“Morning sickness” is a poor name. For most pregnant women the nausea can come at any time of day, and for some it is relentless. At the severe end is hyperemesis gravidarum: vomiting so persistent that it causes dehydration and weight loss and may need hospital treatment.
Start with this
Pregnancy sickness is a physical condition. It is linked to hormonal changes of pregnancy, and research has pointed to a hormone called GDF15 as a key cause. It is not caused by anxiety, by ambivalence about the pregnancy, or by anything a woman is doing wrong.
For decades women with severe sickness were told it was psychological. That was wrong, and it caused real harm. Offering hypnosis is not a suggestion that the problem is in the mind. It is used in the same way it is used for nausea caused by chemotherapy: to help with a symptom that has a physical cause.
Get medical help
See your midwife or doctor if you:
- Cannot keep food or fluids down
- Are passing little or dark urine
- Feel dizzy or faint on standing
- Have lost weight
- Have vomited blood, or have abdominal pain or fever
Safe, effective anti-sickness medicines are available in pregnancy. Severe sickness may need fluids through a drip. Do not struggle on without help.
What the research on hypnosis shows
A systematic review. A 2010 review searched for studies of hypnosis for hyperemesis gravidarum. Of 45 identified, only six met the criteria. All six reported encouraging results. But their methods differed, and the reviewers concluded that the quality of evidence was not sufficient to establish whether hypnosis is an effective treatment.
A randomised pilot study. More recently, women in hospital with hyperemesis were given standard treatment alone, or standard treatment with hypnotherapy added. Those who also had hypnotherapy had less severe nausea and less frequent vomiting, and a shorter hospital stay.
Milder sickness. A small study reported that self-hypnosis reduced the intensity of nausea and vomiting from moderate to mild or none, with no significant change in a control group.
In short: encouraging small studies, and not enough good evidence to be sure. It is reasonable to try as an addition to medical care.
How it might help
- Reducing anticipatory nausea. After weeks of being sick, the smell of the kitchen or the sight of a toothbrush can trigger it. That learned response may be open to change.
- Calming the stomach through imagery and relaxation.
- Lowering stress and exhaustion, which make nausea harder to bear.
- Rest and sleep.
- A sense of some control in a situation that offers very little.
Techniques
- Cool, fresh air: a breeze at an open window, a mountain, the sea
- A settled stomach: a calm pool, or a soothing cool colour
- A dial for nausea, turned down a notch
- Sipping an imaginary cool drink that stays down comfortably
- Changing a trigger: imagining a smell as fainter and further away
- Suggestions that food and drink are comfortable and nourishing
A routine to try
- Lie propped up, somewhere cool with fresh air.
- Breathe slowly through your nose.
- Imagine cool, clean air filling your chest.
- Rest a hand on your upper abdomen and imagine it calm and still, like a quiet pool.
- Picture a dial showing your nausea. Turn it down by one number.
- Tell yourself: “My stomach is settling. I can sip and it stays comfortably down.”
- Stay for ten minutes. Take small sips of fluid afterwards.
Stop if lying still makes you feel worse. Short and often is better than long.
Other things that help
- Small, frequent, plain meals and snacks
- Eating something before getting up
- Sipping fluids little and often
- Cold foods, if smells are a trigger
- Rest
- Ginger, which has some evidence for mild nausea
- Acupressure wristbands, which some women find helpful
- Anti-sickness medication from your doctor
For partners and family
- Believe her. This is not exaggeration.
- Take over cooking and anything with strong smells.
- Help her get medical care if she cannot keep fluids down.
- Do not suggest she should just eat a biscuit and get on with it.
Support
Severe pregnancy sickness is isolating and can affect mental health. Specialist charities offer information and peer support. If you feel low or desperate, tell your midwife or doctor.
Choosing a hypnotherapist
Look for a health professional, such as a midwife, doctor or psychologist, with hypnosis training. Avoid anyone who implies the sickness has an emotional cause, or who suggests stopping medication.
The bottom line
Pregnancy sickness is physical and deserves proper medical treatment. Hypnosis is a safe addition that may ease nausea for some women, with early studies that are encouraging and not yet conclusive.
Next in the series: James Braid: The Surgeon Who Gave Hypnosis Its Name
This article is for general information and is not medical advice. Speak to your midwife or doctor about pregnancy sickness.