No one really knows what causes the nausea of pregnancy, but it affects over half of all pregnant women. It is thought to be related to the high hormone levels of pregnancy, like human chorionic gonadotropin (hcg) and estrogen. The high progesterone level also relaxes a pregnant woman’s esophagus, so that she is more likely to have reflux and gagging.
Symptoms of nausea may be brought on by hunger or swings in blood sugar. Many notice that their nausea is worse when they are tired. Some moms report that smells may make their nausea worse. Sometimes even a vitamin is a trigger, but the vitamins are needed! There are some women who make extra saliva during pregnancy, and this constant swallowing makes them sicker.
The worst week of morning sickness is usually in the middle of the first trimester. By the second trimester, your body will have some relief. If you need relief sooner, here are some things to try:
1. Get lots of rest. Fatigue can cause nausea even when you are not pregnant. What a great excuse to take a nap!
2. Try frequent small meals that include some protein or fat. The old advice of eating crackers may help temporarily, but a little cheese and turkey on the crackers will bring longer relief by keeping blood sugars stable. Sipping on flavored beverages all day long not only improve hydration, which makes you feel better, but may also help those with excess saliva production.
3. Antacids. Tums contain calcium, and are good for pregnancy. In some cases, the heartburn and gagging is helped by pepcid 20 mg every day.
4. Antihistamines. Doctors often prescribe antihistamines like phenergan to help with nausea, but benedryl (diphenhydramine) 25 mg as needed every 6 hours may also help.
OR An older remedy for nausea was to recommend ½ of a unasom tablet (doxylamine 12.5 mg) every 6 hours. Remember that any antihistamine may cause fatigue, and see step 1!
5. Vitamin B supplementation. Some people have less nausea with extra vitamin B6, 50 mg every day.
6. Ginger. Ginger snap cookies, ginger ale, and candied ginger have all been said to improve nausea, though not well studied.
7. Prescriptions have improved over the last 10 years. Doctors often recommend Zofran, Kytril, Reglan, Compazine or others to help with the nausea. Of course, all have side effects that should be discussed with a physician.
The extreme form of morning sickness is called hyperemesis. It causes relentless vomiting and can result in dehydration, weight loss, and nutritional deficiencies. While vomiting occasionally is common, hyperemesis occurs in less than 2% of pregnancies. Hyperemesis needs to be treated aggressively with medications and fluids, and should not be ignored.
Emily Cunningham, MD
Lexington Women’s Health