The Cochrane Review on various treatments for nausea and vomiting of early pregnancy looked at studies investigating medications as well as using ginger, essential oils and acupressure and acupuncture. The overall finding of the review stated the researchers did not find “consistent or strong evidence from trials to support the use of any one pharmacological agent including vitamin B6, antihistamines, and other anti-emetic drugs to relieve mild or moderate nausea and vomiting” (1). They clarify that this is not the same as saying none of the treatments are effective; this just means that the studies performed so far don’t allow us to draw firm conclusions.
One other systematic review concluded that there is some evidence of the benefit of acustimulation for nausea and vomiting during pregnancy, but that more studies are needed (9).
Nausea is included in the list of conditions for which acupuncture has shown a benefit in an evaluation by the International Journal of Obstetrics and Gynecology (6). It is also recommended in the Hutt Hospital Guidelines (NZ) as an indication for which acupuncture treatment may be recommended (7), and acupressure to Pericardium 6 point is listed as a nonpharmacological treatment which appears to be effective in the NICE Clinical Guidelines for Antenatal Care (8) .
Acupressure Findings:
The 2015 Cochrane Review looked at 12 studies on acupressure point stimulation, most of which used a wrist band for stimulating an acupoint called Pericardium 6, located on the inner wrist. Researchers concluded that there was “some evidence regarding the effectiveness of P6 acupressure. There was also some evidence of the effectiveness of auricular acupressure, though further larger studies are required to confirm this.”
Acupuncture Findings:
Only two studies in the review looked at acupuncture for treating nausea and vomiting- which illustrates how little data the researchers had to work with. Although the Cochrane Review researchers concluded that “acupuncture (P6 or traditional) showed no significant benefit to women with nausea and vomiting in early pregnancy,” one of the studies did show some improvements in the acupuncture group. More studies are needed to draw definitive conclusions.
One study by Smith’s research group (3) of 593 women found that after two weeks, women in the traditional acupuncture group had significantly less nausea and dry retching. After 3 weeks, the group of women who were having acupuncture only at the Pericardium 6 inner wrist point started seeing the same benefits. After 4 weeks of the study, both groups of women having acupuncture (both a traditional style and those with pericardium 6 stimulation) continued to see significant improvement, and by this point in the study even women who were having “sham acupuncture” started to see a decrease in nausea. The control group, which did not have any acupuncture, had the least amount of improvement. This rules out spontaneous remission of symptoms as the women moved through their first trimesters. All of the changes mentioned above were considered “statistically significant”- meaning the changes were very unlikely to be due to chance.
The second study which was by Knight’s research group (4) compared 56 women having either acupuncture at Pericardium 6 or “sham” treatment which stimulated the point using a cocktail stick. Although no differences were found between these two groups, this was a much smaller study, so it is possible that if this had been a larger study the researchers would have been able to get a more accurate idea of whether acupuncture had helped or not. Additionally, since this study didn’t include a control group (women getting no acustimulation at all), it’s possible that the results they found were simply due to spontaneous remission of the nausea and vomiting as the women went through their first trimester. Another difference between the Smith study (3) and the Knight study (4) is that Knight only gave acupuncture treatments for 2 weeks, while Smith gave treatments for 4 weeks. It could be that the dosage of acupuncture is an important consideration- would the women have seen more of an improvement if they had continued treatment for 2 more weeks, or had more frequent sessions? We do not know the answers to these questions, therefore more research with larger, well-designed studies will be needed. Furthermore, both of these studies had limitations- a large number of women withdrew from the studies and all results were not clearly reported.
I would also like to briefly mention that the Smith research group wrote a separate paper analyzing the perinatal outcomes, pregnancy complications and infant outcomes of the women in their study (5). They found no statistically significant differences between any of the groups- those having acupuncture, sham acupuncture or no acupuncture during the first trimester. This is just one more study which adds to the growing body of research which reassures us that acupuncture is safe during pregnancy (see the Safety page for more information).