What Is Morning Sickness?

Morning sickness refers to nausea occurring primarily and most intensely in the mornings. This nausea happens immediately after waking up when a woman gets up and takes her first steps of the day. Nausea can occur at any time of the day or night, and at least 80% of women report that their "morning sickness" regularly bothers them throughout the day.

Is Morning Sickness Common?

Morning sickness in pregnancy is a widespread phenomenon. Some degree of morning sickness accompanies 70-90% of all pregnancies. In 60% of cases, morning sickness is so severe that it is episodically accompanied by vomiting.

How Soon Does Morning Sickness Begin?

The first symptoms most commonly occur 4-6 weeks after conception and worsen significantly by the 9th week. Symptoms usually considerably decrease by the 16th to 18th week of gestation.

10% of pregnant women experience morning sickness after the 20th week. 80-85% of morning sickness completely stops before the third trimester, but 5% of pregnant women continue to experience morning sickness until delivery.

Does the Sex of the Baby Matter Affect Morning Sickness?

Scientific evidence on the severity and frequency of morning sickness in pregnant women depending on the sex of the baby is very inconsistent. Still, most studies indicate that pregnancy with a girl is more likely to be accompanied by morning sickness.

Does the Number of Pregnancies Matter?

Repeat pregnancies do not show any significant correlation between the severity of morning sickness and previous pregnancies. In other words, if the first pregnancy is light and there is no nausea, this does not guarantee that the second will be the same. There is a real possibility of experiencing nausea throughout the pregnancy – the reverse situation is equally likely.

What Causes Morning Sickness?

Researchers do not have an exact answer to why morning sickness occurs in pregnant women. Many theories, refutations, assumptions, and doubts exist, but no clear answer exists.

Most commonly, nausea and vomiting are associated with specific hormonal changes in the pregnant woman's body, and the effects of three hormones – estrogen, progesterone, and chorionic gonadotropin – are discussed.

The theory attributing morning sickness to a unique, protective role deserves some attention: the female body is over-sensitive to poor-quality food at that stage of fetal development (4-16 weeks) when it (the fetus) is especially at risk from poisons and toxins coming from the outside.  

When Is It Essential To See A Doctor?

Morning sickness can have different degrees of severity. Still, there may be situations when nausea and vomiting bother the pregnant woman almost constantly – in the morning, during the day, and at night, when normal eating and even drinking become a huge problem. This condition – which is no longer a variant of normal pregnancy but a real diagnosis – is called excessive vomiting of pregnancy (Hyperemesis gravidarum) or hyperemesis.

Hyperemesis gravidarum occurs at a rate of 0.3-2% of all pregnancies. It is characterized by repeated vomiting, loss of more than 5% of body weight, signs of dehydration, vitamin and mineral deficiencies, and significant deterioration in quality of life, all combined with anxiety and depression.

Modern medicine has many ways to help with hyperemesis. The main thing to understand is that the inability to eat normally and especially to get enough fluid is a definite indication to seek immediate medical help.  

It should be noted that nausea and vomiting in pregnant women are not necessarily related to pregnancy. A pregnant woman, as well as any person of any sex, may have nausea and vomiting due to intestinal infection and food poisoning, side effects of medications, overheating, liver disease, kidney disease, thyroid disease, and many other conditions that require special medical control during pregnancy.

Therefore, an important rule: any doubt that nausea and vomiting are due to pregnancy, any condition where, in addition to nausea, there are other alarming symptoms (diarrhea, abdominal pain, increased body temperature, shortness of breath, rash, etc.), any situation where nausea co-occurs in several family members – all these are reasons for urgent medical consultation.

It is extremely rare to find situations when morning sickness is first noted after the 10th week of pregnancy. If there is nausea, it almost always starts from the 4-6th week. Therefore, a strong recommendation: the first episode of nausea in the term of more than ten weeks of pregnancy is a reason to consult a doctor.  

How Does Morning Sickness Affect the Fetus?

In most cases, no adverse effect is observed. The exception is hyperemesis gravidarum when the inability of the pregnant woman to eat normally and to get enough fluids inevitably affects the health of the fetus.  

Natural Remedies for Morning Sickness

We must acknowledge that no magic pill will cure morning sickness. At the same time, several time-tested, simple, accessible, and safe recommendations can significantly alleviate the condition and reduce the duration and severity of episodes of nausea. 

