What is morning sickness?

Morning sickness is nausea and vomiting during pregnancy. Despite its name, it can strike pregnant women at any time of the day.

Morning sickness is very common. Estimates vary, but up to around 85% of pregnant women experience some nausea or vomiting. [1]  Fortunately, it tends to settle down by the 20th week of pregnancy and there are practical things you can do to reduce your symptoms and feel better.

1. National antenatal care guidelines. The Department of Health. Accessed 10 October 2014, from

External link

Signs and symptoms

Morning sickness tends to start in the first month of pregnancy and stop by 16-20 weeks.

Symptoms include:

  • Feeling nauseous or sick in the stomach;
  • Loss of appetite and aversion to some foods, and;
  • Vomiting.

Some women can feel anxious or depressed along with the morning sickness.

An unwell pregnant woman.Symptoms of morning sickness include nausea and loss of appetite. 

1. National antenatal care guidelines. The Department of Health. Accessed 10 October 2014, from

External link

Causes

The cause of morning sickness is unclear. A range of theories have been suggested, such as changes in hormone levels, or reductions in blood pressure or blood glucose (sugar) level, but none of these theories have been proven.

You may be more likely to experience morning sickness if you:

  • Have experienced morning sickness in a previous pregnancy;
  • Tend to experience motion sickness;
  • Have had gastrointestinal problems such as reflux or stomach ulcers;
  • Have menstrual migraines;
  • Experience nausea or vomiting when taking oestrogen-based medication;
  • Are having a multiple pregnancy, or;
  • Are having a molar pregnancy.

Hormone

A chemical substance secreted in one part of an organism and transported to another part of that organism, where it has a specific effect.

Oestrogen

One of a group of steroid hormones involved in the development and maintenance of female sex characteristics. These are the primary female sex hormones.

Ulcers

An open sore in the skin or mucous membranes such as those of the stomach lining, intestine or mouth.

1. National antenatal care guidelines. The Department of Health. Accessed 10 October 2014, from

External link

Methods for diagnosis

Your doctor will do a physical examination and ask about your symptoms.

If your doctor is concerned that another medical condition may be causing your symptoms, they may recommend other tests such as blood tests, a urine sample and an ultrasound.

Blood tests

During a blood test, blood can be drawn using a needle or by a finger prick. Your blood can then be analysed to help diagnose and monitor a wide range of health conditions.

Ultrasound

A scan that uses high-frequency soundwaves to produce images of the body’s internal structures.

1. National antenatal care guidelines. The Department of Health. Accessed 10 October 2014, from

External link

Types of treatment

Taking steps to deal with morning sickness early in your pregnancy may help to reduce your level of symptoms.  As well as helping you to feel better, it is important to be able to drink and eat enough so that you do not become dehydrated or lose weight.

Avoiding things that trigger your morning sickness

There are many things that can trigger morning sickness and they can vary between women. By working out what triggers your morning sickness and avoiding it you can reduce your symptoms.

Common triggers include:

  • A range of smells and odours (such as perfumes, coffee, smoke and some foods);
  • Stuffy, enclosed rooms;
  • Lots of noise;
  • Hot, humid environments;
  • Flickering lights, and;
  • Physical motion (such as driving).

Because motion is a trigger, you may be able to reduce your symptoms by:

  • Moving slowly, particularly when getting out of bed or standing up from being seated, and;
  • Avoiding excessive exercise.

Nutrition

What, when and how you eat can make morning sickness worse. 

You may find it helpful to:

  • Avoid eating spicy foods;
  • Avoid eating a lot of high-fat or high-sugar foods;
  • Eat foods high in protein, such as cheese, milk and yoghurt;
  • Eat foods that have complex carbohydrates such as wholegrain crackers;
  • Eat small amounts of food more frequently, rather than large meals;
  • Drink small amounts of water frequently;
  • Consume food and liquids separately;
  • Try cold and frozen foods and drinks, and;
  • Eat dry crackers before getting out of bed in the morning.

A pregnant woman eating healthy by enjoying an apple.Following a healthy diet may reduce some symptoms of morning sickness. 

Avoiding fatigue and stress

Morning sickness can be worse when you're tired and stressed, so pacing yourself and getting plenty of rest can help to reduce symptoms.

If you have symptoms of depression or anxiety, seeking advice from your doctor or a mental health professional may help.

Prenatal vitamin supplements

Some women can find that their morning sickness gets worse when taking prenatal vitamin supplements that contain iron. It may be helpful to take the supplement at night, before going to bed, rather than first thing in the morning. If symptoms continue to bother you, your doctor can advise what alternatives may be suitable for you.

