How to handle nausea in pregnancy
Nausea during pregnancy can be debilitating.
For some nausea comes and goes in early trimester and for others it can linger relentlessly way beyond the promised 12 or 13 weeks.
With or without vomiting, it’s hard to imagine the relentless nightmare that nausea can be unless you have experienced it for yourself.
WHAT CAUSES NAUSEA?
MEDICAL/PHYSIOLOGICAL EXPLANATION:
Huge physical and hormonal changes in the body occur during pregnancy, including changes to the cells of the heart to adapt to higher blood volume, softening of gums and muscles as well as the building of the placenta and rapidly growing cells and systems of the developing foetus.
An increase in pregnancy hormones of HcG and Oestrogen are thought to be a contributing factor in pregnancy related nausea and vomiting. Pregnancies higher in HcG may contribute to more intense levels of nausea and vomiting.
More severe nausea and vomiting such as Hyperemesis Gravidarum is a more serious condition than we address generally in this article that can lead to needing medical monitoring for dehydration and electrolyte balance and often trips to the hospital for IV fluids, though some of the tips and following information may be of assistance for you too.
FROM A CHINESE MEDICINE POINT OF VIEW:
In Chinese medicine we acknowledge that with the extra demands on the body, some factors in constitution begin to arise. We look at everyone who comes into our clinic as an individual and pay attention to the signs and symptoms showing up in the person in front of us.
Some of our differential diagnose we may look for in nausea during pregnancy might be one or a combination of some of these sets of symptoms and we would treat accordingly:
REBELLIOUS QI
(‘Qi’ pronounced ‘chee’, meaning energy).
In the digestive system, what goes down should not be coming back up but for various pathological reasons that energy in the body is up trending instead of going down. Examples of Rebellious Qi include hiccough, burping, acid reflux, vomiting, and even the sensation of nausea.
STOMACH QI DEFICIENCY
Abdomen feels full and bloated, low appetite, though nourishment with food and drink to top up reserves may bring some temporary relief, pale tongue, weak pulse
STOMACH DEFICIENCY COLD
As with previous but might have cold hands and feet, vomiting clear fluid, and love the feeling of warmth warmth on the abdomen (we don’t recommend heat packs over the lower abdomen or lower back in pregnancy but we do recommend dressing warmly, wearing singlets to keep the abdomen and lower back warm, snuggly couch blankets or warm hands placed over the abdomen is fine)
SPLEEN QI DEFICIENCY
Qi (energy) deficient symptoms such as weak voice, spontaneous sweating, constant tiredness, lack of appetite, feeling heavy and tired in the body, bloating in the abdomen, pale or swollen tongue, may have teeth marks (sides of tongue have a scalloped edge where they are weak and rest in among the teeth) , weak pulse
STAGNANT ‘LIVER QI’ INVADING STOMACH
Burping or vomiting, with bitter taste in mouth, upper abdominal distension and discomfort, tendency to feeling irritable, frustrated or depressed, prone to headaches, red sides of the tongue, wiry (tense feeling) pulse. This type is more likely to have nausea aggravated by stress or high pressured situations
STOMACH HEAT
Vomiting soon after eating, constant thirst, red tongue with yellowish looking coat, rapid pulse.
ACCUMULATION OF PHLEGM
Vomiting of mucous, spitting up lots of saliva, swollen tongue with sticky coat in centre, slippery pulse (feels soft and rolling under the fingers).
WHAT CAN WE DO TO RELIEVE OR MANAGE NAUSEA?
The following tips may provide some relief or at the very least can be management strategies for nausea without being too obvious in the workplace or amongst colleagues or family:
TIREDNESS EXACERBATES NAUSEA
In my clinical experience, being excessively tired appears to aggravate nausea. Pregnancy places extra demands on your body and hormonal systems while you are creating a whole little human body inside you. If you are working full time finding ways to take small rests, even for a minute at a time, where you can close your eyes and just check in with your body rather than just pushing through can help break the momentum. And listen to your body, if it’s telling you to slow down or reduce hours, see if you are able to arrange some extra time during the week devoted to rest or stillness.
HUNGER
As well as tiredness, nausea also often feels worse when you’re hungry. A busy day where you have a lot on (in work or life) or a meeting that goes over time and you get hungry or your blood sugar drops, can be a real trigger for more extreme nausea to come on. dry foods and snacks around with you, even into meetings, snacking every 1 to 2 hours may help to prevent the blood sugar drop. Nausea friendly snacks might be almonds/nuts and dried fruit/raisins, or a bit of fruit or sandwich. Avoid sugary foods such as biscuits or chocolate as they are likely to exacerbate nausea with the peak and drop of blood sugar. More complex carbs such as fruit, rice or bread and pasta should be fine (check with your health professional if you have been diagnosed with gestational diabetes and may have a special diet plan). If nausea affects you during the night it may be helpful to have a higher protein snack at night before bed (nuts or yoghurt) and a more carb based version when you wake in the morning.
DIET
Decreased appetite and cravings may change everything you thought you knew about your approach to eating and diet once pregnant. Remember that everyone is different- what worked for your friend or mother in law may be different for you. You might find that the normal healthy foods you used to like have been replaced by cravings for hot chips and lemonade!
This is because suddenly your body might want more easy to digest, simple foods such as potato or miso soup, almonds, dried fruit and nuts, egg or vegemite sandwiches, baked veges, Chinese rice congee, or other simple, nourishing soups.
SMELLS
If smells set you off (eg somebody’s perfume on the train, or garlic cooking) and make you want to gag, try carrying some vanilla essence a fresh piece of lemon around with you to smell instead. A diffuser with peppermint oil or beautiful fresh fragrance could be a nice antidote, or carrying around some vanilla essence.
ACUPUNCTURE + ACUPRESSURE
acupressure, and leave-on micro acupuncture needles or seeds for nausea management are a mainstay in my clinical practice. If you don’t have access to an acupuncturist you can get sea bands at a chemist, that fit over and press the nausea point on your wrist. You can massage these points with your fingers Nausea during pregnancy.
CARBONATED DRINKS
Sometimes when you’re pregnant plain water such as ginger beer - preferably not containing added sugar. Ginger or peppermint tea can be helpful for some on managing nausea and being tolerable liquids to keep down.
MONITORING FOR DEHYDRATION AND BLOOD SUGAR LEVELS
If you have dry lips or feeling thirsty constantly it may be a sign of dehydration, which is something to avoid but also makes nausea worse. Check in, get help from your doctor and health professionals. If you have excess vomiting, dehydration is more of a concern than just keeping nutrient levels adequate. If you are vomiting more than 3x a day I recommend you seek medical guidance and help. If you’re struggling to keep fluids down, you might find carrying potato, or clear chicken or vegetable soup around, sipping regularly and often as you go about the day. Carry some chopped up watermelon to work or around with you can be a nice sweet but healthy way to keep some fluids down, or sucking on ice cubes. Acupuncture may help with tolerating and keeping more fluids down.
VITAMINS AND MINERALS (SUPPLEMENTS)
Pregnancy creates extra demands for nutrients in your body. It may help your body to feel less depleted (which may lead to further nausea) to make sure you are keeping these extra nutrients up -especially folate, iron, B vitamins and Vit D. My favourite practitioner grade supplements to cover these nutrients that are natural and more readily absorbable are Naturobest, Mygen or Biomedica’s Natal Care supplements (Natal care needs a practitioner prescription).
And finally, Self Care! This is your time. To be guilt free and take care of yourself as much as you can, while you are giving so much of your own energy to grow a little human body.
