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."

C'est souvent la première question que se posent les femmes enceintes au cœur d'une crise. La bonne nouvelle : pour la majorité des femmes, les symptômes s'estompent naturellement.

• 50% des femmes enceintes voient leurs nausées disparaître dès la 14e semaine de grossesse.
• 90% n'ont plus de symptômes à la 22e semaine.
• Dans de rares cas, les nausées peuvent persister jusqu'au troisième trimestre, c'est inconfortable mais rarement dangereux si l'hydratation est maintenue.

Si vos nausées sont très fortes, accompagnées d'une perte de poids, d'une impossibilité de s'hydrater ou d'une grande fatigue qui impacte votre vie quotidienne, consultez votre médecin ou sage-femme sans attendre. Il peut s'agir d'hyperémèse gravidique, une forme sévère de nausées de grossesse qui nécessite une prise en charge médicale.

1) Manger des petites collations

Il vaut mieux prendre des petites collations fréquentes que des gros repas. On appelle cela le fractionnement des repas : idéalement 5 à 6 petites prises par jour pour maintenir une glycémie stable. Cela vous évite d’être trop affamé, ou d’avoir le ventre trop plein, ou d’avoir une baisse de votre taux de sucre dans le sang. Ces trois facteurs sont des déclencheurs courants de nausées !

Astuce pratique : préparez une petite collation à mettre sur votre table de nuit la veille. Manger quelques biscuits secs ou une poignée d'amandes avant même de vous lever peut considérablement réduire l'intensité des nausées du matin.

2) Faire attention à la composition en gras, favoriser les glucides

Les produits trop gras vont retarder la vidange gastrique et favoriser les nausées et vomissements [14]. Les glucides sont faciles à digérer et peuvent vous aider à prendre un peu de calories malgré tout, mais attention car des fluctuations de la glycémie peuvent favoriser les nausées. Privilégiez les glucides à indice glycémique bas (flocons d'avoine, pain complet, légumineuses) plutôt que les féculents raffinés.

Les crackers salés, surtout s’ils sont faits avec des farines blanches, peuvent faire augmenter votre glycémie, ce qui n’est pas une bonne idée. Si vous souhaitez en consommer, ajoutez des noix, du fromage ou un avocat par exemple!

3) Consommer des protéines

Les nausées du premier trimestre sont associées à des dysrythmies gastriques (perturbations de l’activité gastrique). Dans une étude, ils ont observé que les repas à prédominance protéique réduisent les nausées et l'activité dysrythmique de façon significative [15]. Les protéines stabilisent la glycémie en ralentissant l'absorption des glucides — c'est leur rôle clé dans la gestion du confort digestif au premier trimestre.

Mama poule, notre bouillon de poule liquide bio, est riche en protéines !

4) Favoriser les liquides

Les repas liquides diminuent les perturbations de l’activité gastrique, ce qui pourrait diminuer les nausées [15]. C'est souvent la solution la plus efficace lors des crises : un bouillon chaud, un smoothie protéiné ou une boisson chaude au gingembre sont mieux tolérés que les solides.

Astuce pour la consommation de protéines liquides : un latte avec la poudre Mamaload au cacao qui contient du collagène.

5) Les aliments aigres peuvent aider

Même si rien n’est prouvé, ils pourraient aider, ce qui expliquerait pourquoi les cornichons sont une envie fréquente de grossesse. 

Ce qui peut aussi aider : de l’eau au citron.

6) Consommez du gingembre

Le gingembre est connu pour aider à améliorer les nausées et vomissements de la grossesse en stimulant la motilité du tractus gastro-intestinal et en favorisant l'écoulement de la salive, de la bile et des sécrétions gastriques [16]. 

Une étude a montré qu’un traitement avec 250 mg de gingembre quatre fois par jour en comparaison à un placebo pendant 4 jours avait permis une amélioration significative des nausées par rapport aux femmes du groupe placebo [16].

Attention aux compléments alimentaires, ne pas dépasser 1g en 24h (et prendre après avis de votre médecin).

7) Les aliments riches en vitamine B6

La vitamine B6 est couramment utilisée comme traitement de première intention des nausées et vomissements de la grossesse. Elle est associée à une diminution des nausées [17].

Sources de vitamine B6 : pistaches, graines de tournesol, fruits et légumes (bananes, lentilles, etc).

Des médicaments à base de vitamine B6 peuvent être prescrits par votre médecin.

• 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.