Here are 28 tips for relieving symptoms of morning sickness:

1. There is a strong correlation between the amount of food eaten at one time and the probability of nausea. Avoid the traditional three-meals-a-day diet and eat more often, in smaller portions – optimally 5-6 times daily.
2. .Never skip breakfast.
3. If more than 4 hours have passed after a meal and there is no appetite, having at least a small snack is advisable because an empty stomach can provoke nausea—possible variants of this "snack" – toast, crackers, apple, banana, and nonfat yogurt.
4. When leaving home, think about the possibility of a snack. If necessary, take food with you.
5. If possible, eat slowly and chew your food well.  
6. Morning sickness can be incredibly intense immediately after waking up - as soon as you get up or even sit up in bed. In such a situation, eating something while still in a horizontal position is strongly recommended – usually, a few saltine crackers are recommended. Such a «first breakfast» should be prepared in advance, and a box of crackers should be placed on the bedside table before bed.
7. Analyze your sensations and try to find a connection between nausea and specific foods, drinks, and smells. If a link is found, avoid anything that prevents you from enjoying life.
8. Prioritize protein-rich foods and a wide variety of berries, vegetables, and fruits.
9. Limit fatty and spicy foods.
10. Cold foods are better than hot.
11. Soft foods are better than hard.
12. Liquid is better than dry.
13. Anything "very" is not for you: very sweet, very salty, very spicy, very sour, very strong-smelling, etc…
14. Take the opportunity, when possible, to get some fresh air instead of cooking in the kitchen.
15. Air quality is essential for the prevention of morning sickness. Ventilate rooms, turn on fans, and ensure the air is ventilated, especially in the kitchen and bedroom.
16. Avoid tobacco smoke.
17. Avoid clothes that prevent you from breathing freely.
18. If you want to rest after a meal, you should rest, but avoid a horizontal position – use pillows and elevate your shoulders and head.
19. Try to rest regularly: both physical and emotional fatigue increases nausea.
20. Fluid deficiency in the body and the associated dry mouth are the most critical factors contributing to nausea. Preventing dehydration is your main task!  
21. Drink frequently (every 15-20 minutes), in batches, and control your sensations: if after two sips, nausea does not appear (does not increase) – try three sips. 
22. The optimal daily amount of fluid is at least 1200-1500 ml.
23. Avoid drinking with meals (overfilling the stomach will increase the risk of vomiting).
24. Recommended liquids are varied: electrolyte solutions, lemonade, carbonated and non-carbonated mineral water, fruit juices (possibly diluted with water), smoothies, and milkshakes.
25. Be careful not to overuse drinks with caffeine (tea, coffee, cocoa), as caffeine has a diuretic effect and can increase dehydration, and remember that some juices – mainly orange juice – contain a lot of acids and can irritate the stomach.  
26. Ginger is a reliable and effective treatment for nausea in pregnant women. Ginger tea, ginger cookies, ginger gum candies, ginger pieces with sugar, ginger soft beer, ginger lollipops, ginger gum, and simply grated ginger root poured with hot water.
27. Proven remedies – peppermint and honey, and combinations of ginger, peppermint, and honey in various drinks, candies, etc…
28. Frozen foods and drinks are available and safe options to help with pregnancy nausea. It makes sense to try fruit juices in the form of frozen cubes and nonfat flavored milk, yogurts, fruit slices, and watermelon.

Vitamin Considerations and Morning Sickness

Here, we will discuss a separate group of recommendations regarding the intake of vitamin and mineral complexes by pregnant women since there are often complaints that immediately after taking vitamins, nausea increases.

• Try changing the time of day when you take your vitamins.
• Take vitamins with meals.
• If the vitamin contains iron supplements, it is optimal to take it before bedtime.

Discuss with your doctor: 

1. The possibility of using vitamin complexes in the form of chewable tablets.
2. Avoiding (if possible) iron preparations (nausea is a frequent side effect of these remedies).
3. Additional amounts of vitamin B6 (pyridoxine) have proven that vitamin deficiency increases nausea. 

Consult your doctor about unconventional methods of help with nausea in pregnant women. Here, it is very important, and it is important to emphasize, not to try anything on your own and make a decision only after discussion with a doctor who can advise an adequate specialist and the most diverse options are possible - meditation and relaxation techniques, breathing exercises, hypnosis, aromatherapy, acupuncture, acupressure, acupressure massage and even unique bracelets against nausea.     

One last thing. Remember that various prescription remedies in the doctor's arsenal can alleviate morning sickness. If all the methods we have suggested have not made your pregnancy calm and joyful, if there is no improvement or your condition worsens, if you are nervous, do not gain weight, do not get enough sleep, or cannot eat properly – please consult your doctor!      

References:

1. https://www.mayoclinic.org/diseases-conditions/morning-sickness/diagnosis-treatment/drc-20375260
2. https://www.pregnancybirthbaby.org.au/dealing-with-morning-sickness
3. https://www.ajog.org/article/S0002-9378(07)00733-8/fulltext
4. https://www.msdmanuals.com/professional/gynecology-and-obstetrics/abnormalities-of-pregnancy/hyperemesis-gravidarum
5. https://www.msdmanuals.com/professional/gynecology-and-obstetrics/symptoms-during-pregnancy/nausea-and-vomiting-during-early-pregnancy
6. https://my.clevelandclinic.org/health/diseases/16566-morning-sickness-nausea-and-vomiting-of-pregnancy
7. https://www.acog.org/womens-health/faqs/morning-sickness-nausea-and-vomiting-of-pregnancy