"Morning sickness" is a misnomer. (In fact, the technical medical term is "nausea and vomiting of pregnancy.") For some pregnant women, the symptoms are worst in the morning and ease up over the course of the day, but they can strike at any time and, for most women, last all day long. The intensity of symptoms can vary from woman to woman, too.
This condition is very common, affecting about three quarters of pregnant women during the first trimester. About half of all pregnant women suffer from both nausea and vomiting, one quarter has nausea alone, and one quarter lucks out altogether. The nausea usually starts around 6 weeks of pregnancy, but it can begin as early as 4 weeks. It tends to get worse over the next month or so.
About half of the women who get nausea during pregnancy feel complete relief by about 14 weeks. For most of the rest, it takes another month or so for the queasiness to ease up, though it may return later and come and go throughout pregnancy. Unfortunately, for a small percentage of women symptoms persist continually (or nearly so) until delivery.
Some women get a very severe form of nausea and vomiting, called hyperemesis gravidarum (HG). It is very serious and needs specialist treatment, sometimes in hospital.
Nausea can be one of the most trying problems in early pregnancy. It comes at a time when you may be feeling tired and emotional, and when many people around you may not realise you're pregnant and expect you to be your normal self.
No one knows for sure what causes nausea during pregnancy, but it's probably some combination of the many physical changes taking place in your body. Some possible causes include:
- Increased oestrogen levels – These tend to be at their highest during the first 12 weeks of pregnancy. Rising levels of oestrogen can heighten your sense of smell, which may explain why certain smells – such as food cooking – can make you feel sick.
- Increased human chorionic gonadotrophin (hCG) levels - After conception (when the sperm fertilises the egg), the body begins to produce a hormone called human chorionic gonadotrophin (hCG).
- Nutritional deficiency - A lack of vitamin B6 in the diet (found in whole cereals, wholemeal bread, cod, soya beans, milk, potatoes, peanuts, bananas and vegetables). It is adviseable to check with your GP before taking a vitamin B6 supplement.
- Gastric problems – As the levels of progesterone increase during pregnancy, there is less movement in your small intestine, oesophagus (food pipe) and stomach, causing morning sickness
A number of different factors may mean you are more likely to have morning sickness, including:
- Nausea and vomiting in a previous pregnancy
- Your unborn baby being a girl. One study found that women with severe nausea and vomiting in the first trimester were 50 percent more likely to be carrying a girl.
- A family history of morning sickness
- A history of motion sickness, for example in a car
- A history of nausea while using contraceptives that contain oestrogen
- Obesity – where you have a body mass index(BMI) of 30 or more
- Multiple pregnancies, such as twins or triplets
- First pregnancy
- You have a history of migraine headaches
- An enlarged placenta
The symptoms of morning sickness can often be reduced by making changes to your diet and lifestyle, as follows:
- Try and get plenty of rest because tiredness can make nausea worse
- If you feel sick first thing in the morning, give yourself time to get up slowly – if possible, eat something like dry toast or a plain biscuit before you get up
- Drink plenty of fluids, such as water, and sipping them little and often rather than in large amounts, because this may help prevent vomiting
- Eat small, frequent meals that are high in carbohydrate (such as bread, rice and pasta) and low in fat – most women can manage savoury foods, such as toast, crackers and crisp-bread, better than sweet or spicy foods
- Eat small amounts of food often rather than several large meals, but don’t stop eating
- Eat cold meals rather than hot ones because they don’t give off the smell that hot meals often do, which may make you feel sick
- Avoid drinks that are cold, tart (sharp) or sweet
- Ask the people close to you for extra support and help – it helps if someone else can cook but if this isn’t possible, go for bland, non-greasy foods, such as baked potatoes or pasta, which are simple to prepare
- Watch for non-food triggers, too. A warm or stuffy room, the smell of heavy perfume, a car ride, or even certain visual stimuli, like flickering lights, might set you off.
- Try taking your prenatal vitamins with food or just before bed. You might also want to ask your healthcare provider whether you can switch to a prenatal vitamin with a low dose of iron or no iron for the first trimester, since this mineral can be hard on your digestive system.
- Distract yourself as much as you can – often the nausea gets worse the more you think about it
- Wear comfortable clothes without tight waistbands, which can sometimes make you feel uncomfortable
If you have severe morning sickness, your doctor or midwife might recommend a short-term course of anti sickness medication that is safe to use in pregnancy. Some other possible treatments that you may find useful are listed below:
Ginger - There is some evidence that ginger supplements may help reduce the symptoms of nausea and vomiting in some pregnant women. Some women find that ginger biscuits or ginger ale can help reduce nausea. You can try different things to see what works for you.
Acupressure - Acupressure on the wrist may be effective in reducing symptoms of nausea in pregnancy. Acupressure involves wearing a special band or bracelet on your forearm. Some researchers have suggested that putting pressure on certain parts of the body may cause the brain to release painkilling chemicals.
When to Seek Medical Advice
If you are vomiting and can’t keep any food or drink down, there is a chance that you could become dehydrated or malnourished. Contact your GP immediately if you:
- Have very dark-coloured urine or do not pass urine for more than eight hours
- Have repeated episodes of vomiting
- Are unable to keep food or fluids down for 24 hours
- Feel severely weak, dizzy or faint when standing up
- Have abdominal (tummy) pain
- Have a high temperature (fever) of 38C (100.4F) or above
- Have a racing heart rate
- Vomit blood
Will It Affect My Baby?
The mild to moderate nausea and occasional vomiting commonly associated with morning sickness won't threaten your baby's well-being. . If you don't gain any weight in the first trimester, it's generally not a problem as long as you're able to stay hydrated and aren't starving yourself. In most cases, your appetite will return soon enough and you'll start gaining weight.
If nausea keeps you from eating a balanced diet, make sure you're getting the nutrients you need by taking a prenatal vitamin. Choose one with a low dose of iron or no iron if that mineral makes your nausea worse.
Severe and prolonged vomiting, however, has been linked to a greater risk of preterm birth, low birth weight, and newborns who are small for their gestational age. However, a large study of women who were hospitalized with severe vomiting found that those who were able to gain at least 15.4 pounds (7 kilograms) during their pregnancy had no worse outcomes than other women.
Further reading which may interest you: www.rockthebabybump.com/when-does-morning-sickness-start/