The Relationship Between Acupressure Technique And The Reduction Of Nausea And Vomiting In Early Pregnancy

The Relationship Between Acupressure Technique And The Reduction Of Nausea And Vomiting In Early Pregnancy

Authors

  • Faizal Akbar Farid Musliem Tanjungsiang Public Health Centre, Subang Regency, West Java, Indonesia / Graduate of Faculty of Medicine, University of Malahayati, Bandar Lampung, Indonesia

Keywords:

Acupressure, Nausea and Vomiting of Pregnancy (NVP), Early Pregnancy, Morning Sickness, Hyperemesis Gravidarum, P6 Point, Neiguan, Non-pharmacological Intervention, Systematic Review

Abstract

Introduction: Nausea and vomiting in early pregnancy (NVP), commonly known as morning sickness, is a prevalent condition affecting a majority of pregnant women, significantly impacting their quality of life. While often managed with dietary adjustments or pharmacological interventions, there is a growing interest in safe, non-invasive, and non-pharmacological alternatives. Acupressure, a traditional Chinese medicine technique applying pressure to specific acupoints, has emerged as a potential intervention, with the P6 (Neiguan) point being the most commonly targeted. This systematic review synthesizes the current evidence on the effectiveness of acupressure techniques for reducing NVP.

Methods: A systematic review methodology was employed. Electronic databases were searched for studies published up to 2025. Studies were screened based on pre-defined criteria focusing on pregnant women in the first trimester experiencing NVP, interventions using pressure-based acupressure techniques, and designs including randomized controlled trials (RCTs), quasi-experimental studies, and systematic reviews. Data were extracted on study design, population characteristics, intervention protocols (points, method, duration), outcome measures, and results. The findings from 71 included sources were synthesized narratively and quantitatively where appropriate.

Results: The synthesis of evidence from 71 studies, including RCTs, quasi-experimental designs, and meta-analyses, indicates that acupressure is an effective intervention for reducing NVP. The P6 point was the most frequently studied and demonstrated significant efficacy. Meta-analyses reported strong pooled evidence; for instance, one found acupressure reduced nausea (RR=0.47) and vomiting (RR=0.59) significantly (R. Helmreich et al., 2006). Quasi-experimental studies showed substantial pre-post symptom reductions (e.g., B. Devi, 2020). Acupressure was found effective for mild to moderate NVP, with emerging evidence supporting its use even in hyperemesis gravidarum (HG), particularly as an adjunct (Nor Azila Mohd Nafiah et al., 2022; H. Shin & Young A Song, 2005). Combination therapies with ginger or aromatherapy often yielded enhanced effects (Nikmah Jalilah Ritonga et al., 2020; Risa Ayu Faturanti et al., 2025). The safety profile was consistently favorable with minimal adverse effects.

Discussion: The evidence supports acupressure as a viable, safe, and effective non-pharmacological option for managing NVP. Effectiveness appears influenced by symptom severity, methodological rigor, intervention protocol (e.g., continuous vs. intermittent application), and comparator type. While placebo effects may contribute, especially in unblinded studies, the consistent positive findings across diverse study designs strengthen the case for its clinical utility. Acupressure offers a practical, self-administerable option that aligns with patient preferences for minimal intervention during pregnancy.

Conclusion: Acupressure, particularly at the P6 point, is recommended as an effective first-line or adjunctive intervention for reducing nausea and vomiting in early pregnancy, especially for women with mild to moderate symptoms. It presents a favorable safety profile. Future research should focus on standardized protocols, long-term effects, and cost-effectiveness to facilitate integration into routine prenatal care.

References

A. Adlan, Kar Yoke Chooi, and N. A. Mat Adenan. “Acupressure as Adjuvant Treatment for the Inpatient Management of Nausea and Vomiting in Early Pregnancy: A Double‐blind Randomized Controlled Trial.” The Journal of Obstetrics and Gynaecology Research, 2017.

