“Morning Sickness”, or nausea and vomiting is a very common ailment in early pregnancy. Many times the nausea or vomiting starts before you even know you are pregnant, and is often the presumptive sign that prompts you to purchase that pregnancy test. The symptoms of “morning sickness” can range from very mild nausea that is just a mild discomfort, to vomiting so much you aren’t able to keep even liquids down. The main questions on every new mother’s mind when experiencing nausea and vomiting of pregnancy are “is this normal?”, “when will this stop?”, and “is there anything I can do to make this go away?”. Let’s deep dive into this topic and get those questions answered so you can relieve your worries and get back to being blissfully pregnant!

What Exactly is morning sickness?

Essentially, morning sickness means nausea and vomiting during early pregnancy. Anyone who has ever experienced this, knows it doesn’t just happen in the morning, so why call it “morning sickness”? Nausea and vomiting is most common when you have an empty stomach. Since most women have an empty stomach upon waking, these symptoms will be worse at that time, but they can last all day. There is no definitive answer as to what causes nausea and vomiting during pregnancy, but it is believed that it may be one or a combination of the following:

• Hormonal Shifts of Pregnancy
• Low Blood Sugar
• Slowing of the Gastrointestinal Tract
• Relaxing of the stomach muscles

While we may not really understand the true cause, the subject has been well studied, and there is good news. If you experience nausea and vomiting during pregnancy, you are in good company since up to 70% of women will experience this to some degree. Studies also show that pregnancy outcomes are better when these symptoms are present than when they aren’t. However, don’t worry if you aren’t experiencing these symptoms, many women don’t and go on to have perfectly healthy babies! I have had three healthy pregnancies and only had nausea with one of them. Most often nausea and vomiting will start between 4-8 weeks, and be at the worst around 11 weeks. You can also rejoice in the fact the 50% of women struggling with nausea and vomiting will have complete relief of symptoms by 14 weeks, and 90% will have relief by 22 weeks. This too shall pass!!

What Can I do While I Wait?

I am sure it is a relief to know that these symptoms are normal, and will most likely go away, but it still feels miserable while you are going through it. There are many things you can do to help lessen the symptoms while you wait.

• If your symptoms are worse upon waking up, try keeping dry crackers like saltines by your bed and eating a couple before you get up
• Eat small, frequent meals throughout your day rather than 3 large meals, your goal should be to eat a little something about every 2 hours
• Try sipping carbonated beverages like ginger ale (although this is not a good option if you are trying to avoid sugar in your diet)
• Add lemon or lime to water and sip throughout the day
• Avoid high fat foods, as well as foods that are spicy or have a strong odor
• Try making ginger root tea and sipping
• Accupressure wrist bands
• Rest

If all of the above options fail to alleviate your symptoms enough to make it through your day, you will need to talk to your prenatal care provider about your options. It is my advice that if your are able to keep down liquids and small amounts of food, be patient and wait for this to pass. However, some of you will undoubtedly have symptoms that will disrupt your every day life and require more advanced treatment. There are medications that can be used to treat nausea and vomiting, but it is important to consider the safety of taking these medications, as well as the effectiveness of the medication. We will cover medications in pregnancy in another post, but it is always a good idea to talk your care provider before taking any medications during your pregnancy, even over the counter medications.

What if my Symptoms are Severe?

When nausea and vomiting is severe (not keeping down much of anything) and persistent (lasting all day and/or past the first trimester), you may have a condition called hyperemesis gravidarum. This condition can be life threatening if not treated appropriately. Hyperemesis is characterized by dehydration and weight loss. Eventually, this will lead to electrolyte imbalances which can lead to a host of other negative health effects. You may notice that your mouth feels very dry, you aren’t needing to urinate as often, and urine may be darker in color than normal. You may also feel dizzy or confused. If you are experiencing this type of nausea and vomiting, and/or any of the other symptoms listed above, it is imperative that you see your provider right away. There are other conditions besides pregnancy that could cause these symptoms that will need to be ruled out. You will also most likely require hydration through an IV, gastric rest (no oral intake) for a time, and possibly electrolyte replacement. It is most likely at this point that your provider will also recommend the use of the medications we talked about above. It is important to let your provider know how often you are vomiting, what if any food or drinks you have consumed and how long after consumption the vomiting occurred, any medications you have taken, all remedies you have tried, and details about your bowel and bladder habits since the symptoms started. This info is very helpful for your provider to know when making decisions about your care.

The Bottom Line

The most important thing to remember is you are not alone, and these symptoms will eventually go away. Even hyperemesis doesn’t last forever. Be gentle with yourself during this time and let others help you, so you can get plenty of rest for your body and your baby. Use the tactics above to improve your symptoms, and never be afraid to reach out to your care provider if you are concerned.

References:

Varney’s Midwifery
Obstetrics: Normal and Problem Pregnancies