Nausea and vomiting during pregnancy, commonly known as “morning sickness,” can occur at any time of the day. It affects around half of all pregnancies and is usually most severe between the sixth and sixteenth weeks, with peak intensity at eight to twelve weeks. However, for some women, the symptoms can start as early as their first missed period and may persist until the birth of the baby. In some cases, nausea and vomiting can even return in the final weeks of pregnancy.
Morning Sickness; the Facts
The severity of morning sickness can vary greatly among women. Nausea can occur alone or be accompanied by vomiting. It may occur only at certain times of the day or persist throughout the day. The intensity of symptoms can be influenced by factors such as fatigue and eating habits. Severe morning sickness and minimal food intake in the early weeks of pregnancy generally do not lead to malnutrition in the developing foetus. However, the main concern is dehydration caused by persistent vomiting, which may require hospitalisation for intravenous fluid administration.
Hyperemesis Gravidarum: Excessive Vomiting
Excessive vomiting during pregnancy, known as hyperemesis gravidarum, often requires medical attention. Women showing signs of dehydration may undergo blood tests to check their electrolyte levels or urine analysis to measure ketone levels. Monitoring urine output, especially if it is dark in color, can also be useful.
Possible causes of Morning Sickness
There are several theories regarding the cause of nausea in pregnancy:
1. Rapid increase in pregnancy-related hormones, such as hCG and oestrogen.
2. Response of the brain stem, which controls nausea and vomiting, to the elevated levels of pregnancy hormones.
3. Increased risk of morning sickness if a woman is stressed and fatigued before becoming pregnant. Tiredness and exhaustion can also worsen nausea during pregnancy.
4. Emotional response to pregnancy may also play a role, although the relationship is not always clear.
Traditional Chinese Medicine Perspective
According to Traditional Chinese Medicine (TCM), the body functions through a network of channels that distribute essential nutrients, such as Qi (energy) and Blood. The Penetrating vessel (called the Chong Mai in Chinese) is particularly important in ensuring proper Qi and Blood flow in the uterus. When there is disorder in this vessel, it can interfere with the descending action of the Stomach channel, leading to nausea and vomiting.
Chinese Medicine Treatment Approaches for Morning Sickness
Treatment in TCM involves regulating the Penetrating vessel and harmonising Stomach qi, while addressing any specific patterns present in the pregnant woman. These patterns may include Qi deficiency, Qi stagnation, internal Cold or Heat, and accumulation of Phlegm/Dampness, all of which can contribute to the aggravation of symptoms. Acupuncture and Chinese herbs are commonly used in this treatment approach.