Holistic Therapies
Traditional methods of treating Nausea and Vomiting of Pregnancy (NVP) include dietary changes, lifestyle modifications, and medications. However, many holistic therapies can also help women physically, mentally, and emotionally cope with their various NVP-related symptoms.
The management of NVP is complex, and women will often need to engage in various management modalities at the same time. Holistic therapies can easily complement additional techniques women are using to help them eat, drink, sleep, and prevent complications due to constant and severe nausea and vomiting.
Pregnant women should always talk to their HCP prior to implementing any holistic type of therapy (acupressure, aromatherapy, hypnosis, massage, meditation). Women should also make sure they are engaging in these therapies with licensed professionals and clearance from their HCP.
Background
Holistic therapies (also known as complementary or alternative medicine) consider healing and treating all aspects of a person (i.e. not just the gastrointestinal system).
Women may find that using a combination of different therapy types helps them combat their symptoms in the best way possible by having them focus on all aspects of their physical, mental, emotional, and spiritual health.
There are many aspects of a woman’s life that can be positively altered to help her better manage her symptoms. Lifestyle and dietary changes complement each other, are first-step recommendations, and may be all that is necessary for some women. However, in many cases, these changes may not be enough.
Holistic therapies can better balance and complement traditional management techniques by helping women relax, de-stress, practice mindfulness, and become more aware of their overall health.
For women who want to avoid medication, therapies such as hypnosis, aromatherapy, massage, acupuncture, meditation, yoga, and deep breathing can also help women physically, mentally, and emotionally cope with NVP.
Acupuncture, Acupressure, and Acustimulation
Acupuncture, acustimulation, and acupressure all involve different types of stimulation to the Nei Guan (PC6) point on the wrist; acupressure also includes many other points on the body. These methods are often studied in post-operative and chemotherapy nausea, as well as NVP.
Evidence for all types of PC6 stimulation is mixed, but due to a lack of harm and very few side effects, some women may find these methods helpful.
Conversely, acupuncture appointments and electrostimulation bands (ReliefBand®) can be expensive (without insurance coverage). Further, acupuncture appointments may not be tolerated in women with severe symptoms. Pressure wristbands (i.e. Sea-Bands®) may be more cost effective and can be easily added to any management regimen.
Women should also talk to their HCP before using any form of acupressure, acupuncture, or acustimulation.
Read more detailed information on acupressure, acupuncture, and acustimulation and NVP.
Aromatherapy
Aromatherapy is a method in which concentrated essential oils are inhaled via various methods to produce a positive/medicinal physiological effect almost immediately.
Some research indicates that olfactory stimulation (smelling) of various pleasant scents can positively affect pulse, blood pressure, skin temperature, and brain activity that results in a relative calmness, coupled with controlled breathing.
A drop or two of a pure essential oil on a cotton ball (or other method) can be very effective in combating and getting through brief nausea waves, especially when coupled with controlled breathing.
Further, this method may be very effective for women who are especially triggered by malodors. A quick whiff of a pleasant aroma may be enough to help women breathe through even a single wave of nausea, thereby potentially preventing a vomiting episode.
Note: This evaluation is based on inhalation, rather than topical application on the skin or oral ingestion. Essential oils should not be ingested at any time during pregnancy.
Read more information on Aromatherapy and NVP .
Hypnosis
Although there is very little research regarding hypnosis during pregnancy and its effectiveness (except for managing labor pain), some reports have documented significant relief from nausea through hypnosis.
The main component of hypnosis is deep relaxation that acts to decrease sympathetic nervous system arousal (which can activate the vomiting center of the brain). It is theorized that by entering such a deeply relaxing state, women can feel relief from their symptoms.
Hypnosis works through intense concentration, when an individual’s attention is focused on a specific task so intensely that it causes his/her surroundings to be temporarily unreachable.
Examples include not noticing the constant hum of a radiator, the ticking of a clock, or being able to read/study while listening to music (i.e. if a woman is focused on something very specific, she may not have awareness of her nausea).
Several limited studies with small sample sizes have documented symptom relief for women diagnosed with hyperemesis gravidarum. Various forms of hypnosis were used: ego strengthening, hypnotic relaxation suggestions, future-oriented guided imagery and symbolic guided imagery, as well as direct and indirect suggestions for making informed choices about healthy eating.
