The American Congress of Obstetricians and Gynaecologists (ACOG) recently updated its morning sickness advice, and identified the key treatments – from what to eat, to the latest medicines to take – that are genuinely effective in relieving morning sickness.
‘When my patients come to me with morning sickness, the first thing I tell them is that there are ways to help alleviate the nausea,’ says obstetrician-gynaecologist Dr Laura Sirott.
‘The first step is to try key natural treatments. But if these aren’t effective, there’s a next step of effective medicines. You don’t have to put up with it!’
What’s the cause of morning sickness?
It’s also useful to understand what’s causing the nausea in the first place.
‘The most popular theory is that morning sickness is your body’s reaction to the pregnancy hormone hCG,’ explains Laura. You’ve probably heard of this hormone, it’s the one that made those two little blue lines magically appear in your pregnancy test. It’s first produced when you become pregnant, and then makes you produce more progesterone, a chemical that keeps your placenta working properly and the lining of your uterus healthy.
It also keeps your uterus relaxed, allowing your baby to grow bigger – and bigger, and bigger.
But it doesn’t stop there. Scientists think that as well as relaxing your uterus, it relaxes your digestive system. This slows down how quickly you digest food, and can give you acid reflux, where digestive juices leak upwards into your oesophagus, which is enough to make anyone feel ill.
Studies also suggest that morning sickness may have evolved over thousands of years to protect mums-to-be from food poisoning, until their developing baby is strong enough to survive it. It doesn’t harm your child’s health, unless you can’t keep food or drink down for a long time.
‘There’s even an upside,’ says Laura. ‘Morning sickness is associated with a reduced risk of miscarriage and better developmental outcomes for the baby.’
How to help get rid of morning sickness
But what can you do when your morning sickness is so severe that you can’t put up with it any more?
A lot of the research suggests that timing is important.
‘Eat little and often, advises Laura. ‘You don’t want to empty your stomach, or to overload it, as either of these can aggravate your morning sickness.’ And be aware of your fluid intake. It’s essential to stay well-hydrated, but eating and drinking at the same time can increase nausea by making your stomach feel fuller. Instead, wait for 20 minutes after eating before having a drink.
Keeping a diary can be helpful if you want to work out exactly when to eat. A 2010 review found that around 85 per cent of women suffering from morning sickness have at least two episodes a day. If you keep a diary of your symptoms you are likely to see a pattern emerge, including times when you feel better, so aim to eat then.
You are what you eat
Of course, what you eat is also important. Snacking on nuts and other high-protein snacks can relieve symptoms, and always avoid foods with a strong smell or that are spicy or fatty. ‘Work out what are your “trigger foods” that make you feel nauseous, and avoid them,’ says Laura.
If you feel like you can’t stomach any food at all, then many mums find the ‘BRAT’ diet of bananas, rice, apple sauce and toast works when all else fails. It’s low in fat, easy to digest and replaces any nutrients you might have lost through being sick. Talk to your doctor before making any big changes to your diet, however.
‘Consuming ginger can also really help,’ says Laura. ‘In one study, 70 per cent of pregnant women suffering from severe nausea found powdered ginger root effective. Try sipping ginger ale – as long as it’s not overly carbonated or too cold – and ginger tea, or eating ginger snaps.’
Stock up on your vitamins
The ACOG review also found that taking prenatal vitamins for three months before you become pregnant can help to protect you from morning sickness.
But if you try all of these things, and your nausea is still persistent and disruptive, Laura suggests you talk to your doctor about an antihistamine that is safe to take in pregnancy, for which you would need a prescription.
‘If that doesn’t work, the next step is an anti-emetic drug that prevents vomiting,’ she says. ‘But I’d hope that by intervening early, we could stop the morning sickness before it progresses to that stage, so you can get on with enjoying your pregnancy.’
The most severe form of nausea and vomiting, hyperemesis gravidarum (HG) affects up to three per cent of pregnancies. The Duchess of Cambridge was a high-profile sufferer during both her pregnancies. HG can be diagnosed when a woman looses five per cent of her pre-pregnancy weight and is dehydrated. This needs hospital treatment to rehydrate and stop the vomiting.