Quick guide to morning sickness in pregnancy

By Dr. John Yam
Obstetrician & Gynaecologist
MBBS, FRCOG, MMED, FAMS

"Morning sickness" is a term used to describe the nausea and vomiting that occur during pregnancy. It affects about 75% of pregnant women and, despite it being called morning sickness, it can happen at any time of the day.

The good news for most expectant moms is that morning sickness is mild and tends to get better during the last 12 to 14 weeks of pregnancy. But there are some women who have it for a longer time, and sometimes they have it the whole time they are pregnant.

Hyperemesis Gravidarum is a severe form of morning sickness that only a small number of women who are expecting get. It is a condition where nausea and vomiting are so severe that they cause dehydration, resulting in the loss of more than 5% of the pre-pregnancy body weight. Hyperemesis gravidarum may require hospitalization and treatment with intravenous (IV) fluids and medications.

In most cases, morning sickness is mild and does not require any treatment. An expectant mother’s experience with morning sickness will vary. The symptoms can vary between pregnancies as well; while you might experience severe symptoms in one pregnancy, the next one might be a breeze!

COMMONLY ASKED QUESTIONS:

1. What causes morning sickness? 

There is no known single cause. Many factors could play a part in triggering the feeling of nausea. Some people think that the rising level of the pregnancy hormone (hCG) is one of them.  Higher levels of the hormones estrogen and progesterone, as well as reduced blood sugar, may also aggravate symptoms.

Other factors and triggers include:

• Sensitivity to smell: you could keep tabs on what triggers your symptoms and try to avoid these triggers
• Pre-existing motion sickness: this could worsen during pregnancy
• Stress can initiate or aggravate digestive issues
• Physical and mental fatigue
• Certain medical conditions could be associated with increased symptoms of nausea, such as thyroid issues, urinary tract infections
• If you are pregnant with more than one baby, chances are you could have more than your share of symptoms than you might have had if you were carrying just one

2. Will that affect my baby's growth? 

You may not be feeling your best, and you may not be eating as much as you did before pregnancy, but this is usually not a problem.

In the first trimester, your baby gets most of her nourishment from your body’s reserves. Retching and vomiting will not cause any physical harm to the baby, and your appetite should improve by the end of the first trimester.

However, if you have lost more than 5% of your pre-pregnancy weight and your appetite has not picked up (not able to eat or drink anything), it is imperative to consult your doctor.

3. Any tips to cope with it? 

Every woman has a different experience with morning sickness. There is no one-size-fits-all solution. However, lucky for you, there are some ways to alleviate the symptoms.

a. Diet

• Stick to foods & beverages that appeal to you for now. Avoid eating, smelling or even thinking of foods that may trigger the nausea. Even if that means you might be eating the same few dishes frequently.
• Eating small, frequent meals at regular intervals may help to ease the symptoms.
• Eat early! Morning sickness may kick in the moment you are out of bed or even when you are brushing your teeth in the morning. Nausea is likely to strike when your tummy is empty after a long night’s sleep. Try to stock up some healthy snacks like cereals, crackers or nuts by your bedside so you have something to munch on the moment you open your eyes.
• Try a light, healthy supper before bed. Try snacking on complex carbs and something high in protein – e.g. Whole grain meal, a glass of milk, almond nuts, freeze dried fruits.
• Eat nutrient-dense foods! Plan your diet to include protein and complex carbohydrates.

b. Fluid

It is important to get sufficient fluids. Drink plenty of fluids at regular intervals to avoid dehydration. If water is not appealing to you, try sucking on a popsicle instead. Fruit juices are a tasty alternative too.

c. Supplements

Take your prescribed prenatal vitamins. These will help compensate for any nutrients that may be lacking.

d. Ginger

A traditional folk remedy that has stood the test of time. Sucking on fresh or preserved ginger slices, sipping on ginger ale, or even a cup of ginger tea might ease the queasiness.

e. Acupressure wristbands

Some pregnant women swear by the effectiveness of these. This drug-free solution has no side effects and is available at most pharmacies.

 f. Get plenty of rest

Nausea gets worse with fatigue and stress.

g. Get help from your obstetrician

Keep anti-sickness medicine on standby in case you feel unwell.

4. Is my pregnancy normal if I have no morning sickness?

Not all expectant mums experience morning sickness, so lucky for you. There is no way to tell if a pregnancy is normal based on whether or not a woman has morning sickness.