With nearly ¾ of pregnant women affected, nausea is one of the most common pregnancy ailments. Benign most of the time, they can however spoil an already trying start of pregnancy for the mother-to-be. Update on the causes and treatment of nausea during pregnancy.

According to a survey, 72% of pregnant women experience nausea early in their pregnancy (1), so this discomfort is often considered one of the symptoms of early pregnancy.

Nausea usually appears between 4 and 9 weeks old, with a peak around 7 to 12 weeks old. They are often more intense upon getting up, hence the term “morning sickness”, but can be present throughout the day, with or without vomiting. They generally fade around 12 weeks and disappear spontaneously after 16 weeks. For 20 to 30% of expectant mothers, however, nausea will persist beyond 20 weeks (2).

The exact mechanism behind pregnancy nausea is not known, but the causes are likely multifactorial. The elevation of the beta-HCG hormone is one of the hypotheses retained because of the more frequent association in the event of multiple pregnancy and molar pregnancy (3). This “pregnancy hormone” secreted upon implantation, would stimulate the part of the brain responsible for nausea and vomiting. Other hormones, such as progesterone, thyroxine (or T4), and estrogen (which exacerbates sensitivity to odors) may also play a role in causing nausea.

Other hypotheses evoke the role of the stomach, whose muscle movements are slowed down under the effect of hormones. The gastric contents therefore tend to rise, promoting nausea. A bacteria could also be involved: it would irritate the walls of the stomach and exacerbate vomiting.

The psychological component of nausea and vomiting during pregnancy is also recognized.

In most cases, nausea and vomiting during pregnancy is unpleasant but harmless for the mother-to-be and her baby. However, between 0,1 and 2% of expectant mothers (4) suffer from a severe form of nausea and vomiting during pregnancy: hyperemesis of pregnancy. Very common and uncontrollable, vomiting can lead to weight loss and dehydration. It is then important to consult. Hospitalization is sometimes necessary to treat dehydration, acid-base imbalance, ketonuria (presence of ketone bodies in the urine) or hypokalaemia (decrease in calcium levels).

To prevent pregnancy nausea, a few hygienic and dietetic rules should be adopted:

• provide snacks, especially to get up, to avoid feeling hungry because an empty stomach can make nausea worse;
• split meals and make small snacks;
• try to identify foods whose consumption or the mere smell of which tends to trigger nausea. According to pregnant women, it can be coffee, spices, fats, fried foods, sweets, acidic foods…;
• according to a study (5), protein snacks help reduce nausea;
• drink in small quantities and preferably 30 minutes before or after meals in order to avoid feeling of full stomach;
• avoid confined, overheated, smoky atmospheres which tend to aggravate nausea; ventilate their living spaces frequently;
• wash your teeth after a meal and rinse your mouth regularly;
• get enough sleep, take naps if necessary and spare yourself because fatigue tends to make nausea worse.

In allopathy, certain anti-hemetic treatments (against vomiting) are authorized in pregnant women. According to the CRAT (Reference Center on Teratogenic Agents), doxylamine (Donormyl®) or metoclopramide (Primperan®) are the first-line drugs for pregnant women. In France, doxylamine does not have Marketing Authorization for nausea and vomiting during pregnancy, while it does in Canada and the USA. If these options prove to be ineffective or poorly tolerated, ondansetron (Zophren®) may be used regardless of the term of pregnancy (6).

However, the effectiveness of these drugs varies greatly among expectant mothers.

homeopathy

Safe for pregnancy and the fetus, homeopathy is an interesting resource for mothers-to-be. Because there are different homeopathic remedies for nausea of ​​pregnancy, it is important to carefully observe its symptoms in order to choose the right remedy – which a homeopathic doctor or midwife will do with precision. Here are the main ones:

• Nux Vomica 9 CH : the classic remedy for nausea. 5 granules 3 times a day and during symptoms;
• Sepia officinalis 9 CH : in case of morning sickness and severe fatigue. 5 granules before getting up and having breakfast;
• Tabacum compound 9 CH. 5 granules a quarter of an hour before each meal.

Then, depending on the symptoms, add:

• Cocculus indicus 9 CH in case of dizziness, migraines, anxiety associated, and nausea aggravated by fatigue and odors;
• Ipeca 9 CH in case of nausea with vomiting, feeling of weakness, excessive sweating and salivation;
• Tabacum 9 CH in case of nausea associated with cold sweats, palpitations, dizziness, malaise, attenuated by fresh air;
• Colchicum autumnale 7 CH in case of nausea triggered by odors (7).

Note that the laboratories also offer various homeopathic specialties against nausea in general or those of pregnancy in particular.

Herbal medicine

The French National Authority for Health (HAS) recognizes the effectiveness of ginger capsules against nausea of ​​pregnancy (8). Choose a food supplement from organic ginger and be careful not to exceed the maximum dose of 1 g / day (9).

Ginger can also be consumed in other forms (fresh, powdered or candied in dishes), even if their effectiveness has not been validated by the HAS. In decoction, just peel and grate 1 to 2 cm of fresh ginger root and infuse for ten minutes in simmering water.

Lemon balm and / or Roman chamomile herbal teas are also to be tested against nausea, as are mint teas.

Breathing lemon or ginger essential oil would also be effective in some expectant mothers to ease waves of nausea.

acupuncture

The HAS recognizes the effectiveness of acupuncture in the treatment of nausea of ​​pregnancy (10). A specific point will be stimulated: the P6 or Neiguan point (point located on the inside of the forearm, three fingers above the wrist). Consult a general practitioner, gynecologist or midwife graduated from an obstetric acupuncture IUD. Some commercial devices, such as small bracelets, also allow self-stimulation of this point, which can also be done with the touch of a finger.

Relaxation techniques such as meditation, sophrology, prenatal yoga can be a good complement in the prevention of pregnancy nausea because it is often aggravated by stress. In expectant mothers where the psychological component is present in the onset and / or worsening of nausea, hypnosis could be effective suggests a study (11).