The facts of morning sickness

Nausea and vomiting during pregnancy can actually occur anytime of day

What is it?

Between 80 and 90 percent of women experience morning sickness, which is now called nausea and vomiting during preg-nancy (NVP) because many women have these symptoms all day long. Nausea or vomiting usually begins around four weeks’ gestation and will subside for most women by 13 weeks. However, some women have NVP for the entire pregnancy. For a small proportion of women (about three percent), NVP is so severe that they experience significant weight loss and dehydration, and may require hospitalization (a condition called hyperemesis gravidarum), according to Carolyn Lane, a family physician from the Low Risk Maternity Clinic in Calgary.

What causes it?

Nobody knows for sure, but NVP may occur because of a combination of factors, including rising hormone levels and changes in the way food moves through the gut. Women with higher levels of pregnancy hormones, such as those carrying twins or with abnormal placental growth, also have a higher incidence of nausea.

Is it harmful to moms and babies?

“A bit of nausea is actually a good sign and may be associated with better pregnancy outcomes,” says Lane. “If the pregnancy is developing normally and all the pregnancy hormones are there, you are more likely to experience some NVP.” However, if a woman is vomiting so much she becomes dehydrated and her electrolytes are off balance, NVP is potentially harmful. “Women need to discuss their symptoms with their caregiver and work together to try and reduce nausea and vomiting.”

Lifestyle and dietary changes, such as getting enough rest and eating smaller amounts of food throughout the day, instead of three large meals, may help ease NVP. “There’s no hard and fast rule about what a woman should eat to avoid nausea,” says Lane. “Women should follow their own cues; that may mean sticking to carbohydrates, such as bread, fresh fruit and vegetables, if that’s all they can stomach.”

Sea bands, the acupressure wristbands worn to relieve seasickness, have been shown to be effective for NVP, so they’re worth a try, says Lane.

Diclectin (a combination of vitamin B6 and antihistamine) is the most commonly prescribed drug for NVP. It has been tested in pregnancy and proven safe for mother and baby, and Lane does not hesitate to prescribe it. “It should not be considered a last resort,” she says. For severe NVP, treatment has to be tailored to the individual, says Lane. That may mean using Diclectin, a gut motility medication, such as Maxeran, which improves sphincter tone at the top of the stomach to reduce reflux and vomiting or, in really severe cases, intravenous hydration to replenish lost fluids.