Fertility & Pregnancy

Expert Views on Morning Sickness

By NATURA Magazine.

Morning sickness is dreaded by husbands and wives alike. In spite of available treatments, its occurence in early pregnancy conjures up scenes of couples having their sleep unceremoniously disrupted and starting each day with the sound and smell of vomit.

However, ‘morning sickness’ is a misleading term. Dr Christopher Chong, Obstetrician, Gynaecologist and Urogynaecologist at Gleneagles Hospital Singapore clarifies that its symptoms do not just occur in the morning. Dr Chong further notes that perhaps this affliction should simply be termed ‘nausea and vomiting.’ Yet the misnomer remains. Apart from the misconception about the time-sensitive nature of this condition, the causes of morning sickness are still a mystery.

Hormones & Horror

While there are various views as to what causes morning sickness, most of these perspectives tend to indicate the role of hormones. Dr Chong, for instance, ventures that it’s likely to be caused by the rise in pregnancy hormones. “In conditions where women have higher levels of hCG (human chorionic gonadotropin), such as by carrying multiple children, there are also higher rates of nausea and vomiting,” Dr Chong observes. “The exact cause remains a mystery, but it’s also likely due to a combination of physical factors that make a pregnant woman more prone to nausea and vomiting in the first trimester.”

Taking a stab at unravelling this mystery is Dr Jason Lim, Associate Consultant at the Department of Obstetrics and Gynaecology at Singapore General Hospital. “Morning sickness is caused mainly by the presence and gradual rise of two female hormones: hCG and progesterone. These slow down the digestion transit in the stomach and intestines, resulting in nausea, vomiting and, in some cases, reflux of gastric contents,” Dr Lim explains.

But morning sickness can also be attributed to the interplay of several factors. For instance, increased levels of oestrogen, an enhanced sense of smell and sensitivity to odours that trigger the gag reflex, and sensitive gastrointestinal tracts. Certain women may also be psychologically predisposed to nausea and vomiting as an abnormal response to the stress of pregnancy. Thankfully, cases of morning sickness generally improve with each trimester, although the severity of its occurrence does depend on the individual.

There are no known preventive measures against morning sickness—counteracting the hormones coursing through the woman’s body could affect the foetus’ development. Many treatment methods include consumption of healthy foods and ample hydration. Mild nausea, with the occasional vomiting, does not require medical therapy, nor does it threaten the baby’s wellbeing, as long as hydration is maintained. In more severe cases of vomiting, however, morning sickness can result in dehydration, electrolytes imbalance, poor nutritional status, lethargy, giddiness and fainting spells; in most cases, the mother’s appetite will return and she will start gaining weight naturally

Reflexes & Reactions

The Ayurvedic perspective of morning sickness identifies the root causes as reflexes and reactions of both baby and mother. According to Dr Girish Kumar and Dr Vrindha Balachandran, Senior Assistant Professor and Senior Research Fellow respectively from The Institute of Trans-disciplinaryHealth Sciences and Technology in Bangalore, India, morning sickness is due to an imbalance of a vital energy called vata. Vata is a combination of space (akash) and air (vayu). Abnormal reflex actions and psychogenic or psychological factors that occur during pregnancy may initiate nausea and vomiting, the latter of which can be further stimulated when foetal movement, provokes and pushes vayu upwards. In addition, the Ayurvedic perspective of morning sickness also accounts for the reactions of women during pregnancy. Morning sickness then is symptomatic or reflective of the desires for certain foods that are deficient within the body. This non-fulfillment of food desires may produce further deficiencies in the body and result in vomiting.

Constitutions & Cures

Traditional Chinese medicine understands and translates morning sickness as ‘pernicious vomiting with pregnancy.’ According to Physician Chen Yan Fang from the Eu Yan Sang TCM Clinic @ Novena, located in Royal Square, three common types of body constitutions are mostly likely to result in morning sickness: people with weak stomachs and spleens, those who have accumulated excessive phlegm and dampness in the stomach, and patients with a ‘heaty’ body constitution.

Treatments such as herbal remedies and acupuncture are prescribed according to the patient’s constitution. However, acupuncture is not always recommended and acupoints must be carefully chosen. As problematic constitutions are the root cause of morning sickness, these issues will be addressed first before trying to eliminate vomiting. For those with a weak stomach and spleen, treatment is targeted at strengthening those systems before treating the vomiting. Similarly, for the two other body constitutions, treatment seeks to remove phlegm and dampness in the body, and clear away the heat respectively, before prescribing any further treatment for vomiting.

That doesn’t mean that patients are at the mercy of their constitutions. Those with weak stomachs should stay away from fried, oily and spicy foods. They should also limit their intake of ‘cold’ foods, such as raw vegetables. Fresh ginger tea may also be taken to ‘warm’ the stomach and alleviate nausea. Physician Ban also recommends health supplements, such Vitamin B6.


Photo courtesy of Thinkstock. This article first appeared in NATURA magazine issue No.12.


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