Morning Sickness: Nausea and Vomiting in Pregnancy

Morning sickness is the most common pregnancy symptom and usually begins by 8-9 weeks after conception. Most pregnant Indian women strongly associate onset of nausea and vomiting with pregnancy. Although nausea and vomiting in pregnancy often is called “morning sickness,” it can occur at any time of the day. Nausea and vomiting during pregnancy usually is not harmful to the developing baby, but it can have a serious effect on your life, including your ability to work or do your normal daily activities.

Nausea and Vomiting in Pregnancy: When does it start?

Nausea and vomiting occur in up to 74% of pregnant women, and 50% experience vomiting alone.[1] Although the term morning sickness is commonly used to describe nausea and vomiting of pregnancy, the timing, severity, and duration of symptoms vary widely. 

How long does nausea last during pregnancy?

Nausea and vomiting in pregnancy usually starts before 9 weeks of pregnancy. For most women, it goes away by the second trimester (14 weeks of pregnancy). For some women, it lasts for several weeks or months. For a few women, it lasts throughout the entire pregnancy.

Why do pregnant women get morning sickness?

Morning sickness symptoms of nausea and vomiting in pregnancy affects nearly 75% of pregnant women. The exact cause is unknown quotes a study [2].

Best way to treat morning sickness

Morning sickness can be unpleasant and exhausting. But it doesn’t mean that there is anything wrong with your pregnancy. There is no cure for morning sickness. However, there are things you can do to help with the symptoms.

Diet and lifestyle changes may help you feel better with morning sickness. Try more than one of these suggestions:

• Take a multivitamin. (Folic acid during pregnancy)
• Eat small meals throughout the day, so that you are never too hungry or too full.
• Get plenty of rest – being tired can make you feel worse. Try to relax and avoid stress.
• Avoid rich, fatty, spicy foods.
• Avoid foods with smells that bother you.
• Eat more carbohydrates, such as plain baked potatoes, white rice and dry toast.
• Keep a light snack such as a savory biscuit or cracker by your bed and eat it before getting out of bed in the morning, or if you wake in the night, to help prevent sickness in the morning.
• Avoid brushing your teeth immediately after eating.
• Have lots to drink, drinking small amounts often throughout the day, but avoid caffeine and alcohol.
• Get plenty of fresh air.
• If you are producing too much saliva, suck or drink fresh lemon or lime.
• There is some evidence that ginger relieves sickness in some people. Try taking root ginger, ginger capsules or ginger tea. Ginger ale or ginger biscuits may also help.* You should avoid ginger if you are taking any prescribed medications, particularly blood thinning drugs such as aspirin, or tablets for high blood pressure.

If you do vomit a lot, it can cause some of your tooth enamel to wear away. This happens because your stomach contains a lot of acid. Rinsing your mouth with a teaspoon of baking soda dissolved in a cup of water may help neutralize the acid and protect your teeth.

Morning sickness in pregnancy: Treatment

If diet and lifestyle changes do not help your symptoms, Depending on the severity of your symptoms and the test results, you may be given:

• dietary advice
• anti-sickness medication
• anti-sickness medication by injection/ intravenous

Is morning sickness harmful for babies?

Morning sickness shouldn’t hurt your baby and is often considered a sign of a healthy developing pregnancy. However, morning sickness that progresses to hyperemesis can become more of a problem. If you are unable to keep any foods or fluids down and begin to lose a lot of weight, you must see your doctor.

Severe Vomiting during pregnancy (Hyperemesis gravidarum)

Can Morning sickness become severe?

Hyperemesis gravidarum is a more severe form of morning sickness. About 2 out of every 100 women will get severe morning sickness. 98 out of 100 women will not.

You may find Hyperemesis gravidarum debilitating due to persistent nausea and vomiting during pregnancy. Your doctor may diagnose you with the condition if you’ve lost more than 5 percent of your pre-pregnancy weight. Severe cases of hyperemesis gravidarum can lead to problems like dehydration and poor weight gain, which sometimes require hospitalization.

Symptoms of hyperemesis gravidarum

You’re more likely to have severe morning sickness if you:

• have a family history of bad morning sickness
• had severe morning sickness during a previous pregnancy
• are expecting twins, triplets or more
• suffer from migraines
• get bad motion sickness
• used to get sick if you took contraception containing oestrogen
• are having a molar pregnancy – this is when some of the cells that form the placenta or afterbirth grow abnormally (this is rare)

Sincerely follow the tips for managing morning sickness – you never know which one will do the magic for you. But if you are unable to keep the food down and are concerned, talk to your doctor. Try to take it easy and care for yourself as best as you can.

References:
[1] Lacroix R, Eason E, Melzack R. Nausea and vomiting during pregnancy: A prospective study of its frequency, intensity, and patterns of change. Am J Obstet Gynecol. 2000;182(4):931–937.
[2] Nausea and Vomiting of Pregnancy; HOWARD ERNEST HERRELL, MD, East Tennessee State University, Johnson City, Tennessee; 2014 Jun 15;89(12):965-970; https://www.aafp.org/afp/2014/0615/p965.html#afp20140615p965-b2