Coping with nausea and vomiting in pregnancy

UNABLE to eat because of nausea, and nauseous because you can’t eat? This is quite typical of pregnancy, especially in the early weeks.

Nausea and vomiting is seen in up to 90% of pregnancies, particularly during the first trimester. It has a significant physical, mental and social impact, and, contrary to popular belief, it is not limited to morning times, but can affect sufferers throughout the day and night.

It’s stressful because you’re often trying to keep your pregnancy private at this time, so you’re attempting to keep the show on the road and act as normal as possible through the symptoms.

Furthermore, the foods you are able to eat or keep down aren’t necessarily the healthiest ones, so there can be stress around making sure you’re getting all the important nutrients for baby too.

Nausea and vomiting typically begins some time around six weeks of pregnancy, peaks at nine weeks, and eases around the 20th week. These time-frames vary greatly between women, as does the severity of symptoms. It may be that you experience it throughout pregnancy, or that you don’t have any of these symptoms at all.

When the vomiting becomes very severe, a woman may be experiencing Hyperemesis Gravidarium. This is very serious without adequate treatment, as it can lead to dehydration and malnutrition. It comes with severe vomiting, light-headedness, dizziness, and not urinating frequently.

For the milder experiences of nausea and vomiting, there is some evidence for specific remedies and tips. Here are some things worth trying.

Ginger – a systematic review of the literature has shown that ginger improves nausea symptoms without risk of drowsiness, heartburn or miscarriage. It can be incorporated into the diet through fresh ginger root in warm water, capsules, fizzy beer, biscuits, sweets or smoothies.

Fluid alternatives – If struggling to tolerate the smell or taste of tap water, you can increase your fluids by instead having ice chips, coconut water, flavoured water, flat 7Up, tonic water, fizzy drinks, making the tap water ice cold, and by sipping slowly rather than gulping back. Getting 100-200ml of fluid every hour is advised.

Vitamin B6 – this vitamin has been shown to improve symptoms of nausea and vomiting. It is available from bread, whole grain cereals, brown rice, banana, avocado, watermelon and grapes. It’s also present in pregnancy multi-vitamins, so check that you’re getting enough of it in yours.

Lemon – the citrus smell of a lemon has been shown to help curb queasiness from smells that tend to trigger nausea. Having lemon in a diffuser at home can help, or having fresh lemon wedges to hand is also useful.

Acupressure – this uses gentle pressure on particular points of the body to elicit different effects. In the case of nausea and vomiting, there is a pressure point on the inside of each wrist called P6 that, when pressed, can give good relief. There are wrist bands available to provide this consistent pressure, or alternatively you can press the area yourself with your thumb or forefinger.

Eating habits – eat little, often and slowly. Don’t worry about a huge range of foods, stick with those that appeal to you, and avoid eating in places that are too warm or stuffy.

Avoid sudden movements in the morning, take your time getting ready! If you do vomit, give the tummy time to settle, then start with small sips of water and gradually build up to soft, dry foods.

In severe cases of nausea and vomiting, medication is available. There are a few different types, depending on your GP’s recommendation. The reimbursement of Cariban is an ongoing issue in this country currently, as it is not covered on the usual government schemes for women. There are several pharmacies that have pledged to provide it at cost price to those prescribed it, due to its inordinate expense and the financial pressure that it places on women during an already stressful time in their pregnancy. Women often limit their use of it, or forgo it completely due to its cost. The campaign to get this covered on the likes of the Drug Payment Scheme is ongoing.

If nausea and vomiting is something you’re suffering from, know that for the most part it does pass off, and if it doesn’t there is help available. Seek support for it, and give yourself a break in terms of what you’re ingesting. Go with what works, all will be well.

ABOUT THE AUTHOR

Dr Michelle O'Driscoll is a pharmacist, researcher and founder of InTuition, a health and wellness education company. Her research lies in the area of mental health education, and through InTuition she delivers health promotion workshops to corporate and academic organisations nationally. See intuition.ie