Morning Sickness

Morning sickness is the common name for nausea and/or vomiting during pregnancy, also known as NVP. The name can be slightly misleading because NVP doesn’t always just occur in the morning. It can be worse in the mornings for some women, but it can also be worse in the evenings or just the same level of awful all day long. In fact, approximately 80% of women [suffering from NVP during pregnancy] report that their symptoms last all day, whereas only 1.8% report symptoms that occur solely in the morning.

Nausea affects about 75% of pregnant women, while only about 50% of pregnant women actually experience vomiting. The exact cause of these symptoms in pregnancy are unknown, but observational data has shown that these conditions correlate with levels of human chorionic gonadotropin (hCG) and the size of the placental mass, which suggests that placental products may be associated with the presence and severity of nausea and vomiting.

Management Techniques

When we have birth support clients who reach out to us desperately seeking ways to manage their morning sickness, we always recommend a few lifestyle and eating habits that have shown success in managing the symptoms of morning sickness. The American College of Obstetricians and Gynecologists recommends adapting the following eating habits to help keep the nausea at bay:

• Eat dry toast or crackers in the morning before you get out of bed to avoid moving around on an empty stomach.
• Eat five or six “mini meals” a day to ensure that your stomach is never empty.
• Eat frequent bites of foods like nuts, fruits, or crackers.
• Eat bland foods. The BRATT diet (bananas, rice, applesauce, toast, and tea) is low in fat and easy to digest.
• Add protein to each meal. 
• Drink 8-12 cups of water per day, as dehydration can lead to more nausea.
• If you like ginger, add ginger to your diet in the form of capsules, candies, ginger ale made with real ginger, or tea made from fresh-grated ginger. Ginger is very good for soothing the stomach.

Some pregnant women have success fighting off nausea and/or vomiting by taking Vitamin B6. If Vitamin B6 alone doesn’t seem to be enough to ward off symptoms, it can also be paired with doxylamine, an over-the-counter sleep aid. Both drugs, taken alone or together, have been found to be safe to take during pregnancy and have no harmful effects on the baby.

If nothing else is working to fight off the symptoms of morning sickness, antiemetic drugs may be prescribed for women who aren’t helped by other methods. An antiemetic drug that is often prescribed to pregnant women that helps prevent nausea and vomiting is ondansetron, also known as Zofran. It is important to note, however, that while ondansetron is highly effective in preventing nausea and vomiting, studies are not clear about its safety for the baby. Ondansetron also has been linked to heart-rhythm problems in people taking the drug, especially in those who have certain underlying conditions. Your care provider will be your best resource in helping you determine if taking ondansetron or another antiemetic drug is right for you.

Nausea and vomiting of pregnancy usually begins between 6 and 9 weeks of pregnancy. For most women, it goes away by 14 weeks of pregnancy. For some women, it lasts for several weeks or months. For a few women, it lasts throughout the pregnancy. In another blog post, we talk more about hyperemesis gravidarum, which is the term for the most severe form of nausea and vomiting of pregnancy that occurs in about 1-2 percent of pregnancies.