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Nausea and vomiting in pregnancy: An ‘alternative’ approach to care

02 August 2014
Volume 22 · Issue 8


Nausea and vomiting in pregnancy is a complex biopsychosocial syndrome, which is multifactorial, both in terms of aetiology and manifestation. In some women, symptoms resolve after the first trimester, but for others prolonged and unremitting nausea has an adverse effect on their daily lives. A minority develop hyperemesis gravidarum, for which hospital admission is required, but it is those with moderately severe nausea and vomiting in pregnancy who seem to suffer most, particularly as they are usually left to self-manage their condition. This paper explores a selection of commonly-used complementary therapies and natural remedies to which women resort to relieve their symptoms, including ginger, acupressure and acupuncture, stimulation of the vestibular apparatus and hypnosis.

It is thought that as many as 85% of expectant mothers experience nausea, vomiting and associated symptoms such as heartburn (Cardwell, 2012; Pasha et al, 2012; Festin, 2014). The causative factors are thought to be primarily endocrinological, namely human chorionic gonadotrophin, oestrogen, progesterone and thyroid hormones (Asakura et al, 2000; Kopp 2001; Patil et al, 2012; Festin, 2014). Immunological disturbance is thought to play a part (Fessler, 2002), as are nutritional factors, including hypoglycaemia and deficiencies of vitamins B6, B12 and C, plus zinc and magnesium (Dror and Allen, 2012; Wibowo et al, 2012). Associated food aversions may be a feto-protective mechanism, essentially deterring women from consuming foods containing pathogenic microorganisms and toxins (Flaxman and Sherman, 2000; Cardwell, 2012). More controversial aetiological theories include disturbance of the vestibular apparatus in the ear (Black, 2002; Golembiewski and O'Brien 2002), gastrointestinal Helicobacter pylori (Erdem et al, 2002) and musculoskeletal misalignment (Tiran, 2004a). More recently, genetic incompatibility has been explored (Patil et al, 2012) and it is known that familial history of pregnancy sickness predisposes daughters and siblings to the condition (Fejzo et al, 2008). This paper aims to provide midwives with an holistic approach to gestational nausea and vomiting, including some of the commonly-used self-help methods employed by women.

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