Nausea and Morning Sickness during Pregnancy

If only morning sickness was just relegated to the mornings! Here's some help for
every woman coping with nausea during pregnancy, especially during the early
months.

You're sailing along on your early pregnancy adventure at (so far, so good, you're
thinking just a touch of tenderness around the nipples, a little urinary
frequency, a few blue veins across your chest, but nothing you can't handle). Until
one day, you wake with a strangely icky feeling in the pit of your stomach. Could it
be seasickness? Sure does feel like it (that, or the worst hangover you've ever
had). Well, in these pregnant parts, it's called morning sicknessand chances are
you'll be bunking with it for the next few weeks.
WHEN DOES MORNING SICKNESS START?
If you're among the estimated three in four women who suffer from symptoms
related to this misnamed malady in the first trimester of pregnancy, you already
know the bad news: Although that nauseous, queasy feeling in your stomach
often starts when the sun rises, it can hit at any time of the day or night. Also
sometimes known as nausea and vomiting of pregnancy (NVP), symptoms
typically start around week 4 to week 9 of pregnancy and peak somewhere

between week 7 and week 12. And since that sense of smell is extra-keen in a
newly pregnant woman, morning sickness causes many women have strong
aversions to certain foods and smells, too.

The good news: For the vast majority of expectant moms, the worst of it is over
between weeks 12 to 14 (though a few women continue to experience symptoms
into the second trimester, and a very few, particularly those expecting multiples,
may suffer some well into the third). Even better news: Though morning sickness
might make you feel lousy, its not harming your baby. In fact, some research has
found that women who do experience some nausea during pregnancy are
significantly less likely to miscarry than women who don't experience any (though
most women have healthy babies, whether or not they experience morning
sickness).
WHAT CAUSES MORNING SICKNESS?
No one knows for sure though theres no shortage of theories. It could be
triggered by the increased level of the pregnancy hormone hCG (which peaks
around the time morning sickness is worst). Rising levels of estrogen and
progesterone levels relax the muscles of the digestive tract, making digestion less
efficient. The rapid stretching of the uterine muscles likely doesnt help, nor do
other body changes (such as that keener sense of smell or the metallic taste many
women experience during pregnancy). Skipping meals can contribute to an empty
and nauseous feeling as well.

Not all pregnant women experience morning sickness and not in the same way,
either. Some have only occasionally queasy moments, others feel queasy round
the clock but never vomit, others vomit once in a while, and still others vomit
frequently. There are probably a few reasons for these variations:
Hormone levels. Higher-than-average levels (as when a woman is carrying
multiples) can increase morning sickness; lower levels may minimize or eliminate
it (though women with normal hormone levels may also experience little or no
morning sickness).
Sensitivity
Some brains have a nausea command post thats more sensitive than others,
which means theyre more likely to respond to hormones and other triggers of
pregnancy queasiness. If you have a sensitive command center (you always get
carsick or seasick, for instance), youre more likely to have more severe nausea
and vomiting in pregnancy. Never have a queasy day ordinarily? Youre less likely
to have lots of them when youre expecting.
Stress
Its well known that emotional stress can trigger gastrointestinal upset, so its not
surprising that symptoms of morning sickness tend to worsen when stress strikes.
Fatigue
Physical or mental fatigue can also exacerbate the symptoms of morning sickness
(conversely, severe morning sickness can increase fatigue).

