Pregnancy nausea and vomiting: how to manage them naturally?

The precise causes of nausea during pregnancy are still unknown. Studies show that a history of travel sickness or migraines may increase the risk. Nausea may also be linked to a woman's family history, as higher levels of nausea have been observed in women whose mothers experienced nausea during their own pregnancies [3].

The onset, duration and severity of symptoms vary from one woman to another, and from one pregnancy to the next in the same woman [4].

• Rise in hCG hormone in early pregnancy

The factor most closely associated with nausea and vomiting in pregnancy is human chorionic gonadotrophin (hCG). Human chorionic gonadotrophin (hCG) is synthesised and released to stimulate the production of luteal progesterone in order to maintain the pregnancy. It is also responsible for heightened sensitivity to smells in many pregnant women, triggering food aversions that can sometimes be very intense.

This link between the two is largely based on the temporal relationship between the peak in nausea and vomiting and the peak in hCG production, both of which occur between 12 and 14 weeks of pregnancy [5]. Higher urinary and blood hCG levels are observed in women experiencing nausea and vomiting compared with those who are asymptomatic [6][7].

• Thyroid stimulation and the embryo's iodine requirements

The link between hCG and nausea and vomiting can be explained by the fact that this hormone stimulates the thyroid in early pregnancy, in response to signals sent by the foetus. When dietary iodine is scarce, the embryo benefits at the mother's expense, but when iodine is abundant, pregnancy nausea — often mild and sometimes severe — is a consequence of the embryo's undiminished demand for iodine [8].

As such, nausea may indicate good thyroid function and good embryo quality, whereas an absence of nausea could potentially be a sign of a thyroid hormone problem [9] — even though many pregnant women experience no nausea at all and are perfectly healthy!

• Excess oestrogen and progesterone

Oestradiol levels rise in early pregnancy and fall later on, which reflects the typical pattern of nausea and vomiting during pregnancy. The greater the rise in oestrogen levels, the higher the incidence of vomiting [10]. Progesterone reduces smooth muscle contractility and may impair gastric emptying, leading to increased nausea and vomiting. 

Marie, co-founder of Jolly Mama:

"Pregnancy nausea can be very intense, and often what makes the difference is being prepared. Don't wait until you feel hungry. Always have something to hand. Personally, I found that having protein first thing in the morning helped a great deal. If you can manage it, eggs at breakfast are an excellent option. Otherwise, a good smoothie can really make a difference — for example: a banana, frozen fruit, a source of protein or collagen, plant-based milk… it's simple, quick, and often better tolerated than a traditional breakfast. The idea is not to eat perfectly, but to stabilise your blood sugar and avoid having an empty stomach. And that really does change things." 

In one review, researchers found that nausea was strongly associated with a reduced risk of miscarriage [11]. In women who had already experienced one or two pregnancy losses, nausea and vomiting were common in early pregnancy and were associated with a reduced risk of pregnancy loss during the first 20 weeks [12]. 

This could be due to the fact that the body may be protecting us from foods that could make us ill and pass bacteria to the baby [13].  

If you do not have nausea, this does not mean that you will not have a healthy pregnancy; and if your nausea stops, this does not mean that you are at risk of pregnancy loss either.

Alix d'Antras, Naturopath

"As uncomfortable as they are, nausea is most often transient and rarely goes beyond the 1st trimester. If it can reassure you, its presence has even been associated in several studies with a favourable course of pregnancy! That said, when nausea becomes very draining, I always pay attention to 3 things: hydration levels, good blood sugar management and possibly iron status. If this nausea has a physiological explanation, a weakened constitution can amplify it."

This is often the first question pregnant women ask themselves in the midst of a bout of nausea. The good news: for the majority of women, symptoms ease naturally.

• 50% of pregnant women find their nausea disappears by week 14 of pregnancy.
• 90% have no symptoms by week 22.
• In rare cases, nausea can persist into the third trimester — this is uncomfortable but rarely dangerous if hydration is maintained.

If your nausea is very severe, accompanied by weight loss, an inability to stay hydrated, or extreme fatigue that is affecting your daily life, see your doctor or midwife without delay. It may behyperemesis gravidarum, a severe form of pregnancy nausea that requires medical care.

1) Eat small snacks

It is better to have small, frequent snacks than large meals. This is known as meal splitting: ideally 5 to 6 small intakes per day to maintain stable blood sugar. This helps you avoid being too hungry, having an overly full stomach, or experiencing a drop in blood sugar levels. These three factors are common triggers for nausea!

