Morning sickness and nausea in pregnancy
Most women experience at least some sickness during their first trimester, usually from around six weeks, and the symptoms can come and go or occasionally develop later in pregnancy. 'Morning sickness' is a cruel misnomer though: for many pregnant women, the only time they don't feel sick is when they're asleep.
What is morning sickness and what does it feel like?
Firstly, whoever called it morning sickness can do one. Health professionals favour the term 'nausea and vomiting in pregnancy' (NVP) because, in truth, it can strike at any time of the day or night.It's a weird feeling, like having two stomachs – one that wants to throw up and burp constantly, and the other that is constantly ravenous and thinking about food all the time.
Some women are sick, others feel nauseous without actually being sick. At a point when you may already feel tired and emotional and have a heightened sense of smell, it can be very trying – especially if no one else knows you're pregnant yet.
Unfortunately, there is no magic cure if you're suffering – but there are plenty of tried-and-tested remedies which are worth a try.
“Just try and eat as much as you can (don't gorge, I mean little and often) and if you fancy something then have it. Anything to make you feel a bit more human.”
When does morning sickness start?
Nausea and sickness are often one of the first pregnancy symptoms, with the queasiness usually starting when you're around six weeks pregnant – though it can also begin a few weeks earlier. Many women experience at least some sickness during their first trimester, but it doesn't necessarily strike as soon as you've taken a pregnancy test for a missed period.
According to the law of averages, you can expect to feel the worst nausea around nine weeks – though every woman is different.
When will it stop?
Morning sickness will normally stop when you get to 12 weeks to 14 weeks of pregnancy but one in 10 unlucky women still feel sick after 20 weeks. And don't get complacent if it eases early; the symptoms can come and go.
If you're suffering, there are a number of popular treatments which can help ease the nausea, although no one has yet discovered a miracle cure – sorry.
What are the causes?
Scientists don't know exactly what causes morning sickness, but those pesky hormonal changes are probably partly responsible. While there isn’t a definite answer, it’s likely to be caused by:
- A sudden increase in your body’s oestrogen levels
- A sudden increase in Human Chorionic Gonadotrophin (HCG)
- An enhanced sense of smell and increased sensitivity to odours
- A lack of vitamin B6
Why does it happen?
Morning sickness is a very common ailment, affecting around eight out of 10 women, but you're more likely to suffer with it if:
- It's your first pregnancy
- You've had it in a previous pregnancy
- You've had motion sickness before
- You've got a history of nausea while using contraceptives that contain oestrogen
- There's a family history of it
- You're obese (BMI of 30 or more)
- You're expecting twins or triplets
- You're stressed (and who wouldn't be, during pregnancy?)
What is hyperemesis gravidarum?
The majority of women will experience nausea during pregnancy (roughly 7 out of every 10 women according to NHS choices). But some women suffer excessive nausea and vomiting, otherwise known as hyperemesis gravidarum. Signs and symptoms include:
- Long periods of feeling extremely sick, as well as severe vomiting
- Dehydration – due to being unable to keep fluids down
- Weight loss
- Low blood pressure when standing
- Ketosis – the body does not have enough glucose for energy, so it burns fat instead. That causes a build-up of acids (called ketones) in the blood and urine
Why do some women suffer?
Experts don't actually know what causes this condition, but some think it's tied to the changing hormones in your body when you're pregnant.
If you have had HG previously, you are more likely to experience it in your next pregnancy compared to women who haven't – and there is some evidence that it runs in families.
When should I go and see a doctor?
If your nausea and vomiting can't be controlled, you will need to be admitted to hospital so that doctors can assess exactly what treatment you need. There are medicines that can be used to help alleviate the symptoms of HG, such as anti-sickness drugs, vitamins B6 and B12, steroids, or a combination approach.
You may also have intravenous fluids inserted into a vein through a drip, and the anti-sickness drugs may also need to be inserted into a vein or muscle.
Contact your GP or midwife immediately if you notice any of the following:
- You have very dark-coloured urine or do not urinate for more than eight hours
- You are unable to keep food or fluids down for 24 hours
- You feel severely weak, dizzy or faint when standing up
- You have abdominal pain
- You have a high temperature of 38C or above
- You vomit blood
In addition, urinary tract infections (UTIs) can also cause nausea and vomiting. If you have any pain when going to the toilet or notice any blood in your wee, you may have an infection and this will need treatment. Drink plenty of water to reduce the pain, but get yourself to a doctor too (your body will thank you for it).When pregnant I was sick morning, noon and night – night being the worst actually. It's an insulting term for something that can take over your life.
How to stop morning sickness
Unfortunately, there's no fix-all cure for nausea in pregnancy. Everyone's different – a remedy or medication that works for someone else might have no impact on you. Try not to worry if some of the suggested solutions don’t do the trick – but anything that could relieve some has got to be worth a go, at least once.
What helps morning sickness?
Although no one thing can stop morning sickness outright, there are a number of popular treatments that can help alleviate some of the discomfort you may be experiencing.