First-time pregnancy status

Morning sickness is more common and tends to be more severe in first

pregnancies, which supports the idea that both physical and emotional factors
may be involved. Physically the novice pregnant body is less prepared for the
onslaught of hormones and other changes its experiencing than one thats been
there, done that. Emotionally, first timers are more likely to be subject to the
kinds of anxieties and fears that can turn a stomach while women in subsequent
pregnancies may be distracted from their nausea by the demands of caring for
older children. (Generalities never hold true for every expectant mom, though,
and some women are queasier in subsequent pregnancies than they were in their
first).
Genetics
Women whose mothers had morning sickness have been shown to be more likely
to develop the condition themselves.
WHAT YOU NEED TO KNOW
In the short term, not eating very much isn't a problem: Your baby is fortunately
teeny tiny when morning sickness is at its worst and doesn't have very much in
the way of nutritional needs yet. (By the time he or she does, you'll almost
certainly have your appetite back, in spades!) Even women who have such a hard
time keeping food down that they actually lose weight during the first trimester
arent hurting their babies, as long as they make up for the lost weight in later

months. Keep an eye on your urine, though: It should be clear or light colored, like
straw, not dark (which is a sign to drink up).
However if youre not able to keep anything down, including fluids, it may be a
symptom of hyperemesis gravidarum, a more serious condition which affects up
to 2 percent of women with morning sickness. If your nausea is continuous and
severe and you vomit several times a day, make sure to see your doctor: You may
require additional treatment to protect both you and your baby.
WHAT YOU CAN TO EASE MORNING SICKNESS
Doesn't make you feel any better that you and most of your belly mates are all
sailing the SS Queasy together (especially as your head is busy bobbing in the
toilet)? Maybe the following nausea-nipping tips will:
Stick to foods that appeal, for now. Even if it's the same foods over and over and
over again. Avoid eating (or seeing, or smelling, or even thinking about) any
dishes that trigger the queasies (spicy and acidic foods may be particularly
challenging, as well as anything with a strong aroma). Chances are you'll be able
to find a few healthy foods that you can keep down (or at least contemplate
coming fork-to-face with) and that will take care of most of your nutritional
requirements until a more varied diet becomes palatable. Choose only sweet
foods if theyre all you can tolerate (get your vitamin A and protein from peaches
and yogurt at dinner instead of broccoli and chicken). Or select only savories if
theyre your ticket to a less tumultuous tummy (have reheated pizza for breakfast
instead of cereal). Don't worry too much about getting your Daily Dozen in the
short term, since your baby (and his or her needs) is pretty tiny now. And
remember, no one food has a monopoly on any one nutrient so if you turn
green at the thought of anything green, get your vitamin fix from a sweet, juicy
cantaloupe instead.
Eat early Morning sickness doesnt wait for you to get up in the morning. In fact,
nausea is most likely to strike when youre running on empty, as you are after a
long nights sleep. Thats because when you havent eaten in a while, the acids
churning around inside your empty tummy have nothing to digest but your

stomach lining which, not surprisingly, increases queasiness. To head off

heaving, stock your nightstand full of trail mix, crackers, and cold cereal to munch
on first thing in the morning. Its a good idea to even have a little nocturnal nibble
if (or rather, when) you wake up in the middle of the night to pee. and right
before bed. For the same reason, try eating a light snack high in protein and
complex carbs (a banana muffin and a glass of milk, string cheese and a handful of
dried apricots) just before you go to sleep to help ensure a happier tummy when
you wake up.
Be a grazer. The idea is to keep your belly a little bit filled all the time (don't
overfill it, and don't let it get completely empty). Eat six to eight small meals
throughout the day rather than three large squares again, when your tummy's
empty, youre more likely to feel nauesous. Plus, smaller meals are easier to
digest and less likely to trigger the queasies (or to overflow via vomiting). And
dont leave your house without a stash of snacks that your tummy can handle
(dried fruit and nuts, granola bars, dry cereal, crackers, soy chips or pretzels).
Try the combo. No, not the double cheeseburger combo (that's the last thing you
need right now) the protein-and-complex-carbohydrate (dried apricots,
crackers, dry whole-grain toast) pregnancy diet combo. Taken separately, these
food groups are both good for baby. Taken together, they're good for baby and
keeping nausea at bay.
Don't go overboard with fat. The more you steer clear of greasy foods, the
happier your tummy will be. Not only are fats hard to digest, but they can send
your nervous system into warp speed ahead, aggravating your nausea.
Tread gingerly. It's true what the old wives (and midwives) have been saying for
centuries: Ginger can be good for what ails a queasy pregnant woman. Its been
shown in more than one scientific study to reduce nausea and vomiting in
pregnancy. So stock up on staples such as ginger snaps, real ginger ale, ginger tea,
ginger candies, ginger biscuits, crystallized ginger or ginger drinks. Use ginger
when youre cooking (ginger carrot soup, ginger muffins), and infuse your tea with
it. Even the smell of fresh ginger (cut open a knob and take a whiff) may quell the
queasies. It'll help put a damper on nausea.

