Morning sickness

By , 18 March 2014

Morning sickness

 

 

What is morning sickness?

Morning sickness is the feeling of nausea (sometimes with vomiting) that many women get during their pregnancy.  Up to 9 in 10 women will experience morning sickness, and symptoms vary from mild and annoying, to severe - sometimes requiring admission to hospital.

The term "morning" is a bit of a misnomer - most women experience nausea all day long; though many women report vomiting only in the morning.  Most women develop symptoms within the first two months of pregnancy and, often, symptoms improve considerably after the first trimester (three months).  

It is unclear what causes morning sickness, although theories generally include high hormone levels such as beta-hCG (the "pregnancy hormone"), and alterations to stomach and intestinal motility (that is, the movement of food through the gut).  Morning sickness is more common in twin pregnancies (perhaps reflecting the higher hormone levels) and can be worsened by thyroid disorders.  Perhaps the only comfort to be found, in this sometimes debilitating condition, is that moderate-to-severe morning sickness appears to be associated with a lower risk of miscarriage.

 

What are the risks of morning sickness?

In the great majority of cases, morning sickness is an unpleasant nuisance, but poses no threat to the mother or her baby.  In severe cases, however (termed "hyperemesis gravidarum", or HG), a woman may become profoundly dehydrated and undernourished.  Babies generally tolerate poor maternal weight gain in early pregnancy, so problems with baby's growth is rarely seen, even in significant HG.  Mothers, on the other hand, may require admission to hospital where they can be rehydrated through a drip, while receiving medicines to reduce their symptoms enough for them to begin to tolerate a normal diet.

 

Vitamins and medicines for morning sickness

Several medicines are available to help you cope with symptoms of morning sickness, if needed.  These range from specific vitamins and other non-pharmaceuticals, to over-the-counter and prescription medications, such as:

  • Pyridoxine: vitamin B6, a non-drug treatment for nausea.
  • Ginger root: available in tablet form from your pharmacy.
  • Doxylamine succinate: an over-the-counter antihistamine with anti-nausea properties (safe in pregnancy).
  • Acid-reducing agents: such as antacid liquid or chewable tablets, or ranitidine, can help by reducing stomach acidity, which tends to worsens nausea. 
  • Prescription medications: commonly-prescribed examples are metoclopramide or, where symptoms are quite severe, prochlorperazine or ondansetron.  These should only be prescribed after a thorough medical evaluation by your GP or obstetrician

 

Tips for coping with morning sickness

  • Eat as soon as you feel hungry - even beforehand.
  • Frequent, small meals are better-tolerated than three large meals each day.
  • Brush your teeth immediately after eating.
  • Drink plenty of fluids - cold, clear, fizzy drinks are usually well-tolerated (e.g. ginger ale, lemonade).
  • Try to identify nausea triggers, so you can avoid them.  These are different for different women, but often include spicy foods, acidic juices, or foods with strong smells.  Keeping a symptom diary can help.
  • Take vitamins at nighttime with a small snack, rather than in the morning.
  • Avoid lying flat soon after eating.
  • Get plenty of fresh air.
  • Rest as much as possible.

 

Speak to your GP or make an appointment if you are finding difficulty in coping with morning sickness symptoms. 

 

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Morning sickness
 

About Dr David Moore

Morning sickness

David is a Fellow of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, and undertook his specialist training in Queensland.  He is highly skilled in the management of complex and high-risk pregnancies, and has special training in minimally-invasive surgery, endometriosis, pelvic floor and incontinence surgery.  David has completed a Master of Reproductive Medicine and is skilled in the assessment and management of fertility problems, and can offer the full range of assisted reproductive treatments.  He is a Senior Lecturer with The University of Queensland Medical School, and has published both medical journal and textbook contributions.

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