A. Heazell, J. Thorneycroft, V. Walton, and I. Etherington. “Acupressure for the in-Patient Treatment of Nausea and Vomiting in Early Pregnancy: A Randomized Control Trial.” American Journal of Obstetrics and Gynecology, 2006.

A. Norheim, E. J. Pedersen, V. Fønnebø, and L. Berge. “[Acupressure Against Morning Sickness].” Tidsskrift for Den Norske Laegeforening, 2001.

———. “Acupressure Treatment of Morning Sickness in Pregnancy. A Randomised, Double-Blind, Placebo-Controlled Study.” Scandinavian Journal of Primary Health Care, 2001.

Alfira Fitriana, Agus Kristiyanto, and Hanung Prasetya. “The Effect of Accupressure on Hyperemesis Gravidarum and Birth Delivery Pain in Pregnant Women: A Meta Analysis.” Journal of Maternal and Child Health, 2021.

Anita Iriani, and Resi Galaupa. “Effectiveness of Combination of Ginger and B6 with Acupressure Point PC6 and ST36 in Reduce Emesis.” Science Midwifery, 2023.

Apithan Puangsricharern, and Supphachoke Mahasukhon. “Effectiveness of Auricular Acupressure in the Treatment of Nausea and Vomiting in Early Pregnancy.” Journal of the Medical Association of Thailand = Chotmaihet Thangphaet, 2008.

Arne Johan Norheim, Erik Jesman Pedersen, Vinjar F. “Acupressure Treatment of Morning Sickness in Pregnancy. A Randomised, Double-Blind, Placebo-Controlled Study,” 2001.

Ayça Şolt Kırca, and Derya Kanza Gul. “Effects of Acupressure Applied to P6 Point on Nausea Vomiting in Pregnancy: A Double-Blind Randomized Controlled.” Alternative Therapies in Health and Medicine, 2020.

B. Devi. “Effectiveness of P6 Acupressure on Reduction of Nausea, Vomiting & Retching Among Antenatal Women Attending Antenatal Clinic at District Hospitals of Sikkim,” 2020.

B. Nisha. “Effectiveness of Acupressure on Reduction of Nausea and Vomiting Among Antenatal Mothers in Bensam Hospital at Kanyakumari District.” 2012.

Desfita Sari, and Istiqomah Risa Wahyuningsih. “Pengaruh Akupresur Titik Perikardium 6 Terhadap Mual Muntah Pada Ibu Hamil Trimester 1 Di PMB Ariyawati Susiandari, S.Tr.Keb., Bdn.” Vitamin : Jurnal Ilmu Kesehatan Umum, 2025.

Diani Aliansy, Intan Karlina, and Sri Maryati. “Comparative Study: The Effectiveness of Acupuncture, Acupressure, and Aromatherapy in Overcoming Nausea Vomiting in First Trimester Pregnant Women.” Asian Journal of Health and Applied Sciences, 2023.

D.N.Sc. Maha M. Mady Safaa G. Aly. “Effect of Acupressure on Nausea and Vomiting During Pregnancy.” The Medical Journal of Cairo University, 2019.

E. Purba, Suryati Romauli, Gemi Rahayu, and Elisabeth Gultom. “Pengaruh Kombinasi Aromaterapi Lemon Dan Akupresur Terhadap Penurunan Mual Dan Muntah Pada Ibu Hamil Trimester I Di Praktek Mandiri Bidan Suryati Kabupaten Jayapura.” Jurnal Wacana Kesehatan, 2024.

E. Van den Heuvel, M. Goossens, H. Vanderhaegen, Haichen Sun, and F. Buntinx. “Effect of Acustimulation on Nausea and Vomiting and on Hyperemesis in Pregnancy: A Systematic Review of Western and Chinese Literature.” BMC Complementary and Alternative Medicine, 2015.

Elisabet Werntoft, and A. Dykes. “Effect of Acupressure on Nausea and Vomiting During Pregnancy. A Randomized, Placebo-Controlled, Pilot Study.” Journal of Reproductive Medicine, 2001.

