Morning sickness is yet another thing your body goes through during this most incredible of times.
Having suffered with morning sickness myself, I decided to dig deeper into this phenomenon in order to make a helpful guide for moms-to-be experiencing the same thing. I spent an entire weekend researching on the internet, reading papers and speaking to other moms online in forming this All You Need To Know guide.
Remember to always get medical advice from your doctor if you are getting unexplained recurrent nausea or vomiting.
Signs and symptoms
Morning sickness tends to strike in your first trimester, around week 4 of your pregnancy. Studies show it will affect around 70% of expectant mothers. [1] Thankfully, it usually resolves around the 16 week mark. A small number of women report their symptoms continue later into their pregnancy.
Despite the name, morning sickness can actually surface at any time of the day … or night. And as I found out when I was first pregnant … multiple times during the day! It’s not uncommon to wake up in the morning to a queasy sensation but this can occur whenever.
The nausea may be reminiscent of car or sea sickness. For me, the daily car ride to and from work was the trigger. I remember repeatedly sprinting from my car (leaving the door wide open) and straight into the bathroom. It was a surprise my car was never stolen!
Many women report a keener sense of smell during pregnancy. So, as a result certain scents can often spark off nausea. Specific foods (e.g. spicy foods) may trigger a strong reaction within, making you peakish. I couldn’t bear the sight or smell of chicken without turning green. You may feel nauseous straight after eating, almost as if that last meal didn’t sit very well with you. Actually, some ladies report feeling hungry during or straight after bouts of nausea.
Pregnant women often report a metallic taste in the mouth. This can be enough to make anyone feel sick. Other triggers include, heat and excess salivation. Although, symptoms can sometimes come on alone.
Naturally, retching often may lead to actual vomiting.
Causes
The exact cause for morning sickness is still a mystery. There are a few speculative theories:
- Raised human chorionic gonadotropin hormone levels, produced by the embryo and the placenta.
- Elevated estrogen hormone levels, which can be up to 100 times the normal values.
- Higher progesterone hormone levels. This can relax stomach and intestinal muscles, resulting in excessive stomach acid and acid reflux.
- Hypoglycaemia as a result of the placenta draining sugar stores from mom.
- Heightened sense of smell.
- Women whose mothers or sisters had morning sickness, are more likely to have it too. This is suggestive of a genetic link.
- The evolutionary basis theory. Some believe it acts as a defence mechanism for the developing fetus. The baby’s organs are most vulnerable between 6-18 weeks. This coincides with the usual morning sickness time frame.
Risk Factors
All pregnant women are at risk of morning sickness. There are some instances when you are at a higher risk:
- You have a history of nausea and vomiting (e.g. motion sickness). Or associated with migraines, certain smells/foods, and birth control pills.
- You had morning sickness with a previous child.
- You are expecting twins (or more).
- You are expecting a girl.
- You are obese (BMI over 30).
- There is a family history of Hyperemesis Gravidarum.
- You are stressed and anxious. This can lead to tummy upset and more morning sickness.
- You are physically, or mentally, fatigued.
- You are a first time mom! Your body has been shocked by all the rapid biological changes. It’s no surprise that your emotions may be all over the place – and your stomach also. If you already have other children, they may be enough of a distraction to keep your mind off things.
Treatments
Unfortunately, there is no cure for morning sickness. There are many things you can try to help you with the symptoms though. Here are our top tips:
Eating and drinking
- Diet – in the short term, avoid foods that are making you queasy. Find foods that you can eat and keep down. Often you’ll want to steer clear of spicy foods and those that have a strong smell. You should be able to find some suitable healthy alternatives. Cold foods can sometimes be tolerated better than hot foods. The American College of Obstetricians and Gynecologists suggest the BRATT (bread, rice, applesauce, toast, tea) diet. This is bland – but it is also easily digested and low in fat. Don’t worry too much if you are not hitting all your daily nutritional intake targets for a few weeks. Having said that, it is preferable to focus on a higher protein and complex carbohydrate diet. Try munching on peanut butter on whole grain toast, or hard cheese and crackers.
- Regular eating – try to keep your tummy topped up with food throughout the day. Try not to over eat or allow yourself to get too hungry. An empty stomach is more likely to trigger symptoms. This may mean eating 5-6 smaller meals, rather than the traditional 3 larger meals. Smaller portions will be better digested with less risk of reflux.
- Snacks – have something light before bed (e.g. whole grain muffin and some milk). This will keep your tummy satisfied at night. It may be an idea to keep some snacks by your bedside in case you get hungry during the night. Or for when you wake up in the morning and your tummy is empty. Plain biscuits and crackers may fit the bill but can be messy … be sure to hoover up all the crumbs! Don’t forget to take snacks with you when you are out and about. Granola bars, dried fruit and nuts, soy crisps can all hit the spot and keep your stomach settled. Snacking on the same foods may get a bit boring and can themselves become a nauseating trigger. Don’t be afraid to mix it up if a certain snack is beginning to look and smell less appealing.
- Fluids – staying hydrated is one of your most important goals during pregnancy. This is especially true if you are vomiting and actively losing fluids. If possible, try to carry a refillable bottle around with you. This way you can continuously sip on water throughout the day. Mineral and coconut water can help replenish low electrolyte levels. Some women prefer ice cold water as this creates less queasiness. Sucking on ice cubes or flavoured ice popsicles can also be comforting. Do not chomp on ice cubes though. This can cause serious dental issues like enamel wear and fracture of restorations. . If you find that you can’t face drinking a lot of fluids, aim to eat food high in water content (e.g. fruits and vegetables). Experiment in the kitchen. You may invent the most perfect fruit smoothie.
