Nausea and Vomiting during Pregnancy

It is estimated that approximately 75% of women experience nausea or vomiting during pregnancy. In fact, nausea and vomiting are the most common symptoms experienced in the first trimester of pregnancy. Although it usually is limited to the first trimester of pregnancy, nausea and/or vomiting can unfortunately persist for the entire duration of pregnancy.

Why do you get nauseous during pregnancy?

The actual causes of nausea and vomiting remain unknown, which is why it’s difficult to prevent and treat. However, there are several theories proposed for the cause of nausea and/or vomiting during pregnancy. Some of these include:

·         Hormonal changes (possibly progesterone or hCG levels)

·         Imbalances in blood sugar levels

·         Emotional factors (especially stress)

·         Rapid stretching of the uterine muscles

·         Elevated levels of the bacteria called helicobacter pylori (H. Pylori)

Is it Dangerous?

If your symptoms are severe, you may experience excessive loss of fluids and nutrients that could lead to dehydration. Prolonged dehydration can be very serious and affect the available nutrients to your baby. If this occurs it is very important to tell your doctor. If you suffer from hyperemesis gravidarum (severe form of morning sickness that causes unrelenting, nausea and/or vomiting that prevents adequate intake of food and fluid) you likely are suffering from fluid and electrolyte disturbances and should contact your doctor immediately. You may require hospitalization for intravenous fluids and/or observation.

Signs that you should contact your doctor include losing weight, vomiting many times during the day for many days, vomit with blood or a brownish color, or dark/concentrated urine.

What can I do to help with nausea and/or vomiting:

·         Start taking a multivitamin from the time of conception

·         Take your time getting out of bed, it may help to have a small meal/snack before getting out of bed

·         Eat smaller meals and more frequently (every 2-3 hours), even if your not hungry

·         Drink plenty of liquids l(10-12 glasses of water/day) between meals and not during the meals themselves

·         Avoid greasy, fried, and/or spicy food

·         Avoid foul smelling odors or any odor that triggers nausea

·         Rest. Extreme tiredness and fatigue can lead to nausea and vomiting during pregnancy

·         Ginger or products that contain ginger have proven beneficial in the treatment of nausea and vomiting during pregnancy

Basically, there are many things you can try to help with nausea and vomiting during pregnancy. Of course, most of these are not evidenced-based. However, if it is not harmful and it works… keep doing it! I know most women will try anything to help with severe nausea/vomiting. 

What if nothing helps…Is it safe to take medications?

It’s always safer to try the alternatives to medication, as most people are concerned about giving any medication to a developing fetus. Women want definitive answers on the safety of these medications, but unfortunately the research is lacking when it comes to any long term outcomes.  That being said, there are several medications where there is sufficient evidence to suggest that taking these medications will not cause harm to a developing fetus.  Some of these include:

Non-Prescription

·         Although not officially approved for morning sickness, Emetrol is the only nonprescription nausea medication that’s considered safe during pregnancy.

·         Reflux medications such as Zantac or Pepcid sometimes work for women whose nausea and vomiting is triggered by gastrointestinal distress.

·         Vitamin B6 supplements (10 to 25 mg three to four times per day) have been found to reduce symptoms of mild to moderate nausea, but do not significantly reduce vomiting.

Prescription Drugs

As for prescription drugs, your practitioner may suggest nausea medications when symptoms are severe or nothing else has been helpful.

 

·         Anti-histamines such as promethazine (Phenergan®) is available in pill, injectable solution, or suppository form. It is usually taken every four hours, and may cause drowsiness and dry mouth. Rare side effects include muscle contractions that cause twisting or jerking movements.

·         Metoclopramide (Reglan®) speeds emptying of the stomach and may help to reduce nausea and vomiting. It is usually taken by mouth or injection every eight hours.

·         Ondansetron (Zofran®) — Ondansetron is an anti-nausea medication, originally designed to control nausea in chemotherapy patients, is usually taken by mouth or injection every eight to 12 hours. Ondansetron is very expensive, although a generic form has recently become available.

 

When in Doubt…Contact your Heath-Care Provider

If you think morning sickness is keeping you from eating properly or gaining the weight necessary for a healthy pregnancy consult your health-care provider. Untreated, severe vomiting can cause dehydration and can cause serious complications in either you or your unborn baby.