Morning Sickness

By Jiang Liu, Diplomate of Oriental Medicine
AR Licensed Acupuncturist and Herbalist
Acupuncture & Chinese Medicine Clinic
2024 Arkansas Valley Dr., Suite 402
Little Rock, AR 72212


Morning sickness is also called nausea gravidarum, nausea and vomiting of pregnancy, or pregnancy sickness. Usually, it is present in the early hours of the morning and reduces as the day progresses. The nausea can be mild or induce actual vomiting. In extreme cases that are known as hyperemesis gravidarium, morning sickness is so severe and long-lasting that it can cause weight loss, dehydration and even hospitalization.

Acupuncture is considered the most useful form of Chinese Medicine treatment for morning sickness. Various studies show acupuncture provides relief for those who suffer from morning sickness. BBC News Online reports that one Australian study shows acupuncture can ease nausea and vomiting for nearly 600 participants of expectant mothers. The study involved women who were less than 14 weeks pregnant with symptoms of nausea or vomiting. They were given weekly 20-minute sessions of acupuncture for four weeks. Dr. Smith, from the Women’s and Children’s Hospital and Adelaide University said: “We found that traditional acupuncture reduced nausea throughout the trial with dry retching being reduced from the second week”. “Women now have an additional option to manage their morning sickness”. “I hope this exciting evidence that complementary therapy does work, will open up new opportunities for funding future research in women’s health.”

Acupuncture studies on accupoint P6
Various studies have documented the use of acupuncture to combat nausea and vomiting, with P6 (PC6), an acupoint located above the wrist on each arm, among the points most commonly tested. The results show the effectiveness of this acupoint on relieving morning sickness. The following are some of those studies.

Effect of acupressure on nausea and vomiting during pregnancy
In this study, the treatment group comprised 26 women; 25 in the control arm and 24 women were assigned to the placebo arm. The study occurred over a 9-day period. During this time, the treatment group applied acupressure bands to P6 acupressure point on days 4-6 of the study with the placebo group receiving acupressure bands to a sham acupressure point, on the upper side of their wrists.RESULTS AND CONCLUSION: Acupressure would appear to be effective in symptom control, and alleviation and placebo effects in reducing the symptoms of nausea and vomiting during pregnancy. Can Gurkan O et al. Complementary Therapies in Clinical Practice, 14(1):46-52, 2008

Effect of acupressure on nausea and vomiting during pregnancy (NVP)
A randomized, placebo-controlled, pilot study involved 60 women. RESULTS: It is possible to reduce NVP significantly with acupressure at P6 as compared to acupressure at a placebo point or no treatment at all in healthy women with normal pregnancies. Relief from nausea appeared one day after starting treatment in both the P6 and placebo groups but lasted for only six days in the placebo group. The P6 group, however, experienced significantly less nausea after 14 days as compared to the other two groups. CONCLUSION: This study involved 60 healthy women with normal pregnancy and suffering from NVP. According to the results, in healthy women with normal pregnancy it is possible to reduce NVP significantly at P6 as compared to acupressure at a placebo point and to no treatment. Wemtoft E et al. J Reprod Med, 46(9):835-9, 2001

Manual acupuncture reduces hyperemesis gravidarum
Researchers randomly assigned 33 women to acupuncture treatment at a specific point (P6) on the underside of the wrist, or to sham treatments at a different spot. After two days, all treatments were stopped for an additional two days to allow any effects to dissipate. Then the groups were reversed for two more days of treatment. Before treatment all women were vomiting. On day three, only seven out of seventeen women (41 percent) receiving active acupuncture were still vomiting compared with 12 out of 16 (75 percent) receiving sham treatment. After the active and sham groups were switched, more of the women receiving active treatment stopped vomiting. Women also reported experiencing less nausea. Carlsson CP et al. J Pain Symptom Manage, 20(4):273-79, 2000

A double-blind cross-over study to evaluate the effectiveness of acupressure at pericardium 6 (P6) in the treatment of early morning sickness (EMS)
In this study, 23 patients were entered into a double-blind cross-over study to evaluate the use of P6 acupressure versus sham acupressure in the treatment of early morning sickness. Sixteen completed the study. P6 acupressure was significantly more effective than the sham acupressure in the relief of nausea as measured by daily visual analogue scales (P = 0.019). Two thirds of the patients preferred acupressure on P6 as compared to the sham point. Bayreuther J at al, Complementary Therapies in Medicine, 2 (2):70-76, 1994

Morning sickness control in early pregnancy by Neiguan point acupressure
In this study, sixty women in early pregnancy were entered into a randomized, double-blind, cross-over, placebo-controlled trial. During a 12-day period, organized in four steps of 3 days each, the women were divided into two homogeneous groups to test the effectiveness of unilateral and bilateral acupressure. RESULTS: Use of acupressure resulted in a significantly lower frequency of morning sickness compared with placebo treatment. More than a 60% positive effect was found with unilateral and bilateral acupressure, compared with an approximately 30% positive effect of placebo acupressure. Changing from unilateral to bilateral pressure on the Neiguan point caused no significant statistical difference. No noteworthy side effects occurred. CONCLUSION: Acupressure on the Neiguan point relieves morning sickness. de Aloysio D et al. Obstetrics & Gynecology, 80(5):852-4, 1992

