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Riding the Wave

When morning sickness goes from bad to worse, what can you do?

Published on: August 20, 2014

When I found out I was pregnant with my second child, I knew it was only a matter of weeks before the morning sickness began. I expected to deal with nausea off and on throughout the day, and that Sea-Bands and ginger chews probably wouldn’t help much.

But I didn’t expect the nausea to be so intense — and to last all day. I didn’t expect that eating anything but popsicles would mean misery, and that hunger would be even worse. I didn’t expect to spend so much time curled up in bed wishing I could sleep, yet feeling terrible about missing time with my family. I didn’t expect to feel so isolated, or embarrassed and weak for not “coping.”

After weeks of feeling beaten down, I heard my toddler ask, “Why is Mommy crying in the bathroom again?” and realized I needed help.

I started calling friends to watch my daughter on bad days, I stopped apologizing for needing rest, and I found anti-nausea medication that worked better to get me through another couple months of “morning” sickness.

Turns out that, like many women, I was wrong in assuming that at 12 weeks, the morning sickness would simply disappear.

“Although there are periods where it is better, it is a huge misconception that nausea is gone [after] the first trimester. Most patients that experience significant nausea have it until they are between 16 and 20 weeks pregnant,” says Audrey Allard, a certified nurse-midwife at Swedish Medical Center in Seattle, “and it doesn’t all of a sudden vanish. It is a gradual process. There may be good days and bad days, until eventually there are more good days than bad. Then one day, you can’t remember the last day you felt [nauseated].”

Signs of hyperemesis gravidarum

For a small percentage of women, the nausea is more severe, lasts much longer (sometimes the entire pregnancy) and can require IV fluids, feeding tubes and hospitalization. Known as hyperemesis gravidarum (HG), this complication affects roughly 0.5 to 2 percent of pregnant women and can lead to further issues such as malnutrition and fluid imbalance.

Cecilia Robbins, who writes the blog Babies Are Simple, recently shared the story of her own struggle with HG through three pregnancies. She lost up to 20 percent of her body weight, had multiple hospitalizations, vomited up to 20 times a day and had IV therapy and feeding tubes.

During her first pregnancy, Robbins didn’t know her vomiting wasn’t normal and ended up in renal failure before seeking help.

“I had no idea I would become so sick,” she says. “I had no idea I should ask for help, I had no idea if the sickness would ever end. I just thought I would probably die, but I also thought I shouldn't complain too much. Fortunately, I had a great doctor who got me the help that I needed.”

Allard says that diagnosing HG is hard because nausea and vomiting are part of most pregnancies. She suggests seeing your doctor or midwife if you vomit three to five times every day, because dehydration is a risk. Your provider will talk with you about treatment options.

The hardest thing about HG was the time it took away from her family, Robbins says. “When I was pregnant with my twins, my daughter, Eliza, was only 18 months old. I was in bed for seven months and drugged to the point of being incoherent the first four months. I didn't play with her or take her on walks or teach her new words,” Robbins remembers. “Feeling like a failure as a mother has been an overwhelming burden.”

Support from family and friends helped Robbins get through her worst moments. Now, she says, “I’d like to say to other women that you are not alone. Other women have experienced what you are feeling and have survived . . . you are stronger than you can imagine.”

Fighting nausea on the home front

Both Robbins and Allard say that community support is a big help for women with morning sickness and HG. Allard also suggests lots of rest (exhaustion can make nausea worse) and small, frequent meals with protein at each one.

“Greek yogurt is a great source and can be snuck into many things. Almonds and beans are also great sources of protein and have been shown to help with nausea,” she says.

Of the many tips I got from friends, my favorite was probably “bed meat.” A friend who battled nausea with both of her pregnancies until 20 weeks kept a bag of jerky by the bed so she could eat a few bites before getting up. She swore this helped.

I found that eating what sounded best in the moment worked for me. Sometimes that meant a whole can of beans and vinegar, sometimes three popsicles, sometimes just scrambled eggs. Normally a lover of vegetables, I let myself off the hook when they were the last thing I wanted to eat.

Since nausea can wax and wane throughout the day, Allard suggests planning your meals for the times when you feel best. Well-timed fresh air and light exercise made a difference for me as well.

Other remedies that may offer relief include:

  • Sea-Bands and acupuncture
  • Sour liquids and citrus fruits
  • Ginger beverages, chews and tabs
  • Popsicles and hard candies
  • Over-the-counter heartburn medications or papaya enzymes
  • Saltines and plain crackers, potato chips and other complex carbohydrates

Allard also often recommends that patients try vitamin B6 (25 mg, 3–4 times a day) and half a Unisom tablet at night. Sometimes even just the Unisom can be helpful for pregnant women who are having trouble sleeping, she says. (This article from American Family Physician agrees.)

If someone had told me during the thick of my morning sickness that the good days wouldn’t come with any frequency until 16 weeks — or that I wouldn’t start really feeling better until 21 weeks — I probably would have cried (more). But hour by hour and day by day, with lots of support, I made it through. Turns out I was stronger than I knew.

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