Morning Sickness - OAWHealth

Morning Sickness

By Dr. Loretta Lanphier, ND, CN, HHP, CH

Morning sickness is one of the most common symptoms of early pregnancy, but for many women it is a misnomer because they may feel sick at any time of the day or night. Why is this malady so prevalent, and what are the causes behind it? Let’s see what we can discover about these questions, and possibly learn a bit about managing morning sickness along the way.

What is Morning Sickness?

Morning sickness is the common name for a condition that is officially known in medical circles as Nausea and Vomiting of Pregnancy (NVP). It is extremely common, especially during the first trimester (13 weeks) of pregnancy. Statistics tell us that over 50% of women will experience NVP at some point in their pregnancy, with about 75% of cases found primarily during early pregnancy. For the majority of women, NVP first strikes at about 6 weeks, but it can begin as early as 4 weeks. The intensity of NVP symptoms seems to peak about 30 days after they start for most patients, and most women become symptom free after 14 weeks or so. However, there are some who will see NVP return later in pregnancy, and possibly last throughout their whole term.

Morning sickness probably got it’s name because even though it can and does occur at any time of day, it is typically worst for many women the first thing in the morning.

Symptoms vary from woman to woman and from pregnancy to pregnancy, but NVP is usually characterized by nausea and vomiting, and it can be extreme in many cases. Some women have very few or no problems with NVP other than minor stomach upset, while others can have a hard time keeping food and beverages down and find it difficult to function normally due to NVP. In most cases morning sickness is not harmful to mother or baby, but it can cause complications for both if the mother has difficulty getting enough fluids and/or nutrition. On the other hand, NVP can be a good sign that the placenta and the baby are developing normally and according to schedule.

What Are the Causes of NVP?

The exact causes of NVP are not known for certain, but several factors are probably involved, most of them having to do with changes that take place in your body during pregnancy. These include:

  • Hormonal changes:  Pregnancy triggers many hormonal changes in a woman’s body. One in particular, a pregnancy hormone called hCG, is programmed to be released at high levels in the first trimester. Researchers don’t know for sure why hCG triggers NVP, but it is known that symptoms tend to peak when hCG levels are highest. It is speculated that this hormone, and others such as estrogen which also are seen at increased levels during pregnancy, may somehow stimulate a part of the brainstem that is responsible for the nausea and vomiting reflex. This is probably why women who are carrying multiple babies (twins or triplets) have a higher incidence of NVP than single births, due to the presence of more hormones.
  • Heightened sense of smell:  It is common for many pregnant women, especially in the first trimester, to be super sensitive to odors. Often these are related to foods, and can turn a normally pleasant odor into a trigger for nausea and vomiting in many cases. Certain aromas seem to trigger the gag reflex during many pregnancies, and there is some evidence that points to the increase of estrogen levels as a possible cause.
  • Ptyalism:  This is a phenomenon that causes an increase in the amount of saliva that many women produce during pregnancy. Some ladies find that this excess saliva can lead to nausea and vomiting.
  • Changes in the digestive tract:  Sometimes referred to as “tricky stomach,” this is the result of muscle relaxation in the gastrointestinal system that occurs during pregnancy. The result is a slow down of the digestive process, which can cause nausea and vomiting.
  • Postnasal drip:  Again, estrogen is the suspected culprit in this occurrence. Nasal congestion and the resulting postnasal drip can cause stomach upset in many women. One of the effects of estrogen is that it increases blood flow throughout the whole body. When this happens to the mucous membranes of the nose, congestion and drip often result.
  • Psychological:  Some studies have pointed to a connection between NVP and how a woman handles stress during pregnancy. There is little hard evidence to support this, and no reason to think that some women are predisposed to NVP strictly due to psychological factors. However, it is true that severe NVP can definitely increase the amount of stress during a pregnancy.
  • Previous NVP:  Women who have had NVP in previous pregnancies are more likely to experience it in succeeding pregnancies as well.
  • Sensitivity to estrogen:  If you have a history of stomach upset from taking birth control pills, for example, you probably are quite sensitive to estrogen. This may increase your risk for NVP as well.
  • Twins or triplets:  Higher levels of hCG, estrogen, and other pregnancy hormones increase your chances of having NVP, and they may also cause a tendency towards more intense nausea and vomiting than with carrying a single baby. But, this is not written in stone. Some women who are carrying multiple fetuses have minimal NVP symptoms,  or possibly none at all.
  • History of motion sickness:  If you are susceptible to vertigo, carsickness, or other motion-related conditions, you are also more likely to have NVP.
  • Family history:  NVP seems to run in families. If your mother or sisters have experienced it, you are at greater risk yourself. Degree of symptoms may also be passed on. If intense symptoms run in your family line, you should probably prepare yourself for dealing with them as well.
  • Carrying a girl:  For reasons that are not well understood, some research has indicated that women with severe NVP symptoms were 50% more likely to be having a girl than a boy. How’s that for a novel way of predicting the sex of your baby!
  • History of migraines:  Those with a pattern of having migraine headaches also tend to have a higher incidence of NVP. This is no surprise, as migraines have been linked to hormonal changes too.

