Multidimensional Assessment of Nausea in Pregnancy: A Three-Arm Randomized Controlled Study on the Effects of Quince and Acupressure

Nausea and vomiting during pregnancy are common, affecting a large proportion of women (approximately 50-75%). This symptom usually begins in the first trimester and is mostly mild or moderate; however, in some cases, it impairs quality of life, reduces nutritional intake, leads to emotional distress, and, rarely, can develop into serious conditions such as hyperemesis gravidarum.

Pharmacological approaches can be effective, especially in severe cases; however, the fear of drug-related side effects among many pregnant women and physicians is a limiting factor in drug use. Therefore, the role of complementary and non-pharmacological approaches is gaining importance, particularly in pregnant women with mild to moderate nausea. On the other hand, acupressure (especially P6/Neiguan point stimulation) is a non-invasive complementary practice whose effect in reducing nausea and vomiting during pregnancy is debated. Meta-analyses report that acupressure can significantly reduce nausea symptoms in pregnancy. However, there is a need for clearer results in the literature due to methodological differences, variability in effect sizes, and low quality scores of some studies.

Quince (Cydonia oblonga), on the other hand, is not as researched an option as acupressure in the literature for managing nausea in pregnancy. In a study comparing quince syrup with vitamin B6 in the literature, quince was found to be a more effective application than vitamin B6. Quince may theoretically have the potential to reduce nausea due to its positive effects on gastrointestinal motility, its stomach-soothing properties, and its antioxidant compound content. However, randomized controlled trials proving this effect in terms of safety and efficacy during pregnancy are limited.

Nausea during pregnancy not only causes physical discomfort but also reduces quality of life, negatively affects self-care behaviors, and can increase perceived stress levels. Therefore, nausea management should aim not only at symptom reduction but also at supporting the holistic well-being of the pregnant woman. In this context, psychosocial indicators such as the Quality of Life in Pregnancy Scale, Self-Care Ability Scale, and Perceived Prenatal Stress Scale are important in revealing not only the physiological but also the psychological and behavioral effects of complementary practices.

Therefore, examining the effects of quince and acupressure applications on not only the severity of nausea but also on quality of life, self-care ability, and perceived stress levels in pregnant women with mild to moderate nausea will fill the gap in the literature and contribute to the identification of evidence-based, safe, and applicable complementary approaches in the management of nausea in pregnancy.