Morning, noon and night sickness….

the basics

Almost all pregnant women feel like they are going to vomit during pregnancy and just over half actually do. One third of affected women feel sick within 4 weeks of their last period and pretty much everyone else by 8 weeks. I have no idea why it’s called morning sickness when less than 20% of affected women only feel sick in the mornings!

Statistics source: National Antenatal Guidelines page 275

Statistics source: National Antenatal Guidelines page 275

What can I do for myself?

  • try eating smaller meals more often

  • pace yourself, as tiredness just makes you feel worse

  • avoid foods that make you feel worse e.g. fatty, spicy, smelly foods

  • stay hydrated = lots of water (not soft drink, unless it is flat, as the bubbles can make you feel worse)

  • iron supplements may make the nausea worse. Stopping them (including the iron in a pregnancy multivitamin) and using a folate/iodine only supplement instead has been shown to reduce nausea and vomiting. The supplements can be started again once the nausea and vomiting settles

  • ginger helps some women (up to 250 mg four times a day)

  • acupuncture helps some women

  • doxylamine succinate can be purchased from the chemist, is safe in pregnancy, helps some women but can make you very sleepy. You should discuss this with your midwife, doctor or pharmacist to see if they think it will be suitable for you. I suggest you start with 1/2 a tablet (12.5 mg) at night, but you may need 1/2 in the morning, afternoon and 1 (25 mg) at night. DO NOT DRIVE if drowsy

Is there something my doctor can prescribe?

  • your doctor (or midwife) will want to be sure it’s straight-forward nausea and vomiting in pregnancy, so if they want to feel your tummy, test your urine or order blood tests or a scan, for example, there may be a good reason for doing this

  • there are 3 medications considered safe to use in pregnancy if your symptoms are not settling and are distressing, but you would need to discuss this with your doctor and see if one of these would be ok for you:

    • metoclopramide, which helps reduce vomiting more than control nausea

    • prochlorperazine, which helps reduce nausea

    • ondansetron, which helps with both nausea and vomiting (but is newer and more expensive)

  • if you are dehydrated, you may need to have fluids run into your vein through a needle (IV fluids) and perhaps some extra medicine at the hospital

Will baby be ok?

  • almost certainly; babies are very good at taking what they need, even if that means mum runs low!

  • if your vomiting is severe and does not settle, you may have a condition known as hyperemesis gravidarum (only a very few women have this problem, but it makes you feel really lousy if you do!) Fluids, medication, close follow up including monitoring of your weight and baby’s growth (perhaps with an extra ultrasound scan) will be recommended and you will almost certainly need to take time off work/usual duties to manage this

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