Morning sickness

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at December 4, 2015
StartSymptomsMorning sickness

Morning sickness is the term used to describe the nausea and vomiting that usually occurs during the first trimester of pregnancy. Around 75% of women experience some form of morning sickness during pregnancy.

Contents

Definition & Facts

Morning sickness describes the nauseous feeling that many women experience during the early stages of pregnancy. For some women, this manifests as only nausea; however most women experience both nausea and vomiting. Morning sickness can occur at any time of day and at any point during a pregnancy, but it is most common in the first trimester.

The severity and duration of morning sickness is different for every pregnancy. It is often the first sign of pregnancy and generally begins around the 6th week. This condition can get worse over the course of the first trimester. Mild morning sickness is not harmful to a pregnancy as long as some food and water can be consumed.

Causes

Some scientists have theorized that morning sickness is the body’s way of protecting the pregnancy from harmful toxins in food and therefore, is a very normal part of pregnancy. There has not been any conclusive evidence about what causes morning sickness, but researchers and doctors have suggested that hormonal and physical changes that occur during pregnancy may have a role in this common issue.

Drastic increases in the levels of human chorionic gonadotropin (hCG), progesterone, and estrogen are likely to contribute to this condition. Women who are pregnant with multiples or girls are more likely to experience morning sickness due to higher levels of these hormones. A heightened sense of smell and sensitivities to certain foods may also have a role in morning sickness. Fatigue and stress can make nausea worse which is why rest and exercise are important.

Unfortunately, if morning sickness was experienced in a previous pregnancy, then it is more likely in a future pregnancy. Family history can also be an indicator of morning sickness. Because of the lack of conclusive evidence on the causes of morning sickness, it is very difficult to predict whether or not a woman will experience it during pregnancy.

When to see a doctor

It is important to seek medical treatment if morning sickness becomes severe. This condition is known as Hyperemesis gravidarum and characterized by constant nausea or vomiting and an inability to keep anything down. Other symptoms of this condition can be dizziness, blood in vomit, fever, or a lack of urine. This condition may also cause weight loss from a lack of nutrition which can be detrimental to the developing baby. Hyperemesis gravidarum requires prompt medical treatment.

It is also important to contact a doctor if morning sickness is still an issue late in the second trimester or if weight gain goals are not being met. This is particularly true if the mother was underweight before the pregnancy. A doctor should be contacted if morning sickness is preventing a pregnant woman from gaining the weight needed to sustain a healthy pregnancy.

It is also important for pregnant women to listen to their bodies. Always contact a doctor if something does not feel right. Many women are concerned that they are not eating a balanced diet while battling morning sickness. In the short term, however, it is ok to only eat certain foods especially if other foods trigger nausea or vomiting. If diet becomes a concern, then contact a doctor. Morning sickness can be exhausting and disruptive and a doctor can make some suggestions to help pregnant women through this difficult time.

Treatment & Therapy

When a doctor determines that a pregnant woman needs medication to help with morning sickness, there are over-the-counter and prescription medications available. The over-the-counter medications that can help include Vitamin B6, doxylamine (an antihistamine), reflux medications, or phosphorated carbohydrate solution (such as Emetrol®). Pregnancy is different for all women which is why all medication options, including over-the-counter, should be discussed with a doctor before use. If the over-the-counter medications are not helpful, then there are also prescriptions that can be used. These medications include ondansetron, prochlorperazine, trimethobenzamide, and promethazine.

Some women have found acupuncture or hypnosis to be helpful, but research should first be done on the practitioner’s credentials. Taking a prenatal vitamin early in the pregnancy and consistently may also help with morning sickness. If the vitamin upsets the stomach, a different time of day or a different combination of foods may help alleviate symptoms.

Hyperemesis gravidarum is the serious condition in which nausea and vomiting are so severe that a pregnant woman cannot eat or drink. This condition generally requires hospitalization and treatment with intravenous fluids due to the mother not being able to stay hydrated. Anti-nausea or antacid medications may also be used to help the mother get the nutrition that she and her baby need.

There are also a number of home remedies and tips that women can try to use to treat the symptoms of morning sickness without using over-the-counter or prescriptions medications.

Prevention & Prophylaxis

Since morning sickness is different for each woman, some remedies that work for one woman may not work for another. It is important to try different things and remember that morning sickness is only temporary. Some remedies and tips to try are as follows:

  • Eating small, frequent meals and snacks. Try not to have an empty stomach.
  • Constantly sipping water throughout the day.
  • Eating saltine crackers right away in the morning.
  • Settling an upset stomach with ginger. Many different brands of ginger ale are not made with real ginger, so check the label.
  • Eating peppermint candies or drinking peppermint teas.
  • Avoiding spicy and fatty foods they can cause heartburn to flare up.
  • Not lying down after eating. Staying upright aids in digestion.
  • Being careful not to overheat. A cold washcloth on the back of the neck can help.
  • Wearing acupressure bands on the wrists. These are generally marketed for motion sickness.
  • Exercising (particularly yoga or walking).
  • Drinking carbonated water. It still keeps up hydration and provides a bit of variety.