Morning sickness is a normal symptom of pregnancy — but it’s also one that can be highly unpleasant. Kathryn M. L. Konrad, a registered obstetric nurse, assistant professor of nursing, and Lamaze Certified Childbirth Educator, has years of experience working with pregnant patients dealing with this common symptom. She sat down with HealthCentral to answer frequently asked questions about morning sickness in pregnancy.
HealthCentral (HC): What is morning sickness?
Kathryn Konrad (KK): Morning sickness is the name that laypeople call nausea and vomiting that is related to the hormones of pregnancy. Typically, you will see morning sickness confined to the first trimester; however, sometimes you can also experience it throughout pregnancy. Some mothers also see it disappear in the second trimester and return at the very end of pregnancy.
HC: What causes morning sickness?
KK: Morning sickness is a response to the human chorionic gonadotropin (hCG) in pregnancy. hCG is known as the pregnancy hormone, and it is what turns a pregnancy test positive. As this and other hormones fluctuate in pregnancy, sometimes nausea and vomiting can occur. The spikes in hormones are not always the same for every woman; this is why one person’s morning sickness may differ from that of their friends or other pregnant people they know. And while it’s no fun to feel nauseated or to vomit, most of the time it is an indicator of a healthy pregnancy.
HC: Are certain people more likely to get morning sickness?
KK: Pregnant women who have higher hormones levels can sometimes see more bouts of morning sickness. This can translate to longer periods of time when you feel ill, more vomiting, or even just a longer duration of the symptom overall. One reason that a woman might have higher hormone levels is if they have a multiple pregnancy. As you can imagine, carrying twins, triplets, or more results in higher hormone levels. This can lead to an increased feeling of nausea, with or without vomiting. There are also some complications of pregnancy that can result in higher hormone levels, like a molar pregnancy.
HC: Does morning sickness only occur in the morning?
KK: Absolutely not! While many women do experience these symptoms in the morning, it is not unusual to experience it at any point in the day or night.
HC: What are some ways to cope with morning sickness?
KK: Coping with morning sickness involves a lot of different techniques. The most crucial thing is to watch when you’re having symptoms and monitor what helps them and what exacerbates them. For example, sometimes going too long between meals or snacks can lead to a feeling of nausea. The cure for this is to eat small, frequent snacks throughout the day and sometimes even the night. Keeping some peanut butter crackers or something by your bed can be helpful to keep your stomach from being empty.
Other mothers find comfort in sipping cold water, flat ginger ale, or other beverages. There are also a variety of bands you can wear on your wrists that stimulate pressure points to combat nausea. For some, chewing gum can help.
In addition to taking or doing things, there is also the art of avoidance. What do you need to avoid to prevent nausea? For some women, this is a long list. For others, it is something very specific. If certain smells turn your stomach, avoid them whenever possible. Though be forewarned: Sometimes this is your favorite thing, like coffee.
HC: Are there medications you can take for nausea and vomiting?
KK: There are certain things people talk about that you can get over the counter, but it really is important to talk to your doctor first. If you are so sick that you’re considering medications, even vitamins in addition to your prenatal vitamin, then you need to have your doctor’s opinion and blessing. If something is really bad and you or your baby are at risk, there are prescription medications like Zofran [ondansetron] and others that may be prescribed. These are generally only for debilitating cases or people who are suffering from hyperemesis gravidarum.
HC: What is hyperemesis gravidarum? How does that differ from morning sickness?
KK: If you think of morning sickness as nausea with occasional vomiting, hyperemesis is more about the vomiting. The problem with hyperemesis, beyond the fact that you throw up a lot, is that it starts to quickly interrupt your fluids and you can become dehydrated and malnourished. Many women aren’t able to keep anything down and often lose a lot of weight.
HC: How is hyperemesis gravidarum treated?
KK: Depending on the severity, you can treat it with IV fluids, IV medications, and sometimes rectal medication. Some mothers need to be hospitalized because of the severity of the illness. This also may not go away at the end of the first trimester. If you think you have hyperemesis, be sure to call your doctor right away.
Interview has been condensed and edited.
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Robin Elise Weiss, Ph.D., LCCE, CLC, AdvCD(DONA) is a childbirth educator, doula, founder of Childbirth.org, and the award-winning pregnancy and parenting author of “The Complete Illustrated Guide to Pregnancy” and more than 10 other books. Between her nine children, teaching childbirth classes, and attending births for more than two decades, she has built up an impressive and practical knowledge base. You can follow Robin on Twitter @RobinPregnancy, Instagram, and Facebook.