Managing Morning Sickness

There is no “cure” for morning sickness, but there are things you can do to make it suck a little less. (Probably.)

By week 9, some of you will be feeling pretty queasy, and a lucky few of you will feel terribly sick. Like, puking-your-guts-out sick.

One thing that can be super difficult is when you haven’t really told anyone like, say, your boss or co-workers. In person, it doesn’t take a rocket scientist to figure out why you are running to and from the bathroom all the time. If you are working from home, you may be able to finagle things more stealthily, but the situation is not necessarily any less awkward on Zoom. This is tough, because it can take away your ability to tell people on your own timeline. Ack!

While nausea is oh-so-common, especially in the first trimester, if you are vomiting profusely without end, there is something you should know about…

Hyper What?

When I was pregnant with Lucie, I had very severe morning sickness that lasted until 16 weeks. The medical term for this is hyperemesis gravidarum, or HG.

HG is defined as severe morning sickness (or to be more correct, “nausea and vomiting associated with pregnancy” [NVP]) that prevents adequate intake of food and fluids. I’ve also heard it defined as “regularly throwing up 4 or more times per day.”

HG affects about 1-2% of pregnant women (lucky us!!!). Now everyone knows about it because of Princess Kate (thanks PK!).

One of the reasons HG is difficult to discuss with people – especially other women – is that they truly can’t understand how miserable it is because they (98% of you) haven’t experienced it.

I can’t tell you how many times well-meaning friends told me I’d feel better if I just “take a walk” or “eat some saltines” or “chew on some ginger” or “take Vitamin B”… you get the picture. Heh. Take this ginger and shove it up yer….

HG is not your garden variety morning sickness. This is morning sickness from hell. 👿

Feeling constantly nauseated is probably the worst feeling in the world. I’d prefer chronic physical pain to chronic nausea. Any day. There are several factors that contribute to the sheer misery of this condition:

1. You probably didn’t see it coming (or like me, didn’t even know this level of woe was possible).

2. Nobody else really understands how shitty it is.

3. You have no idea how to treat it.

4. Your OB may not be very empathetic.

5. You really can’t function in your daily life, and

6. You have no idea when or IF it will end.

Some Facts about Severe Morning Sickness (HG)

HG starts early and usually lasts past the first trimester, generally resolving around 21 weeks; however, for about a fifth of those who suffer from it, it can last the entire pregnancy (!!!). Nobody knows for sure what causes it, although the chart o’misery tends to correlate heavily with the hormone hCG.

Women with HG are often unable to care for themselves or their families for weeks, sometimes months. Some women may be unable to eat for lengthy periods and lose 5-10% (or more) of their pre-pregnancy body weight in the first few months. This in turn leads to debilitating fatigue and depression.

About 3% of women with HG will choose elective termination (a.k.a abortion) to avoid the misery and stress they face and many will not go on to have another baby. Nobody talks about that part.

Even if you don’t have HG per se, feeling nauseated sucks bad. Here are some things that helped me.

• Huge news that you won’t find any (official) info on… I heard about this on a medical podcast (with guest Dr. Jaime Seeman) and wanted to share: it is now thought that nausea in pregnancy is highly correlated with blood sugar excursions. What does that mean? Basically, when your blood sugar spikes and falls rapidly due to consuming a highly glycemic diet, this could be what is fueling nausea. The difficulty here is that you are probably craving highly glycemic foods (simple carbs), which may be working against you.
  
  For me – anecdotally, this holds true. In my first pregnancy, I was eating a terrible diet (highly processed food – cereal and whatnot) and was terribly sick. It was a cycle I couldn’t break (nor did I know about any of this research…). During my 2nd pregnancy, I ate much healthier (more fat and protein, fewer processed carbs) and was waaaaay less nauseous. Try it! And please comment below if it “works” – thanks!! This is important.

DON’T:

• Don’t let your tummy get empty. Always have something to snack on.
• Don’t ever go to the grocery store or anywhere that sells food. Only go to restaurants if you’re having a “good” day.
• Don’t allow foods that make you nauseous to be cooked in your house.
• Don’t over-hydrate (yes, one of the few times you’ll ever hear this). Yes, stay hydrated, but do not drink too much water. The nights that I was sickest were when I drank too much water.
• Don’t go into stores or places that are enclosed, like big-box stores and malls. Make sure you have access to windows and fresh air.
• Don’t take your prenatal vitamins if they make you sick. Women have had babies for tens of thousands of years without them (plus, the neural tube has already closed around 20 days post-conception, so there is little you can do about that now).
• Don’t force yourself to eat anything you’re not craving. Follow your gut (literally).
• Don’t watch TV if you’re feeling bad. The motion of the pictures often made me vomit. The same holds true for reading.
• Don’t brush your teeth right after vomiting since that’s when the teeth are the most vulnerable to degradation (I know, it’s gross, but a rinse with water is still okay). The acid from vomit may damage teeth directly, especially the top front teeth. It may seem counterintuitive, but you should wait a bit if you can.

DO:

• Do take Unisom (doxylamine) and Vitamin B; sleep is your friend.
• Do eat what you are craving – within reason. You’ll have plenty of time to eat healthy later.
• Seriously — don’t be a tough guy; talk to your OB about medication options. Common oral and IV therapies include Zofran (ondansetron), Reglan (metoclopramide), Diclegis (doxylamine/pyridoxine) and Phenergan (promethazine). Some women will have a PICC line installed for easy IV access.
• Do remember that you aren’t dying and you WILL get better.
• Do listen to relaxing music when all else fails. Podcasts were a friend of mine that summer because TV made me sick.
• Do keep lemons (freshly cut, preferably) in a bowl by the toilet to sniff or lick (yes, seriously) when you’re vomiting, especially if you need to ‘stop the cycle.’ Lemons were my best friend.
• Join an online support group so you know you’re not alone. There’s a group at BabyCenter.com and one at HelpHER.org.

Every case of morning sickness is different; this is just what helped me.

Good luck and keep your eyes on the prize, mom-ee. The reward is great!

P.S. If it’s any consolation, these babies are supposed to be hella smart and healthy.