The Joys of Pregnancy: Vomiting and morning sickness

Published by Health Professional

on Saturday, April 1st 2023

in

  • Children Health
  • Women's Health

    • Nausea and vomiting in pregnancy, often known as morning sickness, It is very common in early pregnancy.

    It can affect you anytime or night, or you may feel sick all day.

    Morning sickness is unpleasant and can significantly affect your day-to-day life. But it usually clears up by weeks 16 to 20 of your pregnancy and does not increase your baby’s risk.

    There is a chance of developing a severe pregnancy sickness called hyperemesis gravidarum. 

    Hyperemesis gravidarum

    Some pregnant women experience very bad nausea and vomiting. They might be sick many times a day and be unable to keep food or drink down, which can impact their daily life.

    This excessive nausea and vomiting is hyperemesis gravidarum (HG) and often needs hospital treatment.

    Exactly how many pregnant women get HG is unknown as some cases may go unreported, but it’s thought to be around 1 to 3 in every 100.

    If you are sick frequently and cannot keep food down, tell your midwife or doctor or contact the hospital immediately. There is a risk you may become dehydrated, and your midwife or doctor can make sure you get the right treatment.

    Symptoms of hyperemesis gravidarum

    HG is much worse than normal nausea and vomiting of pregnancy.

    Signs and symptoms of HG include:

    • Prolonged and severe nausea and vomiting
    • dehydration – symptoms include feeling thirsty, tired, dizzy or lightheaded, not peeing very much, and having dark yellow and strong-smelling pee
    • weight loss

    Unlike regular pregnancy sickness, HG may not get better by 16 to 20 weeks. It may not clear completely until the baby is born, although some symptoms may improve at around 20 weeks.

    See your doctor or midwife if you have severe nausea and vomiting. Getting help early can help you avoid dehydration and weight loss.

    Other conditions can cause nausea and vomiting; your doctor must rule these out first.

    What causes hyperemesis gravidarum?

    It’s unknown exactly what causes HG or why some women get it, and others do not. There is evidence that it is linked to the changing hormones in your body that occur during pregnancy.

    There is evidence that it runs in families, so if you have a mother or sister who has had HG during pregnancy, you may be more likely to get it yourself.

    If you have had HG in a previous pregnancy, you are more likely to get it in your next pregnancy than women who have never had it before, so it’s worth planning in advance.

    Treating hyperemesis gravidarum

    Some medicines can be used in pregnancy, including the first 12 weeks, to help improve the symptoms of HG. These include anti-sickness (anti-emetic) drugs, steroids, or a combination.

    You may need to try different types of medicine until you find what works best for you.

    You can visit the Bumps website to determine which medicines are safe for pregnancy.

    If your nausea and vomiting cannot be controlled, you may need to be admitted to the hospital. This is so doctors can assess your condition and give you the right treatment to protect your and your baby’s health.

    Treatment can include intravenous fluids, which are given directly into a vein through a drip. If you have severe vomiting, the anti-sickness drugs may also need to be given into a vein or a muscle.

    Will hyperemesis gravidarum harm my baby?

    HG can make you feel unwell, but it’s unlikely to harm your baby if treated effectively.

    However, if it causes you to lose weight during pregnancy, there is an increased risk that your baby may be born smaller than expected (have a low birth weight).

    How you might feel

    Nausea and vomiting of HG can impact your life when you are expecting to be enjoying pregnancy and looking forward to the birth of your baby.

    It can affect you both emotionally and physically. The symptoms can be hard to cope with. Without treatment, HG may also lead to further health complications, such as depression or tears in your esophagus.

    Severe sickness can be exhausting and stop you from doing everyday tasks, such as going to work or even getting out of bed.

    In addition to feeling very unwell and tired, you might also feel:

    • anxious about going out or being too far from home in case you need to vomit
    • isolated because you do not know anyone who understands what it’s like to have HG
    • confused as to why this is happening to you
    • unsure about how to cope with the rest of the pregnancy if you continue to feel very ill

    If you feel any of these, do not keep it to yourself. Talk to your midwife or doctor, and explain how HG affects your life and how it makes you feel. You could also talk to a partner, family members, and friends if you want to.

    If you want to talk to someone who has been through HG, contact Pregnancy Sickness Support’s help section. They have a support network across the UK and can put you in touch with someone who has had HG.

