Pregnancy 101: Your Natural Guide to Preventing Morning Sickness

A side effect of running a successful fertility practice is that my patient load often includes a lot of pregnant women. I’ve reached out to many of you through my newsletter for new blog post requests and the #1 topic of interest is how to combat morning sickness. Not a surprise considering morning sickness is incredibly common, occurring to approximately 3/4 of all pregnant women. Pregnancy nausea occurs in the first trimester, typically beginning at week 6 and ending by week 14. Researchers aren’t 100% sure what causes this nausea, but it’s likely due to a combination of the many physical and hormonal changes taking place within the body during early pregnancy. Some possible theories include:

• Elevated hCG: a hormone produced by the placenta after implantation which rises rapidly during early pregnancy. Scientists believe that hCG plays an important role in causing nausea in pregnancy since symptoms tends to peak around the same time that hCG levels are at their highest.
• Stress: Researcher suggests that some women are psychologically predisposed to having nausea and vomiting during pregnancy as a response to elevated levels of stress. Pregnancy, especially if it’s a woman’s first child, comes with a lot of unknowns and can be very stressful. Try deep breathing or guided meditations daily to normalize an overactive nervous system.  My favourite guided meditation apps include; calm, headspace, and stop breathe think.
• A baby girl: Several studies have found that about 55% of women with severe nausea and vomiting in the first trimester give birth to a girl.
  • A study by the University of Washington found that nausea and vomiting in pregnancy is associated with an increase in the number of female births. The study looked at 2110 pregnant women hospitalized for extreme vomiting and compared them to a control group of 9783 women with symptom-free pregnancies. Pregnant women hospitalized for nausea in the first trimester had a 50% increased odds of having a female compared with controls and women hospitalized for three or more days had the greatest odds of giving birth to a baby girl.
  • A study published in the Lancet showed that 55·7% of babies whose mothers were admitted to the hospital for hyperemesis gravidarum (a severe form of morning sickness) in the first trimester were female.
• Iodine sufficiency: The growing baby draws from mom’s iodine stores during the first trimester to support healthy brain development. Iodine deficiency is extremely common and studies show that people with the lowest levels of iodine also had the lowest risk of developing pregnancy sickness. While morning sickness is miserable it can be a sign that the embryo is healthy and that the mother has sufficient iodine in her system. In parts of the world where women suffer from severe iodine deficiency researches see much higher levels of cognitive deficits in babies (a deficit of around 12 – 15 IQ points). Since iodine is critical to thyroid function (thyroid hormone is made from iodine), an absence of any pregnancy sickness may suggest the need for thyroid testing in the mother. I advise that all of my fertility patients to have their thyroid numbers examined regularly since TSH levels of <2.5 are shown to be ideal for fertility, pregnancy, and fetal outcomes.
• An enhanced sense of smell and sensitivity to odors: Researchers believe that this phenomenon is due to increased estrogen during pregnancy but this has yet to be proven by any scientific study. A women’s senses are enhanced during pregnancy to likely help the mother avoid eating mouldy foods that could be harmful to the growing baby.

So what’s a nauseous pregnant gal to do? Here are my favourite natural remedies for morning sickness that have been shown to be both safe and effective for use in pregnancy:

