(1) Dear Alice,

Why do women get morning sickness during their pregnancy?

(2) Dear Alice,

During my first pregnancy I had morning sickness ALL DAY for 8 months! Do you have any suggestions on how to avoid the nausea? I have heard (and tried) a lot of "old wives tales" but nothing seems to work...Please help me, as I would like to have another baby but I don't think I can go through that again!!

— Sick of being sick

Dear Reader and Sick of being sick,

Morning sickness is usually an early pregnancy condition experienced by about seven out of ten of those who are with child. For some who experience it, morning is a serious misnomer — the nausea and vomiting that define morning sickness come up at any time, day or night. It typically begins around week six of a pregnancy and lasts through the first trimester. However, for some people, it can last through the entire pregnancy (as Sick of being sick can attest).

The exact cause of morning sickness is unknown, but is generally attributed to the hormonal changes or lower blood sugar that occurs during pregnancy. Stress, fatigue, traveling, and some foods can make morning sickness worse. Typically, diet and lifestyle changes are emphasized as a first round of defense against morning sickness. Each person will find out what helps relieve symptoms of morning sickness and here are a few tips:

  • Avoid stressful situations.
  • Steer clear of offending smells and foods.
  • Drink plenty of fluids.
  • Eat small, frequent meals (or snacking) rather than larger meals.
  • Nosh on bland foods, such as bananas, applesauce, rice, toast, saltine crackers, and tea.
  • Take toast or saltine crackers to bed, so they can be eaten before getting out of bed in the morning.

If lifestyle changes don’t adequately address morning sickness then there are some additional strategies to pursue with the guidance of a medical professional to reduce the nausea and vomiting. One recommendation includes taking vitamin B6, which can be found over-the-counter (OTC). If the queasy feeling doesn’t subside with B6 alone, experts recommend pairing it with doxylamine (an ingredient in OTC sleep aids) as a compliment. There is also prescription version that may be appropriate for some. B6 and doxylamine, whether taken together or separately, have not been shown to be harmful to the pregnant person or the baby. If neither of those work, an antiemetic (medication that works to prevent vomiting) may be advised. Many antiemetics are safe to take during pregnancy, while other types may have contraindications (i.e., may pose risks to health of the pregnant person, baby, or interact negatively with other medications). Also, talking to other pregnant folks (current or previously) to learn what worked for them could lead to a new strategy. Though they lack sufficient evidence, some people suggest acupressure wristbands, acupuncture, aromatherapy, ginger, or even hypnosis!

It’s also good to know that morning sickness doesn’t usually pose a serious risk for a pregnant person or their baby. There is, however, a severe form of morning sickness during pregnancy known as hyperemesis gravidarum. Up to three percent of people who are pregnant suffer from this condition, which may require hospitalization and treatment with intravenous (IV) fluids and medications. Those more likely to experience severe morning sickness include those who are currently pregnant with multiples (e.g., twins or triplets), have previously experienced morning sickness, have had family members who’ve experienced it before, are pregnant with a female fetus, get migraines, are overweight, or have a condition that leads to abnormal cell growth in the uterus called trophoblastic disease. If morning sickness doesn’t improve, nausea and vomiting continue beyond the fourth month, more than two pounds is lost, blood is vomited, or vomiting occurs more than three times a day, it’s best to see a health care provider immediately.

It’s difficult when morning sickness impacts a pregnancy experience negatively. Remember that each pregnancy is different, so what happened in one pregnancy may not happen in the next. It might help to focus less on the morning (or anytime) sickness and instead think about the joy of welcoming a new person to the world.

Alice!

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