degree). Despite the name, morning sickness or nausea can strike at any time during the day or night. Feelings of nausea usually start around the sixth week of pregnancy and ease after the twelfth week, but some women may experience it earlier and later than these dates.
There are a number of reasons as to why some ladies are more affected by nausea in pregnancy than others. Studies have shown that being pregnant with twins or multiples may increase the presence of nausea due to the higher hormone levels associated with this type of pregnancy. It is assumed that a family or personal history of morning sickness may increase a lady’s risk of suffering with pregnancy related nausea. There are also links with migraine, motion sickness sufferers and mothers with high stress levels and obesity.
Interestingly, a study was published in May 2021, by Authors Young et al, looking into whether there was any evidence to show that increased nausea in pregnancy meant that the mother was more likely to be carrying a girl. They assessed reports from 2543 mothers and concluded that women that carried a female foetus, as opposed to a male foetus, reported significantly higher frequency episodes of nausea and vomiting during their first trimester of pregnancy.
What causes Nausea and Sickness in Pregnancy?
No one really knows the answer to this but it is widely accepted that various metabolic and endocrine factors play a role, many of which come from a placental origin…..Basically, hormones are to blame (aren’t they always)?
A lot of ladies have heard of the hormone ‘Human chorionic gonadotrophin’ (hCG). This hormone is only released when a woman becomes pregnant and is what gives you a positive result on a pregnancy test. It is thought that this hormone might trigger morning sickness as the body isn’t used to it being present. Typically, the hCG levels will double every 72 hours once pregnancy occurs and will reach its peak in the first 8-11 weeks of pregnancy and then will decline and level off. This might explain why morning sickness is usually worse in the first 12 weeks but there is not a lot of evidence to support this theory.
Another well-known hormone that increases during pregnancy is oestrogen. This hormone initially helps to support your baby until the placenta takes over and also plays a role in helping ligaments to soften, giving baby space to grow. The theory is that the increased levels of oestrogen also relax the muscles in the intestines, leading to nausea and vomiting. Studies have shown that progesterone, in combination with the oestrogen, may play a significant a role in pregnancy related nausea and / or vomiting as well because progesterone decreases smooth muscle contractility and therefore alters gastric emptying, leading to increased nausea and vomiting.
Another theory is that morning sickness is actually a way of your body expelling unwanted toxins. This theory hasn’t been proven scientifically but it is widely accepted that this could well be a contributing factor.
So….the BIG question: Does anything actually help with nausea?
The current accepted therapy for pregnancy related nausea and sickness is generally directed at improving gastrointestinal mobility. When you search online for remedies you see all sorts of options including; sickness kits, sprays, drinks, sweets, inhalers, lollies, rollers and wrist bands, you name it, you can buy it! BUT, does it work and is any of it actually backed up by scientific research? Let’s take a closer look:
The most common remedies advised online are:
- Ginger
- Pyridoxine (vitamin B6)
- Acupressue
- Aromatherapy
- Hypnotherapy
- Reflexology
We’ve looked at the most recent studies that have investigated the effects of these proposed remedies, here is what we found:
Ginger
Ginger can come in various forms, is safe for mother and baby and is low in cost, it is said to be one of the best options for expectant mothers suffering from pregnancy related nausea and sickness. Some scientists believe that certain chemicals found in ginger may influence various systems within the body. They think that nausea is reduced because some of these chemicals work directly on the stomach and help to increase the movement of the Gastrointestinal tract.
Historically, lots of studies have looked into the use of ginger in pregnancy; in 2013, researchers Ding, Leach & Bradley studied the effectiveness and safety of ginger in pregnancy, using a systematic review. They concluded that ginger was a safe and effective treatment for pregnancy related nausea and vomiting but advised that more research was needed to determine the exact dosage and duration of treatment. Viljoen et al also carried out a similar systematic review and meta-analysis in 2014. They found that evidence was limited into the use of ginger but that it could be considered a harmless and possibly effective alternative option for women suffering from nausea and sickness.
Although ginger is seen to be effective in treating mild to moderate nausea in pregnancy, studies haven’t concluded which form of ginger is most effective.
The most popular and best selling on Amazon are the Ginger Tablets. These tablets by the company Mobu are Manufactured in the UK and GMP-approved.
The other most popular option is Ginger tea. These come in many different forms with various herbs added. These tea bags by HOTTEA MAMA are very popular on Amazon and a really popular and trusted brand in the UK, in fact, they won the prize in the UK baby awards for the best maternity product.
Pyridoxine (vitamin B6)
Vitamin B6 (pyridoxine) is thought to help the body process certain amino acids (proteins). Scientists believe that it is this that somehow helps to reduce nausea but the exact mechanisms are unclear. Sharifzadeh et al (2017) actually compared the effects of ginger, pyridoxine and a placebo for the treatment of first trimester nausea and vomiting. They concluded that ginger was more effective than the placebo for the treatment of mild to moderate nausea and vomiting and was comparable with the vitamin B6 results. They found that the ginger was more effective than B6 and placebo for the intensity and distress associated with vomiting.
