Often the first sign of pregnancy, morning sickness can turn the most joyful news into an unpleasant experience. Don’t be surprised if you feel sick at any and every time of the day either. The hormones causing the sickness are a great sign but how do you handle them when some of those around you don’t even know you’re pregnant? Read on to find out what your options are.
Why you feel sick
As I’ve already said, morning sickness should more accurately be called pregnancy sickness because it can happen at any time of day. For some, it is the morning when they feel the worst, for others it might be the evening, and for some it can even last all day!
Some people just feel really really sick, while other will actually vomit. Neither is pleasant and both can really impede your ability to get on with your day. Unfortunately, sometimes if you tell your midwife about this she smiles! I’m not denying that midwives can be scary and unfeeling at times (mostly in labour when she tells you that you can have a baby but you think you can’t). However, let me explain why I am pleased when a woman tells me how sick she feels or how often she vomits during the day.
The physiology behind morning sickness
In the early days and weeks of pregnancy, the fertilised egg floats down into your uterus and finds a comfy spot to settle in. Once in that spot it wiggles itself in to the lining of the uterus. This lining is called the endometrium and is on average about 8mm thick. It is filled with gorgeous juicy tiny blood vessels.
The egg’s next job is to get itself linked in with you and your blood system. This means you can start feeding it all the oxygen and nutrients it needs to grow and develop into the baby. It does this by developing some of its cells into the placenta, the baby’s life support system. The placenta provides a link between your blood vessels and the baby’s circulation. To do this, the cells of the placenta have to alter the cells and blood vessels in your endometrium. This creates a large surface area for oxygen and nutrients to cross from you to the baby. Waste products like carbon dioxide can cross from the baby to you, so that you can get rid of them for the baby. This is the beginning of the rest of your life where you are tidying up after your child!
Where the hormones come in
The way the cells of the placenta alter your endometrium to make this essential interchange between you and your baby is by releasing hormones. Hormones like prostaglandins help to change the structure and purpose of cells so that they can do new things. As the placenta changes more of these cells and grows larger, it produces more hormones which again change more cells and increase growth. The speed of this growth phase of pregnancy is incredible! The placenta can be larger than the baby at this stage.
The presence of hormones is therefore an important sign that the pregnancy is healthy. The placenta is growing strong to support the developing baby. For many women, these hormones also make them feel sick or vomit. That is why your midwife might pleased to hear that you have morning sickness.
Levels or degrees of sickness
Every woman will experience sickness in a different way and even different pregnancies can create different levels of nausea in the same woman.
Feeling sick without being sick is one way that women can be affected. I’m definitely not saying this is the least or easiest way to experience pregnancy sickness though. Feeling sick without being able to be sick can mean the feeling stays all day, reducing your ability to eat and drink.
Feeling sick at certain points during the day and then vomiting is another way that those pesky hormones make your life horrid. Now, I am certain that none of us enjoy throwing up. Often though, you start to feel a little better once you have vomited and can get on with your day a little easier. You can sometimes manage to eat a little snack or meal and drink enough to stay hydrated.
For some women, sickness and vomiting is an all day experience. No matter what time of day it is, you feel dreadful and the slightest thing can have you retching. I’ve even known women who have to walk around with a bowl in their hand as the need to vomit can hit them at any time. If you can’t keep any food or drink down, you may have the most extreme form of pregnancy sickness, called hyperemesis gravidarum. For those of you in the UK, it’s what the Duchess of Cambridge suffered with at the beginning of her pregnancies. If this is what you are experiencing, please contact your midwife or hospital care provider, as you may need extra help that you can’t get at home.
For the rest of you, read on to find out what strategies and solutions might be available to you.
Managing morning sickness
Being pleased that your pregnancy is growing well does not mean I think that you should feel horrid for weeks! There are plenty of options for managing pregnancy sickness no matter how intense or debilitating it becomes.
The most important thing you must do is try to drink. Water may be best if the smell of tea or coffee makes you gag. Don’t drink a whole glass of water at once. Instead, drink little sips as often as you can. If you can’t manage sips of water, buy some ice pops. These are long sticks of frozen coloured water with some flavourings. If you can lick them they will help you keep hydrated. It might seem strange licking ice pops in winter, but sometimes that’s what you have to do!
If you can eat, stick to small carbohydrate based meals like pasta or potatoes. High fat food will make you feel worse. Plain toast or crackers are helpful. Having said that, don’t worry too much about your choice of diet at this point. Whatever calories you can get into you are good calories in my opinion!
If your sickness occurs in the morning, have a small snack before you venture out of bed to settle your nausea a little.
Some research studies find that eating ginger in various forms can help, so experiment with what makes you feel better. There are tablets, tea and biscuits forms of ginger available so you should find something that works for you.
Some people find that drinking fizzy or slightly flat previously fizzy drinks help when they are feeling sick. It may help to release gases and make you burp, making you feel less sick. If this doesn’t help you, don’t worry. Just try something different.
More recently, acupressure and acupuncture have been found to reduce nausea. Why not check for local trained practitioners near you? Some people find that wristbands sold as sea or travel sickness bands can be effective too.
Firstly, let me say that you should only take medication under the guidance of a doctor. My recommendations below are only here as suggestions. You must check with your own doctor to make sure you get the right medication for you.
You should start with tablet forms of anti-sickness medications. There are lots of different options, and I’m not going to list them here. I don’t know all the brand names for every country and don’t want to give incorrect information. If you need tablets, speak to your doctor.
Thankfully, there are lots of anti-sickness tablets that you can use. You can be on one, swap to another or have a combination of several of them. Always return to your doctor if they aren’t helping and try another option or additional type. We have now got many years of experience of using these tablets in pregnancy so we will only give you ones that are safe for you and baby.
If you are unable to take tablets or you vomit them up as soon as you take them, try taking them at a different time of day. Some women find they can’t eat anything first thing in the morning, but the afternoon is better. Take your anti-sickness tablets in the afternoon with whatever you manage to eat.
If there is nothing you can eat or drink and no time of day that you can take tablets and not throw up straight away, you need more help. Contact your doctor or hospital immediately. They will need to give you anti-sickness medication via a drip into your arm to settle things down enough so that you can start taking tablets. They will also probably have to give you some fluids this way too as you will probably be very dehydrated.
Where to go from here
Please remember that for most women, pregnancy sickness will ease off by about 10-12 weeks. You may need to confide in your boss and friends about your pregnancy before this. They will then be able to help you with time off work or childcare of older children.
Have a look at the resources page for some other helpful websites. One I really like is Pregnancy Sickness Support. This has great articles and even an online forum for those struggling with this issue. You can also look at the UK’s national guidance for health professionals treating pregnancy sickness here . Alternatively, you can view a patient information leaflet from the Royal College of Obstetricians and Gynaecologists here.