What Can Be Done to Relieve or Prevent the Symptoms of NVP?

There are many practical, natural, and noninvasive ways that you can treat or prevent the nausea and vomiting associated with morning sickness. Of course, there are allopathic anti-nausea medications that are available too, but as with any drug, there are side effects that you should consider before using them. This is especially true if you are pregnant. What you put in your body not only affects you, but your unborn child as well. Some common alternatives to drugs include:

  • Vitamin B6:  Many women find relief from NVP by supplementing with B6. Use a high-quality source that is bioavailable so that it can be efficiently absorbed by your body. Typical dosage for NVP relief is 10-25 milligrams per day. Don’t take more than the recommended dosage because too much can cause nerve damage and numbness and may damage  the development of the baby as well.
  • Eat frequently:  Having six small meals or snacks throughout the day will do two things that may help:  It will never leave your stomach totally empty, and it will maintain your blood sugar at normal levels. Both of these factors can help prevent nausea and vomiting.
  • Crackers:  Try keeping a supply of salty crackers by your bedside. Many women find that if they eat a couple of crackers before getting out of bed in the morning, it helps greatly with nausea and vomiting.
  • Choose mild foods:  Stay away from foods that are high in fat (they take longer to digest) or excessively spicy foods. Some women also have found that food served cold or at room temperature will be less likely to aggravatethem from spicy flavor or strong odors.
  • Ample fluids:  This is especially important if you have been vomiting a lot. One suggestion though: try to take in most of your fluids in the form of pure, clean water, and drink it between meals, not while you are eating. A sports drink may be appropriate at times to restore electrolyte balance and potassium and other minerals that you may have lost due to excessive vomiting.
  • Ginger:  This herb has a long history of being used to squelch stomach upset and vomiting. You can grind it up and drink it as a tea. Or you can go to a health food store and find natural ginger candy or genuine ginger ale made with real ginger (most of the ginger ale in the grocery store does not have real ginger in it).
  • Sea bands:  These are cotton wristbands that are used by many folks to help with motion sickness such as seasickness or carsickness. Some pregnant women swear by them for helping with NVP as well. They act by putting acupressure on the wrist, and are available at health food stores and some drug stores.

Can Complications Occur from NVP?

Generally, NVP is not a condition that is harmful to you or your baby. Occasionally severe nausea and vomiting will make it difficult for new mothers to gain weight in the first trimester, but in the vast majority of cases, NVP stops or greatly minimizes after 14 weeks, and most pregnancies are not adversely affected.

There is one condition known as hyperemesis gravidarium (literally “excessive vomiting in pregnancy”). Women who suffer from this are unable to keep enough fluids and nutrients in their systems, and it can put themselves and their babies in harms way due to possible dehydration or malnutrition. The usual treatment for this is several days of hospitalization in order to provide intravenous fluids and nutrients. Typically, patients recover well, and are able to carry on with a normal pregnancy.

Morning sickness is one of those conditions that can be managed well for most women by taking a few simple preventative steps to avoid or minimize the discomfort of nausea and vomiting. Common sense and the collective wisdom of countless women who have been through the joys and trials of pregnancy can go a long ways towards finding relief from NVP.

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