• Take a prenatal multivitamin: Take a great prenatal multi in the first trimester to ensure you’re getting adequate nutrients despite a decreased appetite and possible vomiting. I typically recommend that my patients avoid drug store multi vitamins and grab one from their local health food store or naturopathic doctor instead. Popular pharmacy brands contain additives like BHT (based on animal studies, the National Toxicology Program has concluded that BHT “is reasonably anticipated to be a human carcinogen”), red dye #40, sodium lauryl sulfate, titanium dioxide, talc, the list goes on … These chemicals and colourings are completely unnecessary in a vitamin, and we don’t know for sure how the combination of these chemicals may impact the sensitive system of a developing fetus. Pharmacy brands also typically contain the oxide form of nutrients which have lower absorption, and can be irritating to an already sensitive digestive tract.
• Peppermint tea: Peppermint is classified as a category A herb in pregnancy, meaning it’s proven to be safe for both the mother and developing baby. There are a few studies showing that the oils found in mint are better than placebo for relieving morning sickness and anecdotally many of my patients report less nausea and vomiting when drinking mint tea daily.
• Eat small meals and snacks frequently throughout the day: I’ve noticed that high-protein foods and complex carbohydrates have been especially helpful in my pregnant patients. Eat slowly and chew thoroughly so your stomach has less work to do with incoming food. Some of my favourite snack foods to recommend include: hard boiled eggs, trail mix, whole grain breads with smashed avocado, bananas with nut butter and greek yoghurt with berries.
• Relax: Unwind and take naps whenever you can – nausea can get worse if you’re tired or stressed. Get some fresh air by taking a walk in nature or try relaxing by an open window.
• Ginger (tea or capsules): Ginger is another category A herb that has a good evidence base for its ability to reduce symptoms of nausea and vomiting in pregnancy. Start by grating some fresh ginger into hot water to make ginger tea and drink a cup up to 4 times daily. If you need stronger support check with your Naturopath or herbalist about taking powdered ginger root in capsule form – they have training to know which brands are proven to be safe and reliable.
• Acupuncture or acupressure: Consider seeing an acupuncturist or ND who has experience treating nausea during pregnancy. I typically recommend that my patients come for 1 session weekly during the first trimester to reduce nausea and support a healthy pregnancy. One of my favourite points for nausea of pregnancy in located on the wrist and is called PC6. There are also acupressure bands that pregnant women can wear around the wrist to stimulate this point.
• Take a B6 Supplement: Research shows that taking extra vitamin B6 (also known as pyridoxine) helps relieve nausea and vomiting for some pregnant women, though the exact mechanism here is unknown. Check with your health care provider before taking any additional vitamins in pregnancy, but women can start incorporating foods high in B6 into the diet right away. These include: bananas, nuts, beans, cauliflower, potatoes, carrots, lean meats, and wild caught fish. A dose of 25mg three times daily with food is considered a safe dose in pregnancy (high dosing of B6 supplements, >200mg daily, can cause numbness and tingling in the extremities and should only be used under the supervision of an integrative health doctor).
  • Diclectin, which is a form of B6 prescribed by your medical doctor may be an option but it also contains a medication called doxylamine, which has been shown to cause drowsiness, dizziness, headache, constipation and stomach upset, which are symptoms already prevalent in the first trimester. This drug has also come under some controversy lately as a 2013 study published in the American Journal of Perinatology found worrisome errors in the 1997 Motherisk study which formed the basis for the recommendation of this drug as a first line therapy in pregnancy. The newer research questions claims regarding the drug’s safety and argues that there is “stronger support for the safety” of non-prescription vitamin B6 alone. For these reasons I prefer to prescribe natural products as a first line therapy to my patients with mild to moderate morning sickness, before turning to conventional medications.

Note: Always work with a trained medical provider during pregnancy. Severe and prolonged vomiting has been linked to a greater risk of preterm birth and low birth weight, which is why it’s important to seek medical guidance from your health care provider if your symptoms are severe or if there is significant weight loss in the first trimester due to morning sickness.

Looking to connect with a Naturopath in Oakville to develop your own personalized pregnancy protocol for optimal health results in both mom + baby? Book your appointment here or visit my website for more information. 

If you’d like to work together and you’re not a resident of Ontario*, or if you do live in Ontario and you’d prefer an online consultation you can book online with Dr. Sarah here. 

*Note: online services provided by Dr. Sarah to those of you living outside of Ontario are delivered as a Certified Functional Medicine practitioner consult and not as an Naturopathic doctor appointment & as such they will not be eligible for reimbursement through private insurance.

References:

• https://www.ncbi.nlm.nih.gov/pubmed/21112920
• https://www.ncbi.nlm.nih.gov/pubmed/20453023
• https://bmccomplementalternmed.biomedcentral.com/articles/10.1186/s12906-016-1079-z
• https://www.ncbi.nlm.nih.gov/pubmed/29614764
• Pinn G and Pallett L. “Herbal medicine in pregnancy,” Complementary Therapies in Nursing and Midwifery 8 (2002): 77-80.
• Ranzini A. “Use of complementary medicines and therapies among obstetric patients,” Obstetrics and Gynecology 97, 4 Suppl. (2001 April): 46.
• Vutyavanich T, et al. “Ginger for nausea and vomiting in pregnancy: randomized, double-masked, placebo-controlled trial,” Obstet Gynecol 97, 4 (2001): 577-582
• Kennedy DA, et al. ‘Safety classification of herbal medicines used in pregnancy in a multinational study.’ BMC Complement Altern Med. 2016 Mar 15;16:102.
• https://www.ncbi.nlm.nih.gov/pubmed/28818674
• https://www.ncbi.nlm.nih.gov/pubmed/25052410
• https://www.ncbi.nlm.nih.gov/pubmed/24323370

This information is not intended as a substitute for the advice provided by your Naturopathic doctor or primary care physician. Do not use the information in this document for diagnosing or treating a health problem or disease. Always speak with your Naturopathic doctor before taking any medication or nutritional or herbal or using any treatment for a health problem. If you have or suspect that you have a medical problem, contact your health care provider promptly. Do not disregard professional medical advice or delay in seeking professional advice because of something you have read online.