Morning or all-day sickness?


For anyone with nausea and vomiting in pregnancy, you might appropriately assume that the person who coined the term ‘morning sickness’ had never been pregnant! ‘All day, anytime, anywhere sickness’ would have been a better choice of phrase!

My first pregnancy, after a trying time with infertility and reproductive assistance, saw me on regular intravenous fluids from early pregnancy until 16 weeks. I lost four kilograms in the first few weeks, and I can still tell you where every public rubbish bin was located on my drive to and from work. I felt exhausted, frustrated and mostly just miserably sick. Getting out of bed was a struggle and work a challenge.

In my second on-going pregnancy my nausea and vomiting was much less intense but persisted until the moment my daughter was born.

Some degree of nausea, with or without vomiting, is experienced by up to 90 percent of pregnant women. Thankfully for most women this does not continue much beyond 16 weeks and is manageable without admission to hospital.

There are many very safe and appropriate options for managing pregnancy nausea and/or vomiting. These include avoiding trigger foods, changing to smaller and more frequent meals, consuming products containing ginger, ginger extract or vitamin B6 (pyridoxine) supplements, as well as using acupuncture, acupressure or hypnosis.

If these are not successful prescription medication such as metoclopramide (Maxolon), doxylamine (Restavit), promethazine (Phenergan) and ondansetron (Zofran) are commonly used. These later option should be discussed with your doctor before use, but are nonetheless commonly and safely used during pregnancy.

Hyperemesis gravidarum is the medical term for women who experience severe nausea and vomiting. Usually this presents as regular daily vomiting (>3 times/day), weight loss, along with physical and laboratory signs of dehydration.

Hospitalisation is commonly required in order to receive intravenous fluids, and this can sometimes last for an entire pregnancy. Unfortunately there is a high chance of this recurring in later pregnancies – and is sometimes a reason some of us choose to not have more babies!

Whether you have nausea, nausea and vomiting, or hyperemesis itself, thankfully none of these are typically associated with any concerns for the baby.

So why do some get unlucky with nausea and vomiting while others sail through pregnancy?

The short answer is that we don't know. There are many risk factors for nausea and vomiting in pregnancy including twins, female babies, having a mother who had hyperemesis, having underlying gastric reflux, hormonal-related migraines, a history of motion sickness, and having had hyperemesis before.

Unfortunately this still doesn't truly allow us to predict who will experience nausea and vomiting during pregnancy, how bad it will be, or how long it may last.

If you have issues with nausea and vomiting in pregnancy make sure you talk to your obstetrician, GP or midwife. Not all nausea and vomiting needs to be treated, but there can be situations where you may benefit from additional nutritional support, medication, psychological support or hospitalisation.