C9 Chinese obstetrics text, C19 re-edition, Woodblock print
Nausea and vomiting in pregnancy – the facts
Nausea and vomiting in pregnancy is believed to occur in about half of all pregnancies, usually between the sixth and the sixteenth weeks and is at its most intense at eight to twelve weeks.
Although it is commonly called morning sickness, nausea and vomiting in pregnancy can happen at any time of the day or night. The degree to which women experience morning sickness hugely varies: a woman can have nausea only or accompanied by vomiting. The intensity or the time of the day it is felt can also vary. But it can also be constant, including on waking at night.
Although women are often eating less and possibly lose weight while experiencing nausea and vomiting early in pregnancy, the real concern is the possibility that excessive vomiting (hyperemesis gravidarum in scientific terms) can lead to dehydration and the woman may then require hospitalisation to receive intravenous fluids. Doctors or midwives who suspect dehydration in pregnant women often give them blood tests to check their electrolyte levels or urine testing sticks to measure their ketone levesl.
The Causes
There are many theories as to why nausea happens in pregnancy:
Hormonal reasons - HCG the hormone used as an indicator in pregnancy test and rising oestrogen levels are cited as the main culprit
Brain stem – this part of the brain is believed to be the control centre of nausea and vomiting. The way it responds to the hormones produced in pregnancy might influence the level of nausea and vomiting a woman experiences
Stress levels and fatigue – they are believed to increase the risks of developing morning sickness
Acupuncture to treat nausea and vomiting in early pregnancy
Women’s experiences of morning sickness varies as much as their experience of labour: some are bedridden and might need hospitalisation, some damage blood vessels in their throat from vomiting so often and violently, some are not vomiting but feel that if they could, it might help them. Finally some carry on with their normal daily routine whilst feeling absolutely awful. There is no ‘normal’ and it certainly doesn’t support the myth that suggests that morning sickness is both mild and a normal part of pregnancy.
Whatever the symptoms, acupuncture offers a real, safe, natural alternative to simply putting up with the nausea and vomiting in pregnancy.
A traditional Chinese medicine viewpoint – Pattern differentiation and treatment
From a traditional Chinese medicine perspective pregnancy brings up changes to the energetic balance of the body but these changes are not considered pathological developments. It is therefore considered normal to see the following
· Increase in blood
· Increased heat
· Increased dampness
· Increased Liver energy
· Decreased kidney energy
(note that blood, heat, dampness, Liver and Kidney energy here are Chinese Medicine terms and concepts)
However, because of constitution or lifestyle, the balance can be sometimes disrupted by one of the elements above. Too much heat or dampness, too much Liver energy or not enough Kidney energy for example can evolve in patterns of disharmony.
In Chinese medicine each pattern of disharmony presents with specific symptoms. As mentioned before in the case of nausea and vomiting, a trained and skilled Chinese medicine acupuncture practitioner will see a different pattern in a patient who vomits her food soon after eating it, with a persistent thirst, a red tongue and a rapid pulse, and a patient who feels nauseous with no vomiting but with epigastric distension and fullness and who presents with extreme tiredness of the arms and legs, lethargy, weak voice, spontaneous seating, a pale tongue and a weak pulse.
The acupuncturist is able to identify the causes of the imbalance and chooses the appropriate treatment (a combination of acupuncture points) tailored to address the particular symptoms of the patient but also the causes of her imbalance.
The number of needles used in a single treatment is limited to 6 to 8 to prevent excessive stimulation and they are usually retained between 15 and 20 minutes
Although not all women will flourish following treatment, the majority will see a dramatic improvement that put them back in control. It is worth warning the patient that no matter how good she feels after the treatment, she needs to be aware of her body’s limit, stick to appropriate food, not skipping regular meals or snacks, or not staying up late for example.
Patient advice
An acupuncture practitioner should also be able to help women incorporate life-style changes in their routine, rest and hydration being paramount. Again not everything will work on everyone but according to the specific symptoms each woman presents, a tailored list of food, snacks and beverages can be introduced in the diet to relieve the symptoms.
Safety and effectiveness of acupuncture treatment in early pregnancy
Smith et al. (2002) published two articles from their research on nausea and vomiting during early pregnancy. The study involving 596 women who were followed through their pregnancy until childbirth to record any adverse outcomes, confirmed the benefits of acupuncture and concluded that acupuncture was a safe and effective treatment for women who experience nausea and dry retching in early pregnancy.
So if you’re pregnant and feel that your quality of life is impacted by morning sickness, it is worth considering acupuncture as a drug-free option to relieve your symptoms.
For more information or to book an appointment, please contact sophie at sophie@silverwoodacupuncture.co.uk
References
Betts D (2006). The essential guide to Acupuncture in Pregnancy and Childbirth.
Smith C, Crwother C, Beilby J (2002). ‘Acupuncture to treat nausea and vomiting in early pregnancy: a randomised trial”. Birth. 29(1):1-9
Smith C, Crwother C, Beilby J (2002). ‘Pregnancy outcome following women’s participation in a randomised controlled trial of acupuncture to treat nausea and vomiting in early pregnancy.” Complement Ther Med. 10(2):78-83