Most women know that a normal symptom of early pregnancy is nausea and occasional vomiting. There is nothing unusual about this and mild cases are annoying, but not a cause for concern. Sometimes the condition is severe and requires medical help to avoid dehydration and help you function in your day to day life, your morning sickness will usually improve around 12 to 15 weeks’ gestation.

When do the symptoms begin?

Between 5-7 weeks nausea will commence. Vomiting once a day is common. While most women in early pregnancy feel better as the day wears on, some experience nausea and even vomiting all day. When symptoms are this severe, we call it “Hyperemesis Gravidarum”

Does every pregnant woman get nausea?

Definitely not. Some ladies are fortunate and experience no nausea at all, and have completely healthy pregnancies. Likewise having morning sickness does not always mean all is well, and occasionally miscarriage (early pregnancy loss) can occur still despite symptoms.

Is morning sickness harmful?

With common milder cases the answer is no. Nausea can be very tiring and make concentration on day to day tasks difficult. Fortunately, medication is safe and available to help with this.

Are there side effects of morning sickness?

Yes. The first is dehydration. With severe cases, if you are vomiting several times a day, and unable to tolerate fluids you will become dehydrated. This can be easily treated by short admissions to hospital for intravenous rehydration, and safe anti-nauseant medication. Some hospital stays will be for a few hours at a time only, others for a day or two.

Occasionally when the condition goes on for a month or two, depression can occur. Like any chronic illness where a person cannot go about their normal day, morning sickness, particularly when severe can really wear you down. If you are feeling low due to these symptoms please feel free to discuss how we might improve the situation.

Are certain foods easier to digest when I am nauseated?

Typically, rich fatty food, pastries, and meat will not be easy to digest in early pregnancy. Dairy may also not be well tolerated. Often you will crave simple carbohydrates such as bread, crackers, rice etc. Nuts and dried fruit and raw vegetables are other options. Women have a heightened sense of smell when pregnant so cooking certain foods esp. meat will often bring on nausea and or vomiting. Individuals will have specific cravings which is not unusual.
Try to keep the fluid intake up; water, flat lemonade or ginger ale sipped regularly can be tolerated, electrolyte solutions are handy for salt replacement as well as a little sugar. Avoiding dehydration helps limit how bad you feel.

Can medication help?

Yes. There has been for many decades safe and effective anti-nauseants for use in pregnancy. The most common ones are metoclopramide (often known as Maxolon or Pramin) and ondansetron (known as Zofran or Ondaz commonly). Taking doxylamine (a calmative muscle relaxant with anti-nauseant property is helpful at night if sleep is poor. Yes, hard to believe but morning sickness can be all day sickness if you are unlucky!

Very resistant cases can require additional medication if first line treatments don’t work well. Appropriate treatment till the condition resolves can stop vomiting and allow women to go to work, look after their families, feel happier, and keep reasonable dietary intake down.

When will it cease?

Most women will feel better and normal by 15-16 weeks. The lethargy and nausea lift and they start to really enjoy the pregnancy. Up to 5% of cases will persist for longer, on occasion for the entire pregnancy. Careful support at home and work, and temporary lifestyle modification will help.

 

Thank you to Dr Peter England for providing content for this post.

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