Nausea and Vomiting in Pregnancy

Nausea and Vomiting in Pregnancy

Nausea and vomiting are so common in early pregnancy that it’s a movie and TV cliché. Over half of all pregnant women will be affected.

For decades, we considered morning sickness an inevitable part of pregnancy that had to be endured. In part, this was due to a fear of using medications in pregnancy. Our generation are too young to be familiar with the thalidomide scare of the 1950s and 60s, but our parents likely remember the affected children. Thalidomide was marketed as a wonder drug for morning sickness, but caused terrible birth defects. After this, the medical profession became extremely cautious about using any new drugs in pregnant women.

Thankfully, in recent years we’ve taken a more proactive approach to morning sickness. There are now several treatments available alongside sensible lifestyle changes.

It’s not just morning sickness

The name “morning sickness” sounds trivial and doesn’t do justice to the experience of many women. Doctors now call it “nausea and vomiting of pregnancy.”

There is a spectrum of severity. Some lucky women only experience mild nausea on waking, while for others the vomiting can be severe and persist throughout the day. Symptoms usually commence around Week 6 and settle around Weeks 14-16 but can continue until the end of pregnancy.

Hyperemesis gravidarum (HG) is the most severe form of morning sickness. It occurs in about 1 in 1000 pregnancies. The vomiting becomes so severe that affected women frequently need admission to hospital and fluids through a drip. The Duchess of Cambridge put HG in the spotlight when she had it during her pregnancies.

I get mild morning sickness – what simple remedies can I try?

There are several lifestyle changes that we recommend to all women. These, plus some simple home remedies, are often enough to relieve mild nausea and vomiting.

  • Keep dry crackers and a water bottle by your bed and have someas soon as you wake up.
  • Frequent snacking on small amounts of plain food (like toast, crackers or fruit) is a tried-and-true strategy.
  • Keep up your fluids. Carry a drink bottle everywhere and drink small amounts frequently. Ice-cold drinks often stay down better than warm drinks.
  • Break your three standard meals up into five or six smaller meals. Avoid eating a big meal right before bedtime.
  • Avoid spicy, acidic, fatty or fried foods.
  • Don’t brush your teeth straight after eating – it can trigger nausea
  • Acupressure and acupuncture aren’t proven to work but some women have felt they were helpful.
  • Ginger tablets, or food/drinks containing ginger are also quite helpful

I’m really struggling and the simple measures aren’t helping. What treatments are available for bad nausea and vomiting?

If the nausea and vomiting are making it hard to keep up your regular daily activities, talk to your GP or obstetrician about the options. If you have reached a point where you are unable to keep down oral fluids, please seek advice from your doctor or midwife immediately.

There are a number of medications we can safely prescribe for nausea and vomiting in pregnancy. You may also need extra treatments such as anti-reflux tablets. Women with hyperemesis often need regular IV fluids or input from a dietitian.

It’s important to keep up the lifestyle changes even after you commence medication. The lifestyle changes will help you get the most out of the medication.

Will vomiting hurt my baby?

The good news is that for the vast majority of women, the nausea and vomiting won’t hurt the developing baby. As long as you are able to maintain a good fluid intake and eat a reasonable variety of foods, both you and baby will be fine. The physical action of vomiting might make your abdominal muscles sore, but baby is well protected inside the uterus and won’t be bothered.