“We’re pregnant, now what?” Morning sickness and heartburn

Laura Scheurer, MS L.Ac., RN, LMT

This is the second part of a series of articles about pregnancy by YinOva Acupuncturist and Obstetric Nurse, Laura ScheurerYou can read other articles in this series by clicking here.

Morning sickness, one of the most common of complaints in pregnancy, can vary widely from person to person.  One might experience a mild aversion to aromas that previously were perceived as pleasant and not much more.  In another, the mere thought of food can induce a wave of nausea accompanied by dry retching and or vomiting.  It may not come as a surprise to hear that “morning sickness” can occur at any time of the day. For some it is first thing in the morning only, for others it may be present constantly, even waking some women during the night.

Although no one is really clear as to the cause of nausea during pregnancy, it is thought to be due in part to an increase in estrogen levels and human chorionic gonadotropin (hCG), a hormone produced by the developing embryo after conception and later by the placenta.  Theories about other contributing factors include high stress levels and fatigue before conception and in early pregnancy.  Some believe emotional factors play a part as well.

Regardless of the cause, it is considered a “normal” side effect of pregnancy that is generally time-limited and will pass by the 12th to 14th week.  Conventional treatment usually involves reassurance and possibly an anti-emetic (medicine to stop the nausea and vomiting). From a Chinese medicine perspective, there are very dramatic and profound changes occurring  during pregnancy as the Conception Vessel and the Penetrating Vessel are now redirected from supporting a menstrual cycle to nourishing a growing fetus.  These extraordinary vessels traverse the front and center of the body.  The Penetrating Vessel (the sea of Blood) communicates with both the uterus and the Stomach.  It is said that when the Penetrating Vessel is disordered, it interferes with the descending action of the Stomach, causing a rebellious rising of Qi, leading to nausea and vomiting.

Acupuncture has been used effectively offering great results in the treatment of morning sickness, providing a real alternative to just putting up with feeling sick all the time. Treatment with Chinese medicine recognizes nausea and vomiting to be caused by one of a number of imbalances.  Some may sound familiar to you such as Stomach Qi deficiency, or Stomach cold, Spleen Qi deficiency, accumulation of phlegm or Liver Qi stagnation invading the Stomach.  These differential diagnosis, assist your acupuncturist in devising a treatment plan specific to your particular imbalance. Once you have received acupuncture and are on the road to recovery, we have some very helpful self-care suggestions that will help keep those nauseating episodes at bay.
Fluids
  • Avoid dehydration, even mild dehydration can make any nausea worse.  Dry lips, feeling thirsty, and decreased urinary output with dark concentrated urine are signs that your fluid intake is inadequate.
  • Suitable fluids start with water, water, water.
  • Teas, such a chamomile, peppermint or ginger tea are settling to the stomach.  For ginger tea, shave a thumbnail size of ginger into your cup, pour hot water over the ginger, add honey to taste, let steep for 10 minutes.  Limit the ginger tea to no more than 2 cups a day so as to not create heat in the Stomach.
  • Ginger ale, is helpful for those who feel some relief after burping.
  • Mineral water with lemon is refreshing and hydrating.
  • Some women find that a teaspoon of apple cider vinegar in a cup of hot water with a bit of honey to taste, settles an upset stomach.
  • If there are no symptoms of cold, ice pops and watery fruits like watermelon will keep you hydrated, and may be all you can tolerate for the time being.
  • Soups and broths are a great way to maintain hydration and supply some nutrients.  Potato soup, miso soup, chicken broth are all nourishing, in addition to providing hydration.
Foods
  • When thinking about what you can eat, think of what you would feed a 9-month old baby – bland, easy to digest foods.
  • Baby rice, porridge, potato, pasta, yogurt, peaches and pears, go down easily and are not difficult to digest.
  • Frequent, small meals encourage blood sugar levels to remain stable.
  • Avoid sweet, sugary treats as they will cause blood sugar levels to fluctuate contributing to nausea.
  • High protein snacks throughout the day and before bed, and a carb based breakfast may be helpful during this time.
Smells
  • Sometimes just a whiff of an odor or an aroma that was previously inoffensive, now triggers a wave of nausea.
  • A little essential oil on a hankie can save the day.  Try peppermint, lemon, or vanilla.
Acupressure Bands
  • Worn on both wrists, pressure is applied to an acupuncture point known as PC-6 or Neiguan (inner gate) as it is the empirical point for the treatment of nausea.
Heartburn

It is thought that the rising hormone levels of estrogen and progesterone during pregnancy, relax the smooth muscle of the sphincter between the esophagus and the stomach causing acid to counter-flow from the stomach into the esophagus.  Acid reflux, or heartburn can occur at any time during pregnancy, but most often at the end, in the last trimester when the gravid uterus rises up into the diaphragm.  The degree of discomfort can vary from very mild to severe pain with vomiting.  It is usually worse when in a reclined position and better when sitting upright.A Chinese medicine differential diagnosis may include Stomach Fire Blazing with strong thirst for cold drinks, or Food Stagnation, with a sensation of abdominal distention and belching.Acupuncture points on the foot, lower leg, wrist or mid-abdomen can be helpful to redirect the flow of digestive juices to their proper place.  Sometimes we can send our patients home with ear press needles to be applied to the webbed area between the 2nd and 3rd toe as an adjunct to weekly treatments.

Self-help suggestions
  • Small frequent meals as opposed to fewer larger meals makes more sense for you now.  As your baby grows, your internal organs are displaced smaller meals are processed easier than a large meal, especially when space is limited.
  • Learn to recognize and avoid the foods that trigger heartburn.  Some common culprits are highly seasoned rich foods, fried or fatty foods, processed meats, chocolate, coffee, alcohol and often times commercially prepared yeast containing products.
  • Antacids are generally safe to take, but avoid sodium bicarbonate since the sodium is absorbed into the blood stream causing a potential for other issues.
  • A safer alternative is an herbal antacid, hai piao xiao, or cuttlefish bone is a simple formula that also contains gan cao (licorice).
  • Read our blog for more detail on what foods to eat and what to avoid during pregnancy.
We think you will find these suggestions easy to incorporate into your daily routine and quite effective. Please see Part I of Laura’s series, Conquering Pregnancy Fatigue.
 
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