Morning Sickness

During the first three months of pregnancy, feeling sick or nauseated is quite common, as is vomiting. The problem varies from woman to woman. Some just feel a little sick in the morning and throw up once, whilst others suffer from constant nausea and frequent vomiting throughout the day. About 75% of women are troubled and the incidence has not changed over 20 years.^{0301, 0601}

For the majority, the nausea stops after the first three months of pregnancy. A few, however, continue to have problems even after four or five months.

The actual causes of nausea and vomiting are still unknown. It is probably brought about by the hormonal changes. Physiological, psychological, genetic, and cultural components have been quoted as contributing factors⁰¹⁰¹ although evidence that underlying depression is a risk factor is lacking.⁰⁶⁰²

It is not increased in association with malformed babies. Younger women are more troubled by it. It is increased when there have been a number of miscarriages. Twin pregnancies are more affected.⁰⁶⁰¹ It is not increased in association with malformed babies. It is increased when there have been a number of miscarriages.⁰⁶⁰¹

There is a some good news. Morning sickness is associated with pregnancies that are less likely to result in miscarriage, preterm delivery, or intrauterine growth retardation.⁰¹⁰¹ There is no evidence that morning sickness, even if severe, causes any harm to your baby. It has been suggested that morning sickness is promoted by secretion of human chorionic gonadotrophin (hCG), largely on the basis of the coincidence between the onset of NVP and hCG secretion and the peaks of both at around 12 to 14 weeks' gestation and also the increase in symptoms associated with twins. Furthermore, when there is a hydatidiform mole, hCG and morning sickness are both increased.

If you are vomiting heavily and often, you may lose so much liquid that it causes dehydration. When morning sickness is this severe it is called hyperemesis gravidarum and requires medical attention. This usually requires hospital admission and being given fluids through an intravenous drip.

Treatment generally begins with non-pharmacologic interventions; if symptoms do not improve, drug therapy is added.

In the mornings:-.

Do not rush about.

Take your time getting out of bed.

If you tend to feel really sick in the morning, eat a little as soon as you wake up and before getting out of bed.

Ask your partner to bring the food to you, or prepare a snack the night before and leave it beside your bed.

 

Throughout the day:-



Eat little and often, every two or three hours - even if you're not hungry.

Open windows or turn on exhaust fans when cooking and after meals.

Cooking in the microwave usually produces less odours.

Drink a lot of liquid, preferably 10 to 12 glasses of water, fruit juice or herbal tea each day.

Avoid food containing a lot of fat or spices.

Avoid alcohol and caffeine.

Eat dry crackers, toasted bread or rusks.

Ginger tea or ginger tablets can help reduce nausea.0501, 0502

Rest several times a day. Lie down with a pillow under your head and legs.

Move slowly and avoid sudden movements.

After eating, sit down so that gravity helps to keep the food in your stomach.

Avoid smells that make you feel sick or throw up.

Get some fresh air and exercise by going for a little walk every day.

Avoid smoking. Not only is it harmful for you and your child, it also diminishes your appetite.

 

At night:-

Before going to bed, it may help to eat a snack such as a yoghurt, bread, milk, cereal or a sandwich.

If you wake up during the night, eating a small snack may stop you feeling sick in the morning.

Sleep with the windows open to get some fresh air, if possible.

Visit your doctor

If none of the remedies mentioned above seem to work. <

If you vomit more than three or four times a day.

If you lose weight.

If your vomit contains blood or looks like ground coffee.

If you lose more liquid than you can keep down.

If you are worried about your condition, or believe that something serious is the matter.

 

Your doctor may examine you for signs of dehydration. A simple urine test (ketones) is often helpful in deciding the degree of dehydration.

Anti-sickness tablets, notably antihistamines and pyridoxene (vitamin B6) can be prescribed. There is evidence for their effectiveness and safety of these medications.⁰³⁰¹

Your doctor will be careful to ensure you are prescribed medication that does not harm your baby.

Acupressure was found to be effective in reducing symptoms of nausea but not frequency of vomiting in pregnant women ⁹⁴⁰¹ but a more recent study⁰⁷⁰¹ found that acupressure therapy is no more effective than vitamin B6 in reducing nausea and vomiting in symptomatic women in the first trimester of pregnancy.

 

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DISCLAIMER

The aim of this web site is to provide a general guide and it is not intended as a substitute for a consultation with an appropriate specialist in respect of individual care and treatment.

Thank you for your visiting us at 2womenshealth.com.

This is the personal website of David A Viniker MD FRCOG, Consultant Obstetrician and Gynaecologist at Whipps Cross University Hospital, London.

I do hope that you find the answers to your questions in the patient information and medical advice provided. If you still have unanswered questions, please consider entering them into one of our forums and I will try to assist you.