    Bear in mind that HG is much worse than regular pregnancy sickness. It is not the result of anything you have or has not done, and you need treatment and support.

    Treatments for morning sickness

    Unfortunately, no hard and fast treatment will work for everyone’s morning sickness. Every pregnancy will be different.

    But there are some changes you can make to your diet and daily life to try to ease the symptoms.

    If these do not work for you or you have more severe symptoms, your doctor or midwife might recommend medicine.

    Things you can try yourself

    If your morning sickness is not too bad, your GP or midwife will initially recommend you try some lifestyle changes:

    • get plenty of rest (tiredness can make nausea worse)
    • avoid foods or smells that make you feel sick
    • eat something like dry toast or a plain biscuit before you get out of bed
    • eat small, frequent meals of plain foods that are high in carbohydrates and low in fat (such as bread, rice, crackers, and pasta)
    • eat cold foods rather than hot ones if the smell of hot meals makes you feel sick
    • drink plenty of fluids, such as water (sipping them little and often may help prevent vomiting)
    • eat foods or drinks containing ginger – there’s some evidence ginger may help reduce nausea and vomiting (check with your pharmacist before taking ginger supplements during pregnancy)
    • try acupressure – there’s some evidence that putting pressure on your wrist, using a special band or bracelet on your forearm, may help relieve the symptoms

    Anti-sickness medicine

    Suppose your nausea and vomiting are severe and do not improve after trying the above lifestyle changes. In that case, your doctor may recommend a short-term course of an anti-sickness medicine, called an antiemetic, that’s safe to use in pregnancy.

    Often this will be a type of antihistamine, which is usually used to treat allergies but also work as medicine to stop sickness (antiemetic).

    Antiemetics will usually be given as tablets for you to swallow.

    But if you cannot keep these down, your doctor may suggest an injection or medicine inserted into your bottom (suppository).

    See your doctor if you’d like to talk about getting anti-sickness medication.

    Risk factors for morning sickness

    It’s thought hormonal changes in the first 12 weeks of pregnancy are probably one of the causes of morning sickness.

    But you may be more at risk of it if:

    • you’re having twins or more
    • you had severe sickness and vomiting in a previous pregnancy
    • you tend to get motion sickness (for example, car sick)
    • you have a history of migraine headaches
    • morning sickness runs in the family
    • you used to feel sick when taking contraceptives containing estrogen
    • it’s your first pregnancy
    • you’re obese (your BMI is 30 or more)
    • you’re experiencing stress

    Conclusion

    Nausea and vomiting, also known as morning sickness, are common in early pregnancy and can occur at any time of the day or night. While it can be unpleasant and affect day-to-day life, it usually clears up by weeks 16 to 20 of pregnancy and does not increase the baby’s risk.

    However, in some cases, severe pregnancy sickness called hyperemesis gravidarum can occur, which may require hospital treatment. Although it’s uncertain how many pregnant women get HG, it’s estimated to be around 1 to 3 in every 100.

    If you experience frequent vomiting and cannot keep food down, it’s crucial to tell your midwife or doctor or contact the hospital immediately. This prevents dehydration; your healthcare provider can ensure you get the proper treatment.

    FAQs

    Is morning sickness a sign of a healthy pregnancy?

    1. Morning sickness is a common early pregnancy symptom and is generally a sign of a healthy pregnancy. However, if you experience severe symptoms, such as excessive vomiting or dehydration, it’s essential to consult your healthcare provider.

    How long does morning sickness last?

    1. Morning sickness typically starts around the sixth week of pregnancy and lasts until around the 12th week. However, some women may experience symptoms throughout their pregnancy.

    Can I take medication for morning sickness?

    1. Some safe and effective medications can alleviate morning sickness. However, talking to your healthcare provider before taking any medication during pregnancy is important.

    What is hyperemesis gravidarum?

    1. Hyperemesis gravidarum is a severe pregnancy sickness that can cause excessive vomiting and dehydration. It can be dangerous if left untreated and may require hospitalization.

    Can hyperemesis gravidarum harm the baby?

    1. Hyperemesis gravidarum does not harm the baby directly but can lead to dehydration, affecting fetal growth and development. It’s essential to seek medical attention if you experience severe symptoms.