Morning Sickness

 

What causes this?

Although this is probably the mostwell documented complaint of pregnancy, no definitive cause has been identified. Various contributory factors are widely recognised, but it is not clear why some women are affected by these more than others, nor why the same woman, having several children, may have morning sickness in one pregnancy and not in another. 

  • Hormone levels alter dramatically during the first few weeks of pregnancy. Nausea and /or vomiting are often the bodies reaction as it adjusts to the massive doses of hormones flooding your system.
  • Metabolic changes in pregnancy may make you more sensitive to low blood glucose levels [hypoglycaemia] and feel nauseous as a result.
  • Balance mechanisms - signals which are relayed between the vestibular system within the ear and the gut, which are involved in motion sickness, have also been linked to morning sickness, as many women do not feel nauseous until they begin to move around.
  • Random triggers, regardless of the underlying cause, can provoke an episode of nausea or vomiting. This can seem logical, such as the sight or smell of certain foods,or illogical, such as turning on a tap or opening the curtains.

Can it start at any stage of pregnancy?

Morning sickness usually starts from about 4-6 weeks gestation and is resolving by 14-16 weeks. There may be some occasional vomiting towards the end of pregnancy, in association with indigestion and acid reflux, or during labour. However, it is important to remember that in pregnancy you are still able to pick up the same tummy bugs as when you are not pregnant, and can also still get food poisoning.

If you have any bouts of nausea and /or vomiting which start unexpectedly after the first trimester and particularly if there is diarrhoea as well, it is most likely to be a bug. Most of these are self-limiting and you should feel better after 24-48 hours.

Dont worry about trying to eat until you feel ready, just drink plenty of water if you can. If you are unable to tolerate even sips of water, contact your GP or maternity unit for advice. It is best to avoid coming into hospital if you do have a bug, due to the risk of you passing it on to others. However, if you are extremely unwell this might be necessary.

How long will it last?

Morning sickness is usually self-limiting, and should pass by 12 -16 weeks. If it goes on longer you need to discuss it with your midwife or doctor.

What if Im sick at other times of day?

As suggested by the name of this ailment, most pregnant women tend to suffer with nausea and vomiting on getting up first thing in the morning, but often then feel fine for the rest of the day. However, it is perfectly normal to find other times of the day more troublesome.

Many women only feel sick in the evenings, because they are tired, hungry, or are nauseated by the smell of food cooking.

If random triggers cause the nausea, it can be more difficult to predict and can occur throughout the day. If you are being sick repeatedly throughout the day and night, and are unable to eat at all, phone your maternity unit for advice.

When should I worry?

If you are vomiting constantly, to the point where you have not eaten anything at all for more than 24 hours and cannot even tolerate sips of water or other fluids, you should phone your maternity unit for advice. If you vomit up any blood, stop passing urine, have diabetes, or you are thought to have a more serious type of early pregnancy sickness, called hyperemesis gravidarum, you will probably need to be admitted to hospital.  

Will it harm my baby?

Unless excessive vomiting continues without treatment, or you are already malnourished at the start of your pregnancy [this is unlikely unless you have an eating disorder or other pre-existing health problem], your baby should be able to absorb the nourishment it needs from your system.

It is important that you do not become dehydrated or deficient in certain vitamins and other nutrients, so if you are concerned about your condition, seek the advice of a GP or midwife.

Is there anything I can do about it?

Just as there are different theories about the causes of Morning Sickness, there are many different suggestions for treating it. Some of these are merely old wives tales and others may actually be harmful, so always seek the advice of a midwife or doctor before trying any remedies.

Likewise, some complementary therapies such as homeopathy, reflexology or acupuncture can be very helpful, but make sure you only attend a practitioner who is fully qualified and experienced in treating pregnant women. The following simple suggestions are safe, but may only work for some women and not for others:

If you start to feel nauseous on waking:

  • keep a drink by the bedside to have before you get up in the morning. Something like apple juice is ideal, as it is quite sweet and not too acidic if you do get sick later.
  • Get up slowly. Try to avoid bending over and making sudden movements.
  • Try to identify and avoid random triggers which affect you.
  • Always try to eat a little bit of food in the morning it may not be something that you would usually eat for breakfast, and it doesnt have to be much, just enough to settle your stomach.
  • Avoid peaks and dips in blood glucose levels as the day goes on. This may mean having small, frequent snacks, rather than full meals. Try to chose foods which will give a steady release of carbohydrate if you snack on biscuits and other sugary foods, they may make you feel better initially, but will make you feel worse again as your blood sugar level drops.
  • Travel bands usually worn on the wrist to prevent sea-sickness, can help when placed correctly over a particular acupressure point.
  • Morningwell is available to download to your ipod. Listening to the carefully selected rhythmical beats through headphones can interrupt the signal between the gut and the ears, thus preventing your brain from thinking you have motion sickness. This is well researched and has been trialled within the NHS with good results.
  • Anti-emetics if none of the above suggestions help, and your condition is deteriorating, you should see a doctor. There are several prescription medications available which can stop you being sick. These can be given as a tablet, but if you are vomiting continuously they are more likely to be given as a suppository or an injection. If you are in hospital they may be given intravenously.