According to a medical study published in 2015 regarding relief from chemotherapy-related nausea and vomiting, the addition of hypnosis to antiemetic (anti-vomiting) medication was found to significantly reduce symptom severity.
Massage
Massage has tremendous benefits on stress levels, swelling, and general discomfort during pregnancy, may help reduce depression and anxiety, and may be very effective for some women during labor.
In one study of tactile massage (slow strokes, light pressure) on 10 hospitalized women with severe NVP, it was determined that these women used this brief period of massage as a relieving moment of rest and a sense of normalcy despite nausea ruling their lives.
However, the safety of prenatal massage is hardly ever studied during pregnancy, and current studies have focused on mental health effects, labor pain, and birth outcomes, not on safety, change of blood flow, blood pressure, or NVP. However, although data is very limited, there is currently a lack of evidence that massage is harmful during pregnancy, to include the first trimester.
There are relatively few general contraindications to massage, but side effects may include muscle soreness from too vigorous of a massage, or possible allergic reactions to lotions or oils used. It is also possible that massage may decrease blood pressure enough to lead to dizziness or exacerbate nausea.
All pregnant women should speak to their HCP before getting a massage, and make sure their therapist is registered/licensed, and has additional training or certification in prenatal massage. Women should also be aware that most massage therapy locations will not accept pregnant women until the second trimester, as a precaution.
Read more information on Massage and Pregnancy.
Meditation
Meditation (or learning to meditate) may help women focus on other aspects of the present that do not include their physical symptoms. However, meditation is a skill, and some women can instead end up focusing on their symptoms. Women can learn about meditation (mindful.org), and determine for themselves if this is a technique they would like to try.
Controlled breathing has also been shown to have a very powerful effect on nausea, especially when complemented with aromatherapy. Taking slow and controlled breaths at three seconds per inhale and exhale, and breathing in through the nose and out through the mouth creates better control and can slow down heart rate.
Mental Health/Counseling
Mental health concerns occur as a direct result of NVP; they are not the cause of NVP. It is imperative that women find an HCP who understands the true reality of this condition, and treats not only its physical symptoms, but the emotional and mental health aspects as well.
NVP can significantly affect a woman’s mental health and overall quality of life. Women tolerate nausea differently; some women can handle six weeks of nausea without much consequence, while others may break down after a week or even a day. Every woman is different, and every woman requires adequate support from her family, friends, employer, and HCP.
Even in extreme cases, women should recognize they are strong enough to handle this condition and they have resources available to help them, even if that support does not include their immediate family or social circle.
Women should talk to their HCP regarding their mood, emotional well-being, how they are coping with their symptoms, and how NVP is affecting their lives. Women also need to call their HCP immediately if they are becoming increasingly anxious, overwhelmed, helpless, and/or depressed.
Read more information on Mental Health and NVP.
Action
The management of NVP is complex, and women will often need to engage in various management modalities at the same time. Holistic therapies can easily complement additional techniques women are using to help them eat, drink, sleep, and prevent complications due to constant and severe nausea and vomiting.
Pregnant women should always talk to their HCP prior to implementing any holistic type of therapy. Women should also make sure they are engaging in these therapies with licensed professionals and clearance from their HCP.
Women should also consider sharing their NVP experience below, especially if their experience included managing symptoms with any holistic therapies. This can help other women gain additional perspectives on this condition and help them manage their own symptoms.
Resources
Pregnancy and Massage (American Massage Therapy Association)
Treatments for hyperemesis gravidarum and nausea and vomiting in pregnancy: a systematic review and economic assessment: Aromatherapy (Health Technology Assessment/U.K. National Health Service; 2016)
Aromatherapy for treating postoperative nausea and vomiting (Cochrane; March 2018)
Aromatherapy (U.S. National Center for Complementary and Integrative Health)
Effect of acustimulation on nausea and vomiting and on hyperemesis in pregnancy: a systematic review of Western and Chinese literature (BMC Complement Altern Med. 2016)
Meta-analysis of Acustimulation Effects on Nausea and Vomiting in Pregnant Women (Explore (NY). 2006)