Belfast experience with P6 acupuncture antiemesis
In a strictly controlled clinical situation, (postoperative sickness) where variables were reduced to a minimum, it was possible to demonstrate an effective prophylactic antiemetic action of P6 (Neiguan) acupuncture. Manual and electrical invasive (needling) stimulation of this point were equally effective. Non-invasive stimulation (transcutaneous electrical or pressure) was effective in the early postoperative period, but the effect did not last as long as for invasive acupuncture–although it was as good as standard antiemetics. Stimulation of a “dummy” acupuncture point was ineffective as was administration of the acupuncture after the emetic stimulus (opioid). This effect can be blocked by local anaesthesia at the P6 point. Acupressure on P6 is moderately effective in reducing morning sickness, but here there is more of a psychological element as pressure on a “dummy” point gives some alleviation of symptoms. Given in conjunction with standard antiemetics, P6 acupuncture is a useful adjuvant in reducing sickness after cancer chemotherapy. This effect can be prolonged for 24 hours by acupressure. Dundee J W. Ulster Medical Journal, 59(1):63-70, 1990

Acupressure therapy for morning sickness
A prospective, controlled clinical trial examined the efficacy of acupressure therapy for morning sickness, using a two groups, random assignment, crossover design. Subjects in Group 1(N = 8) used acupressure wristbands for five days, followed by five days without therapy. Subjects in Group 2 (N = 8) had no therapy for five days, followed by five days use of wristbands. The Multiple Affect Adjective Checklist and Sickness Impact Profile were used, and extent of nausea was assessed at baseline, day five, and day ten. Use of acupressure wristbands relieved morning sickness for 12 of 16 subjects. Acupressure therapy resulted in statistically significant reductions in anxiety, depression, behavioral dysfunction, and nausea. Limitations of the study and suggestions for future research are presented. Hyde E. Journal of Nurse-Midwifery, 34(4):171-8, 1989

P6 acupressure reduces morning sickness
A prospective study was designed to test the efficacy of pressure at the P6 (Neiguan) acupuncture point, in preventing morning sickness. Three groups of patients in early pregnancy recorded the severity and frequency of sickness over a period of 4 consecutive days following daily pressure at P6 point, pressure at a point near the right elbow and with no treatment. Troublesome sickness was significantly less in both the genuine (23/119) and dummy (41/112) pressure groups as compared with the control series (67/119). When the data are adversely ‘weighted’ to compensate for the lower incidence of fully completed returns in the active treatment groups, only the P6 group show a significant reduction in sickness. No side effects occurred in either group and while anticipation of benefit may offer a partial explanation for the findings, pressure at the Neiguan point appears to have a specific therapeutic effect. Dundee J W et al. Journal of the Royal Society of Medicine, 81(8):456-7, 1988.

Etiology & Classifications & principle of treatment
In Chinese Medicine, when a woman becomes pregnant, the vital substances of her body such as the essence, blood and kidney qi are collected together to form the new life within her body. This change often causes an obstruction or stagnation in one of major meridians (Chongmai) that regulate the blood and qi of the body, which leads to rebellious stomach qi rising up and causing nausea. Because of this pathology, several patterns of disharmony can occur in the body, such as qi imbalance between liver and stomach, qi deficiency of spleen and stomach, phlegm/damp accumulation, or qiand yin deficiency.

A single acupoint P6 is effective in relieving the symptoms of morning sickness in the various clinical studies. However, in clinic practice, multiple acupoints are commonly used according to individual situation and are much more effective than single acupoint. Depending on your specific presentation of symptoms, the Chinese Medicine practitioner will select the most effective points to relieve the nausea and vomiting.

Disharmony between Liver and Stomach
Sign and symptoms: vomit bitter fluids, stressful and hypochondriac fullness/pain
Principle of treatment: soothe liver, harmonize stomach and descend qi

Spleen Stomach deficiency
Sign and symptoms: vomit clear fluids, poor appetite and digestion, fatigue, loose stools and pale complexion
Principle of treatment: tonify stomach and spleen, descend stomach qi and regulate Chongmai

Phlegm-Damp accumulation
Sign and symptoms: vomit sputum-like or sticky fluids, sweet, sticky mouth, no appetite, palpitation chest/abdominal fullness or bloating
Principle of treatment: transform phlegm, resolve damp, harmonize stomach and spleen, and regulate Chongmai

qi and yin deficiency
Sign and symptoms: vomit with blood strips, low spirit, skinny, tired extremities, fever, thirsty, dry lips and tongue, scanty urine, constipation
Principle of treatment: tonify qi, nourish yin, regulate stomach and stop vomiting

Since the nature of morning sickness (nausea and vomiting), herbal medicine is rarely used. Acupuncture, acupressure, TuiNa, and some other Chinese medicine modalities can be used.