Ginger and Morning Sickness
Background to Morning Sickness
There are many causes of vomiting and nausea but this hub will focus on that which occurs during the first trimester of pregnancy. While this is commonly known as ‘morning sickness', it can actually occur at any time of the day. Mild to moderate nausea and/or vomiting during affects up to 80% of women during pregnancy. In a few cases, symptoms last the whole day. The nausea and vomiting of pregnancy (NVP) usually peaks by the ninth week and subsides by week 20 but in a few cases it can last throughout the whole pregnancy.
The exact cause of NVP is unknown. Nausea and vomiting involves various neural pathways and motor responses to sensory stimuli. While nausea and vomiting can occur independently, both involve a central nervous system (CNS) response using the same neural pathways to and from the brain. Once the trigger is activated it is followed by a gastrointestinal response which includes hypotonicity, hypoperistalsis, hyposecretion, decreased small intestinal motility, and ejection of stomach and small intestine contents. Whatever causes this reaction in pregnancy, may be attributed to natural hormone changes. A sudden rise of a hormone called human chorionic gonadotrophin (HCG) during early pregnancy controls the production of other pregnancy hormones. Levels of HCG rise rapidly during the first six weeks, are greatest at approximately 10 weeks, and begin to fall at approximately 12 weeks. This pattern fits in with the common pattern of NVP.
NVP is considered to be a normal feature of early pregnancy and has been associated with a healthy pregnancy, being linked to a lower miscarriage rate and larger healthier babies. However, NVP is inconvenient at best. Severe nausea and vomiting can progress to hyperemesis, especially if the woman is unable to maintain adequate hydration, fluid and electrolyte balance, and nutrition.
The development of pharmacological treatments has been hampered by the lack of consensus regarding the cause of NVP. The possible teratogenic effects of antiemetics make doctors reluctant to prescribe such drugs. Instead, traditional treatments involving dietary and lifestyle changes have been encouraged. Such treatments rarely result in the elimination of symptoms so many pregnant women and clinicians turn to complementary and alternative medicine in search of effective relief. This is where ginger comes in.
Chinese and Indian medical texts from the 4th and 5th century B.C. suggest that ginger is effective in treating nausea, diarrhoea, stomach aches, cholera, toothaches, bleeding, and rheumatism. Ginger was later used by herbalists to treat a variety of respiratory conditions, including coughs and the early stages of colds.
Arabian traders carried ginger root from China and India to be used as a food spice in ancient Greece and Rome. Medicinal use was recorded by the Greeks, and Romans probably transferred the practice to Britain. There are reports that Queen Elizabeth I used it for digestion.
Ginger's modern use dates back to the early 1980s, when a scientist noticed that ginger-filled capsules reduced his nausea during an episode of flu. Inspired by this, he performed the first double-blind study of ginger. Subsequently ginger was approved in Germany as a treatment for indigestion and motion sickness.
How the natural chemicals help
The above diagram the main known chemical constituents of ginger.
- The volatile oil stimulates the circulation and causes sweating.
- Cumene has a narcotic effect.
- Zingiberine is a terpene which is a chemical known to be an anti-nauseant.
- The resin contains gingerols and shogaol, which warm the body and assist circulation by inhibiting prostaglandins.
- Gingerol also helps block the action of the chemical messenger serotonin, which makes the stomach contract to cause vomiting.
Ginger as a reliever of Morning Sickness
Ginger is the herb most commonly used to treat the nausea and vomiting of pregnancy. However, the exact mode of action of ginger on morning sickness is largely unknown. In fact, the cause of morning sickness is largely unknown also but there are a few probable theories. GI tract motility is one of the changes associated with pregnancy and this could produce nausea and vomiting as well as constipation and a delay in stomach emptying time. The chemicals in ginger may increase the production of saliva and gastric juices as well as increase tone and peristalsis in the gut. Food that passes more rapidly through the digestive system is less likely to cause nausea and vomiting (See Mode A Diagram). Additionally, ginger may block the gastrointestinal reactions and subsequent nausea feedback.
The other big change associated with pregnancy is a rise in HCG and other hormones. The hormonal change probably leads to a hypersensitivity towards smells and tastes which subsequentially leads to feelings of nausea. Ginger is also thought to have absorbent properties which may reduce the stimuli to the chemoreceptor of the brain which sends messages to the emetic centre, prompting nausea and vomiting. The messages are usually initiated by toxic substances or raised blood levels of urea and ketones from the foetus (See Mode B Diagram).
It's also thought that the volatile oils kill any bacteria that may be causing the sickness and soothe the nerves that produce feelings of nausea.
Is it safe?
Ginger has no known toxicity. Side effects are rare but the main one is heartburn which usually occurs after excessive doses. Side effects such as heartburn or belching may be avoided by taking ginger in the form of capsules.
Ginger may not be suitable for people with gallstones, a bleeding disorder, or those who are taking blood thinning medication.
The studies I have read reported no adverse effects on babies but as there have not been enough specific studies into the safety of ginger ingestion during pregnancy, it is not clear whether its use should be recommended. It has been used with great results traditionally and has widespread support so as is the case with many medicines; it might be suitable for some but not all.
Researchers generally agree that studies need to be reproduced with a larger number of participants to gain a more accurate picture of the risk of adverse effects.
I hope that other factors are taken into account in future research as treatment with ginger may have dual benefits for pregnant women. For example, ingesting ginger in the form of tea may be useful for women who find it difficult to take in enough fluid, while ingesting ginger in the form of sugared sweets or biscuits may be useful for women who are underweight or low on appetite.
Some of my favourite ginger products
Many of the studies involving ginger and morning sickness have used capsules as the treatment method but there are many ways to enjoy ginger.
- Ginger tea
- Ginger biscuits/cookies
- Ginger cake
- Fresh ginger,
- Pickled ginger,
- Ginger candy,
- Ginger crystals
- Sugared ginger
- Grated ginger added to food such as salad
- Ginger essential oil aromatherapy treatment
Some people also choose inhaled powdered ginger, and while this does not sound like my cup of tea... each to their own!