Morning Sickness - your need-to-know guide

Morning sickness usually occurs in the first trimester of pregnancy. It makes you feel nauseous and queasy, and may cause vomiting and dry retching. And while it’s called morning sickness, it can make you feel sick at any time of the day, or even at night.

Combined with general fatigue, especially in the first trimester when your baby is undergoing huge development, morning sickness can make you feel quite low and even vulnerable. Hang in there – it usually passes soon after you reach your second trimester.

What causes morning sickness?

Despite being so common, the exact cause of morning sickness is unknown. However, a combination of factors are thought to play a part, including:

• Significant hormonal changes, including high levels of oestrogen
• The different way your body metabolises carbohydrates during pregnancy
• Blood pressure fluctuations, particularly if it dips lower than usual, and
• The enormous physical and chemical changes triggered by pregnancy.

And while the precise cause of morning sickness remains a bit of a mystery, so does the reason why it affects some women more than others, or why you may experience it for one pregnancy but not for another.

Is morning sickness serious?

In most cases, morning sickness is an unpleasant part of pregnancy that you’ll be keen to pass. While you’ll feel unwell and may need to get more rest and adjust your routine a bit, you should generally be able to go about your usual life.

However, for some women, morning sickness can be very serious. About one in 100 will experience a condition called hyperemesis gravidarum. It causes severe and ongoing nausea and vomiting. Women with this condition completely lose their appetite and really struggle to keep food and drink down, which can lead to dehydration and weight loss. In these cases, hospital admission may be needed to receive fluid via a drip and medication.

If you have morning sickness and are worried about your health or your baby’s development, you are losing weight or can’t keep down enough fluids, get help by calling your doctor or midwife.

Tips for coping with morning sickness

It might take some trial and error to find ways to ease your morning sickness symptoms. The following tips may help:

1. Change up your food routines

Nausea and a loss of appetite will make eating difficult, but adjusting your diet or changing the way you usually eat might help.

• Rather than getting up as soon as you’re awake, take a few minutes to ease into your day. Sit up in bed with some dry biscuits or crackers and sip a cup of weak tea (no milk might help) or water.
• If you’re overwhelmed at the idea of eating three main meals, try breaking your usual food intake into smaller and more frequent meals.
• Avoid greasy, fatty and strong-tasting foods, including spicy foods and coffee.
• Even though you may not have a big appetite, try not to go too long without food because this can make nausea worse. A little bit of food is better than skipping an entire meal.
• If you’ve become more sensitive to smells during your pregnancy, try to avoid cooking or being around strong-smelling food. If someone offers to cook for you, accept their help.
• Have a range of foods and snacks on hand (for example, salty, sweet, crunchy) in case you suddenly have an appetite throughout the day.

2. Keep your fluids up

It’s important to stay hydrated, especially if you’re vomiting and not eating your usual amounts of food.

• Aim to drink plenty (about six to eight glasses) of water throughout the day. Keep a water bottle close so you can take a sip when you need it and monitor how much you are drinking.
• If even sipping on water is difficult, try sucking on crushed ice.
• Some people find that ginger-based drinks, such as dry ginger ale or ginger tea, eases nausea. The childhood remedy of flat lemonade can also help, as can fruit juice or clear soup.
• If you’re really struggling to keep your fluids up, talk to your pharmacist about an oral rehydration solution.

3. Other remedies

Sometimes the everyday approaches used to treat other types of nausea can help with morning sickness, such as sucking on ginger or mint-based jellies or chews. You could ask your pharmacist about acupressure wrist bands normally used to ward off motion sickness.

Some people take a vitamin B6 supplement (a lack of B6 is thought to contribute to morning sickness) but speak to a pharmacist first about taking this, or any other supplement, during pregnancy.

There are also medications that can ease nausea and won’t harm your baby – speak to your doctor to find out more.

Maintaining a healthy diet

You may be keen to eat really well throughout your pregnancy, but what if the thought of eating certain foods (even healthy ones like fruit and vegetables) makes you feel sick?

During pregnancy, around six in 10 women go off certain foods that they usually like. But this aversion usually settles down by the first couple of weeks of the second trimester, which is also when morning sickness generally eases.

Don’t worry too much if your diet consists mostly of plain foods like breads and cereals for a while. Keep trying every couple of weeks to see if your appetite for certain foods has come back. If it doesn’t and you’re concerned, speak to your doctor or midwife.