When life gives you morning sickness, make lemonade. Another trick of the
queasy trade: lemons. Many women find the smell and taste of lemons
comforting. Sour sucking candies or a sniff of freshly-cut lemon may be your ticket
to relief.
Switch off. Often, what starts out as a comfort food (its the only thing you can
keep down, so you eat it 24/7) becomes associated with nausea and actually
starts to trigger it. If youre so sick of crackers that theyre actually beginning to
make you sick, switch off to another comforting carb (maybe itll be Cheerios or
watermelon next).
Drink up. Making sure you get your eight glasses of fluid a day is especially crucial
if vomiting is leaving you high, dry, and dehydrated. Cant stand water? Try
sucking on Popsicles. Some women find that drinking and eating at the same
sitting puts too much strain on their digestive tract; if this is true for you, try
taking fluids between meals. If youre finding liquids are easier to get down when
youre green, drink your vitamins and nutrients with soups, smoothies and shakes
(many women find icy cold fluids and foods are easier to get down, too).
Smell (and see) no evil. Thanks to a much more sensitive sense of smell, pregnant
women often find once appetizing aromas suddenly offensive and offensive
ones downright sickening. So stay away from smells that trigger nausea
whether its the sausage and eggs your spouse likes to make on the weekends or
the aftershave of his that used to make you head over heels (but now makes you
head for the toilet). Steer clear, too, of foods that you cant stand the sight of
(raw chicken is a common culprit).
Supplement. Take your prenatal vitamin to compensate for nutrients you may not
be getting, at whatever time of day youre least likely to cuck it back up. Make
sure it's iron-free, at least until the morning sickness during pregnancy passes.
Take it with a meal, and consider a coated, powder or chewable one, which may
agree with your stomach more. Afraid that vitamins will only make matters worse
besides being hard to choke down? Actually, that one-a-day can decrease
nausea symptoms (especially if you take a slow-release vitamin thats higher in

quease-combatting vitamin B6). If your symptoms are particularly rough, ask your
practitioner about taking a vitamin B6 supplement.
Try Sea-bands. These 1-inch wide bands worn on both arms put pressure on
acupressure points in the inner wrist. They cause no side effects and are widely
available at drug and health food stores and have been shown to lessen
pregnancy nausea.
Take time to relax. Try any of the classic stress-reduction techniques, like
meditation and visualization or prenatal yoga. And as always, hit the sack for as
many hours as you can clock every night.
Use complimentary approaches. There are a wide variety of complementary
medical approaches, such as acupuncture, acupressure, biofeedback or hypnosis,
that can help minimize the symptoms of morning sickness and theyre all worth
a try.
Treat your mouth well. Brush your teeth or rinse your mouth after each bout of
vomiting, as well as after each meal. (Ask you dentist to recommend a good
rinse.) Not only will this help keep your mouth fresh and reduce nausea, it will
decrease the risk of damage to teeth that can occur when bacteria feast on
regurgitated residue in your mouth.
Ask your doctor about medication. If your morning sickness is severe, you may
want to talk to your doctor about taking Dioletis, an FDA-approved drug to treat
nausea and vomiting of pregnancy. You'll likely be prescribed to take two tablets
daily at bedtime, and if your symptoms are not mitigated, your dose can be
increased to a maximum of four tablets daily with the approval of your doctor.
Dont take any medication (traditional or herbal) for morning sickness unless its
prescribed by your practitioner.