Practical tip: prepare a small snack to leave on your bedside table the night before. Eating a few plain crackers or a handful of almonds before you even get up can significantly reduce the intensity of morning nausea.

2) Pay attention to fat content, favour carbohydrates

Foods that are too high in fat will delay gastric emptying and contribute to nausea and vomiting [14]. Carbohydrates are easy to digest and can help you take in some calories regardless, but be mindful that blood sugar fluctuations can trigger nausea. Choose low-glycaemic index carbohydrates (oats, wholemeal bread, legumes) rather than refined starchy foods.

Salted crackers, especially those made with white flour, can cause your blood sugar to spike, which is not ideal. If you do want to eat them, add some nuts, cheese, or avocado for example!

3) Consume protein

First-trimester nausea is associated with gastric dysrhythmias (disruptions to gastric activity). In one study, researchers observed that predominantly protein-based meals significantly reduced nausea and dysrhythmic activity [15]. Protein stabilises blood sugar by slowing carbohydrate absorption — this is their key role in managing digestive comfort during the first trimester.

Mama Poule, our organic liquid chicken broth, is rich in protein!

4) Favour liquids

Liquid meals reduce disruptions to gastric activity, which may help ease nausea [15]. This is often the most effective solution during episodes: a warm broth, a protein smoothie, or a warm ginger drink are better tolerated than solid foods.

Tip for consuming liquid protein: a latte with the powder Mamaload with cocoa that contains collagen.

5) Sour foods may help

Even if nothing is proven, they may help — which could explain why pickles are a common pregnancy craving. 

Something else that can help: lemon water.

6) Consume ginger

Ginger is known to help improve nausea and vomiting during pregnancy by stimulating gastrointestinal tract motility and promoting the flow of saliva, bile, and gastric secretions [16]. 

A study showed that treatment with 250 mg of ginger four times a day, compared to a placebo over 4 days, led to a significant improvement in nausea compared to women in the placebo group [16].

Please note: with food supplements, do not exceed 1g in 24 hours (and take only on the advice of your doctor).

7) Foods rich in vitamin B6

Vitamin B6 is commonly used as a first-line treatment for nausea and vomiting during pregnancy. It is associated with a reduction in nausea [17].

Sources of vitamin B6: pistachios, sunflower seeds, fruits and vegetables (bananas, lentils, etc.).

Vitamin B6-based medications may be prescribed by your doctor.

• Using acupressure

Acupressure is a non-invasive variant of acupuncture that involves applying constant pressure to specific points or areas. P6 acupressure (also known as the Neiguan point) is recommended for managing these symptoms. The P6 point is located on the inner forearm, near the wrist [18].

It is better to book an appointment with a specialist rather than giving yourself a massage alone. Certain acupressure points should not be stimulated during pregnancy.

• Aromatherapy may help with nausea

Lavender essential oil is safe to use during pregnancy and can be quite effective if it is smells that trigger your nausea. Diffuse a blend of 4 drops of true lavender + 1 drop of lemon or ginger. 

Do be mindful, however, of the essential oils you use during pregnancy.

• Aromatherapy may help with nausea

Lavender essential oil is safe to use during pregnancy and can be quite effective if it is smells that trigger your nausea. Diffuse a blend of 4 drops of true lavender + 1 drop of lemon or ginger.

Do be mindful, however, of the essential oils you use during pregnancy.

It is recommended to eat slowly, mindfully and according to your hunger. Avoid drinking during meals. If smells trigger your nausea, ask your partner to do the cooking.

• Eat foods cold rather than hot: they release fewer odours.
• Ventilate your living space regularly to limit triggering smells.
• Stress can worsen nausea by disrupting digestion: incorporate short sessions of deep breathing or relaxation into your daily routine.
• Keep a diary of your triggers (smells, foods, times of day) to anticipate the most intense episodes.

The vast majority of pregnancy nausea is physiological and harmless. However, certain clinical signs should prompt you to consult a doctor or midwife promptly:

• Inability to stay hydrated or eat for more than 24 hours
• Notable weight loss (> 5% of body weight)
• Very dark urine or no urine (a sign of dehydration)
• Very frequent vomiting (more than 3 to 4 times a day, for several days in a row)
• Extreme fatigue, dizziness, or confusion

These symptoms may be a sign of hyperemesis gravidarum — a severe form of pregnancy nausea affecting around 1% of pregnant women. It requires prompt medical attention, sometimes including hospitalisation, to prevent complications related to dehydration and nutritional deficiencies. In this case, self-medication — even with natural remedies — is not sufficient: medical support is essential.