Morning sickness: what actually helps

Nausea is one of the most common complaints in early pregnancy, and most mums-to-be experience it to some degree. For some it is a mild queasiness on waking; for others it means difficult weeks when working, cooking or even brushing your teeth feels like a challenge. Here is what we know about why it happens, how long it usually lasts, what genuinely helps and when to get medical support.

Why it happens and when it ends

The exact cause is not fully understood, but pregnancy hormones play the main role — above all human chorionic gonadotrophin (hCG), which rises quickly in the first weeks. Oestrogen, a heightened sense of smell, a slower-emptying stomach, tiredness and stress all add to it.

Nausea usually starts around weeks 5–6, peaks at about weeks 8–10 and eases noticeably for most women by weeks 14–16. For some it lasts longer, and occasionally it continues throughout pregnancy. The name ‘morning sickness’ is misleading: it can come at any time of day, and evenings are often worse.

The important thing to know is that ordinary nausea, however unpleasant, does not harm your baby. At this stage your baby is tiny and draws what it needs from your reserves. Having no nausea at all is also completely normal and is not a sign that something is wrong.

Eating: little, often and without forcing yourself

An empty stomach makes nausea worse — and so does a very full one. Small, frequent meals work best:

• Eat small portions every 2–3 hours rather than waiting until you are very hungry.
• Keep plain biscuits, crackers or a piece of non by the bed and nibble something before you get up in the morning.
• Choose simple, low-fat food that is not piping hot: rice, potatoes, boiled chicken, yoghurt, bananas, apples. Cold dishes smell less than hot ones.
• Rich plov, fried somsa and spicy dishes can wait for now — they stay in the stomach longer.
• Sip drinks between meals rather than with them: water, weak tea, water with lemon or unsweetened fruit compote.

In the first trimester, try not to worry about eating ‘perfectly’. If rice and apples are all you can manage at the moment, that is fine. What matters most is staying hydrated and continuing the folic acid and potassium iodide your doctor has prescribed. If the tablets make you feel worse, try taking them in the evening or after food, and mention it at your next appointment.

Other things that help

• Ginger. Ginger tea, a slice of fresh ginger in water or ginger biscuits help some women, and ginger is one of the few home remedies with reasonable evidence behind it. Take concentrated supplements or capsules only after checking with your doctor.
• Rest. Tiredness makes nausea noticeably worse. Go to bed earlier if you can and rest during the day. Ask family to take on some household jobs, especially cooking.
• Smells. Air your home, cook with a window open or ask someone else to cook. Strong smells — perfume, cigarette smoke, frying oil — often trigger a wave of nausea.
• Fresh air and a gentle walk help many women, especially in the cooler part of the day.
• After vomiting, do not brush your teeth straight away: rinse your mouth with water and wait about 30 minutes to protect the enamel.

There are anti-sickness medicines that are safe in pregnancy, but only a doctor should choose the medicine and the dose. Do not take anything on the advice of friends or the internet.

Myths to ignore

Relatives sometimes say that nausea means you are expecting a girl, or that you should simply put up with it and not bother the doctor. Neither is true. Nausea cannot predict your baby’s sex, and severe vomiting should never just be endured: it can be treated, and treatment works quickly.

When to see a doctor

Sometimes nausea turns into a condition called hyperemesis gravidarum — severe pregnancy sickness. It is not a matter of willpower; it is a medical condition that needs treatment. Contact your obstetrician-gynaecologist at the family polyclinic or antenatal clinic if:

• you are vomiting many times a day and cannot keep food or fluids down;
• you are passing urine rarely, or it is dark and concentrated;
• you are losing weight;
• you feel dizzy, especially when standing up, or very weak;
• the sickness is so bad that you cannot work or look after yourself.

Call an ambulance on 103 or go to hospital if there is blood in your vomit, if you cannot keep down even a sip of water for more than 12 hours, or if you have severe abdominal pain, a high temperature or confusion. Nausea that starts for the first time after 10–12 weeks, or comes with pain and fever, also needs checking, as the cause may not be the pregnancy.

The takeaway

Nausea in early pregnancy is common and usually temporary. It does not harm your baby, and for most women it eases by the start of the second trimester. Eat little and often, keep water within reach, rest more and do not hesitate to ask your family for help. And if vomiting is taking over your life, do not suffer in silence: tell your doctor — there are safe ways to help.