Morning Sickness in Pregnancy – Causes, Symptoms, and Treatment

Morning sickness is one of the first (and common) signs of pregnancy. A misnomer by name, it is neither an alarming sickness nor does it always happen in the morning. It refers to the symptoms of nausea and vomiting that typically begin in the morning and usually resolve as the day progresses. If you have recently found out that you are pregnant, and experiencing morning sickness, there’s nothing to worry about. Here’s everything you need to know about morning sickness during pregnancy. In this article, you will also learn how to deal with morning sickness in pregnancy in an effective manner (which includes not having to trouble your doctor at odd hours!).

What Is Morning Sickness?

Morning sickness is nausea and vomiting experienced during pregnancy. It is very common in pregnancy, especially in the first trimester of pregnancy. Despite its name, morning sickness can occur at any time of the day. That said, the effects of nausea and vomiting of pregnancy linger throughout their pregnancy, with symptoms improving by the second trimester of pregnancy (beginning at 14 weeks), and in rare cases, extending until delivery (1). Professional treatment is not usually needed for this.

Causes of Morning Sickness During Pregnancy

Most women complain of nausea during pregnancy as the most common symptom. About 70-80 per cent of all pregnant women experience morning sickness (2). While there isn’t any specific cause, nausea and production of the human chorionic gonadotropin (HCG) hormone appear to be linked. Medically, this pregnancy hormone is produced by the body once the fertilised egg attaches itself to the uterine lining. While the exact linkage between hCG and nausea is unknown, it is true that they both peak around the same time. This is why experts assume that there is a clear connection between them.

The exact causes of morning sickness during pregnancy are still unknown (3). However, most experts agree that hormonal changes probably play a vital role. These include:

1. Estrogen Levels

This hormone can increase significantly during pregnancy when compared with levels found in women who are not pregnant. The changing hormone levels can trigger morning sickness (4).

2. Progesterone Levels

During pregnancy, the levels of progesterone also rise. Higher hormone levels relax the uterus (womb) muscles to prevent early childbirth. However, due to the relaxation of the stomach and intestines, excess stomach acids accumulate, causing gastroesophageal disease or acid reflux.

3. Human Chorionic Gonadotropin (hCG)

As discussed, the developing embryo produces this hormone soon after conception, and then it is produced by the placenta. There may be a potential connection between hCG and morning sickness.

4. Sense of Smell

When you are pregnant, you might experience an increase in sensitivity to strong odours, which might aggravate nausea further (5). A pregnant woman may also secrete increased saliva and have heightened sensitivity to certain smells, and feel changes in the taste of some foods.

Remember, not all vomiting may be due to pregnancy. Some other contributing factors might be:

• A sensitive stomach can worsen morning sickness.
• A urinary tract infection can also be a possible reason (6).
• Stress or fatigue causes a physical reaction within the body, leading to nausea and vomiting (7).

Some pregnant women might experience excessive nausea and vomiting in pregnancy. They may feel sick multiple times a day and be unable to keep food or drink down, significantly impacting their daily life.

Excessive vomiting is known as Hyperemesis Gravidarum (HG) and often needs advanced care. It’s not known what causes HG, or why some women are susceptible to it. Experts believe that it is linked to the changing hormones in the body that occur during pregnancy.

Signs & Symptoms of Morning Sickness in Pregnancy

Most women suffer from both nausea and vomiting during pregnancy. The symptoms and intensity can change according to overall fitness, eating habits, and genetic influence. The most common symptoms of morning sickness include:

• Feeling queasy and nauseated
• Loss of appetite
• Aversion to certain foods
• Dehydration
• Depression – When there is severe vomiting, you may find yourself unable to do daily work or take care of your home. It can affect your relationship with people around you and cause depression
• Feeling weak or light-headed

The queasiness might start after waking up in the morning or might be triggered by certain smells. The feeling of nausea and unease can happen at any time in the day and may continue for weeks or even months.

The intensity of symptoms differs from person to person. Nausea and vomiting during pregnancy improve for most pregnant women after the 12^th week. Unfortunately, for some, these symptoms can affect their entire pregnancy.

