Morning sickness: Treatments, prevention, and when it starts (original) (raw)
Morning sickness is a common term for nausea and vomiting that occurs during pregnancy. It results from hormonal changes. Rest, drinking fluids, eating small meals, and avoiding triggers can help manage it, but some people may need medication.
For many, the symptoms of morning sickness are among the first signs of pregnancy.
In most cases, morning sickness carries no health risk for the fetus. In fact, some studies suggest that mild morning sickness can be a sign of a healthy pregnancy and is associated with lower rates of pregnancy loss.
In this article, we discuss the causes, symptoms, and complications of morning sickness, as well as the treatments.
A person may not need medical treatment for their morning sickness — self-care strategies can effectively alleviate the symptoms for some people. Below, we explore these strategies and the medicinal approaches that a doctor may recommend.
Rest
Fatigue is common during pregnancy, and it can make nausea worse. While the exact causes of fatigue and nausea during pregnancy remain unknown, it is important to rest and get enough sleep whenever possible.
Liquids
During pregnancy, it can be beneficial to drink smaller amounts of fluids more regularly. This may help reduce vomiting.
Food
Having smaller meals more frequently
manage morning sickness.
And certain types of food, such as dry, savory foods, may be
to cause nausea and vomiting than spicy foods, for example.
Avoiding triggers
Certain odors, tastes, or both may trigger morning sickness. Understanding and avoiding known triggers can help a person reduce the frequency and severity of nausea and vomiting.
Antinausea medication
If morning sickness symptoms are still severe despite these home care techniques, a doctor may recommend a short course of an antinausea medication, also called an antiemetic, that is safe to use during pregnancy.
Ginger supplement
Some studies suggest that ginger supplements help reduce nausea symptoms during pregnancy, with little risk of negative outcomes. However, clinical evidence to support the use of this remedy is lacking.
B6 and doxylamine
The over-the-counter version of this combination of medications is called Unisom SleepTabs.
It may help treat morning sickness during the first trimester. Trials have found the combination to be effective at reducing nausea and vomiting in up to 70% of participants.
Diclegis
Diclegis is the brand-name version of a similar combination: doxylamine succinate and vitamin B6, in the form of pyridoxine hydrochloride.
The Food and Drug Administration (FDA) has approved this product for use during pregnancy. One clinical trial found that Diclegis relieved nausea in 44% of participants with morning sickness. However, a
questioned the efficacy of the drug.
Anyone interested in this treatment should discuss it with a doctor first.
The exact causes of morning sickness are still unknown. However, hormonal changes may play a key role.
Estrogen levels
Increased levels of the hormone estrogen circulating in the body may contribute to morning sickness. However, studies have yet to confirm this link.
Progesterone levels
When a person is pregnant, their levels of the hormone progesterone also rise. This relaxes the muscles of the uterus, or womb, to prevent early childbirth. However, it may also relax the stomach and intestines, resulting in excess stomach acid and gastroesophageal reflux disease, or acid reflux.
Human chorionic gonadotropin
Levels of the hormone human chorionic gonadotropin (hCG) rise as well, and this may cause vomiting. The developing embryo produces this hormone soon after conception.
hCG levels peak around weeks 9–12 of pregnancy, and nausea and vomiting may peak at this time, as well. While many studies have found that increased hCG and nausea and vomiting are linked, the exact role of the hormone in morning sickness is still unclear.
Sense of smell
During pregnancy, a person may become more sensitive to odors. This can overstimulate the body’s regular nausea triggers and lead to nausea and vomiting.
Any pregnant person may develop morning sickness. The risk is greater if:
- Before the pregnancy, the person experienced nausea, with or without vomiting, due to:
- motion sickness
- migraine
- some tastes or smells
- birth control pills
- Morning sickness occurred during at least one previous pregnancy.
- The person is expecting more than one baby.
Despite the name, morning sickness can happen at any time of day and include nausea, vomiting, or both. It is more common in the first trimester of pregnancy.
Contact a doctor if:
- Nausea, vomiting, or both are severe.
- Urine is darker than usual.
- There is less urine than usual.
- It is difficult or impossible to keep liquids down.
- There is dizziness when standing.
- The person faints when standing.
- The person has a racing heartbeat.
- There is blood in the vomit.
Most people find that morning sickness improves after the 12th week of pregnancy, though it can persist throughout each trimester.
Morning sickness can significantly affect a person’s quality of life. Some people feel that the name for this issue downplays its severity.
If nausea and vomiting are continually severe, it can lead to hyperemesis gravidarum, which develops in about 0.3–3.0% of pregnancies. We describe this below.
Hyperemesis gravidarum is a rare, severe form of morning sickness. Most cases resolve by the 20th week of pregnancy, but a person may have it until the delivery.
The symptoms may include:
- an inability to keep fluids down, due to severe vomiting
- dehydration and weight loss
- alkalosis, which is a dangerous drop in the acidity of the blood
- hypokalemia, which is low potassium levels in the blood
Anyone with severe symptoms should receive medical care immediately. For some people, hospitalization and treatment with IV fluids are necessary.
If a person is pregnant and experiencing nausea and vomiting without another underlying cause, the diagnosis of morning sickness is typically straightforward.
Diagnosing hyperemesis gravidarum is more complicated. A doctor typically looks for:
- prolonged nausea and vomiting
- a pre-pregnancy weight loss of more than 5%
- an electrolyte imbalance
- dehydration
The doctor may also order an ultrasound scan to confirm the number of fetuses and check for any underlying health issues that could contribute to the nausea and vomiting.
Morning sickness is a common name for nausea and vomiting during pregnancy. It can develop, however, at any time of day.
Up to 80% of pregnant people experience some degree of nausea and vomiting, and these issues are more common in the first trimester. The precise underlying cause is still unclear, though changing hormone levels may play a role.
Morning sickness can significantly affect the quality of life. It
poses no risk to the developing fetus.
Various home care strategies can help, such as resting, avoiding pungent or spicy foods, and taking antinausea medications after checking with a doctor.
In rare cases, a person develops a severe form of morning sickness called hyperemesis gravidarum, which requires medical attention.