Nausea During Pregnancy (Morning Sickness)

It is common for a pregnant woman to live through nausea and vomiting during her first few months of pregnancy. It is difficult to predict whether it is going to happen. Some women have no nausea during their first pregnancy, but feel sick with subsequent pregnancies.

"Nausea and vomiting are the commonest symptoms experienced in the first trimester of pregnancy, affecting 70-85% of women"
(British Medical Journal, 2004;328:503 28 February, doi:10.1136/bmj.328.7438.503)

The severity of the nausea varies from pregnancy to pregnancy. Some will feel a bit queasy during the morning hours, others may vomit just in the mornings. Others will feel bad all day long, and throw up at any time. The term "morning sickness" may seem meaningless to the mother who is throwing up in the evening.

In most cases the nausea goes away during the end of the third or beginning of the fourth month. It can, however, continue right up to the end of the fifth month.

Why do some pregnant women experience nausea?

Doctors and scientists are not completely sure. As hormonal changes take place when a woman becomes pregnant it makes sense to suppose that they are the cause. Some say an imbalance in the blood sugar could also be to blame.

It might be no coincidence that hCG, a pregnancy hormone, as well as estrogen rise in levels during the first trimester, and drop at about the same time the nausea starts going away.

Anecdotal reports by doctors, nurses and midwives indicate that women who carry twins/triplets are more likely to experience morning sickness during their first months of pregnancy, compared to mothers who are carrying a single baby.

Should I be worried about nausea during pregnancy?

If your vomiting is such that you are losing too much liquid and essential nutrients and minerals, if you are suffering from dehydration you should tell your doctor. If you suffer from hyperemesis gravidarum - the vomiting is causing fluid and electrolyte disturbance - your doctor may decide to give you fluids through a drip, this usually requires hospitalization.

You should see your doctor if you are losing weight, vomiting many times during the day for many days, becoming dehydrated, or your vomit has blood or a brownish color, your urine is dark colored and looks concentrated.

In the vast majority of cases the nausea will go away without anything to worry about.

How do I know if I am dehydrated?

The simplest way is to ask your doctor to do a urine test (ketone test).

Tips on Lessening the Severity and Frequency of Nausea

-- Don't get out of bed quickly, take your time.

-- Eat a little bit of something when you get up. Some women have found that eating a dry cracker or some dry cereal before getting out of bed helps.

-- Eat a little bit of something just before you go to bed at night.

-- Eat regularly, in small amounts, throughout the day.

-- Make sure you are having plenty of liquids.

-- Keep away from fatty foods.

-- Keep away from spicy foods.

-- Avoid caffeine.

-- Many women say dry foods, such as crackers or toast help.

-- If you are particularly sensitive to smells, remember that cold foods smell less.

-- Some women find ginger tea helps a lot.

-- Make sure you are getting enough physical rest. However, try to avoid having a nap immediately after you have eaten.

-- Try not to move around straight after eating.

-- There might be smells that make you feel sick - avoid them.

-- Get some light exercise each day, go for a walk.

-- Fresh air often helps.

-- Have a small snack next to your bed. If you wake up during the night, eat some of it. Many women find this helps stave off the nausea the following morning.

-- Eat snacks that are high in protein (March of Dimes).

Do not take anti-sickness tablets unless your doctor has prescribed them for you.