When Does Morning Sickness Normally Start and End During Pregnancy?

Nausea and morning sickness in the first trimester start within 4 to 8 weeks of gestation and reduce between 13 and 14 weeks. However, it can also start earlier and last longer. Every woman doesn’t experience nausea for the entire duration of the first trimester. It could carry on for only a couple of weeks or come and go throughout the first few months.

Treatment of Morning Sickness for Pregnant Women

Morning sickness can significantly impact a mother’s quality of life. The loving support of family and friends greatly helps during pregnancy in overcoming common health issues. Some dietary alterations and getting plenty of rest are usually all that is needed to treat morning sickness. Depending on the severity of your symptoms, doctors recommend seeking necessary medical treatment as a remedy for morning sickness.

There are medications that can be used in the initial stage of pregnancy to help improve the symptoms of morning sickness. These include medicines that include vitamins (B6 and B12) or their combinations to make you feel better. There are many supplements and drugs which are available as pills and are safe for the foetus.

There are several over-the-counter treatments available for morning sickness that may help alleviate your specific symptoms.

• Vitamin B6 is beneficial in alleviating mild to moderate nausea in pregnant women.
• Antihistamines, available readily in forms like doxylamine, are used to treat vomiting and nausea during pregnancy. Having a combination of Vitamin B6 (pyridoxine) and doxylamine may also be prescribed as an initial treatment for morning sickness (8).
• Zantac or Pepcid are reflux medications that may help alleviate nausea caused by stomach or intestinal issues.

Natural Remedies for Pregnancy Sickness

There are some natural home remedies for morning sickness that our mothers and grandmothers swear by for dusting off your question on how to deal with morning sickness during pregnancy.

If you experience mild nausea and vomiting, adopting simple measures might be enough as a remedy for morning sickness during pregnancy. These suggestions are not supported by hard evidence, but obstetricians commonly recommend them.

• Eat small meals and snacks slowly and frequently throughout the day to keep your stomach from becoming empty. Food rich in protein and carbohydrates might be helpful.
• Avoid lying down immediately after eating, as this can delay digestion.
• Snacking on fruits, nuts, and crackers may also help you feel better if you wake up feeling nauseated at midnight.
• Dry, savoury foods are known to be less likely to cause nausea during pregnancy than spicy foods (9).
• Take your time getting up in the morning – wait in bed for a while.
• Avoid eating oily foods and being exposed to smells that trigger your nausea.
• Eat dishes served cold or at room temperature, as steaming hot foods tend to have a more pungent aroma.
• Don’t eat fatty, deep-fried, acidic, or junk foods because they can slow down your digestive system.
• Drink fluids between meals, but avoid drinking too much at once so that your stomach doesn’t become too full. Sipping fluids regularly throughout the day is a great way to stay hydrated without feeling overly full.

• Carbonated beverages must be taken in moderation only. Some women also find sour juices like lemonade or sports drinks containing glucose, salt, and potassium helpful in replacing lost electrolytes.
• Be cautious of non-food triggers that cause nausea. These include a damp or stuffy room, the smell of heavy perfume, a bumpy or fast car ride, or even certain visual stimuli, like flashing lights.
• De-stress and sleep. Watch TV, chat with a friend – nausea can get worse if you’re tired or stressed.
• Ginger helps relieve nausea and is also an alternative remedy for alleviating an upset stomach and reducing queasiness (10).
• Sip peppermint tea or suck peppermint candies if possible, especially after meals, as it can relieve nausea.
• Aromatherapy is helpful for some women who find the scents of lemon, mint, or orange refreshing.

If these home remedies don’t help, consult your doctor for anti-nausea medications tailored to your specific condition.

Risks & Complications of Morning Sickness During Pregnancy

Generally, morning sickness is a common feature of pregnancy and has a very low risk. Unless it leads to dehydration or makes you feel too ill, it does not need medical attention.

According to the National Institutes of Health, HG affects only about 1 per cent of pregnant women and usually goes away during the second half of pregnancy, and typically does not cause serious complications in the mother or child.