F. Saberi, Z. Sadat, Masoomeh Abedzadeh-Kalahroudi, and Mahbobeh Taebi. “Impact of Acupressure on Nausea and Vomiting During Pregnancy,” 2012.

F. Saberi, Z. Sadat, Masoumeh Abedzadeh-kalahroudi, and M. Taebi. “Acupressure and Ginger to Relieve Nausea and Vomiting in Pregnancy: A Randomized Study.” Iranian Red Crescent Medical Journal, 2013.

F. Tara, H. Bahrami-Taghanaki, Masoud Amini Ghalandarabad, Z. Zand-Kargar, H. Azizi, H. Esmaily, and H. Azizi. “The Effect of Acupressure on the Severity of Nausea, Vomiting, and Retching in Pregnant Women: A Randomized Controlled Trial.” Complementary Medicine Research, 2020.

Fatma saber Nady Mohammed, Asmaa Mohamed Ahmed Madkour, Safaa Sayed Mustafa Ibrahim, and Amal Ahmed Abdelhafez. “Effect of Acupressure Band-Aid Combined with Expectancy Manipulation Instructions on Pregnancy Related Nausea and Vomiting.” Egyptian Journal of Health Care, 2024.

Gusti Ayu Tirtawati, Ni Ketut Somoyani, Ni Luh Putu Sri Erawati, Putri Yuniartis, and Siti Rahmadani Nasution. “Effectiveness of Acupressure at PC6 Versus ST36 Points on Nausea and Vomiting in First-Trimester Pregnant Women: A Quasi-Experimental Study.” Journal of Health and Nutrition Research, 2025.

H. Mahmood, T. Shah, Sohail Rasool, Ammara Waqar, Zia-ul-Miraj, Z. Maken, Awais Gohar, and A. Rauf. “Effect of Vitamin B6 and Acupressure on Vomiting Symptoms in Pregnant Women with Hyperemesis Gravidarum.” American Journal of Biomedical and Life Sciences, 2021.

H. Shin, and Young A Song. “[The Effect of P6 Acupressure for Symptom Control in Pregnant Women Having Hyperemesis Gravidarum].” Taehan Kanho Hakhoe Chi, 2005.

Hastuti Marlina, and Sherly Vermita Warlenda. “Pericardium 6 (PC6) Acupressure in Reducing the Frequency of Emesis Gravidarum in First Trimester Pregnant Women in the Work Area of Community Health Center X.” Jurnal Multidisiplin Madani, 2022.

Hejing Liu, Cai Liao, Junyuan Deng, Yunhao Yang, Yan Yang, Xiao Guo, Chunshan Liu, and Chenglin Tang. “Efficacy of Acupoint-Related Therapies for Nausea and Vomiting in Pregnancy: A Bayesian Network Meta-Analysis.” Frontiers in Medicine, 2025.

I. Neri, G. Allais, P. Schiapparelli, I. Blasi, C. Benedetto, and F. Facchinetti. “Acupuncture Versus Pharmacological Approach to Reduce Hyperemesis Gravidarum Discomfort.” Minerva Ginecologica, 2005.

Ika Nur Saputri. “The Effect Of Acupressure On Decreasing The Frequency Of Emesis Gravidarum Pregnant Women In Trimester I.” JURNAL KEPERAWATAN DAN FISIOTERAPI (JKF), 2023.

Indah Gasela, Ratna Dewi Putri, and Stella Maris Bakara. “The Effectiveness Of PC6 Point Acupressure In Overcoming First Trimester Degree Ii Hyperemesis Gravidarum.” Media Informasi, 2025.

Indah Kusmindarti, Veryudha Eka P, and I. Yulianti. “The Effect of Complementery Acupressure Therapy for Morning Sickness.” Jombang Nursing and Midwifery Journal, 2022.

Intan Roesyati, Faizah Betty Rahayuningsih, and Siti Nurlaili. “Effectiveness of Acupressure Therapy in Reducing First Trimester Hyperemesis Gravidum: Case Study.” Open Access Research Journal of Science and Technology, 2023.

