Nausea and vomiting in pregnancy

Early pregnancy can be a very exciting time, but many women find that nausea and vomiting (commonly known as morning sickness) can make the first trimester not so pleasant. Although it is often called morning sickness, nausea and vomiting can happen at any time of the day or night.

So, how do you make the first few months more bearable?

Nausea and vomiting in pregnancy is very common. Around 85 per cent of women experience symptoms at some stage in their pregnancy. For most women it’s really not too bad. A lot of women may feel  nauseous or a bit unwell, but they’re still able to live their lives normally with maybe  a slight tweak to their diet. Some women may require anti-nausea medication to get through the day and unfortunately a small number of women may experience a more serious form of nausea and vomiting called hyperemesis gravidarum. Women who suffer from hyperemesis gravidarum may need to be admitted to hospital to be treated with medications and fluids. 

What causes morning sickness?

The pregnancy hormone bHCG (beta human chorionic gonadotropin)may affect the area in the brain that is associated with nausea and vomiting, although we don’t really understand why this part of the brain is affected by pregnancy. 

How do I make myself better?

Changing your eating pattern can help you feel better.  Eating small meals more frequently (instead of three big meals per day) and avoiding getting overly hungry can help.

Spicy, fatty, and smelly foods can trigger morning sickness, so if you aren’t feeling very well it might be best to steer clear. Plain, dry and cold foods (such as crackers, plain biscuits  and nuts) are often more manageable. Yoghurt, fruit and cheese may also be good options. Having a range of snacks to graze on throughout the day will hopefully make your symptoms a little easier to manage.

Even more important than the food you eat is maintaining your hydration. If you are vomiting a lot you may get dehydrated, so try and drink around eight glasses of fluid per day. Soft drinks often don’t go down too well, (the bubbles seem to make nausea worse) but water, some herbal teas (for example containing ginger or peppermint) and sugar-free mineral or soda water may help settle your stomach.

A lot of women swear by ginger (in tablets, food and drinks) for morning sickness . Other over the counter options may include pyridoxine (vitamin B6) which can be used in conjunction with doxylamine (an antihistamine which is safe in pregnancy but might make you drowsy).  These are probably helpful for mild symptoms, but may not be overly helpful for women with more severe cases of nausea and vomiting in pregnancy.  If preparing food and cooking are something you can’t face (or stomach) try and outsource it to your partner or another family member.

Some women may also find acupuncture helps with nausea and vomiting.

If I’m not feeling any better, when do I  seek help?

If nausea and vomiting is bothering you and you just can’t seem to get on top of it with the tips we’ve mentioned above, it might be time to talk to your doctor or midwife.

Your doctor or midwife will be able to explore other possible causes or concerns and may do some blood tests and a pregnancy ultrasound (especially if you haven’t had one yet). They might be able to suggest some other measures, such as taking some anti nausea medication.

If you are struggling to keep hydrated, have severe vomiting or nausea that is preventing you from eating or drinking, your urine is very dark and of a small volume, or you are otherwise worried seek assistance more urgently. This may involve a trip to your GP, your local Emergency Department or the Mater Pregnancy Assessment Centre.

When will I start to feel better?

The good news is that nausea and vomiting in pregnancy doesn’t last forever. Most women will notice a big  improvement towards the end of the first trimester or early in the second trimester—around the 12 to 15 week mark. Occasionally some women may find that nausea and vomiting continues through the entire pregnancy or returns in the third trimester.

Will my baby be okay if I’m losing weight?

That’s a really common question from mums-to-be. Babies are very good at extracting the nutrients that they need out of you. A lot of women find that while they may lose weight in the first trimester (or so), they catch back up once nausea and vomiting resolves and both weight gain in pregnancy and the baby’s birth weight are normal by the time the baby is born.

The most important things to do when suffering from nausea and vomiting in pregnancy are to try and maintain your hydration and optimise your food intake where possible.

A scan to check on your baby’s growth may be recommended later on in your pregnancy, particularly if you have had severe or prolonged nausea and vomiting or if you haven’t put on much weight by the second or third trimester.

Will it reoccur?

Nausea and vomiting in pregnancy affects around 85 per cent of women, so it is fairly likely it will happen again.

The recurrence rate for the more severe form, hyperemesis gravidarum, is unclear, but the risk of recurrence in future pregnancies is between 15 – 80 per cent.

If you have had problems with nausea and vomiting or hyperemesis gravidarum in a previous pregnancy you may find it helpful to start diet and lifestyle modifications before you start to feel unwell the next time around.