When to Seek Help

If you find sickness and vomiting during pregnancy affecting you too much, you might need medical intervention. Please discuss your situation with the doctor if you experience any of these symptoms:

• If the symptoms get too severe to handle
• If you are unable to take your regular food and water intake
• If you are losing weight too quickly
• If your fluid consumption reduces drastically
• If vomiting is associated with fever, headaches or abdominal pain

Hospital care may be needed if your condition deteriorates or you become dehydrated and ill. As discussed earlier, severe morning sickness during pregnancy or hyperemesis gravidarum (HG) needs to be treated medically for a smooth pregnancy.

Various metabolic and neuromuscular factors are thought to contribute to HG; however, the exact cause is unknown. Consequently, treatment of HG can be difficult as the aim of its treatment or the full effects of potential treatments on the growing foetus is unknown.

Pregnant women should call their doctor if they notice any of the following signs:

• Severe nausea or vomiting
• Frequent urine
• The urine gets dark yellowish in colour
• Unable to drink any liquids
• Dizziness while standing
• Faint while standing up
• Feel an increase in their heartbeat
• Vomit blood

FAQs

There are some common doubts and fears in the minds of all expecting mothers who undergo morning sickness. Here we address these common questions to help you deal with the condition better.

1. Can morning sickness lead to miscarriage?

Women who have miscarriages are, in fact, less likely to have had nausea. If your baby or your placenta was not developing properly, it means you’d have lower levels of pregnancy hormones in your system. Hence, you’re not suffering from vomiting.

However, don’t be worried if you don’t experience morning sickness. A significant percentage of pregnant women in their first trimester with normal pregnancies have mild or no nausea. Consider yourself blessed and don’t worry if you’re not suffering!

2. Will morning sickness harm my baby?

Fortunately, vomiting doesn’t harm your baby in any way. Even if you’re unable to gain any weight in the first trimester, it’s generally not a concern as long as you’re able to complete your daily food intake. Take a prenatal vitamin supplement, after consulting with your doctor, to ensure that your nutrient needs are met.

However, please note that severe and prolonged vomiting has been linked to a greater risk of preterm birth, low birth weight, and newborns who are small for their gestational age. If you are experiencing severe symptoms that you’re struggling to deal with, it is best to consult your doctor.

3. When does morning sickness or nausea peak during pregnancy?

Morning sickness usually peaks around eight to 10 weeks of pregnancy. However, this time may vary with each pregnancy.

4. Does morning sickness stay throughout the pregnancy?

Nausea during pregnancy often starts to decrease or disappear by the 13th week (the conclusion of the first trimester). Nevertheless, some women may continue to experience symptoms into the early second trimester (weeks 14 to 27 of pregnancy). In uncommon instances, morning sickness may persist until the pregnancy is complete (1).

Morning sickness and other health worries of pregnancy might cause temporary unease. However, all mothers learn coping mechanisms to focus on the care to be taken for a successful pregnancy. Do not let the pains of constant nausea, vomiting, and resultant tiredness affect your normal life. A positive approach and hope of taking your baby after nine months of pregnancy should help you deal with the experience of morning sickness.

Also Read:

Fever while Pregnant
Diarrhoea in Pregnancy
Headaches during Pregnancy
Reasons of Typhoid during Pregnancy

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Sources References

1. Cleveland Clinic – Morning Sickness

2. PubMed Central – Nausea and Vomiting of Pregnancy-What’s New?

3. Mayo Clinic – Morning Sickness Symptoms & Causes

4. American Family Physician – Nausea and Vomiting of Pregnancy

5. PubMed Central – Pregnancy and olfaction: a review

6. NHS – Vomiting and morning sickness

7. PubMed Central – Associations between Nausea, Vomiting, Fatigue and Health-Related Quality of Life of Women in Early Pregnancy: The Generation R Study

8. Mayo Clinic – Morning Sickness – Diagnosis & Treatment

9. PubMed Central – Taste, smell and food-related nausea and vomiting responses in hyperemesis gravidarum: A case-controlled study

10. PubMed Central – A systematic review and meta-analysis of the effect and safety of ginger in the treatment of pregnancy-associated nausea and vomiting