J. Gong, Dandan Gu, Hui Wang, Feng Zhang, Wangqin Shen, Haiou Yan, and Juan Xie. “Effect of Acupressure in Nausea and Vomiting Treatment During Pregnancy: A Meta-Analysis.” Explore, 2023.

Langka Langka, and Lailatul Magfiro. “THE EFFECT OF ACUPRESSUR ON NAUSEA AND VOTING IN PREGNANT MOTHERS TRIMESTER I.” Jurnal Ilmu Dan Teknologi Kesehatan, 2023.

M. Galeshi, A. Ghanbarpour, M. Naeimi Rad, and Shokat Asghari. “A Comparison of the Effect of Pressure on the KID21 (Youmen) and P6 (Neiguan) Points on the Severity of Nausea and Vomiting of Pregnancy.” Journal of Complementary and Integrative Medicine, 2020.

M. Naeimi Rad, M. Lamyian, R. Heshmat, M. Jaafarabadi, and S. Yazdani. “A Randomized Clinical Trial of the Efficacy of KID21 Point (Youmen) Acupressure on Nausea and Vomiting of Pregnancy.” Iranian Red Crescent Medical Journal, 2012.

Magfirah Magfirah, S. Fatma, and Idwar Idwar. “The Effectiveness of Acupressure Therapy and Aromatherapy of Lemon on the Ability of Coping and Emesis Gravidarum in Trimester I Pregnant Women at Langsa City Community Health Centre, Aceh, Indonesia.” Open Access Macedonian Journal of Medical Sciences, 2020.

Maria Tariq, Uzma Nayyer, Sana Hassan, Sara Jamil Khan, Aisha Yousaf, and Maryum Noor Malik. “Effectiveness of Acupressure at Neiguan (P6) Point on Nausea and Vomiting During Early Pregnancy.” Annals of PIMS-Shaheed Zulfiqar Ali Bhutto Medical University, 2024.

Marliana Rahma, and Y. S. Rahayu. “The Impact of Using Acupressure Wristband on PC 6 Point to Reduce Nausea and Vomiting During Pregnancy.” Malahayati International Journal of Nursing and Health Science, 2024.

Melike Punduk Yilmaz, S. Yazıcı, and İ. Yılmaz. “Effect of Acupressure at PC6 on Nausea and Vomiting During Pregnancy: A Randomized Controlled Trial.” Innovations in Acupuncture and Medicine, 2023.

N. N. D. Witari, and N. M. Dewianti. “Effectiveness of Providing Self-Management Education to Deal With Emesis Gravidarum on Decreasing Nausea Vomiting Pregnancy (NVP) at Private Practice Midwives Puskesmas IV Denpasar Selatan Work Area.” Indian Journal of Public Health Research & Development, 2020.

Nanik Handayani. “Effectiveness of Acupressure on Reducing of Nausea and Vomiting in Pregnant Women in Independent Midwifery Practice, Sidoarjo, East Java.” Childhood Stunting, Wasting, and Obesity, as the Critical Global Health Issues: Forging Cross-Sectoral Solutions, 2020.

Nanik Handayani, and Yasi Anggasari. “The Effect of Acupressure on Decreasing Nausea and Vomiting in Pregnant Women in Midwives Independent Practice Sidoarjo,” 2020.

Ni Made Dewi Satrianingsih, Ni Made Egar Adhiestiani, and Putu Ayu Dina Saraswati. “The Effect of PC6 Acupressure Therapy on Emesis Gravidarum in First Trimester Pregnant Women.” Jurnal Ilmiah Kebidanan (The Journal Of Midwifery), 2024.

Nikmah Jalilah Ritonga, Fahma Shufyani, and E. Sembiring. “Efektifitas Kombinasi Akupresure Dan Minuman Jahe (Zingiber Officinale) Terhadap Emesis Gravidarum Di Desa Bandar Setia Kecamatan Percut Sei Tuan Kabupaten Deli Serdang.” Jurnal Riset Hesti Medan Akper Kesdam I/BB Medan, 2020.

