Nausea and Vomiting in Pregnancy
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Nausea and vomiting in pregnancy, called morning sickness, can be a challenge to manage but is very common. It’s actually experienced by most pregnant people, though the severity will vary. In rare cases, nausea and vomiting can be severe and require intervention. This very extreme form of nausea and vomiting in pregnancy is called hyperemisis gravidarum.
Morning Sickness
Morning sickness can feel like seasickness or carsickness. Despite its misleading name, this nauseous feeling can happen at any point in the day or persist throughout. Some people just have mild nausea, while others may end up vomiting several times a day. Typically peaking in severity around week nine of pregnancy, symptoms usually subside after the first trimester. The exact cause of morning sickness is unknown, though hormone changes in pregnancy plays a role. Morning sickness doesn't typically have any negative effects on fetus. It can be helpful to remember that it is really common. Most pregnant people are dealing with this and go on to have healthy pregnancies and babies. In fact, experiencing morning sickness can be a reassuring sign of a healthy pregnancy.
But even more mild cases of morning sickness can be very challenging. One big reason for this is that it often lasts for weeks. It’s not easy to feel sick for such a long period of time, especially when paired with the intense fatigue that commonly happens in early pregnancy. And many expectant parents are experiencing these significant symptoms at a time when those around them are not yet aware of the pregnancy. Also, working and/ or taking care of older children is not easy when not feeling well.
When it comes to nutrition, the symptoms of morning sickness can make it really difficult to eat healthy. Besides the nausea and vomiting, it’s also very possible to experience strong aversions to certain foods. I remember asking myself, what is the point of feeling sick at a time when you would want to focus on good nutrition? Why do I hate salad so much right now? I should be eating salad! There is actually quite a bit we don’t know about morning sickness, but it's possible that these frustrating symptoms serve a purpose from an evolutionary standpoint. They may exist as a way of protecting the fetus when it's most vulnerable from certain types of meat and vegetables that, historically, were more likely to contain things like toxins and parasites.
There really isn’t a cure for morning sickness, other than time, but there are things you can do to help manage the symptoms until they subside. Let’s take a look at my Morning Sickness Relief Roadmap. I created this to provide you with some guidance on common strategies for managing morning sickness. I’ll start with an overview of the steps and then we can talk about each one in more detail.
📝 Note: This roadmap contains information and ideas, not medical advice!
Start by avoiding triggers and making simple dietary and lifestyle changes.
Consider trying aromatherapy (with lemon essential oil), and/ or acupressure bands.
Talk to your care provider about supplementing with vitamin B6 alone or in combination with Unisom.
Talk to your care provider about trying a prescription medication.
💡 Tip: Start with step one and progress through each next step only as necessary. It’s also important to talk with your care provider about what you’re experiencing, as well as the steps you are taking to manage your morning sickness.Start with step one and progress through each next step only as necessary. It’s also important to talk with your care provider about what you’re experiencing, as well as the steps you are taking to manage your morning sickness.
Step One: Start by avoiding triggers and making simple dietary and lifestyle changes.
Common triggers:
Certain odors (mine was a cupboard that housed all of our spices)
Motion
Warmer air temperatures
Your triggers may differ from this list. Avoid what you find to be a trigger for you, personally.
Next, let’s talk about making simple changes to your diet to help with the nausea and in keeping food down:
Eating smaller, more frequent meals is one strategy.
Eat bland foods, like bananas, rice, applesauce, and toast. Crackers can also be helpful.
Making swaps to handle food aversions is another idea. For example, if salads are unappetizing, you may be able to keep some dark-green vegetables in your diet by adding them to sandwiches and smoothies.
You may also find foods or flavors that are soothing. There may even be certain foods that you crave. For me, anything lemon-flavored was really great. Many people find ginger ale or ginger tea to be helpful.
Taking a prenatal vitamins can sometimes help with nausea, but they can also trigger it. If these seem to be an issue for you, make sure you’re not taking them on an empty stomach. Talk to your care provider if prenatal vitamins continue to be a trigger, because they may have recommendations for some different options.
Other basic lifestyle things you can do:
Getting adequate rest can help to minimize the effects of morning sickness.
While it can be difficult to find the motivation when you’re not feeling well, exercise and movement can help you feel better.
Any support you can get during this time is really beneficial. Do you have a partner, friend, or family member that can assist with meal planning, cooking, and other household tasks? It may be easier to eat healthy when you have someone to help prepare meals (plus, cooking odors can be triggering). Sharing the load around the house may give you an opportunity to get some additional rest and free up some time to make sure you can fit in some regular exercise.
Step Two: Consider trying aromatherapy (with lemon essential oil), and/ or acupressure bands.
Lemon essential oils have been shown to be effective. Make sure to purchase from a reputable source. You can either place a drop into a cotton ball and inhale or diffuse the essential oil for a maximum of 10-15 mins each hour.
Acupressure bands are an inexpensive and non-medical option that may be worth a try, though evidence on the effectiveness of this is limited. People also use this option for carsickness or seasickness.
Step Three: Talk to your care provider about supplementing with vitamin B6 alone or in combination with Unisom.
Vitamin B6 has been shown to help with morning sickness. Talk to you care provider about this option first for guidance. If vitamin B6 alone isn’t enough, you can also take it in conjunction with Unisom, which is a sleep aid (so it can make you drowsy). Make sure to look for the active ingredient Doxylamine. Vitamin B6 supplements and Unisom are both available separately over-the-counter. Diclegis is a prescription medication that combines them both into one pill.
Step Four: Talk to your care provider about trying a prescription medication.
If nothing else seems to be working and you are struggling, talk to you care provider about your options. They may be able to prescribe a medication that can help.
Hyperemesis Gravidarum
Hyperemesis gravidarum (HG) is severe nausea and frequent vomiting that occurs during pregnancy. Pregnant people suffering from this are unable to keep food and liquids down, which leads to issues like severe dehydration, significant weight loss, complete loss of appetite, and light-headedness. Symptoms can continue well past the first trimester and will likely have a significant impact on daily life. Talk to your care provider if you have concerns. This is a disease that will require medical intervention, including possible hospitalization. Unlike morning sickness, HG can have long-term negative effects on you and your developing baby. It can even be life-threatening.
It may be helpful to think of the severity of nausea and vomiting on a spectrum. A small number of pregnant people fall at the extreme ends, while everyone else is somewhere in the middle. Most people can manage symptoms by avoiding their triggers and finding management strategies that help. If you’re headed down the more severe end of the spectrum and struggling to manage using the typical morning sickness strategies, early and aggressive medical treatment can help you avoid the more harmful and dangerous affects of HG. This progression in severity is typically gradual. Don’t delay in talking to your care provider about your options. This often happens before the first prenatal appointment, but please don’t let this prevent you from seeking help!
For more information and resources, make sure to click on link below:
Nausea and vomiting is a really challenging symptom experienced by many in early pregnancy. It’s common to struggle with this before you’ve even had a prenatal care appointment. Get tools, information, and support for changes and challenges associated with pregnancy in my toolkit, called Proactive Pregnancy: Early Essentials for Expectant Parents. Click the button below to check it out!