Morning sickness treatments: from ginger to self-pity

A blog for people wanting to know what the evidence is on the safety and effectiveness of treatments for morning sickness – and for anyone interested in the kind of things that have been tried!

Page last updated: 29 June 2022 

Take-home points

Nausea and vomiting in early pregnancy (‘morning sickness’) is very common. There are many treatments available to women, including drugs and complimentary and alternative therapies. A Cochrane Review looking at whether treatments for morning sickness are effective and safe found that there is a lack of high quality evidence for any of the treatments, so whether any of them work or are safe is still uncertain. The NHS web page on ‘Vomiting and morning sickness’ has advice on when to seek help and on things you can try yourself.

‘Morning sickness’ – an age-old problem we haven’t solved

Looking at medical books written about five hundred years ago, there are some very strange ideas about women’s bodies. It was a world in which women were seen as inverted, faulty versions of men, with unruly wombs that wandered around the body and caused havoc if they didn’t get enough sex.

Fast forward to now and we are in an age of mind-blowing technical capabilities which allow us to explore the human body and intervene when it’s sick in ways unimaginable to our grandparents, never mind the people of the 16th century. So it’s rather surprising that we still haven’t conquered some pretty basic stuff. The nausea and vomiting that many experience in early pregnancy, often called ‘morning sickness’ despite its tendency to ignore the time of day, is one thing we haven’t mastered at all. We still don’t fully understand what’s going on to cause it and our rather clumsy casting around for things to relieve it suggests that we haven’t come on much in recent centuries.

 

Three pregnant women.
Three pregnant women. Published 1546.
Credit: Wellcome Library, London.

The evidence on treatments for morning sickness

There are so many things to try, from drugs to ginger, but do we know if they work and if they are safe?

A Cochrane Review Interventions for nausea and vomiting in early pregnancy (September 2015) brought together the evidence available that might help to answer these questions. The very severe pregnancy sickness ‘hyperemesis gravidarum’ is dealt with in another review Interventions for treating hyperemesis gravidarum (May 2016) and we have a blog about it: Hyperemesis gravidarum: support and better research are needed.

The review includes studies of many treatments including acupressure, acustimulation, acupuncture, ginger, chamomile, lemon oil, mint oil, vitamin B6 and several anti-sickness drugs. Disappointingly, there simply isn’t good, high quality, evidence to support the use of any of these.

We can’t say from this review that these things don’t work; rather that we don’t have the evidence to demonstrate whether they do, or whether they are safe. It’s important to understand that advice to try any particular remedy is not based on good evidence and to bear in mind the potential for harm and not to see ‘natural’ products as necessarily harmless.

If you have morning sickness…

Where does this leave you? Well, when making choices about treatments, it can be helpful to think BRAIN: What are the Benefits, Risks, Alternatives, what do want and what if I do Nothing?

It’s a shame we still don’t have any good evidence to put into the mix, but people’s preferences and priorities should always be part of decisions about treatment. If you can’t stand ginger, then you would probably choose to try other things first. Eating little and often is frequently suggested and it was common advice five hundred years ago too (you can be grateful that a number of other things, such as wafting frankincense fumes under your bottom, have fallen out of fashion).

The NHS page Vomiting and morning sickness has information about when to seek help and things you can try for yourself, including making changes to your diet and daily life. They suggest that distraction may be helpful, but I thoroughly enjoyed reading this opposing view from someone on Mumsnet: “My aunt recommended sitting on the bathroom floor wailing ‘Oh please, just let me die’. I felt more comforted by her telling me that than by all those who offered more conventional advice.” A reminder that, in the absence of good evidence, and alongside it when there is any, the patient’s preferences and experiences really do matter!

The Cochrane Review:

Matthews A, Haas DM, O’Mathúna DP, Dowswell T. Interventions for nausea and vomiting in early pregnancy. Cochrane Database of Systematic Reviews 2015, Issue 9. Art. No.: CD007575. DOI: 10.1002/14651858.CD007575.pub4.

Join in the conversation on Twitter with @CochraneUK @SarahChapman30 or leave a comment on the blog.

Please note, we cannot give specific medical advice and do not publish comments that link to individual pages requesting donations or to commercial sites, or appear to endorse commercial products. We welcome diverse views and encourage discussion but we ask that comments are respectful and reserve the right to not publish any we consider offensive. Cochrane UK does not fact check – or endorse – readers’ comments, including any treatments mentioned.

Sarah Chapman has nothing to disclose.

 



Morning sickness treatments: from ginger to self-pity by Sarah Chapman

is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International

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