Nilan Sari, Nur Azizah, Lidya Natalia Sinuhaji, Rosmani Sinaga, and Junida Laia. “Pengaruh Terapi Akupresure Terhadap Hyperemesis Gravidarum Pada Ibu Hamil Trimester I Di Puskesmas Kuala Bangka Kab. Labuhan Baru Utara Tahun 2022.” NAJ : Nursing Applied Journal, 2025.

Nor Azila Mohd Nafiah, Wei Keong Chieng, A. A. Zainuddin, K. T. Chew, A. Kalok, M. Abu, B. Ng, N. A. Mohamed Ismail, and A. G. Nur Azurah. “Effect of Acupressure at P6 on Nausea and Vomiting in Women with Hyperemesis Gravidarum: A Randomized Controlled Trial.” International Journal of Environmental Research and Public Health, 2022.

Nur Azizah, and Rusmei Yanti Gultom. “The Effect of Acupressur Therapy on Hyperemesis Gravidarum in Trimester I Pregnant Woman Aceh 2022.” Science Midwifery, 2022.

Olivia Nency, and Nurseha Nurseha. “The Effectiveness of Acupressure in First Trimester Pregnant Women with Emesis Gravidarum at TPMB Nurseha in 2023.” International Journal of Health and Pharmaceutical (IJHP), 2024.

Ozlem Can Gürkan, and H. Arslan. “Effect of Acupressure on Nausea and Vomiting During Pregnancy.” Complementary Therapies in Clinical Practice, 2008.

Prasanti Adriani, Suryo Ediyono, Mariah Ulfah, and Siti Haniyah. “The Effect of Nei-Guan Point Acupressur Massage on Emesis Gravidarum.” International Journal of Health Science and Technology, 2022.

Pupus Ultraluana, and S. A. Farizi. “Effectiveness of Acupressure Therapy Against Nausea and Vomiting in Pregnancy.” World Journal of Advanced Research and Reviews, 2024.

Qurotul ‘Aini, and Sherlyani Desianti Basri. “The Effect of PC6 Acupressure on Nausea and Vomiting in First Trimester Pregnant Women at PMB Y Purwakarta in 2024.” Jurnal Indonesia Sosial Sains, 2025.

R. Helmreich, S. Shiao, and L. Dune. “Meta-Analysis of Acustimulation Effects on Nausea and Vomiting in Pregnant Women.” Explore, 2006.

Rahma Dewi, and Halimatus Saidah. “Effect Of Complementary Acupressure Therapy On Emesis Gravidarum In Pregnant Women Trimester I,” 2020.

Risa Ayu Faturanti, Tetet Kartilah, Sofia Februanti, and Teti Nurhayati. “Pengaruh Aromaterapi Jahe Dan Akupresur Pada Titik Perikardium 6 Terhadap Skor Mual Muntah Pada Ibu Hamil Trimester I Dengan Emesis Gravidarum.” Jurnal Keperawatan Klinis Dan Komunitas (Clinical and Community Nursing Journal), 2025.

S. S. Mobarakabadi, S. Shahbazzadegan, and G. Ozgoli. “The Effect of P6 Acupressure on Nausea and Vomiting of Pregnancy: A Randomized, Single-Blind, Placebo-Controlled Trial,” 2020.

S. Suryani, Ika Murtiyarini, Yuli Suryanti, and Misnanda Misnanda. “THE EFFECT OF ACUPRESSUR THERAPY IN REDUCING NAUSEA AND VOMITING PREGNANT WOMEN TRIMESTER I : QUASI-EXPERIMENTAL STUDY.” NSC Nursing, 2021.

Sadegh Dehghanmehr, M. Rahdar, Sadegh Karimirad, Elhamallahyari Elhamallahyari, and M. Sheikhi. “Investigating the Impact of Acupressure on Pregnancy Nausea and Vomiting (A Systematic Review),” 2017.

