The Duchess of Cambridge is expecting her first child, and is having a severe bout of morning sickness. So much so that she must be hospitalized for it. Morning sickness is very common in pregnancy starting around the 5th week and continuing up to 16 weeks. There are smaller groups of women who have morning sickness throughout pregnancy or who have it at the end of their pregnancy. Most cases of morning sickness are not harsh, and can be tolerated. How do you know if you have a severe case of morning sickness or hyperemesis gravidarium?
Women who have hyperemesis gravidarium have repeated bouts of vomiting through the day. They cannot keep down any food or drink. They may have abdominal pain or feel dizzy when standing. Their urine may be dark. Weight loss of 5% and/or 5 pounds or more during this period would give you a diagnosis of hyperemesis gravidarium. Should you experience any of this it is recommended that you see your doctor for treatment and further evaluation.
For women with mild cases of morning sickness, there are some simple things that you can try. You can avoid things that make you nauseous. Spicy foods, odors, noise, lighting, heat, and motion can contribute to the nausea. If prenatal vitamins make you feel sick, try taking them at night. If you’re still feeling sick, stop them until you feel better. For some women, eating frequent small meals throughout the day helps keep the stomach from being empty causing an exacerbation of the nausea. Brushing the teeth can either help or make the situation worse. Some women have to wait until after eating to brush and some women need to brush before. Believe it or not, but some women will feel much better if they cut out the high sucrose snacks.
Some other things to try would be ginger snaps, ginger ale, or saltines. Over the counter medications such as vitamin B6 (10 mg to 25 mg three times per day) can help to reduce the nausea. Doxylamine (Unisom or GoodSense sleep aid) when combined with the vitamin B6 works well to reduce the vomiting. Take ½ the tablet of doxylamine. Over the counter Benadryl or other anti- nausea medications such as Meclizine can also help. Just be aware that Benadryl and Meclizine can cause drowsiness. Some women have found success with acupressure wristbands and hypnosis in combating morning sickness.
Now, if the above is not doing the trick, go see your physician. There are prescription medications that may help. You may also need further evaluation with blood tests and ultrasound to make sure there isn’t an underlying medical condition such as thyroid disease or maternal condition such as twins.
The good news is that for more than 80% of women who have morning sickness this will not last much past the first trimester. The comforting part of morning sickness means a beautiful healthy baby at the end of all this.
Cynthia Wilkes MD
Stafford Womens Health Associates