You may be feeling a little queasy if you’re in the early stages of pregnancy. So let’s talk about pregnancy sickness and find out what’s normal.
One of the harsh realities of pregnancy comes just when you may be keeping your pregnancy a secret from most people. Yet you may have one obvious outward symptom – the need to be sick.
Morning sickness happens to nine in ten women in the early stages of pregnancy. It is more common in multiple pregnancies and starts at around week six (Lee and Saha, 2011; NHS Choices, 2015). For one in three women, it’s a case of feeling queasy but others may be sick a few times a day (Ebrahimi et al, 2010; NHS Choices, 2015).
What you may have heard: Morning sickness happens, as the name suggests, in the morning.
The reality: Sorry to be the bearers of bad news but morning sickness is not limited only to the morning, leaving you feeling fine by midday. In fact, morning sickness – or nausea and vomiting in pregnancy (NVP) as it’s known too – can happen at any time of day or night (NHS Choices, 2015). Some women may also experience excessive saliva, known as ptyalism.
What you may have heard: You need to eat something healthy, no matter how you feel.
The reality: Obviously, in an ideal world you’d have a healthy balanced diet. But this isn’t the time to be worrying about your kale quota. If toast is all you can eat, go with the toast. Keeping food down will help with the nausea so prioritise this over making sure you order that salad.
What you may have heard: Morning sickness is a concern for the baby.
The reality: Do not worry: morning sickness is in fact associated with healthy babies at birth (Hinkle et al, 2016). It’s not known what causes the nausea but there are various explanations. They include changing hormone levels, lack of vitamin B6 and your body protecting the baby from things like caffeine or petrol fumes (smells that may provoke nausea).
Whatever the cause is, a normal level of morning sickness is not doing the baby any harm. The concern comes when we get onto serious nausea and vomiting in pregnancy, called hyperemesis gravidarum.
What you may have heard: Morning sickness can be serious.
The reality: Yes, hyperemesis gravidarum (HG) is a serious form of morning sickness. Just ask Kate, the Duchess of Cambridge, who suffered from it in all three of her pregnancies. It is uncommon, with 0.3% to 1% of pregnant women suffering from it (O’Donnell et al, 2016).
If you do develop hyperemesis gravidarum, the symptoms are severe and can make it impossible to drink anything. Continuous vomiting can lead to dehydration and weight loss.
If your symptoms are so bad that you can’t drink at all, you should contact your doctor or midwife as soon as possible. You should also speak to a doctor immediately if you:
have very dark-coloured urine or do not wee for more than eight hours
are unable to keep food or fluids down for 24 hours
feel severely weak, dizzy or faint when standing up
have stomach pain
have a temperature of 38°C or above
- vomit blood.
What you may have heard: Hyperemesis gravidarum (HG) can require a stay in hospital.
The reality: Yes, if needed it can. If your symptoms are so bad you contacted the doctor or midwife, they will rule out other conditions that could cause the vomiting. They will also offer treatment advice. The earlier treatment is started, the more effective it will be but sometimes a stay in hospital may be what the doctor orders.
It’s likely that HG will hang around until your baby is born. Check out HER Foundation for more information on hyperemesis gravidarum. Do note that hyperemesis gravidarum is unlikely to affect your baby as long as it’s treated (Harding, 2016). So while it’s unpleasant, try not to worry.
One thing you may want to look into is some psychiatric or psychological support. The longevity and severity of hyperemesis gravidarum can impact on your mental health (RCOG, 2016).
Morning sickness SOS (save our stomachs)
Tips and tricks for easing the vomiting and getting morning sickness relief.
Head to the sofa. Rest is crucial so take the excuse and put your feet up (NHS Choices, 2015).
Eat small and eat simple. This isn’t the time for the three-course taster menu at a local restaurant (NHS Choices, 2015).
Avoid fatty foods, powerful cooking smells and strong flavours. Eating food cold can help too as the smell is more subtle (NHS Choices, 2015).
Have a dry snack like toast or a biscuit before you get up (NHS Choices, 2015).
Drink little and often and separately from your meals (Ebrahimi et al, 2010; NHS Choices, 2015).
Suck peppermints or ice (Ebrahimi et al, 2010).
Go for ginger – in a tea, crystallised, as a biscuit or in any other form that makes you feel better (O’Donnell et al, 2016).
Speak to your doctor. If you spend most of your time unable to eat and feeling sick, some drugs like pyridoxine (vitamin B6) or antihistamines could help (RCOG, 2016).
In October 2018, Xonvea the first pill of its kind to specifically tackle NVP was licensed for use by a drug firm in the UK. Pregnant women with NVP are recommended to take between two and four pills a day. General advice is that the pill should be used by women who have already tried changing their diet and lifestyle to avoid sickness but still need medical help. Talk to your GP or midwife to find out more.
Go the alternative therapies route. There is some evidence that acupuncture or acupressure may help some pregnant women feel less sick (Lete and Allué, 2016; RCOG, 2016).
Our support line offers practical and emotional support in many areas of pregnancy, birth and early parenthood: 0300 330 0700.
We also offer antenatal courses which are a great way to find out more about birth, labour and life with a new baby.
Make friends with other parents-to-be and new parents in your local area for support and friendship by seeing what NCT activities are happening nearby.
It’s always recommended that you talk to a pharmacist before taking supplements to check whether there are any risks and always buy from a reputable supplier such as a supermarket or pharmacist.
Pregnancy Sickness Support is a UK charity working to improve care, treatment and support for women suffering from Nausea and Vomiting in Pregnancy and Hyperemesis Gravidarum.
Ebrahimi N, Maltepe C, Einarson A. (2010) Optimal management of nausea and vomiting
of pregnancy. International Journal of Women’s Health. 2:241–248. Available from: https://www.ncbi.nlm.nih.gov/pubmed/21151729 [Accessed 27th March 2018].
Harding M. (2016) Nausea and vomiting in pregnancy - including hyperemesis gravidarum. Available from:
https://patient.info/doctor/nausea-and-vomiting-in-pregnancy-including-hyperemesis-gravidarum [Accessed 27th March 2018].
Hinkle SN, Mumford SL, Grantz KL, Silver RM, Mitchell EM, Sjaarda LA, Radin
RG, Perkins NJ, Galai N, Schisterman EF. (2016) Association of Nausea and Vomiting
During Pregnancy With Pregnancy Loss: A Secondary Analysis of a Randomized
Clinical Trial. JAMA Intern Med.176(11):1621-1627. doi: 10.1001/jamainternmed.2016.5641. Available from: https://www.ncbi.nlm.nih.gov/pubmed/27669539 [Accessed 27th March 2018].
Lee N M, Saha S. (2011) Nausea and Vomiting of Pregnancy. Gastroenterology Clinics of North America, 40(2):309 Available from: http://doi.org/10.1016/j.gtc.2011.03.009 [Accessed 27th March 2018].
Lete I, Allué J. (2016) The Effectiveness of Ginger in the Prevention of Nausea and Vomiting during Pregnancy and Chemotherapy. Integrative Medicine Insights. 11:11-7. Available from: https://www.ncbi.nlm.nih.gov/pubmed/27053918 [Accessed 27th March 2018].