The NVPI comprises three questions that ask the participant to evaluate the frequency of nausea, retching, and vomiting symptoms during the past week. Items are scored on a six-point Likert scale from 0 to 15. Higher scores indicate more severe symptoms. The instrument has acceptable internal reliability at two gestational time periods with a Cronbach’s alpha coeffient of 0.76 at Time 1 and 0.82 at Time 2. The teat-retest reliability was high, although only a small sample completed the instrument twice (0.83; 95% confidence intervals 0.71-0.90) (Swallow,Lindow,Masson,&Hay,2002).