In the first three months of pregnancy, many women suffer from nausea. Often that nausea is accompanied by vomiting. About one pregnant woman in two suffers from it to a lesser or greater extent. Some only experience it in the morning, others almost all day long. Usually the complaints disappear around weeks 16 to 20.

The causes of nausea during pregnancy

The cause is not well known. Possibly it is a result of hormonal changes at the beginning of pregnancy that stimulate the vomiting center in the brain. It would not be a psychological problem due to stress, for example. In most cases, it is especially annoying but not serious, and there is no risk to the mother or the unborn child. On the contrary, according to some studies, women with common pregnancy sickness are up to half as likely to have a miscarriage. One possible explanation is that nausea is likely to protect against certain toxic substances.

When to see a doctor?

Do consult your doctor in the following situations:

  1. If you vomit more than three times a day.
  2. If the many vomiting does not stop after a few weeks.
  3. If you are getting more and more dehydrated
  4. If you lose more than 5 percent of your weight that you had before pregnancy.
  5. If nausea and vomiting persist even in the second half of pregnancy: this may indicate another cause (e.g., gastrointestinal inflammation, Gestational Hypertension,).
  6. If you suffer from accompanying symptoms such as fever, general unwellness, permanent nausea, change in bowel pattern, pain when urinating.

A severe but fortunately quite rare form of pregnancy vomiting, hyperemesis gravidarum, manifests itself in persistent vomiting, weight loss (more than 5% of the weight before pregnancy) and dehydration. In that case, you should consult your doctor as soon as possible and a temporary hospitalization may be necessary to administer intravenous fluids.

Tips against pregnancy sickness

  1. In case of morning sickness, you can eat something small before getting up in bed, for example a rusk or toast, a jar of yogurt, etc.…
  2. Drink a glass of lukewarm water or fruit juice immediately upon getting up.
  3. Have a light breakfast.
  4. If you are nauseous all day, it is best to eat or drink something small regularly (every two to three hours). For example, eat a sandwich or a piece of fruit between meals. Do not stop eating. Because you eat less than usual, it is important to mainly eat products that provide enough energy. So, for example, choose whole products (whole milk, whole yogurt,) instead of light ones.
  5. Try to check which stimuli (e.g., smells, long car journeys…) or foods induce or strengthen your nausea. Avoid these as much as possible. For example, let someone else cook, or cook in the microwave with fewer odors. Also ensure sufficient fresh air in the house and regularly get a breath of fresh air outside.
  6. Drink plenty of water, especially if the nausea is accompanied by vomiting. Sometimes carbonated drinks help.
  7. Rest sufficiently as fatigue can worsen nausea. Do not lie down immediately after dinner but stay upright for another ten to twenty minutes.
  8. Avoid highly seasoned, acidic, and high-fat or deep-fried foods. A lot of fat causes food to stay in the stomach longer and can therefore worsen the nausea.
  9. Take a cold meal if you tolerate it better than a hot meal. Cold food also smells less. Be careful with raw products (e.g., no raw fish or raw meat).
  10. You may also experience nausea in the last months of pregnancy. That is because the uterus presses against the stomach. Then eat small meals regularly.
  11. Avoid alcohol and tobacco.
  12. If you are already nauseous, it can help to breathe in slowly through the nose and exhale through the mouth. You can also suck or chew on ice cubes, or suck on a lemon slice.
  13. Take extra care of your dental hygiene, because vomiting will cause your teeth to suffer a lot. So, after vomiting, rinse your mouth well with water, but do not brush your teeth immediately. Wait at least half an hour. The acids that enter the mouth when vomiting soften the enamel, which makes it susceptible to damage.

Medicinal products

In case of serious complaints that persist and that have a major impact on your normal functioning, the doctor or gynecologist can prescribe a medicine. Never take a medicine on your own during pregnancy, but always discuss it with your doctor first. In addition, take the medication as short as possible. Stop as soon as the symptoms are over and after the first trimester.

  • Anti-histaminica (Meclozine: Agyrax, Postafene)

These are medicines that are also used in allergy. Preferably take 12.5 mg in the evening up to a maximum of 12.5 mg twice a day. Meclozine can cause drowsiness and drowsiness. So do not drive a car if you are taking this medicine. The use of meclozine in case of impending preterm birth is not recommended.

  • Metoclopramide (Dibertil, Docmetoclo, Metoclopramide EG, Primperan): 5 to 10 mg three times a day (max. 0.5 mg/kg/day).

Metoclopramide can cause so-called extrapyramidal symptoms: sudden disturbances in muscle tension, movement disorders, abnormal movements of the face, eyes, stiff neck, involuntary movements, restlessness. Therefore, women under 20 years of age should not take this medicine. The European Medicines Agency prescribes a maximum use of five days. You should also not take it in combination with sedatives and if you suffer from epilepsy or Parkinson’s disease.

  • Domperidone (Motilium and generics)

Domperidone, especially at high doses (more than 30 mg per day) and in people with certain heart conditions or in combination with certain medicines, can cause cardiac arrhythmias and cardiac arrest. You should not take it for more than seven days.

Other treatments

Various guidelines, the British National Institute for Health and Care Intelligence (NICE) and the American College of Obstetricians and Gynecologists (ACOG), recommend ginger root-based preparations for the treatment of pregnancy sickness. Doses of 250 mg, four times a day (i.e., up to 1 g per day), prove safe. Use it as briefly as possible (some guidelines provide a maximum of four days). If you are considering taking a ginger preparation, talk to your doctor first.

Several studies show a beneficial effect of acupuncture and acupressure on the wrist in pregnancy sickness and vomiting, but some studies also find no effect. On the other hand, no side effects of acupuncture or acupressure are known. The UK’s National Institute for Health and Care Intelligence (NICE) recommends wrist acupressure as a possible alternative to medicines.

Unrecommended treatments

  • Hypnosis or homeopathy

Hypnosis or homeopathy has not been shown to help against pregnancy sickness. It is therefore not recommended.

The effectiveness of Pyridoxine has not been sufficiently demonstrated. It is therefore better not to use it during pregnancy.

Erica Delaney

An experienced nurse, Erica focuses on subjects related to pregnancy and infant health. She enjoys dancing and playing the piano in her free time.