Pregnancy is filled with many exciting moments: hearing the baby’s heart beat for the first time and feeling that first kick. These memories will last a lifetime. Unfortunately, pregnancy can also present moments you would just as soon forget. Many women would like to erase the feeling of nausea and bouts of vomiting that all too often come with the pregnancy’s first trimester. Over half of all pregnant women experience some degree of nausea or vomiting, often referred to as “morning sickness.” It usually starts at five to six weeks of pregnancy and improves by 16 to 18 weeks. A lucky 10 to 20 percent of women will escape without any symptoms. Many pregnant women can attest that the phrase “morning sickness” is not entirely accurate because the queasiness, nausea, and vomiting can occur at any time of day or night.
The nausea and vomiting associated with pregnancy is most common during the first trimester, sometimes beginning as soon as two weeks after conception and lasting usually through the twelfth week. Typical symptoms include nausea and possibly vomiting, often when you first wake. Usually symptoms subside once you eat something. Usually, it is not necessary to consult your health care provider unless you experience severe nausea and vomiting, become light-headed or faint, vomit blood, or are unable to keep down any liquids. In these cases, it is important to contact your health care provider to avoid dehydration and other complications.
The exact cause of nausea and vomiting in pregnancy is not known but is suspected that fluctuations in hormone levels are probably the chief cause. Also during pregnancy, the smooth muscle of the stomach relaxes and may contribute to nausea and vomiting. It’s also not entirely understood why some women will experience more acute nausea and vomiting. Some groups of women seem to be more prone to nausea and vomiting in pregnancy, including women pregnant with multiples, women who experienced symptoms in a previous pregnancy, and women who experience motion sickness.
In most instances, nausea and vomiting in pregnancy does not require any special medical intervention. In severe cases, also called hyperemesis gravidarum, your health care provider may order blood or urine tests to monitor the severity of your symptoms. Your health care provider will also closely monitor your weight gain or, in some cases, weight loss. The traditional treatment for conventional nausea and vomiting in pregnancy includes recommendations about how to minimize the chances of becoming nauseous. These include eating crackers before you get out of bed in the morning, avoiding eating and drinking at the same time, trying to eat smaller portions more often, avoiding foods and smells that can trigger nausea, and avoiding fatty or spicy foods.
Health care providers may also recommend ingesting ginger and avoiding an empty stomach. Some women with moderate symptoms have had success with motion sickness bands, acupressure, or hypnosis. If symptoms are acute, health care providers may prescribe vitamin B-6 and doxylamine (Brand name: Unisom) or other anti-nausea medications that can help with symptoms, including Emetrol (a non-prescription anti-nausea medication), or prescription medications like Compazine or Phenergan. In some instances, an anti-nausea medication traditionally used for chemotherapy patients called Zofran may be recommended.
In rare cases when oral medications are not effective, women may be required to be admitted to the hospital to receive intravenous treatments to replace lost fluids and receive IV medications that can hopefully abate the nausea and vomiting. Nausea and vomiting in pregnancy generally does not threaten the health of either mother or baby. However, an underweight woman before pregnancy who does not gain an adequate amount of weight because of nausea and vomiting may be at risk of having a low birth-weight baby.
Currently there is no known way to prevent the onset of nausea and vomiting in pregnancy. Some older studies showed that women who were taking vitamins prior to becoming pregnant often times experienced less nausea and vomiting when they became pregnant. Often times, health care providers will recommend avoiding stress because anecdotal evidence seems to show a correlation between high levels of stress and increased nausea and vomiting in pregnancy. Physical reactions to both the pregnancy hormones and stress hormones may be more than the body can handle, and nausea and vomiting are a consequence.
If you experience nausea and vomiting during pregnancy, share this information with your health care provider. Let him or her help you come up with a plan to minimize this often unpleasant side effect of pregnancy. With the proper advice and guidance, you should be able to enjoy your pregnancy and look forward to all the happier milestones that come with a healthy pregnancy.
Dr. Hardy is a solo physician in practice with Atlantic Ob/Gyn with locations in Chesapeake and Va. Beach. Call 757-463-1234 or visit www.atlanticobgyn.com.