Morning Sickness

Morning sickness is the common term for the nausea and/or vomiting which may occur at any time of day during pregnancy. Morning sickness is a common feature of many pregnancies. No one is quite certain what causes this phenomenon. Hormones, and hCG in particular, top the list of suspects. It has been known for decades that a woman with a molar pregnancy or a multiple gestation may have both very high levels of hCG and severe nausea and vomiting. Other theories speculate that the extreme swings in a pregnant woman’s blood sugar levels may trigger nausea (blood sugar levels are at their lowest in the morning after fasting all night). Whatever the cause(s), it is a particularly dissatisfying component of pregnancy.

Nausea (and vomiting, too) may affect a woman during any part of her pregnancy. However, for most women it is primarily a problem which arises somewhat suddenly in the 5th to 7th weeks. It’s occurrence is largely unpredictable day-to-day, and for most it slowly disppears between the 12th to 15th week. Most women who experience nausea and vomiting in the early part of pregnancy will improve dramatically, but may continue to be bothered occasionally throughout the pregnancy. Often food odors are the triggers for nausea.

There are some things which you can do to help yourself (this does NOT apply to diabetic women!). Most strategies are directed at attempts to keep the blood sugar levels from crashing to low levels. Eating and drinking before one gets out of bed in the morning is the initial effort. Simple sugars begin to enter the blood stream in the mouth. So, the combination of a simple sugar (for example, juice) and a more complex carbohydrate (a cookie or cracker) will begin to immediately raise one’s blood sugar and keep it above fasting levels for an hour or so. A good way to do this is to keep some juice and cookies next to your bed. Set your alarm to sound 20 minutes before you actually need to get up. Drink some juice and eat a cookie and lie back down for 15 minutes. When you get up, eat breakfast immediately. Try to eat some complex carbohydrates, some fats and some protein with that meal in order to maintain higher blood sugars for a longer period of time (nutritional slow-release). Then, instead of eating 3 meals per day, stretch your daily intake over many smaller meals throughout the day…..what one midwife calls “grazing”.

The vitamin, B6 (pyridoxine), may also help. In doses of 10-25 mg, taken several times throughout the day, the vitamin has shown some value in decreasing nausea.

Accupressure may be of some value to some women in controlling morning sickness. Stimulation of the P6 (pericardium 6) accupressure point, also known as the Neugian point, which is located on the wrist, may be of some beneficial effect. Wrist bands, which place pressure on the Neugian point, are available.

Ginger root may also be of some value in decreasing nausea and vomiting. Buy some whole ginger root. Cut 4-6 dime-size slices with a carrot peeler and steep them in a cup of boiled water until it cools enough to drink. Squeeze a quarter to a half of a lemon into the drink and sweeten to your taste. Make a pot, put it in a Thermos, and sip throughout the day.

If this does not help……there is another common remedy that your doctor or midwife will know about. For liability’s sake, it will not be discussed here. However, if you’ve tried the above without much benefit, ask your clinician about the story of Bendectin. If your clinician is less than 40 years old, they probably will not have had any personal experience with it, but they should know about it. Bendectin was a drug marketed prior to the late 1970s. It was removed from the market due to a lawsuit. Many millions of doses of this effective drug were given to many hundreds of thousands of pregnant women. Several good scientific studies showed that it was a safe medicine for pregnant women (it is still marketed in Canada and Europe). However, the manufacturer decided that it did not want to wage a series of legal battles at a time when obstetrical malpractice settlements were reaching new highs almost weekly. So, they took it off the market. Your clinician probably knows how to formulate this medicine, and if they’re familiar with the scientific literature on the topic, may agree that it is a safe alternative for some women. If you are at your wit’s end with nausea and/or vomiting, and nothing else is helping, ask your clinician about this.

Severe nausea and vomiting may be a symptom of a larger problem. A very rare condition, molar pregnancy, is often accompanied by severe nausea and vomiting. However, far more often severe nausea and vomiting becomes Hyperemesis Gravidarum. Hyperemesis is a state of dehydration and malnutrition resulting from loss of fluids and an inability to ingest any food or fluids. A woman with hyperemesis is often listless, thirsty, almost continuously nauseated, and has begun to lose weight. Often, the cycle of hyperemesis can be interrupted by a course of intravenous fluid replacement, commonly called, an “IV”. Sometimes it is necessary to do this several times, and add an anti-nausea drug (also called an antiemetic) such as Phenergen, Reglan, Compazine or Vistaril. Fortunately, for almost all, the condition improves with time. In the most extreme cases of hyperemesis, steroid drugs and “parenteral nutrition” (IV, liquid food) may be used.

If you have nausea and/or vomiting associated with a fever, abdominal pain, or vaginal bleeding, you should call your midwife or doctor.

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