Why are you getting sick all the time?
You just found out that you’re pregnant with your first child. You’re super excited, but the next you know, you start feeling sick to your stomach all of the time. Why does this happen? When should you be concerned? How can you treat it?
Morning sickness is nausea and vomiting that happens during pregnancy. Despite the name, it can occur any time, day, or night. While it’s more common during the first trimester, it can happen throughout the entire pregnancy. The cause of morning sickness isn’t known but is thought to be related to the hormonal changes that take place.
Symptoms include nausea and vomiting. They can be triggered by certain odors, spicy foods, heat, excess salivation, or nothing at all. Often, symptoms start about the ninth week of pregnancy and improve by the mid to late second trimester. Certain things can increase your chances of having the condition, such as you’ve had nausea/vomiting from motion sickness, migraines, certain smells or tastes, or exposure to estrogen (in birth control pills, for example) before pregnancy, you’ve had morning sickness during a previous pregnancy, or you’re pregnant with twins or other multiples.
Sometimes, morning sickness can become so severe that the expectant mother becomes dehydrated or loses body weight (usually greater than 5% of pre-pregnancy weight). This condition is called hyperemesis gravidarum. It’s thought to be caused by the rapidly rising levels of hormones, like estrogen and human chorionic gonadotropin (HCG). Symptoms are vomiting more than three to four times per day, so much that you lose more than 10 pounds, so much that you feel dizzy and lightheaded, or so much that you become dehydrated. Certain things can elevate your chances of having hyperemesis, like having it during an earlier pregnancy, being pregnant with a girl, having a family history of the condition, being overweight, having a multiple pregnancy, being a first-time mother, or the presence of trophoblastic disease (abnormal growth of cells inside the uterus).
Typically, mild nausea and vomiting don’t cause any complications. If it’s severe, you’re at risk for dehydration and electrolyte imbalances. So, if you’re pregnant and have severe nausea/vomiting, pass only a small amount of urine, your urine is dark in color, you can’t keep any liquids down, you feel dizzy/faint when you stand up, or your heart races, you should be seen by a doctor.
There are several treatment options for morning sickness. Your doctor may recommend vitamin B-6 supplements (pyridoxine), ginger, and over-the-counter options (ex. Doxylamine). You can also try having smaller, more frequent meals because sometimes an empty stomach can trigger nausea. Try to pick bland foods that are high protein, low in fat, and easy to digest. This can include rice, bananas, applesauce, and toast. Avoid anything greasy, spicy, or fatty. Sometimes, salty foods are helpful. In fact, it’s recommended that you try eating a few crackers or a piece of dry toast before even getting out of bed in the morning. Drink plenty of fluids such as water and ginger ale. Try to get 6 – 8 cups of noncaffeinated fluids a day. If your prenatal vitamins make your stomach upset, try taking them with a snack or just before bed. Some women swear by pressure-point wrist bands, but they don’t work for everyone.
If your morning sickness is moderate, your doctor will advise you to take in extra fluids and give you prescription medicine. There are a number of them available that are safe to take during pregnancy, such as promethazine, meclizine, and droperidol. For individuals with hyperemesis gravidarum, you’ll need to go to the hospital to receive intravenous (IV) fluids and anti-nausea medicines. In the most severe cases, you’ll need to receive a complex, balanced solution of nutrients through an IV. This is called total parenteral nutrition (TPN).
There’s no way to completely prevent morning sickness or hyperemesis gravidarum. The most important thing to do is to avoid anything that triggers it. The next step is to follow the lifestyle changes discussed in the treatment section.
No expectant mother wants to have morning sickness or hyperemesis gravidarum, but know that it will get better if you do. If you have any questions or concerns about morning sickness or hyperemesis gravidarum, please speak with your doctor. If you would like more information, please visit the American Pregnancy Association’s hyperemesis gravidarum page at https://americanpregnancy.org/healthy-pregnancy/pregnancy-complications/hyperemesis-gravidarum/