Sarah Cimperman, ND

Pregnancy can be a magical time. Anticipation of a new baby brings families and couples closer together and inspires positive thoughts about the future. Strangers suddenly display random acts of kindness, offering to open doors, help carry groceries, and give up their seats. Hormone surges and increased circulation promote thicker hair, fuller breasts, and a healthy glow. The physiological changes behind these positive aspects of pregnancy can also have unpleasant side effects like morning sickness, heartburn, constipation, and back pain. Most of the time, natural remedies can treat these common complaints safely and effectively.

Morning Sickness

Increased levels of hormones during pregnancy can cause nausea and vomiting. Symptoms are often worst in the morning but can last all day and persist into the second trimester as well. A small percentage of women suffer from Hyperemesis gravidarum, a dangerous condition where frequent vomiting (more than three times per day) causes other symptoms like dehydration, low potassium levels, and/or weight loss, and may require hospitalization. Women who experience morning sickness also have lower rates of miscarriage during the first trimester. One study found that women, especially older women, who experienced morning sickness had an 8 percent risk of miscarriage compared to 30 percent in women who didn’t experience morning sickness.1

Natural remedies for morning sickness include ginger and vitamin B6, which should be taken under the supervision of a doctor. Iron in prenatal multivitamins can make nausea and vomiting worse, especially when taken on an empty stomach (they should always be taken with food). Women who experience morning sickness may benefit from taking a multiple without iron during their first trimester, when morning sickness is worst, and switching to a multiple with iron for their second and third trimesters. This should only be done under the supervision of a physician who can monitor iron levels.


Gastroesophageal reflux, commonly known as heartburn, can happen as the growing baby puts pressure on mom’s stomach and hormone changes relax the lower esophageal sphincter, which is the muscle that keeps acid in the stomach. When it isn’t tight enough, acid from the stomach can travel up into the esophagus where it causes inflammation and damages delicate tissues that were never meant to encounter an acidic environment.

Heartburn is often treated with acid-reducing medications, but too much stomach acid isn’t the problem. The problem is stomach acid in the wrong place. Turning off stomach acid in otherwise healthy stomachs isn’t a good solution for pregnant women who need stomach acid to absorb minerals. Instead I recommend eating smaller amounts more frequently to avoid over-filling the stomach, optimizing digestion by chewing food thoroughly (at least 20 chews per mouthful) and drinking fluids away from meals, remaining upright for at least two hours after eating, and avoiding foods that further relax the LES or otherwise aggravate heartburn. These include carbonated beverages, coffee, tea, dairy products, citrus fruits and juices, chocolate, peppermint, tomatoes, onions, spicy foods, fried foods, oily and high-fat foods, and alcohol. To heal inflamed tissues, pregnant women can safely take chewable deglycyrrhizinated licorice (DGL) lozenges twenty minutes before meals to prevent heartburn or between meals as needed when symptoms occur.


Increasing progesterone levels during pregnancy reduce motility in the gastrointestinal tract, slowing transit time to increase water absorption. Constipation can be exacerbated by lack of physical activity, diets low in fiber, and dehydration. Pregnant women can optimize transit time by drinking plenty of water, making non-starchy vegetables at least half of each meal, and getting regular physical activity. They can safely add prunes, prune juice, and/or ground raw flax seeds to their diet. If needed, natural remedies include probiotics, magnesium, psyllium, and senna. Like all supplements, they should be taken under the supervision of a doctor.

Back Pain

Back pain during pregnancy can have several causes. Hormone changes cause ligaments to loosen and muscles to spread apart. An expanding uterus puts pressure on the spine.  Posture changes result from a change in the body’s center of gravity. And even stress can contribute to back pain. There are several ways to treat it without medication. Exercises that can  help relieve back pain are low-impact activities like swimming, water aerobics, recumbent cycling, and yoga. Home treatments include exercising and stretching with large inflatable balls, taking a warm bath or shower, and applying an ice pack or hot water bottle to the affected area for up to twenty minutes several times a day. If needed, professional treatments like prenatal massage, chiropractic, and physical therapy can also be helpful. Pregnant women should always call ahead to make sure they will be able to work with a practitioner who has experience with pregnant women.


1 Chan RL, Olshan AF, Savitz DA, Herring AH, Daniels JL, Peterson HB, and Martin SL. Severity and duration of nausea and vomiting symptoms in pregnancy and spontaneous abortion. Human Reproduction. 2010;25(11):2907-12.

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Sarah Cimperman, ND is the author of the new book, The Prediabetes Detox: A Whole-Body Program to Balance Your Blood Sugar, Increase Energy, and Reduce Sugar Cravings. She graduated from NCNM in 2002 and has a private practice in New York City. Her expertise has been featured on Fox News and Huffington Post and in Natural Health magazine, Whole Living magazine, and the Well Being Journal, among other publications. Dr. Cimperman also writes two blogs, A Different Kind Of Doctor and The Naturopathic Gourmet.

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