Doing Battle with Morning Sickness
Nothing can blast the euphoria of discovering you're pregnant faster than morning sickness. For Deborah Wood, a mother of three and writer in Evanston, Ill., certain smells were killers, especially with her first pregnancy. In fact, opening a refrigerator became an occupational hazard. Just the mention of tuna -- a food she normally loves -- would make her heave. She even started carrying plastic grocery bags in her pockets for those times when a mad dash to the bathroom was impossible.
She's not alone. As many as 90% of all pregnant women experience some degree of nausea or vomiting during pregnancy, says Dr. Jennifer Niebyl, head of obstetrics and gynecology at University of Iowa College of Medicine. In most cases, the symptoms are associated with a perfectly healthy baby, and they disappear by the fourth month. But some women have the symptoms longer, even lasting their whole pregnancy.
The trick is finding out what helps, although that's often easier said than done. Not only is every woman different, but so is each pregnancy. "There isn't a one-size-fits-all remedy," says Miriam Erick, a registered dietician at Brigham and Women's Hospital in Boston and author of "No More Morning Sickness: A Survival Guide for Pregnant Women" and "Take Two Crackers and Call Me in the Morning."
Erick advises a methodical approach. Take note of any smells or tastes that set you off, and avoid them. Then experiment with foods and drinks that soothe your symptoms. Be open to what your body's telling you, not what you've heard works for others. In fact, the old standby -- crackers and ginger ale -- isn't as effective as potato chips and lemonade for many women, although Erick doesn't know why.
Show Me a Sign
Doctors still aren't sure exactly what causes morning sickness, but the most popular theory is that morning sickness is the body's reaction to the pregnancy hormone, human chorionic gonadotropin (hCG), which is produced at higher levels during the first trimester than at any other time during pregnancy, says Dr. Niebyl. What they -- and every woman who's had it -- do know is that it can hit you at any time of day, not just in the morning.
On some level, the nausea can be reassuring -- an early sign that a tiny human being really is growing inside of you. Carla Laszlo, 29, of Southwick, Mass., recently found out she was pregnant and a week later started to feel queasy. "I finally feel like something is happening to me," she says. "With this being my first pregnancy, I was anxious to 'feel' pregnant. Fortunately or unfortunately, I'm getting my wish."
Some studies, in fact, have indicated that women with little or no morning sickness have a higher rate of miscarriage. That's because women who end up miscarrying typically have lower levels of hCG, says Dr. Niebyl. Another theory, although widely disputed, is that morning sickness is actually nature's way of keeping women away from substances that could harm the developing fetus.
Quelling the Queasies
One principle that might help keep morning sickness at bay is that nausea is often worse on an empty stomach. So eat small, frequent meals throughout the day rather than the traditional breakfast, lunch and dinner. Keep some crackers on your nightstand to munch on before you get out of bed in the morning. If taking a prenatal vitamin in the morning on an empty stomach exacerbates your nausea, try taking it at night instead.
Bland starches, such as breads, rice or pasta, which are metabolized quickly, are often the best choices for morning sickness, says Anne Dubner, a registered dietician and nutrition consultant in Houston. So are high-protein snacks, which take longer to digest and therefore stay in your body longer. A combination of the two -- crackers with peanut butter or cheese, for instance, might be particularly helpful. Also, avoid highly spiced or greasy foods and gas-producing vegetables like cabbage.
"Whatever works, that's the rule in morning sickness, and what makes you feel good at 9 a.m. may not make you feel good at 4 p.m.," says Elizabeth Ward, a registered dietician in Boston and author of "Pregnancy Nutrition: Good Health for You and Your Baby." Don't worry about not getting enough nutrition during the first trimester if you don't have much of an appetite, either, because the nutritional needs of the fetus are still minimal.
Drinking enough fluids, especially if you're queasy, is particularly important since dehydration is one of the most serious consequences of morning sickness. Pregnant women should drink at least eight 8-ounce glasses of liquid daily. Many women find that water doesn't sit well with nausea. If carbonated drinks such as ginger ale work best, Erick recommends those with the most bite, such as Schweppes or Jamaican ginger beer. Herbal teas such as red raspberry, lemon, spearmint, peach or chamomile may work. Erick says watermelon is a great "solid liquid" that may help.
Ginger traditionally has helped many women quell morning sickness and nausea. One study showed that ginger capsules with 250 milligrams of ginger four times per day were effective, but a quarter-teaspoon of grated ginger root steeped in 1 cup of boiling water may be just as helpful, says Amanda McQuade Crawford, an herbalist and author of "Herbal Remedies for Women."
Vitamin B-6 is another common and safe tummy soother. A study conducted by Dr. Niebyl, and duplicated by another researcher, showed that taking 25 milligrams of B-6 three times a day helped a majority of women with moderate-to-severe morning sickness. Dr. Niebyl says the standard B-6 vitamin is 50 milligrams, so you can break it in half. With any over-the-counter supplement, including herbs, it's always a good idea to check with your physician or midwife first, particularly to make sure the symptoms aren't related to a more serious condition that needs different treatment.
By her third pregnancy, Deborah Wood swore by acupressure wristbands, which are commonly used to prevent seasickness. The bands theoretically relieve nausea by applying pressure to a point located on the forearm about 2 inches above the wrist, although studies are inconclusive that they're effective. "I never took them off," say Wood, 46. "I'll never know if they really worked, or if it was psychological, or if I wouldn't have been sick anyway; but this was the only pregnancy I used them with, and it was the only time I didn't get sick."
Those Rare, but Serious Cases
If nothing seems to work and morning sickness is getting in the way of your everyday activities, then doctors might suggest anti-nausea drugs that are safe for pregnancy, says Dr. Niebyl. "It depends on how sick you are. If you can't take care of your kids or go to work, most would prefer to take a medication."
In about 1% of all cases, morning sickness can be so severe as to cause dehydration and imbalances in the body's chemistry. When that happens, a woman will probably need to be hospitalized so that she can be treated with intravenous fluids and anti-nausea drugs. "If a woman can't keep anything down for 24 hours or she's lost weight, she should go to the hospital or contact her physician," says Niebyl. "It just not good for the mother."
Erick says women often wait too long to seek medical attention. "I think people get really out of control with being dehydrated because they read a book that said, 'Oh, this is normal' or somebody said, 'Buck up, it's only pregnancy. Meanwhile, they can't get out of their pajamas and fail to differentiate that some morning sickness is one thing, but outrageous morning sickness is not a good thing."
Kim Clifford of Western Springs, Ill., knows firsthand how bad morning sickness can get. She was so sick she could barely keep any solid food down, except sweets. "I kept waiting for it to stop, and the doctor and nurses said, 'When you get to be 10 or 12 weeks, it'll stop.' " But about 10 weeks into her pregnancy -- and 15 pounds lighter -- Clifford was hospitalized and when she was discharged she had to continue wearing a feeding tube to get nutrition directly into her bloodstream for the next three months.
"I remember being at the doctor's office and just crying," Clifford says. "Everything I ate or drank made me sick, and I was thinking, 'Oh my God, what's wrong?' " Still, she delivered a healthy 8-pound, 8-ounce baby boy, Patrick, now 15 months old, and the morning sickness is a distant memory. "Nobody wants to be sick like that, but it's a relatively short period in your life, and once you have that baby it's all worth it."©1996-2005 WebMD Inc. All rights reserved.