It appears that ginger is equally effective as adding vitamin B6 into your daily routine. There aren’t many supplements that you can get online that state that they are safe for pregnancy but these ‘melts’ by ‘My Expert Midwife’ contain both Ginger and Vitamin B6 so could be a good option.
Acupressure
For the relief of nausea, the acupressure point known as P6 (or the ‘inner gate’) is used. This point is located on the inside of the forearm, just above the wrist. 
This form of treatment for pregnancy related nausea is one of the most widely investigated and has been used for many years. The most recent detailed study that we found, which investigated this form of treatment, was by authors; Ozgoli and Naz (2018). They completed a systematic review on the effects of complementary medicine on nausea and vomiting in pregnancy. The review looked into randomised controlled trials, carried out in the last 20 years. They concluded from this that ginger and P6 acupressure were the most reliable treatments consistently and also confirmed that no adverse effects were found with either of these treatments.
These results are really promising and suggest that a combination of the wrist bands and ginger could be the best option as there is more chance of one being affective that way. There are lots of wrist bands available online, some more expensive than others but they all do the same thing, so what you pay is simply down to what they look like and the materials used. These wristbands on amazon are cheap and cheerful and simple colours. The other option is to look at a ‘package’ like this from Myrtle and Maude which includes the wristbands and ginger tea. They are a UK based company, all of their products are vegan and as an added bonus, I think the packaging is really nice!
Aromatherapy
Essential oils are the active compounds found in plants that have been made into concentrated oils. It is thought that some of these properties can work to kill bacteria, relax muscles, relieve pain, improve digestion, and cure nausea. Essential oils are associated with general relaxation and also have minimal side effects with their use so are popular in pregnancy.
The oils are usually infused into the air using a diffuser, they are not meant to be ingested as they can be toxic in their concentrated form. Although essential oils have been used for many years, there isn’t a lot of high- quality research available investigating its use in pregnancy related nausea. We did find some evidence that the oils can be beneficial however, in particular lavender and peppermint but it emerged that there weren’t significant differences when compared to other remedies (like ginger for example). Trials also suggested that the essential oils were more effective when used over a few days (Ghani et al 2013 and Pasha et al 2012), so this needs to be taken into account if trying oils as a treatment option in your pregnancy.
Olson, Donnelly and Perlman (2019) carried out an interesting systematic review which looked into the use of aromatherapy in postoperative nausea and vomiting and found that aromatherapy was very useful and should be considered as a treatment in adult surgical patients. It seems as though the use of essential oils just needs more specific research carrying out but there is certainly potential for it’s use in pregnancy related nausea and sickness.
This spray by ‘My Expert Midwife’ seems to be a popular option when it comes to essential oils. It’s a combination of peppermint, lemon and grapefruit. They also do a ‘package’ for nausea that has the essential oils spray, a box of ginger melts (which contain Vit B6) and a pocket sized Roll-on, which contains coconut oil, cardamom, ginger, lemon and spearmint.
Hypnotherapy
Hypnosis is thought to work by altering our state of consciousness. It is used to create a state of focused attention and increased suggestibility, to help treat a medical or psychological disorder or concern. Several researchers have proposed that certain women are psychologically predisposed to having nausea and vomiting during pregnancy, as an abnormal response to stress.
Various studies have investigated the role that psychological factors play in the aetiology of nausea and vomiting during pregnancy, but there are very few studies of high methodical quality that assess the effects of hypnosis on these symptoms. There are however, a number of studies that have looked at the effects of hypnosis on chemotherapy induced nausea and vomiting which have shown some very promising results but it is not clear whether this would transfer to pregnancy related symptoms.
Reflexology
Reflexology is an alternative medical practice involving the application of pressure to specific points on the feet, hands or ears. It is thought that the reflexologist’s application of pressure to these areas sends a calming message from the peripheral nerves in these extremities to the central nervous system, influencing the circulatory, respiratory, endocrine, immune, and neuropeptide systems in the body.
Reflexology is another alternative medicine that has minimal research into its effects on nausea in pregnancy. Studies in the past have shown benefit from reflexology when treating conditions such as diabetes, premenstrual syndrome, cancer patients, multiple sclerosis and dementia. A study in 2017 looked at the effects of reflexology on chemotherapy-induced nausea, vomiting, and fatigue in breast cancer patients and found that the reflexology decreased the experience, development, distress of nausea, vomiting and retching as well as fatigue in the experimental group of patients (Özdelikara and Tan 2017). Results like this are really promising for the treatment of pregnancy related nausea and vomiting but more specific studies are needed to draw a confident conclusion, in order for us to recommend reflexology to pregnant ladies.
Conclusion
We can say with some confidence that ginger and acupressure are two of the best options for conservative treatment of mild to moderate nausea and sickness in pregnancy. The safety of both of these treatment methods has also been looked at in some detail and experts are happy to recommend them.