The pregnancy hormone hCG typically peaks around the time nausea and vomiting begin. Genetics and history with morning sickness also play a role.
Severe nausea and vomiting can cause dehydration, weight loss and other serious complications. If you’re suffering from hyperemesis gravidarum, seek medical help immediately.
Your obstetrician may prescribe medicine to prevent nausea and vomiting (antiemetics). These medicines are usually the same types used to treat allergies.
Symptoms
Mild nausea and vomiting in early pregnancy is a normal part of the pregnancy experience. It usually starts around week six or seven, but it can start earlier for some women. It usually improves or stops by weeks 12 to 20.
Most pregnant women can find some relief from the symptoms by eating bland foods that are easy to digest, such as bananas, rice, toast and applesauce. They may also want to drink lots of water or fluids and avoid greasy, spicy and acidic foods. Ginger can be helpful, as can taking a supplement that contains vitamin B6 (pyridoxine).
Severe nausea and vomiting can harm the fetus. It can prevent a woman from getting the nutrition she needs, cause her to lose weight and become dehydrated. If untreated, this condition can lead to premature birth and other complications. It is called hyperemesis gravidarum (HG). It occurs in about one in 1000 pregnancies.
If nausea and vomiting persist, contact a health care provider. They may suggest a higher dose of medication or other treatment. If the nausea and vomiting are severe, they may suggest hospitalization to provide IV fluids and nutrition.
Treatment
Severe morning sickness can harm the mother and baby if not treated. Women who can’t keep food or fluids down may lose weight, become dehydrated and experience a loss of stomach acid (hyperemesis gravidarum). If untreated this condition can prevent the mother from getting the nutrition she needs and can affect her baby’s weight at birth.
If symptoms are severe, your doctor may prescribe vitamin B6 and doxylamine. These are antiemetic drugs that help stop vomiting. They are available over-the-counter in the form of a pill or liquid, and you can also find them in some OTC sleep aids. Your doctor may also give you a medicine that combines them.
Your doctor may recommend that you eat small amounts of bland foods such as boiled potato, mashed or baked chicken or fish, or plain rice. These are low in fat and salt, and can help settle the stomach. They can be eaten during the day or at night, but should always be taken with a drink of water. Ginger products (such as tea or candy) and acupressure wrist bands might also reduce nausea.
Some alternative and complementary medicines for morning sickness have not been rigorously tested for safety, so talk to your doctor before trying them. For example, a traditional African remedy called Nzu can contain high levels of lead and arsenic and should not be taken by pregnant women.
Prevention
For many women, the best way to combat morning sickness is to avoid foods that trigger it. Keeping a journal of the time of day that nausea strikes and what food or smells may make it worse can help you identify what causes it so you can steer clear going forward. You also might want to try keeping a box of tissues in your purse or car and keep a plastic bag handy in case you need to empty your stomach.
In most cases, vomiting and nausea caused by pregnancy is not harmful to the fetus. For some women, however, it can cause a condition known as hyperemesis gravidarum that can lead to dehydration and malnutrition. If you experience this severe form of nausea and vomiting, talk to your obstetrician about treatment options.
In most cases, your doctor will recommend dietary changes and home remedies to ease nausea and vomiting in early pregnancy. Your health care provider will ask questions about your past pregnancies, your current symptoms and whether you have had any other signs of pregnancy that you weren’t expecting. You might also have to undergo some tests, such as urine and blood samples, an ultrasound or a CT scan of the pelvis. They might also order vitamin and mineral supplements to make sure you are getting enough nutrients. If you are not eating well, your doctor might prescribe an antiemetic medicine such as Vitamin B6 and doxylamine (you can get both of these over-the-counter in single dose tablets).
Other Conditions
Many women have nausea and vomiting throughout the day and at night. This may be because a growing baby triggers the release of hormones that can cause a woman to feel sick at any time of the day or because they are sensitive to certain smells.
In general, moderate morning sickness doesn’t harm the fetus. However, if the nausea and vomiting are severe, or a woman is losing too much weight, she should seek medical advice. She might need treatment that doesn’t affect the fetus, such as taking medication that relieves nausea and vomiting.
Some women have extreme, unrelenting nausea and vomiting that doesn’t improve with home treatments. This is called hyperemesis gravidarum and requires hospital treatment. Women with this condition need to eat small meals often, get lots of rest, avoid fatty foods and strong smells and take extra fluids. Some women also find that eating cold foods makes them less nauseous, because they produce less odours than hot ones.
The symptoms of mild morning sickness usually go away by weeks 12 to 20, but they may last longer for some women. If a woman can’t keep anything down, including water or a healthy snack, she should contact her doctor or midwife right away. A doctor or midwife can recommend some things that might help, such as sips of flat lemonade, diluted fruit juice, cordial, clear soup and ginger ale. Vitamin B6 supplements and acupressure or acupuncture on the wrist might also help.
