Nausea and Vomiting During Pregnancy

Some studies have found that as many as 70-80% of pregnant women experience some degree of nausea and vomiting.

The severity of morning sickness can also vary greatly, with some women experiencing only mild symptoms and others experiencing more severe nausea and vomiting. Nausea and vomiting during pregnancy tend to be the worst 6 to 10 weeks after your last menstrual period and usually goes away by 12 to 16 weeks after your last period. While it is often called “morning sickness,” it can occur all day long.

Mild to moderate nausea and vomiting may make you feel awful, but it will not hurt you or your baby. Severe vomiting during pregnancy that prevents you from keeping food down is called hyperemesis gravidarum. It is rare but can cause health problems. If morning sickness is severe and persistent, it is important to talk to your healthcare provider. You should call our office if you are unable to keep liquids or food down for 24 hours, you are vomiting several times a day or after every meal, or if you have abdominal pain, difficulty urinating, or have a fever.

The exact cause of nausea and vomiting during pregnancy is not fully understood, but it’s believed to be related to the hormonal changes that occur in a woman’s body during pregnancy. Specifically, the hormone human chorionic gonadotropin (hCG) is thought to play a role.

There are several factors that may increase a woman’s risk of experiencing morning sickness during pregnancy. These include:

• Being pregnant with twins or triplets
• A history of motion sickness or nausea and vomiting during previous pregnancies
• A family history of nausea and vomiting during pregnancy
• High levels of the hormone human chorionic gonadotropin (HCG) in the body
• Low levels of a substance called chromium in the body
• Smoking or exposure to secondhand smoke
• Consuming large amounts of caffeine
• Having a diet that is low in carbohydrates or high in protein

While these factors may increase a woman’s risk of experiencing morning sickness, it is important to note that not all women who have one or more of these risk factors will necessarily experience morning sickness. Additionally, many women who do not have any of these risk factors may still experience morning sickness.

Mild to moderate nausea and vomiting during pregnancy is generally not dangerous for the mother or baby. In most cases, it is a normal and common part of pregnancy that does not cause any harm. However, if a woman experiences severe nausea and vomiting during pregnancy, it can potentially be dangerous. This condition is known as hyperemesis gravidarum (HG) and requires medical attention as it can cause dehydration, weight loss, and other complications. If a woman has severe nausea and vomiting during pregnancy, it is important to talk to a healthcare provider who can provide treatment and support.

Signs and symptoms of hyperemesis gravidarum include prolonged and severe nausea and vomiting, dehydration, and weight loss.

You should call your healthcare provider if any of the following apply to you:

• Morning sickness does not improve, despite trying home remedies.
• Nausea and vomiting continue beyond your 4th month of pregnancy. This happens to some women. In most cases this is normal, but you should have it checked out.
• You vomit blood or material that looks like coffee grounds. (Call immediately.)
• You vomit more than 3 times per day, or you cannot keep food or liquid down.
• Your urine appears to be concentrated and dark, or you urinate very infrequently.
• You have excessive weight loss.

First Step: Lifestyle and Diet Changes

Simple diet changes may lessen nausea and help avoid vomiting. This is all it takes for many women.

• Drink plenty of fluids, especially water, to stay hydrated
• Nausea during pregnancy is worse if you are dehydrated or if the levels of sugar in your blood are low from not eating often enough
• Eat plain crackers or dry toast in the morning before getting out of bed and at any time during the day when you feel nauseous
• Eat small, frequent meals throughout the day instead of three large meals. This can help keep your stomach from feeling empty, which can make nausea worse.
• Avoid foods with strong odors
• Sucking on a lemon or lime slice may help
• Try eating foods that are high in carbohydrates such as potatoes, noodles, or toast
• Do not lie down right after eating
• Try drinking carbonated caffeine-free beverages between meals; wait for 30 minutes after eating to drink liquids
• Dairy products may make nausea and vomiting worse, but some women say yogurt is helpful
• Avoid spicy, fatty, or greasy foods, which can be difficult to digest and may make nausea worse
• Some women find that prenatal vitamins make nausea worse. If so, check with your doctor about stopping the vitamins until the nausea goes away. If you stop taking a prenatal multivitamin, you should take one tablet of folic acid daily (0.4mg which is 400 micrograms per day) during the first trimester. Folic acid tablets will not worsen nausea
• Eat protein-rich foods. Protein can help keep you feeling full and may help reduce nausea. Good sources of protein include lean meats, poultry, fish, eggs, beans, and tofu.
• Try ginger. Ginger has natural properties that can help ease nausea. You can try ginger tea, ginger ale, or ginger chews to help ease symptoms.

Second Step: Nonmedication Treatment

Ginger

Ginger has been used for treating nausea since ancient times. Ginger root tea, ginger gum, ginger chews, gingersnaps, ginger syrup added to water, and ginger ale are all safe and can decrease the severity of your nausea. You can also buy ginger capsules at the drug store. The daily dose of ginger that has been tested is 1 gram (250mg capsules powdered ginger taken four times per day). Ginger capsules come in several doses. If you want to use ginger capsules, ask your doctor how often you should take them.

Acupressure Bands

Sea-bands are wristbands with a pressure point placed on the inside of your wrist. They are often used for motion sickness. Some women find them helpful for nausea, and they are safe.

Third Step: Over-the-counter medication

Start by taking vitamin B6, this vitamin has been shown to reduce nausea and vomiting in some pregnant women. The American Academy of Family Physicians suggests women try 10-25 mg of vitamin B6 every 8 hours.

If vitamin B6 does not provide enough symptom relief, you can try 12.5 – 25mg of doxylamine every 8 hours (brand name Unisom SleepTabs). Since they can cause drowsiness, you may wish to use a lower dose during the morning and afternoon and larger dose at night.

Fourth Step: Medication

There are prescription medications that can be used if your nausea and vomiting are severe. Talk with your doctor before taking any additional vitamins or medicines.

Nothing is more important than the health of you and your baby. If you ever feel like something isn’t right, call your doctor or visit your nearest emergency room.