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Morning Sickness

 

I thought I’d write my first blog about morning sickness as it’s incredibly common and it makes people miserable; those with it as well as those around them. There you are, excited to be pregnant, struggling to keep things quiet for your first trimester, and morning sickness is ruining everything for you!

While some women are told there is nothing they can do about it and just to put up with it until it goes away (a lot harder than it sounds!), others are given a well meaning, but often overwhelming, plethora of advice. Some remedies will work for some people some of the time, and some won’t ever, but, let’s face it, when you are feeling awful for hours/days/weeks/months on end, it is well worth trying what you can. To this end, I thought I’d give you a nice, thorough overview of things you might be able to do to feel better, supporting evidence and things you would do best to avoid. Hope it helps!

 

Who does morning sickness affect?

It’s estimated that 75 – 80% of women experience morning sickness to some degree, ranging from mild nausea to being unable to keep any food or fluids down, with severe cases even requiring a hospital stay. Some factors can increases the likelihood of morning sickness. These include a multiple pregnancy, a previous history of morning sickness or motion sickness, previous nausea or vomiting when taking the oral contraceptive pill, a family history of morning sickness, or a history of migraine headaches.

On the up-side, numerous studies have shown that moderate morning sickness is associated with reduced incidence of miscarriage, so as long as you are able to stay adequately hydrated then rest assured, your baby is doing fine. Some women worry the pressure of the vomiting may harm their baby but, again, don’t fret, as the amniotic fluid in the gestational sac is perfectly designed to protect your baby.

 

When does it occur?

I think we all know morning sickness is quite inappropriately named, seeing as most women would call it all-damn-day sickness, or any-old-time-of-the-day sickness, or well-into-the-night sickness, or is-it-ever-going-to-end sickness. Take comfort, for most women, it will pass soon enough and lead into a far more comfortable and pleasant second trimester. Morning sickness can begin at between 4-6 weeks and then typically ends from 12-16 weeks. An unlucky minority may experience morning sickness throughout their entire pregnancy.

 

Why, why, WHY?

We aren’t exactly sure why women experience morning sickness but the theories include;

  • Rapid increase of hormone levels in HCG and oestrogen in the early stages of pregnancy.
  • Blood pressure fluctuations associated with the normal physiological changes your newly pregnant body is undergoing.
  • Changes in carbohydrate metabolism.
  • Fatigue and increased stress levels can worsen morning sickness symptoms.

 

Treatment

Unfortunately, there is a sad lack of good quality evidence to support an effective and definitive intervention for morning sickness. However, over the many years of talking to a multitude of women experiencing morning sickness, what I do know is that different remedies will work for different women. Here are some good treatments that have worked for my patients and clients, and I really hope that the cure for your morning sickness is among them.

 

Dietary advice

 

  • Hunger is usually a pregnant woman’s kryptonite – it will make you feel a lot worse than you need to and can be quite unbearable in a way that you have not experienced before. To combat this, attempt to eat smaller, more frequent meals. There’s no evidence to suggest that a carb heavy diet is superior to a protein rich one, or vice versa, so eat what you can eat, what you feel like eating when you feel like eating it. Carry around plain biscuits or chips or some kind of snack that you can stomach so that you do not get hungry. Many women also keep dry biscuits on their bedside tables to ward off hunger pangs as well as to eat before hopping out of bed in the morning, and most morning sickness sufferers will swear by this advice.
  • Avoid dehydration by ensuring an adequate fluid intake. You can rest assured that if you are still urinating frequently, and the colour is relatively normal for you that you are drinking enough. When you feel nauseated, it can be difficult to keep your fluids up. Some ways to help achieve adequate hydration include sipping on weak tea or cordial, or clear soups or broths.
  • This is not the time to be a foodie adventurer. Avoid spicy and fatty foods, and don’t eat too close to bedtime. Your sense of smell will be hypersensitive, so avoid foods or smells which trigger nausea and vomiting. If you are experiencing regular illness at a particular mealtime, a food diary may help to pinpoint specific foods which may be causing you trouble.
  • Take yourself off cooking duty. Many women find preparing food and meals, particularly meat, very difficult as it usually increases the experience of nausea. If possible, ask for help from partners or family – do not be afraid to be demanding, your body is doing a lot of work and you will need extra help. If you can’t always get help, try to prepare lots of meals at once and put it in the freezer. Consider ready-made meals even if you don’t usually like them. Be kind to yourself and take an easy option if one exists – being a domestic goddess can wait until your morning sickness has subsided, believe me.

