Morning Sickness

Tips for coping with morning sickness

Morning sickness in pregnancy is serious to sufferers and can be quite debilitating. Morning sickness is a misnomer because nausea in pregnancy can affect women at any time during the day. It may come and go through the day or last for a few hours or all day. Some people experience it in one pregnancy and not the next. While others may experience it in all their pregnancies to various degrees. Usually morning sickness abates by the end of the first trimester or part way through your second trimester. Occasionally you may experience it right through your pregnancy. Other people may have morning sickness in their first trimester and then feel well until about the last month of pregnancy when the morning sickness seems to reoccur.

Morning sickness is also referred to as nausea and vomiting in pregnancy or NVP.

Morning sickness may present as a constant or intermittent feeling of nausea with or without vomiting. Even though you may not be vomiting it can be quite debilitating leaving you feeling exhausted, unmotivated and you may struggle to carry on with your usual daily life.

In fact people who suffer from morning sickness severe enough to affect their self esteem by interrupting their normal life may be predisposed to postnatal depression.

Morning sickness is not a psychological condition although dwelling on your nausea can make it feel worse. It is not acceptable for other people to judge how nauseous you are and how well you are coping with morning sickness. This attitude is not helpful to you. What is helpful is if other people lend a hand e.g cooking, looking after other children to allow you to rest, taking over chores that involve you bending over, helping out to remove stress and workload, or helping in anyway that offers you some relief.

The exact cause for morning sickness is not known but highly speculated on and various suggestions have been made. There has not been a lot of research on morning sickness and no agreed upon cause. Because of this there is no one cure. Some things may help you for a period of time, or you may experience complete remission.

My personal theory is that it is likely to be a combination of different factors, such as pregnancy hormones, changes in gut motility due to pregnancy, changes in sensitivity to smells and tastes, fatigue, empty stomach, changes in tolerance to things like caffeine, nicotine, reflux/heartburn, changes in oesophageal sphincter due to pregnancy hormones etc. And quite possibly everyone will have a different cause.

There are many and various options for you to try and see what works or doesn’t for you. Starting with dietary and or lifestyle changes through to prescription drugs. Ideally if you can find relief without the use of prescription medicine this is preferable, however usually this takes a bit more effort on your part and it may be a combination of things that gives you relief. If however you have tried various things and nothing is working or your morning sickness has become so severe that you are becoming dehydrated you need to contact your midwife.

Always check with your midwife, pharmacist, doctor or qualified practitioner before trying any over-the-counter drugs, herbal or homeopathic remedies and always let other health care practitioners know you are pregnant before seeking advice or medication for nausea.

Although morning sickness can be debilitating for you it does not adversely affect your baby unless you become dehydrated. This severe morning sickness is known medically as hyperemesis gravidum and in its most severe form may require hospitalisation for rehydration.

Things for you to try yourself.

  • Take note of when you feel nauseous and try to identify your triggers and avoid these as much as possible.
  • Distraction and fresh air can help sometimes. Gentle exercise such as walking can also help some women.
  • Asking for or getting the help you need in your daily life as mentioned above. Sometimes de-stressing and getting more rest will actually make you feel well enough to cope.
  • Reduce or completely cut out coffee and tea and caffeine drinks.
  • Stop smoking.
  • Often nausea will be worse when you are tired. So sleep can make a big difference to how well you feel. If you are able, take naps when you are feeling at your worst.
  • Save work or chores for periods of the day when you feel less nauseous. If you have the option, organise your day around times when you feel your best.
  • Get up slowly in the mornings and have a biscuit or plain cracker to nibble on before you get up.
  • Sip glasses of water with a slice of lemon in it.
  • Ironically your morning sickness can be aggravated or worse on an empty stomach. Remember the golden rule “a little and often”

  • Try ginger eg. ginger tea. This can be taken as a hot drink or cooled down as a cold drink. Try slices of lemon or mint in it to make it more palatable if you are not a fan of ginger. We don’t recommend things like ginger biscuits nor ginger-ale as these contain very little ginger and lots of sugar
  • Try peppermint tea.
  • One line of thought is that lower potassium levels may at least aggravate nausea, so try unflavoured sports drinks, (not the energy drinks with caffeine, but the electrolyte ones). Bananas are also a good source of potassium.
  • Massage, find a masseuse that is qualified in pregnancy massage. Sometimes the relaxation and massaging aches and pains away is helpful.
  • Acupuncture.
  • The acupressure point for nausea is on the entre of the inside of your wrist about 3/4 finger widths above your wrist bone. Apply firm pressure here for at least a minute. Alternatively you could try some of the sea-sick wrist bands.
  • Try small amounts of food frequently through the day rather than 3 main meals. Don’t let your stomach get empty. Some people experience increased stomach acid production in pregnancy and suffer from reflux and heartburn which can be a cause of nausea and vomiting. Another theory is that keeping your glucose levels on an even keel will help alleviate nausea. So having several smaller snacks of carbohydrates with a high G.I may help.
  • Another theory is that low vitamin B6 and B12 may contribute to nausea. So make sure you are getting plenty of B vitamins in your diet. Good sources of the B vitamins are; whole grains, bananas, meats ( vit B12 is not available in plants), brewer’s yeast, marmite, (Note. Only marmite NOT vegemite has vit B12 & one serving has up to 50% of your RDA). Both Marmite and Vegemite are good sources of folate as well.
  • If you are on iron supplements this may aggravate your nausea. Don’t take iron supplements on an empty stomach, (but remember to avoid taking with foods high in calcium, magnesium or zinc).
  • Anaemia may be a possibility as to why women feel nauseous in pregnancy. Ensure your diet is adequate in iron and vit B12.
  • Keep your fluids up. It can become a vicious circle when you are constantly nauseous and you don’t want to eat or drink, but dehydration will actually make your nausea worse. People feel better in hospital once they have been rehydrated. They think their nausea is ‘cured’ until they get home feel nauseous and become dehydrated and feel worse.
Remember you may have to try several of these suggestions or a combination to find what works for you.

Hyperemesis Gravidum

If none of these things work for you and there is a risk of you becoming, or you have become dehydrated then there are prescription medications to try. Some may work for you and some may not. Again it may be trial and error. Normally prescription medications are not recommended in the first trimester.

If your hyperemesis gravidum becomes so severe that it is affecting your health and that of your baby, or you are requiring repetitive hospitalisation, an obstetric referral may be recommended, but this is unusual.

What to look out for:

If your vomiting has become so severe you are unable to keep anything in your stomach or are unable to eat or drink;

and/or your urine output has decreased;

and/or your urine is dark or brown;

and/or you have accompanying headaches, these are symptoms of dehydration and you need to see your midwife or doctor;

If vomiting is accompanied by diarhorrea and/or fever the cause is most likely a bacterial or viral infection. Usually this will pass in a day or so. However if it does not improve in this time and/or you develop any of the symptoms previously described you need to see a doctor.

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