By James N. Martin, Jr, MD
President, The American Congress of Obstetricians and Gynecologists
Pregnancy-related nausea and vomiting is common in early pregnancy and affects an estimated 70%–85% of pregnant women. Often referred to as “morning sickness,” these symptoms can actually occur at any time during the day or night.
In most women, morning sickness begins within the first nine weeks of pregnancy. There’s no way to predict how long it will last, although many women’s symptoms improve by the 14th week of pregnancy. The cause remains unknown, but increased hormone levels are thought to be a contributing factor.
Symptoms usually strike without warning—some women may become nauseated by the smell of certain food odors or get sick after eating a meal—and can range from mild, occasional nausea, to severe, continuous nausea with bouts of vomiting. Most mild morning sickness will not harm you or your baby’s health. However, it can become a more serious problem if you can’t keep any food or liquids down and begin to lose weight. Severe morning sickness, called hyperemesis gravidarum, occurs in up to 2% of pregnancies.
Women who cannot tolerate liquids without vomiting and who show signs of dehydration may be given fluids and nutrients through an IV in the hospital. You may be at higher risk for developing hyperemesis gravidarum if you are carrying multiple fetuses, have a mother or sister who had the condition, are carrying a female fetus, have a history of hyperemesis gravidarum in a previous pregnancy, or have a history of motion sickness or migraines.
Nausea and vomiting can lessen a pregnant woman’s quality of life, but many women avoid telling their doctor about their symptoms or downplay how bad they feel. Some women may think that suffering through morning sickness is a rite of passage of pregnancy, but your doctor needs to know if you are getting sick because your symptoms can get worse over time. It is often harder to treat morning sickness once it becomes severe, so it’s a good idea to manage the condition in the early stages.
Mild cases may be resolved with lifestyle and dietary changes. Studies have shown that taking vitamin B6 and doxylamine can help improve symptoms in some women. You may find that eating crackers before getting out of bed, drinking beverages made from real ginger such as tea or ginger ale, and consuming smaller nutritious, high-protein meals and snacks throughout the day can help keep nausea and vomiting to a minimum. Be sure that you are getting enough rest and try to avoid foods and smells that make you feel sick. For more severe cases, your doctor may prescribe safe and effective anti-nausea medications.
The ACOG Patient Education Pamphlet “Morning Sickness” is available at www.acog.org/publications/patient_education. ?
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