Sahar Saadatnia, A. Tiznobaik, and A. Saber. “The Effects of Psychological Counseling and Acupressure Based on Couple Therapy Procedure for Alleviation of Vomiting and Nausea in Pregnant Women in Iran Country.” Journal of Complementary and Integrative Medicine, 2021.

Sanaz Nehbandani, H. Salehi, Khadijerezaie Keikhaie, H. Ghalenow, F. Mirzaie, and M. Badakhsh. “The Effect of Ear Acupressure Medicine at the “Shen Men” Point on the Nausea and Vomiting During Pregnancy.” Pakistan Journal of Medical & Health Sciences, 2021.

Shital Ghule. “Effect of Accu Tens with Accu Band on Nausea, Vomiting, Retching and Quality of Life in Early Pregnancy.” Indian Journal of Physiotherapy and Occupational Therapy, 2020.

Suk-Woo Jang, In-Suk Ahn, Min-sun Choi, and Dong-Il Kim. “Review on RCT Research Papers Related Nausea and Vomiting in Pregnancy - Focusing on Acupoint Treatment -,” 2013.

T. Tian, Wei-na Xie, Yunyan Deng, Zhong-qiang Li, Yang Zhang, and Suyin Zhao. “A Meta Analysis on Effect of Auricular Point Sticking and Pressing Therapy in the Treatment of Hyperemesis Gravidarum.” Chinese Journal of Integrative Nursing, 2022.

“THE EFFECT OF SUPPORTIVE COUNSELING WITH ACUPRESSURE ON NAUSEA AND VOMITING IN PREGNANT WOMEN REFERRING TO HEALTH CENTERS IN HAMADAN, IRAN: A RANDOMIZED DOUBLE BLIND CONTROLLED TRIAL STUDY.” JPMI - Journal of Postgraduate Medical Institute, 2023.

Tuti Meihartati, L. Suddin, and Zatul Akmar Ahmad. “Dual Method P6 Acupressure to Overcome Nausea and Vomiting During Early Pregnancy.” Healthcare in Low-Resource Settings, 2024.

Upma Sharma. “To Assess the Effect of Acupressure on Reduction of Nausea and Vomiting Among Primigravida Women.” International Journal of Obstetrics and Gynaecological Nursing, 2023.

Vina Kartika Mahira, Y. Yulianto, Suprida Suprida, and Aprilina Aprilina. “THE EFFECT OF GINGER DRINKING AND ACUPRESSURE THERAPY ON MORNING SICKNESS IN PREGNANT MOTHER TRIMESTER I.” Journal of Maternal and Child Health Sciences (JMCHS), 2022.

Wenyuan Jiang, and Esther O. Dela Cruz. “The Effects of Acupressure on Vomiting, Stress, and Anxiety in Chinese Pregnant Women with Hyperemesis Gravidarum.” Journal of Clinical and Nursing Research, 2024.

Xinhui Wang, Guangyi Yang, Ke-Yi Li, Fujing Yang, Xiaoyu Liang, and Shangping Wu. “Efficacy and Safety of Acupressure in Nausea and Vomiting During Pregnancy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.” Archives of Gynecology and Obstetrics, 2023.

Yasemin Hamlacı Başkaya, Kevser Çimen Coskun, Güleser Ada, Kevser Ilçioğlu, and Osman Esen. “The Effect of Plaster Applied to the Umbilical Area (Shenque-CV8 Point) on Nausea and Vomiting During Pregnancy.” Explore, 2025.

Yuliasti Eka Purnamaningrum, Yuni Kusmiyati, and Iphigienia Iradati. “Effectiveness of the Pericardium (PC) 6 Point Massage on Emesic Decrease First Trimester Pregnant Women.” PUINOVAKESMAS, 2021.

Downloads

Published

2026-01-19

How to Cite

Faizal Akbar Farid Musliem. 2026. “The Relationship Between Acupressure Technique And The Reduction Of Nausea And Vomiting In Early Pregnancy”. The International Journal of Medical Science and Health Research 26 (2): 102-56. https://doi.org/10.70070/0yyhyn40.