- Ginger – many moms report that even the whiff of ginger can settle their queasiness right down. Research has confirmed the benefits of ginger when dealing with nausea and vomiting. [2] You can consume it in various forms, like ginger snaps and ginger cake. Try adding ginger to your cooking. You can also get it in drinks like ginger tea and ginger ale. Ginger can have anticoagulant effects, so always consult your doctor if you will be consuming large quantities.
- Lemon – sniffing the sharp zingy zest of a freshly cut lemon or chewing on some sour candies can help with nausea.
Lifestyle
- Fresh air – keep your rooms well ventilated and get rid of stuffy air. Open windows and doors (if weather permits) at home and work. Go out for a stroll and get a change of scene.
- Relax – being pregnant officially makes you delicate. That means you need to slow down and take your time. Whether it’s getting ready for work, or cleaning the bathroom, give yourself a few more minutes to complete these tasks. Rushing around can aggravate nausea. If you’re feeling stressed out then try mediation, visualization and prenatal yoga to help you relax.
- Sleep – get as much sleep as you can at night. Go to bed a bit earlier. Get into the habit of winding down in the late evening rather than being active.
- Clean mouth – always rinse your mouth out with water after retching or vomiting. This will remove residual acid that can attack your teeth and freshen your taste. Avoid toothbrushing for at least 30 minutes though. Brushing acid-softened enamel will do more harm in the long run. Try sugar free gum/mints to get rid of the bitter acid taste. These can stimulate saliva flow and protect the enamel on your teeth.
Medications and supplements
- If your symptoms are severe then speak to your doctor about taking an FDA (Food and Drug Administration) pregnancy approved anti-sickness (antiemetic) medication. Be sure to take your prenatal vitamins to ensure your baby is getting all the nutrients (e.g. folic acid) they need at the right time. Try to take them with food. But be wary that vomiting may see you expel them before absorption by your body. Supplements high in iron can take their toll on your tummy. If you are having more severe symptoms, speak to your doctor about switching to something higher in Vitamin B6. See if your doctor suggests trying Vitamin B6 in combination with an antihistamine (e.g. Doxylamine). These are available over the counter (e.g. Unisom SleepTabs or Diclegis). Taken in the first trimester, research shows up to 70% improvement in symptoms. [3] There are a few side effects to be wary of. These include drowsiness, dry mouth, headaches, nervousness and stomach pain. Only take these tablets after consulting with your doctor.
- Metoclopramide is used to treat nausea and vomiting in other conditions. It can be well tolerated in pregnancy. Your doctor will need to determine whether this medication is suitable for you.
Support
- Morning sickness can significantly affect a pregnant woman’s quality of life and daily activities. Those who get support from family and friends tend to cope better.
Alternate options
- Acupressure – wristbands can be used to place pressure on the inner wrist acupressure point. Simple sea-band wristlets or PSI Bands are widely available in most drug stores. They are safe to use in pregnancy and some women find them very useful. Your doctor may recommend you try something like Reliefbands. These are battery operated and produce gentle electric stimulation to the pressure point.
- Acupuncture – this involves the insertion of very fine needles into the skin, by a trained specialist. Strong evidence is lacking, but some women do find it beneficial.
- Aromatherapy – again research is limited, but there have been positive reports with the use of certain scents produced by essential oils (e.g. lemon).
- Hypnosis – there is little research into this area but women susceptible to suggestion have used hypnosis to help with their morning sickness.
- Biofeedback – this uses an electrode on the palm which can detect the smallest amount of sweat produced at the onset of nausea and vomiting. Through exercise and training, you can learn to stop the vomiting early in its tracks.
Complications
Morning sickness rarely tends to cause any significant problems for mom or baby. Often the worst symptoms are over and done with whilst the developing embryo is only very small. At this stage they have little nutritional needs, so if you are vomiting don’t worry that you are harming them.
When to call the doctor
Pregnant women should speak to their doctor if they :
- Suffer severe nausea and vomiting
- Pass dark coloured urine
- Pass small volumes of urine
- Have not passed urine in 8 hours
- Can’t keep any food or fluid down over 24 hours
- Experience dizziness or faintness when standing
- Feel their heart is racing
- Notice blood in the vomit
- Notice weight loss
Hyperemesis Gravidarum
1-2% of all moms-to-be will suffer from a very severe form of morning sickness termed Hyperemesis Gravidarum. Normally this resolves by the 5th month of pregnancy.
Severe vomiting can cause dehydration, weight loss, alkalosis (high blood alkalinity) and hypokalemia (low blood potassium). These conditions require urgent medical attention. Often hospitalization with IV (intravenous) fluid and antiemetic treatment is necessary.
Thankfully, there is only a very small risk to your baby with this form of morning sickness. Sometimes though, if mom suffers from weight loss, there is a chance her baby may be born with a lower birth weight.
For more help and support on Hyperemesis Gravidarum, click here.
So what next?
Morning sickness is just another one of those things that a lot of women will go through during pregnancy. The good news is that it generally only lasts for a few weeks and it doesn’t harm your baby.
There’s loads of ways you can manage your symptoms and you’ll soon find out what works best for you. It’s actually a good time to discover new foods and indulge in your favourite ones … if of course they’re all you can keep down. In the rare case you have severe symptoms, you will need to seek urgent medical attention.
If you want to know more about what you should eat when you’re expecting, make sure you read our healthy pregnancy diet article.