 

Dietary supplements

  • Vitamin B6 (pyrixodine) – Supplementation with vitamin B6 can improve the symptoms of morning sickness, and the combination of Vitamin B6 and ginger is a common combination in morning sickness tablets. These tablets can be very effective, but you must remember a few tricks and follow your pharmacist’s advice regarding dosage. The supplements must build up in your system, so don’t expect a quick fix, but remember, it is worth persisting as they will probably bring you some relief. These tablets also need to be taken before your symptoms begin – for example, take one upon waking before the nausea sets in properly, and then take the next at a set time rather than waiting to feel sick and then taking it. Of course, you can also obtain B6 from food, which include fish, whole grains, vegetables, nuts and bananas. This option is obviously dependent on what your morning sickness is actually allowing you to eat and keep down though, so just do whatever works for you.
  • Ginger – Ginger is a tried and tested, well-known anti-emetic and can be taken in several forms. Some women will grate fresh ginger into boiling water, use ginger tea bags, eat crystallised ginger, drink ginger ale or take it in a tablet form (available from a supermarket or chemist). Whichever works best for you is fine!
  • Mint tea – Some women will find that mint is more effective than ginger for their morning sickness. The taste of mint can also be more agreeable than ginger to a nauseated woman and so may be easier to swallow. Fresh or dried mint in hot water, mint tea bags, mint lollies or chewing gum are all ways which could alleviate your sickness.

 

  • Apple cider vinegar – If you are experiencing nausea and vomiting, try adding 2 – 3 teaspoons of apple cider vinegar to warm water and drinking this first thing in the morning or before going to bed. I recommend that, for best results, you obtain a good quality organic apple cider vinegar, which can be found in any health food shop.

 

Physical remedies

 

  • Acupuncture – Many women seek help from an acupuncturist for relief from the symptoms of morning sickness. GPs will commonly recommend acupuncture and, as I have mentioned, anything is worth a try when you are suffering. In my experience, sometimes it works very well to alleviate or cure morning sickness, but sometimes, I just can’t seem to help a client feel better. With those who it seems to help, twice weekly or weekly treatments are recommended until the symptoms begin to subside anywhere from the 12 to 16 week mark.
  • Seasickness bands – Many women report success using these bands, which are available from chemists and are used to put pressure on the acupuncture point Pericardium-6, located two fingerbreadths above the wrist crease in the middle of your wrist between the two tendons. The band is generally quite wide, so you don’t need to be too worried about putting it on the point’s exact location. You can play around with its position anyway, and if you feel one spot alleviates the nausea better than another, use it. The only downside of the bands is that they will be visible to other people, including your work colleagues. You could use your imagination to think of a reason – I did once hear a story about one lady who had seasickness for almost twenty years! You also might be able to cover the bands up with bangles or long sleeves. Depending on your circumstances, you may also not even mind telling people you’re pregnant or just not wear them to work and pop them on when you get back into your car at the end of your day. Whichever way, if you find these work for you, then I’d suggest wearing them as often as possible.
  • Rest – Again, this is a time for letting your body do its thing and being kind to yourself. Let go of any expectations you had/have about continuing to be Wonder Woman now that you are pregnant. Remember that the goal here is a beautiful, healthy baby and a happy, healthy new mum – there are no certificates or ribbons for you getting through your first trimester with everything ticked off your To-Do list. Each trimester will present different challenges so it is imperative that you learn now to listen to your body and respect what it needs to do. Many of my clients report worsening symptoms when they are tired and haven’t been resting enough. Overdoing it will more often than not make you feel worse, especially the following day, which gets you into a cycle of one-step-forward and three- steps-back. Obviously, things will sometimes be out of your control but do not feel guilty if you cannot do everything that everyone wants you to. As soon as you eventually announce your pregnancy, friends, family and work will all happily forgive you for missing a coffee date or party. Remember that this period will pass, and if you need to lie on the couch when you get home from work for half an hour instead of going to the gym, then do it. Listen to your body; it might feel like forever, but it is really just a few months in a whole lifetime – your second trimester will generally be a whole lot better, so be kind to yourself and have an afternoon nap, work from home if possible, go to bed at 7pm, whatever it takes, just do it.

 

MedicationsAlways consult your doctor before taking any medications, as tablets you may have taken for nausea prior to pregnancy may not be okay once you are pregnant. Do not rely on Google – get your doctor’s advice and get a second opinion if you feel you need to. This is your body and your baby, so be careful.

Whilst many women want to avoid medications, for some it will be near impossible. If nothing else is working and you are still feeling awful, it may well be best that you head to the GP and get yourself a script – why should you feel terrible when you don’t have to and when you have tried everything else? Your doctor will give you good advice which best suits your situation.

Medications commonly prescribed include;

  • Antihistamines
  • Maxalon (Metoclopramide)
  • Zofron (Ondansertron)

 

Hope it helps!

Being pregnant sure isn’t easy, so remember your end goal – seeing that bouncing bub for the first time will hopefully make memories of this wretched morning sickness fade quickly. Try to stay positive by trying to find a remedy which works for you and getting help when you need it. Above all, be gentle with yourself – let this pregnancy be your priority for nine months, and for that to happen, you have to be your priority for the next nine months (then bub can take over your life). Persistence is the key to surviving morning sickness with your sanity intact. Don’t forget that you will often need to persist with these treatments, there is no quick fix for morning sickness – your body is undertaking a massive task and those hormones will continue to be produced, so having just one cup of ginger tea or only one B6 tablet is not going to help – keep trying! And if one remedy doesn’t help, try another, you will get there.