Pregnancy Nausea: What Does it Mean?

Pregnancy Sickness

In Chinese Medicine, there are three classifications of nausea in pregnancy.

1. Morning sickness (or evening sickness)

2. All day, all night pregnancy nausea and vomiting

3. Hyperemesis Gravidarum

Hyperemesis Gravidarum

Hyperemesis gravidarum is a pregnancy condition with symptoms of severe nausea and vomiting. It leads to dehydration, weight loss and electrolyte disturbances. It affects 1-3% of pregnant people and can require hospitalisation. If you are pregnant and have severe nausea rendering you unable to drink for more than 8 hours or eat for more than 24 hours, seek medical help immediately. Acupuncture is not used for hyperemesis but can treat the milder versions of pregnancy sickness effectively.

Mild to Moderate Pregnancy Sickness

Nausea and vomiting in pregnancy typically begins at 4-6 weeks affecting 50-80% of pregnant women. 60% of those who suffer with pregnancy nausea are better by 12 weeks, and 90% improve by 16 weeks of pregnancy.

The primary cause of pregnancy nausea and vomiting is:

• GDF15

  This a hormone named Growth Differentiation Factor that is produced by the foetus and placenta.

  Increased GDF15 levels in the Mother's bloodstream during the first trimester are associated with a greater severity of nausea and vomiting. GDF15 regulates energy balance, promotes weight loss, modulates inflammatory responses and influences insulin sensitivity. It is linked to the immune system. Some women have higher levels of GDF15 in their blood naturally before pregnancy and this determines whether or not they would experience pregnancy nausea and vomiting.

  
  

  Prior to the recent research relating to GDF15, pregnancy nausea was thought to be related to:

  
  

• Increased hormone levels, such as oestrogen and HCG

• Excess stomach acid

• Stress

• Fatigue

  
  

  Pregnancy Nausea in Chinese Medicine

  
  

  In Chinese Medicine, there is a channel that passes through the midline of the body, in front of the abdomen. It is named the Chong, which means Penetrating Vessel. It is also known as the Sea of Blood as the Chong's function is to nourish the blood of the fertility organs. It is a very important channel for fertility and pregnancy.

  
  

  The Chong is associated with pregnancy nausea. This is because the Chong is related to menstruation. With the onset of pregnancy, when menstruation ceases, the blood of the Chong is now needed to nourish the foetus. The Chong continues to send blood down to the uterus in pregnancy but the foetus blocks the uterine gate and isn’t yet developed enough to make use of the extra blood in an energetic sense. This causes a blockage in the Stomach channel as the Chong has a close relationship with the Stomach and Uterus. This prevents the descending action of the Stomach, leading to nausea and vomiting. It doesn't affect the developing foetus.

This is worsened if you have an existing diagnosis of Spleen Qi Deficiency and Damp, Liver Qi Stagnation and Heat or Kidney Deficiency.

How Do We Treat It?

In Chinese Medicine we would be looking at your symptoms and treating the diagnosis accordingly. For example if you had the following symptoms, they would relate to the corresponding diagnoses.

• Nausea with bloating, emotional changes and feeling hot - Liver Qi Stagnation

• Vomiting phlegm, bland taste, weak limbs, fatigue - Spleen and Stomach Deficiency and Damp

• Vomiting or nausea, feeling cold, fatigue - Kidney Deficiency

  
  

  An acupuncturist would needle the acupuncture points to support the Chong vessel as mentioned above and then include points for your specific diagnosis, such as moving the Liver and clearing Heat for Liver Qi Stagnation.

Dietary Recommendations

The following foods can help to ease pregnancy nausea:

• Ginger (especially if the nausea is associated with feeling cold or Kidney deficiency)

• Peppermint tea (if nausea is associated with Liver Qi Stagnation and Heat)

• Regular small meals helps to calm the Stomach.

• Avoid cold foods and drinks as this weakens the Spleen and Stomach and can create Damp which exacerbates pregnancy sickness.

• Avoid Damp creating foods such as fried foods, dairy, bananas and peanuts.

  
  
  
  

  Who Might Experience Pregnancy Nausea (And Why It's OK if You Don't)

  
  

  I know that some of my patients feel reassured when experiencing pregnancy nausea in the first trimester as they feel as though the pregnancy is progressing. It can be hard to wait for long periods between scans, and any symptoms usually help to ease anxiety. However, the absence of nausea isn't a bad sign. It all depends on your underlying pre-pregnancy constitution as to whether you would naturally be more susceptible to sickness in early pregnancy.

So what conditions might indicate a higher likelihood of nausea in pregnancy:

• Twins or multiples (increased HCG)

• Higher hormone levels prior to pregnancy, eg high oestrogen during IVF or from PCOS or endometriosis

• Reduced GDF15 hormone levels prior to pregnancy as the body has not been exposed to it in high levels.

• Spleen Qi Deficiency with Damp

• Liver Qi Stagnation

I hope this helps you to understand why you may be experiencing strong nausea and vomiting which progresses after 12 weeks, mild nausea in the first trimester or no nausea at all. And if you are hoping to get pregnant soon, understanding your Chinese Medicine diagnosis may give you an idea of what to expect in your pregnancy.

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