Coping With Morning Sickness
by Susan Miller

Morning sickness is the most common and significant complaint of early pregnancy. Seventy to 85 per cent of pregnant women suffer from morning sickness which typically begins four to six weeks after conception and continues throughout the first trimester (the first three months) of pregnancy. For almost 20 per cent of pregnant women, morning sickness lasts through the second trimester and for a few unlucky women, morning sickness can last into the third trimester as well.

Morning sickness is usually more pronounced for first-time mothers and for those carrying twins or more. A woman is more likely to have morning sickness if she had it in a previous pregnancy, if her mother or sisters had it, if she suffers from migraine headaches, is prone to motion sickness or has had nausea as a side effect of taking the birth control pill. Some research suggests that a woman is less likely to miscarry if she has pronounced morning sickness and there is also a higher possibility that she is carrying a female fetus.
 
Levels of estrogen and a hormone called human chorionic gonadotropin (hCG) increase as a pregnancy becomes established. These hormones circulating in the mother’s bloodstream are produced at the highest levels during the first trimester and are thought to cause the side effect of nausea and vomiting. There is also evidence to suggest that stress and fatigue contribute to morning sickness as well.

Symptoms of morning sickness can range from mild to debilitating. About half of all women experience vomiting, while other women experience a queasiness that is often brought on by a heightened sensitivity to food smells and tastes. Even though the woman may be hungry it can be hard to face food and to get it down. This nausea and/or vomiting are usually accompanied by varying levels of fatigue. Although we use the term “morning sickness,” nausea and vomiting can and do occur at any time during the day.

Typically morning sickness poses no threat to the mother or her baby. Mothers who have considerable nausea and vomiting may be prescribed a medication called Diclectin. In about 1 per cent of cases, severe and persistent vomiting can lead to serious dehydration in the mother, and if this continues she can become malnourished. This more severe condition is called hyperemesis gravidarum and may require that the mother be hospitalized to receive intravenous fluids and supplemental nourishment.

A mother with morning sickness may worry that her developing baby is not getting adequate nutrition because of the limited amount of food she is able to consume and keep down. Even when a mother is losing weight in the first trimester due to morning sickness, her baby is not suffering from nutritional deprivation. It is reassuring to know that in the first 12 to 14 weeks of pregnancy, the nourishment of the fetus depends almost exclusively on the nutrients stored in the lining of the mother’s uterus. These valuable nutrients were laid down at least six months before conception.

Any pregnant woman suffering from morning sickness will crave relief, especially when the symptoms interfere with her ability to function at work or care for a child. Finding the right remedy may take some time and experimentation. What works for one mother may not work as well for the next. Here are some strategies for working out your own personal plan for coping with morning sickness.

Manage Your Meals
Try to avoid having an empty stomach. Eat small, frequent meals. When your stomach is empty, its acids have nothing to digest and this can trigger nausea. A low blood sugar level caused by long stretches between meals can have a similar effect. Before going to sleep for the night, have a snack of protein and complex carbohydrates to help you through the night and early morning (a glass of milk and a bran muffin, for example). Keeping crackers at the bedside to eat about 20 minutes before getting up is an age-old remedy for early morning “empty stomach” queasiness.

Eat a diet high in protein and complex carbohydrates. Carbohydrates such as pasta and potatoes tend to be well tolerated. Avoid spicy, greasy or strong smelling foods. These foods tend to stimulate more digestive juices in the stomach and add to the problem. Some women find it helpful to separate their food and fluids by leaving 30 to 60 minutes between a drink and a meal. Remember to eat before the nausea strikes, as this may help to prevent an attack.

Avoid the Triggers
Keep away from the sight, smell and taste of foods that cause you to feel nauseated. There are too many examples to mention, and you will know what your triggers are! Being a martyr and preparing or eating foods that you think you “should” eat for proper balanced nutrition can actually work against you. Eat only what you can tolerate at this time. You may also find that you are less sensitive to nausea triggers at certain times of the day.

Keep Snack Foods Handy
If you discover one food that helps to quell the nausea and give you some energy throughout the day, keep a supply with you at all times. Some foods that are commonly useful for this are soda crackers, Cheerios, dried fruit, raw almonds, frozen juice pops, celery, peppermint gum, lemon drops and cinnamon fireballs. Some people even find pickles and olives soothing!

Get Your Liquids
If you are nauseated and vomiting fairly regularly you will need to make an extra effort to consume more fluids. Drinking more, however, can cause more vomiting so you may have to go slow and easy. Try sucking ice chips and taking sips of water throughout the day. Some of the drinks mothers have found to be well tolerated are grapefruit juice, lemonade, vegetable juice and flat or bubbly pop.

Vitamin Supplements
Prenatal vitamins may help to compensate for the nutrients you are not getting, but if you just throw them up each morning you are no further ahead. Iron supplements tend to be the most irritating to the stomach and may have to be discontinued until the morning sickness passes. Check with your doctor or midwife about this. Some doctors are now prescribing a 50 mg supplement of vitamin B6, which seems to bring some relief from morning sickness.

Herbal Remedies
Some herbal preparations can be dangerous in pregnancy. Always check with your caregiver before taking any over the counter preparations. In her book Take Charge of Your Body: Women’s Health Advisor, author Dr. Carolyn DeMarco recommends some herbs as safe and effective in treating morning sickness. These are ginger, slippery elm bark, and peppermint or raspberry tea. Ginger can be taken in capsule form several times a day or you can brew fresh ginger tea by using one tablespoon of grated ginger to two cups of boiling water. Slippery elm bark is available in powdered form or capsules. Take this throughout pregnancy or as often as necessary. Drink peppermint or raspberry tea as often as you like.

Acupressure
A trained practitioner in acupressure can apply manual pressure on nerve endings at specific points in the body to relieve a variety of symptoms including nausea. Some people wear Sea-Bands on the inside of the wrists for this same purpose.

Slow Down and Accept Help
Emotional and physical fatigue can aggravate morning sickness. It is important to look at all of your responsibilities and decide which ones you can let go and which ones you need some help with. If you have small children to look after, you may be able to arrange for someone to care for the children for a few hours while you get some rest and relaxation. Women in the paid workforce may need to talk to their supervisor to arrange for regular breaks at work, or shortened work hours, and if this is not possible may have to take some time off. Rest and relaxation are important elements to build into your lifestyle while you are pregnant. You and your baby will both benefit from this now and in the weeks and months ahead.

Susan Miller, R.N. BScN, is a Perinatal Educator and Certified Breastfeeding Counsellor. She works with prenatal and post-natal families in the Greater Victoria area.