Complementary therapies

Some complementary therapies, such as ginger supplements, acupressure and acupuncture, have been recommended for relieving morning sickness. However, there is variable evidence supporting the effectiveness and safety of many of these therapies.

Ginger

There is evidence that products containing ginger may be helpful to pregnant women experiencing nausea and vomiting. The safety of taking high doses of ginger is unclear. If you wish to use ginger products, your doctor can discuss what may be suitable for you.

Acupuncture

Acupuncture is an alternative therapy that involves fine needles being inserted at various points of the body in order to provide health benefits. It has not been shown to relieve nausea and vomiting in pregnant women.

Acupressure

Acupressure is an alternative therapy based on acupuncture that involves a therapist applying pressure at various points of the body in order to provide health benefits. Applying pressure to the lower forearm has been studied for relieving nausea and vomiting in pregnant women; however, evidence is limited regarding its effectiveness.

Prenatal

Before the birth of a baby.

Carbohydrates

One of the three macronutrients in foods that supply the body with energy. Examples include sugars, starches and cellulose.

Dehydrated

The state of insufficient hydration; excessive loss of water; requiring more water in order to function normally.

Iron

An essential mineral required by the body. Iron is part of a protein in the blood called haemoglobin, which carries oxygen around the body.

Protein

1. One of the three macronutrients in foods that supply the body with energy. Food rich in proteins include meats, legumes and dairy foods. 2. Large molecules, such as antibodies and albumin, that are found in the blood.

1. National antenatal care guidelines. The Department of Health. Accessed 10 October 2014, from

External link

Medications

Many women with mild symptoms do not require medications for morning sickness. However, if symptoms are bothering you, there are safe medications you can take. Remember to discuss any new medications with your doctor before you start taking them as not all medications are safe to take during pregnancy - this includes over-the-counter medications, nutritional supplements and herbs.

Pyridoxine

Pyridoxine (vitamin B6) can be taken to help reduce mild to moderate nausea.  It is important to follow your doctor's recommendations regarding taking pyridoxine because in high levels it may cause health problems. Taking 200 mg/day has been shown to be safe for pregnant women.

Antiemetics

Antiemetics are medications that can help reduce vomiting. They may often be combined with pyridoxine for morning sickness. If you think that you may require medication it is best to discuss this option with your doctor. 

Treatment of severe morning sickness

While most women experience mild to moderate symptoms of morning sickness that gradually get better without treatment, a small percentage of women experience severe, persistent nausea and vomiting that can last the entire pregnancy. This condition is called hyperemesis gravidarum.

Persistent vomiting can lead to dehydration which, if severe, can be dangerous and may require hospitalisation.

Signs that you may require further care include:

  • Dehydration (look for dark-coloured urine, urinating infrequently, or being dizzy while standing);
  • Vomiting continually throughout the day;
  • Blood in the vomit;
  • Being unable to keep any food or liquids in your stomach for more than 12 hours, and;
  • Losing weight.

Dehydration

The state of insufficient hydration; excessive loss of water; requiring more water in order to function normally.

1. National antenatal care guidelines. The Department of Health. Accessed 10 October 2014, from

External link

Potential complications

Whilst unpleasant, morning sickness usually does not cause any harm to pregnant women and their babies. In fact, women with mild morning sickness symptoms have been shown to be less likely to experience miscarriage or stillbirth than women who do not experience it.

Oral health

Vomit is quite acidic and this can damage the tooth enamel. However, avoid brushing your teeth directly after vomiting. Waiting 30 minutes before brushing your teeth can help to avoid further weakening of the enamel.

In the meantime, you can:

  • Rinse your mouth out with water or a mouthwash straight after vomiting;
  • Rub toothpaste on your teeth with your finger, and;
  • Chew sugar-free gum, which helps to stimulate saliva and neutralise the acid.

If excessive saliva is a problem, spitting or using a mouthwash can help.

Miscarriage

The loss of a pregnancy before 20 weeks.

Stillbirth

The death of a fetus after 20 weeks of pregnancy.

Tooth enamel

The outer layer of the tooth. Typically 1-2mm thick, this is the whitest part of the tooth, forming a protective shell over the underlying dentine.

1. National antenatal care guidelines. The Department of Health. Accessed 10 October 2014, from

External link

Prognosis

Most women who have nausea and vomiting due to morning sickness recover without any ongoing health problems for themselves or their babies.

1. National antenatal care guidelines. The Department of Health. Accessed 10 October 2014, from

External link

Prevention

While it is not possible to prevent morning sickness, taking steps to reduce symptoms when they first occur may reduce the severity of symptoms. 

1. National antenatal care guidelines. The Department of Health. Accessed 10 October 2014, from

External link