GYNECOLOGY

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MORNING SICKNESS

Morning Sickness

Understanding Morning Sickness
Physician Lim Yin Jia

What is Emesis Gravidarum (EG)?
Emesis Gravidarum (EG) is more commonly known as ‘Morning sickness’ – a pregnancy discomfort which occurs in the early stages of pregnancy. Pregnant women may experience loss of appetite, nausea and vomiting. Symptoms can occur at any time of the day, particularly evident in the morning. Under normal circumstances, the bouts of nausea/ vomiting will gradually reduce and be relieved by the end of the first trimester, without the need for medication. It is common for one to lose approximately 5% of her pre-pregnancy weight.

When is EG a cause for concern?
EG is a naturally-occurring reaction experienced by most mothers-to-be. Its severity is dependent on the individuals’ state of health and body constitution. Immediate medical attention is required if the symptoms severely aggravate or persist beyond the early stages of pregnancy, affecting daily activities. This condition is known as Hyperemesis Gravidarum (HG) – extreme nausea and vomiting, whereby one is unable to consume sufficient food and drinks, possibly leading to dehydration, weight loss and electrolyte (i.e. salts and ions in your blood and body fluid) imbalances. It is estimated to affect 0.5-2% of pregnant women. This pregnancy complication can harm both mother and fetus if no treatment is received. Sufferers of HG also find themselves to be extremely sensitive to particular smells, and certain odours may further induce vomiting.

Why does EG occur?
EG is believed to be associated to changes in the hormonal levels (mainly hCG) and emotional stress. During gestation, there is an increase in hormones which affect the gastric mobility, giving rise to nausea and vomiting. hCG levels decline after the first trimester, hence the relief of symptoms thereafter. Other than the physiological factor, pregnant women can experience a change in emotional state as well. Over-worrying can also result in anxiety, causing EG.

It is also observed that severe EG or HG can be hereditary.

What is TCM’s view on EG?
In the theory of TCM, EG is associated with the disharmony of ‘Stomach/Spleen’ and ‘Liver’. Upon conception, there is increased Qi and Blood supply to the womb for fetal development, strongly enhancing the Qi of the Chong Meridien. Chong Meridien is known to govern the Qi and Blood circulation in all main Meridiens, its function is closely linked to the reproductive system. The boost in Qi may affect disgestive system, leading to an abnormal upsurge of Stomach Qi, causing nausea and vomiting. This is especially evident in women with weaker digestion (weaker Spleen function).

In TCM, Liver is known to store and regulate circulation of Blood. More Blood is channeled to the womb during pregnancy, causing the relative decrease of Blood (Yin) in the Liver. The deficiency in Yin level result in its inability to curb the Liver Fire (Yang). The excess in Liver Fire can upset the Stomach Qi, causing nausea and vomiting too.

Lifestyle tips
1. Keep to a bland diet. Avoid cold, fried, fatty, salty and spicy food to minimise gastric irritation.

2. Distribute daily food intake over more mealtimes (which can be of smaller intervals), such that each meal consists of a smaller portion of food.

3. Take smaller sips of water at frequent intervals. Do not down a large amount of water at one go.

4. Avoid consuming herbs with strong warming properties (eg. Ginseng, Danggui) which are commonly known for their ‘nourishing’ effects, as such herbs may not be suitable for all. It is best to seek professional advice on treatment and medication.

5. Keep stress levels down. It is understandable for pregnant women to be worried over their pregnancy. Relax by listening to soothing music or speaking to others who can help to ease your concerns. Staying optimistic and adopting a positive mindset help in the growth of the baby too.

How can TCM help to alleviate morning sickness?

1. Simple Herbal Recipe (Plum and ginger tea乌梅生姜茶):

Boil dark plum fruit and fresh ginger slices (6-10g each) in approximately 300ml of water for 10-15 minutes.

Leave tea to cool, it may be consumed warm or at room temperature.

Drink in small amounts at regular intervals, especially when nausea acts up.

gingerdriedplum 

*It is advisable to consult a doctor/physician regarding your condition if symptoms persist.

2. Acupressure Point Massage:

Nei Guan (内关PC6) acupressure point is located on the inner forearm, approximately 3 finger-spacing below the wrist, in the depression between the two tendons.

Open Hands 

It is commonly used to relieve nausea, motion sickness and palpitations.

Gently apply downward pressure and massage the area in a circular motion. Do take note not to exert too much pressure.