I feel sick!
Nausea is common in the first trimester. It usually settles by 12 to 14 weeks.
While the term “morning sickness” is used the nausea is often not confined to the morning.
Also the nausea varies in severity considerably from one person to another and one pregnancy to the next. Some pregnant women have none, while others have considerable. It is also often worst in pregnancies subsequent to the first ongoing pregnancy
It is thought due to hormone changes in pregnancy and so is often worse with twins.
It is commonly considered that absence of nausea implies an adverse outcome to the pregnancy. This is not necessarily the case. I have had many women without nausea and with good pregnancies, and many with considerable nausea who miscarry.
With nausea is sometimes vomiting. Again the severity and frequency of vomiting varies considerably.
Sometimes nausea will return in advanced pregnancy, because of the uterine size and compression of the stomach. But for the same reason at this advanced pregnancy stage heartburn is more common.
What can be done?
- Diet Nausea can be reduced by adjusting your diet. Small frequent meals are usually better. You may find a more bland diet more appealing. Avoid having rich, fatty foods and spicy foods. Avoid foods if their taste, smell or appearance is not suitable to you.
- Multivitamin and iron supplements can make your nausea worse. If so avoid supplements while nauseated. Also taking supplements with food can help.
- While tolerance of food at this early stage is not essential, it is important that you are at least tolerating fluids. You should let me know if this is not the case
- Listen to your cravings. I have had patients tell me of the most unusual craving and by eating these foods their nausea was less. I remember one pregnant patient who found greasy hamburgers settled her nausea, even though when not pregnant she did not eat hamburgers.
- Medications Vitamin B6 supplements or ginger can help. Occasionally prescription medications are required. Maxolon has been very popular. Zofran wafers are far more effective but are expensive.
- Minimising stress and trying to stop worrying. Excess stress and pressures in your life can make the problem worse. This includes stress at home and at work. It includes excessive worrying about even your pregnancy. I often see it worse if someone is a new resident of Australia and they miss the company and support of their family ( especially their mother) who are still in their country of origin. Some people are more worriers by nature and because of this are more likely to have excessive morning sickness.
- Getting extra support at home. Get your husband, family, friends or even paid help with household chores and with looking after children.
- Taking time off work. This can help immensely especially if there is considerable pressure and stress on you in the work place or you have work place relationship conflicts.
- Hospitalisation Occasionally hospitalisation is needed because of extreme vomiting (called hyperemesis gravidarum) that can lead to dehydration. You will know you are getting dehydrated by being aware you are not tolerating even small amounts of oral fluids and that you are passing less urine. When hospitalised will usually be given require intravenous fluids, antiemetic medication and rest. Blood tests will often be done to assess your wellbeing and a pregnancy ultrasound scan to assess your baby’s wellbeing.