Excuse Me, I need a Puke Bucket!

Morning sickness is nausea and vomiting in pregnancy affecting more than half of all pregnant women. While some mothers may only experience nausea but not vomiting, others can have both symptoms. They commonly experience the symptoms in the early morning and as the day progresses, most women will feel much better although there are women who will get it at any time of the day or night.

The morning sickness symptom will usually start at about six weeks of pregnancy after which it tends to get worse for another month or so and for most mothers it ends at about 12 weeks of pregnancy. What each mother experiences varies from just nausea and occasional vomiting to frequent vomiting several times a day, while in some of the fortunate ones they have no morning sickness at all.

Up until now the cause for morning sickness remained unknown but researchers have put forward several theories. Pregnant mothers are found to have higher levels of circulating hormones like Oestrogen and Human Chorionic Gonadotrophin, the two hormones which rise rapidly in early pregnancy during which the morning sickness symptoms are usually at its peak. Progesterone hormone, also found in higher level in early pregnancy, has been found to relax the stomach and intestine resulting in excessive stomach acids and gastro-oesophageal reflux.

Pregnant mothers usually have increased sense of smell and sensitivity to aromas or odour, all of which can trigger gag reflex and instantly making them to feel nauseated. Psychological predisposition is another theory for morning sickness in pregnant mothers.

Pregnant mothers can expect that they are more likely to have the nausea and vomiting if they are pregnant with twins, had experienced nausea and vomiting in the previous pregnancy, experienced nausea and vomiting when taking birth control pills, having motion sickness and if they have mothers or sisters who had severe morning sickness.

Managing Morning Sickness

There are simple measures that mothers suffering from mild morning sickness can try to help them going through the troublesome nausea and vomiting. While there is no hard evidence for most of these measures pregnant mothers will find that these simple measures can actually help them to manage their symptoms better. The following are among the measures that are available for women can try out:

1.         Changing what to eat and when to eat is often the key to minimise the symptoms. They should avoid an empty stomach and taking too much food all at once, both of which can make their nausea worse. Instead try to take frequent small meals like five to six small meals a day.

2.         For women having nausea if taking liquids with food, try to avoid liquids with meals. What they can do is to take the liquids between meals or take liquids about 30 to 45 minutes after taking solid food. But they should bear in mind that the fluid intake is adequate so that they will not end up dehydrated instead. For those with frequent vomiting, mineral water and sports hydration drinks are good to replace lost electrolytes. When drinking, they should not take so much at one time because they will feel full and make them less hungry for food. It is very common to feel that the nausea is worsened after taking milk and coffee, so it is wise to avoid them.

3.         Since each women reacts differently to food, food that are known to worsen their symptoms should be avoided. Instead, try to eat healthy foods that are well tolerated. Food with complex carbohydrates for example breads, rice, potatoes, pasta and cracker biscuits are most suitable because they will increase the blood sugar levels as well as maintaining the levels in the blood for longer periods of time.

4.         Most women will find that greasy food will make them feel nauseated. Oily and fried food, spicy food and acidic food can irritate the digestive system. As such, it is best avoided. Instead, try bland food which is usually better tolerated.

5.         Iron supplements can actually make nausea worse, so try taking the supplement with food or just before bedtime or alternatively change to a low iron supplements for the first trimester. When they are much better, they can take the usual supplements later.

6.         For pregnant mothers having morning nausea they can try taking small snacks before getting out of bed. It is also sometimes helpful to get out of bed slowly because sudden change in position from lying to standing can make them feel dizzy which will worsen the morning sickness.

7.         Getting sufficient rest, taking a short nap and making time to relax is advisable because stress and fatigue can worsen morning sickness. Deep breathing exercise, relaxation exercise and massage can help women to focus on other things other than their sufferings.

It is very important that the pregnant mothers who did not get better despite the measures mentioned above, they should seek help before their symptoms worsened and becoming difficult to treat. Among the things to look out for is when they start to vomit more than three times a day, cannot take anything including liquids for the past 24 hours, vomiting blood or black coloured substance, losing weight more than one kilogramme, the symptoms persist and continue beyond four months of pregnancy although can be normal, they should seek medical advice.

The excessive vomiting in pregnancy is a condition referred to as hyperemesis gravidarum. Pregnant mothers having this condition may need several hospital admissions because they are dehydrated often requiring intravenous fluids and given anti nausea medication. Their condition will improve and they will feel much better. Those suffering from severe hyperemesis, they will be dehydrated, malnourished and lose weight as well as having low birth weight babies, delivering preterm babies and having newborns smaller for their gastational age.

Pregnant mothers suffering from morning sickness will be very worried and concerned whether their pregnancy will be affected. It is really reassuring to note that for women having only mild to moderate nausea with occasional vomiting, their baby are not harmed provided they can continue taking fluids and eat some food. Most mothers actually have no worse outcome than other mothers.