Dealing with nausea and vomiting during pregnancy

July 12, 2021

By Dr. Inna Russell, OB-GYN with Clark Just for Women Health Solutions

Nausea and vomiting of pregnancy is a common condition. It can occur any time during the day, even though it’s often called “morning sickness.” Nausea and vomiting of pregnancy usually doesn’t harm the fetus, but it can affect your life, including your ability to work or go about your normal everyday activities. There are safe treatment options that can make you feel better and keep your symptoms from getting worse.

Nausea and vomiting of pregnancy usually starts before 9 weeks of pregnancy and goes away by 14 weeks of pregnancy. For some women, it can last longer or throughout the pregnancy.

Some women feel nauseated for a short time each day and might vomit once or twice. In more severe cases, nausea lasts several hours each day and vomiting occurs more frequently.

Ideas for managing it
If you experience nausea and vomiting due to pregnancy, these changes to your diet and lifestyle might help you feel better. 

  • Take a prenatal vitamin. Studies show that taking a vitamin supplement before and during pregnancy reduces the risk of having severe nausea and vomiting of pregnancy.
  • Eat dry toast or crackers in the morning before you get out of bed to avoid moving around on an empty stomach.
  • Eat five or six “mini meals” a day to ensure that your stomach is never empty.
  • Try bland foods. The BRATT diet (bananas, rice, applesauce, toast, and tea) is low in fat and easy to digest.
  • Ginger can help settle your stomach, and different forms of it are available such as capsules, candies, ginger ale made with real ginger, and ginger tea made from fresh-grated ginger
  • Drink water throughout the day, not just when you are thirsty. Aim for 8 to 12 cups a day during pregnancy. Not drinking fluids can lead to dehydration, which can make nausea worse. If a bad taste in your mouth makes it hard to drink water, chew gum or eat hard candy.

When it’s severe
Hyperemesis gravidarum is the term for the most severe form of nausea and vomiting of pregnancy. It occurs in up to 3 percent of pregnancies.

This condition may be diagnosed when a woman has lost 5 percent of her prepregnancy weight and has other problems related to dehydration (loss of body fluids). Women with hyperemesis gravidarum need treatment, sometimes in a hospital, to stop the vomiting and restore body fluids.

Any of the following can increase the risk of severe nausea and vomiting of pregnancy:

  • Being pregnant with more than one fetus (multiple pregnancy)
  • A previous pregnancy with either mild or severe nausea and vomiting
  • Your mother or sister had severe nausea and vomiting of pregnancy
  • A history of motion sickness or migraines
  • Being pregnant with a female fetus

This condition usually does not harm your health or your fetus’s health. It also does not mean that your fetus is sick. But it can become more of a problem if you cannot keep down food or fluids and begin to lose weight. When this happens, it sometimes can affect the fetus’s weight at birth. Weight loss can also lead to problems with your thyroid, liver, and fluid balance. 

Talk to your OB-GYN or obstetric care provider if you experience intense nausea and vomiting of pregnancy. Early treatment can keep hyperemesis gravidarum from becoming severe.

Medical treatment that can help
If diet and lifestyle changes don’t relieve symptoms, or if you have severe nausea and vomiting of pregnancy, there are medications that might help.

Vitamin B6 is a safe, over-the-counter treatment that may be tried first for nausea and vomiting of pregnancy. Doxylamine, a medication found in over-the-counter sleep aids, can be added if vitamin B6 alone does not relieve symptoms. A prescription drug that combines vitamin B6 and
doxylamine is also available. Both drugs, taken alone or together, have been found to be safe to take during pregnancy and have no harmful effects on the fetus.

If B6 and doxylamine don’t relieve your symptoms, “antiemetic” drugs, which prevent vomiting, may be prescribed. Many antiemetic drugs have been shown to be safe to use during pregnancy, but others have conflicting or limited safety information. You and your OB-GYN or other obstetric care provider can determine the best treatment for you.

The OB-GYNs at Clark Just for Women Health Solutions are here to guide you through all the ups and downs of pregnancy. Give us a call at 812-280-7063 to schedule an appointment.