Popular remedies for morning sickness
- Lots of rest
- Plenty of fluids – sip drinks slowly and frequently
- Eating little and often – choose foods that are plain and high in carbohydrate but low in fat (see below)
- Travel sickness wristbands
- Ginger – the biscuit variety, or ginger tea works well
- Sucking on ice or ice lollies
- Vitamin B supplements
- Fresh air – take a walk or sit outside
- Distract yourself (easier said than done, we know)
What to eat for morning sickness
- Opt for bland, non-greasy foods that are easy to prepare
- Plain carbs like pasta, rice, bread and potatoes
- Snack on crackers, oatcakes or digestive biscuits
- Foods high in zinc: seeds, wholemeal bread, small amounts of eggs and red meat
- Avoid smelly and spicy foods
- Eat cold meals rather than hot ones – hot foods have stronger smells and flavours which may make you feel more sick
- Avoid drinks that are very cold, sour or sweet
- Try flat fizzy drinks to settle your stomach
- Fruit or herbal teas like peppermint tea
- Sorbet or ice lollies will help to keep you hydrated
Is medication for morning sickness safe?
If you've tried natural remedies, including diet and lifestyle changes, and your nausea and vomiting is severe, a doctor may recommend a course of medication that is safe for use in pregnancy – probably anti-sickness medication (antiemetics) or an antihistamine.
Antihistamines, which are often used to treat allergies, can also work as antiemtics and your GP may prescribe a short-course of these to help with the nausea. Commonly prescribed antiemetics can have side effects, such as muscle twitching, but these are rare.
Is morning sickness a good sign?
Gross and debilitating as it is, it won't usually harm you or your baby in any way. In fact, if you do feel sick, research suggests you're less likely to have a miscarriage (clouds, silver linings, and all that).
Is morning sickness worse if you’re having a girl?
Pregnancy myths suggest that if you’re pregnant with a girl, you’ll experience worse sickness than those expecting a boy. There’s a small amount of evidence to back this up – baby girls produce more hormones, which may increase your nausea – but we wouldn’t recommend throwing out your list of boys’ names just yet. Plenty of women who give birth to baby boys are also unlucky enough to be saddled with all the vomiting.
Should I worry if I don’t get morning sickness?
Try not to worry if you don't get it – and keep your fingers crossed that you don't develop it later on in pregnancy. So long as your doctor says your hormone levels are fine, consider yourself as having had a lucky escape!
“I had none at all with my first pregnancy and he came out perfectly healthy. I've always had a bit of a beef against people who say 'sickness indicates a healthy pregnancy'. Rubbish! Everyone reacts to pregnancy hormones in their own way.”
Losing weight during pregnancy
If you do find your clothes feeling a little looser during your first trimester, most of the time there's nothing to worry about, and there's no risk posed to you or your baby. Morning sickness can often mean that you don't feel like eating as much as you would normally, which can lead to weight loss – and vomiting may cause you to burn calories. Pregnancy can also cause food aversions, which makes eating difficult. If you do experience dramatic weight loss, however, speak to your midwife or doctor and they can assess your condition and choose the best course of action.
Morning sickness at work and taking time off
As with any illness, if you are experiencing morning sickness to a degree that would impact your ability to work, you may want to – and are entitled to – take time off work. You employer should respect this and be supportive.
The 2010 Equality Act states that it is unlawful discrimination for an employer to treat a woman unfavourably due to pregnancy or illness relating to pregnancy. Discriminatory treatment includes withholding sick pay and unfair dismissal. If you think you have been subject to discrimination, you may wish to claim for compensation through an employment tribunal.
If other words – if you're too sick to work, you're too sick to work. It's as simple as that. Visit your doctor and explain the situation, and ask for a sick note if you need it.
If an illness is pregnancy-related, it should be recorded as such – it won’t count towards your sickness record and you cannot be dismissed for it.
If you are able to continue working, you might want to tell your employer so they can make adjustments, which they are legally required to do to protect your health. For example, it may be that you need easier access to a toilet, or a desk not so close to the kitchen and the smell of someone heating up last night's curry for lunch.
Coping with morning sickness at work
Recommendations from women who have been there, done that and have the sick bag in their desk drawer to show for it:
“Take things one hour at a time. It might sound silly, but I found that worrying how I was going to get through a whole working week only made things worse.”
“Keep nibbling throughout the day – make sure there are plenty of snacks in your desk or your coat pocket.”
“I’m a teacher and found that walking around the classroom all day really helped – but I also made sure I properly rested during my lunch break.”
“I used to wear travel bands under my shirt. It might not work for everyone, but it certainly helped me.”
“Speak to your manager and see if you can work from home – it won’t help the nausea, but you’ll be more comfortable and relaxed.”
“Know your limits – if it gets really bad, go to your doctor and get signed off.”
Where can I access pregnancy sickness support?
Make sure you communicate with your partner, family and friends about how you are feeling, so they know exactly what you need and how they can make you as comfortable as possible. Whether it's a quiet room to lie down in or extra help with day-to-day tasks, don't suffer in silence and don't feel guilty about speaking up. Just because lots of women go through this experience, it doesn't make your case any less difficult or important.
If your symptoms are becoming more extreme and difficult to manage, make sure you talk to your employer as it may start to affect your work and they need to be aware of the situation.
There are also a number of services out there offering help and support, including:
- Pregnancy Sickness Support – they have an information line, a wealth of advice from professionals, and forums where you can talk to people who have been through it
- Tommy’s – a really informative website, and they also have a midwife helpline