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Nausea During Pregnancy

Nausea during pregnancy occurs in 70% of women during the first trimester. Also known as morning sickness, first trimester nausea makes you feel sick to the stomach and is accompanied by vomiting in the first few pregnant monthsIt is referred to as morning sickness so people expect nausea in the morning, however, this feeling of nauseousness and vomiting can occur at any point of the day and can even last all day. 

When does pregnancy nausea start?  

The first questions that probably comes to your mind is When does morning sickness start? Morning sickness is an early signs of pregnancy and can start as early as when implantation happens. However, for most women, it tends to start in the 6th week of the pregnancy and becomes worse by the 9th week. Some women get relief in the second trimester but for some this can last throughout the pregnancy. If the symptoms are mild it does not harm the baby or you. However, if the nauseousness and vomiting symptoms become severe, you should reach out to your healthcare provider. When morning sickness becomes extreme the condition is called hyperemesis gravidarum and can be problematic.  

What is hyperemesis gravidarum? 

3 percent of pregnant women suffer from hyperemesis gravidarum. This condition arises when nausea and vomiting are excessive during the pregnancy. It leads to loss of water resulting in dehydration and causes loss of weight. This may start at an early stage and last throughout the pregnancy. If you do have Hyperemesis Gravidarum, you will require medical treatment to keep your baby and yourself safe.  

You could be at a higher risk for hyperemesis gravidarum if 

  1. You are expecting for the first time. Your body is less prepared as it is experiencing the changing hormonal levels for the first time. The levels of anxiety are also higher as everything is unknown and could cause an upset stomach. 
  1. You are expecting twins or more. In that case, you are at an increased risk of severe morning sickness as your placenta is larger and the pregnancy hormones are higher than average pregnancy level hormones.  
  1. There is a family history of severe morning sickness or if you have had a severe form of nausea in your past pregnancy 
  1. You are overweight, suffer from migraines or motion sickness 
  1. You are suffering from trophoblastic disease which is a condition leading to abnormal cell growth in the womb 

Certain signs and symptoms indicate that you must see your doctor immediately and control hyperemesis gravidarum either through medication or Intravenous fluids. If you find yourself throwing up around 4 times daily, if you have lost a lot of weight while pregnant, if vomiting makes you dizzy or dehydrated leading to a dry mouth, no urine, and a fast heartbeat; chances are you have a severe case of morning sickness and require medical attention.  

What are the causes of morning sickness?  

There is no sure-shot reason for the occurrence of morning sickness though it is believed to be caused by increased pregnancy hormones and low blood sugar. This condition can be worsened by stress, fatigue and certain foods. A few factors that could affect pregnancy nausea are:  

  • Elevated levels of hCG which is a pregnancy hormone and peaks when morning sickness is at its worst 
  • Digestion becomes less effective as the increased levels of progesterone and estrogen relax the muscles of the digestive tract 
  • Many women experience metallic taste while pregnant increasing pregnancy nausea  
  • Pregnant women tend to have more heartburn and Gastrointestinal reflux causing vomiting and nausea  
  • Other reasons for morning sickness include having an increased sense of smell due and the fact that the uterine muscles stretch rapidly. Excess saliva is also produced increasing nauseousness 

Every pregnant woman experiences morning sickness differently- infact some may not experience it at all. Some have only occasional nauseous moments and others feel the queasiness all day long. Some may just have the feeling but not actually vomit and some may vomit very frequently. 

Can you prevent or get help with pregnancy nausea? 

There are a few habits and techniques that help with pregnancy nausea.  

  • Have an easy early morning routine. Do not rush as that tends to increase morning sickness. Keep some light snacks like crackers by your bedside and eat a few before you get out of bed to help your stomach settle.  
  • Change your eating habits. Refrain from consuming fatty and spicy foods. Have light meals multiple times a day rather than 3 big meals. Try to choose food options that are easy to digest. Eat healthy snacks like in between meals to prevent your stomach from staying empty and causing nausea. Include plenty of fluids in your daily routine. Include ginger in your diet, it helps bring down nausea.  
  • Try activities that reduce stress and help de-stress. Prenatal Yoga, meditation and visualization are techniques that help minimize queasiness. Try and sleep long hours.  
  • Steer clear of offensive smells that increase pregnancy nausea. Some scents that you once loved may start making you sick to the stomach, avoid such smells. Keep the house ventilated so the odour does not stagnate in your house.  
  • Try alternative therapies like Acupressure and acustimulation wristbands. The technique involves stimulation of certain body points by putting pressure on them and safely reducing or preventing nauseousness.  
  • Acupuncture is another suggested option. This treatment involves the insertion of thin needles into your skin. Your healthcare provider maybe able to recommend a trained acupuncturist who specializes with pregnant women. 
  • Some women have found relief using apple cider vinegar diluted with water in the morning.

Is there a medical treatment for morning sickness relief?  

If you are unable to treat morning sickness on your own using natural remedies, you may reach out to your healthcare provider. Severe vomiting and nausea can be treated using medication.  

Vitamin B6 and doxylamine 

You may be asked to get help with pregnancy nausea using either of these two medicines or sometimes even both.  You may discuss if you should switch any of your vitamins with Vitamin B6 supplements and reduce iron (as that causes queasiness when had on an empty stomach). Antihistamine doxylamine is found in Unisom SleepTabs that help you sleep. Both of these are OTC medicines but it is best to discuss with your doctor before consumption.  

Antiemetic drugs 

These drugs prevent vomiting and may be prescribed for you if Doxylamine and Vitamin B6 for morning sickness are not creating an impact and bringing the nauseousness down. Not all antiemetic drugs are safe to consume during pregnancy so it best to let the doctor prescribe the best one for you.  

Never consume any drugs without a prior discussion with your doctor even if they are OTC drugs or are widely being consumed for morning sickness relief.  

SECOND AND THIRD TRIMESTER NAUSEA 

Your second trimester is relatively easy on you as the worst of the nausea has passed and the baby has not grown enough to give you discomfort. Some women may have a longer period of morning sickness which may extend till the beginning of the second trimester, in that case they should continue following the first trimester relief tactics.  

Some women get lucky and only experience first trimester nausea. But for others third trimester morning sickness is unfortunately a real phenomenon. Now you may wonder why are you experiencing this when you are so close to your date of delivery.  

There are multiple reasons for this. Your baby has grown and the room in your stomach is limited for this grown baby. This puts pressure on the digestive system causing constipation, heartburn and nausea.  

Your prenatal vitamin which contains high amounts of iron becomes difficult to digest without GI distress. If you have been experiencing nausea all throughout the pregnancy or have recently changed your prenatal vitamin brand – this could be a cause for the rising nauseousness.  

Even though the hormones are said to level out after the first three months, they are very unpredictable. The hormonal ups and downs may be a cause for the third trimester morning sickness.  

You may crave spicy, oily, and other food that could be high in acid-content. These are you baby’s cravings but your GI tract pays a price for it. Since there is less room in your stomach, a few cravings could be the cause of nauseousness.

If you have felt as nauseous throughout your pregnancy, there is nothing to worry about. However, if the level of nauseousness is extreme in the third trimester and new to you, it is best advised to consult a doctor.  

You may deal with third trimester sickness just as you did during the first trimester. Avoid nausea triggering foods and odour, sip on ginger tea, take a B6 supplement after discussing with your doctor, try and sleep as much as you can, have lemon and peppermint candies and the likes. 

If your nausea worsens and you feel it is causing dehydration, it is best to get it checked out. Let’s hope you are lucky and don’t have anything more than first-trimester nausea. 

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