Pregnancy | Morning sickness and Hyperemesis gravidarum

“It’s probably something I ate,” she says while looking uneasy. She excuses herself and leaves the room. Cut to a long shot of vomiting over the toilet. That’s how the audience learns that a female protagonist is pregnant – all the time. From Bella in Twilight, to Lori in The Walking Dead, to Alison in Knocked Up, and Dina in the video game The Last of Us II, we’ve all seen that scene countless times. Pregnancy sickness is the easiest way to reveal that someone is pregnant. It’s dramatic, it’s distinguishable, and it catches our attention. The problem is that, unsurprisingly, there’s a gap between reality and fiction. Morning sickness doesn’t plague every woman, it’s not how every woman learns about her pregnancy, and symptoms definitely don’t only occur in the morning. What is morning sickness, what are the signs, causes, and symptoms, and how is it different from hyperemesis gravidarum? An article to read on an empty stomach.

What is morning sickness and how soon does it start?

Morning sickness is the appearance of nausea and vomiting during pregnancy. It is pretty common; between half to two-thirds of pregnant women will experience the condition to a degree (more women experience nausea than vomiting). But contrary to popular belief, it does not happen to every mother-to-be. In most cases, morning sickness is limited to the first trimester (and disappears after week 12-14). Only about 20% of women will have symptoms through the second trimester and some will experience morning sickness throughout their pregnancy. 

It is hard to predict if a woman will experience pregnancy sickness, but some risk factors do exist. Those include pregnancy of more than one child, if morning sickness runs in the family, and if the mother-to-be tends to get motion sickness, has a history of migraines, is obese, or is experiencing stress.

Morning sickness has been linked to quick changes in blood sugar levels, caused by hormones in early pregnancy blood. This is where the condition gets its name: morning generally comes after an extended period of fasting, which causes blood sugar to drop quickly. (Which is why the meal we eat in the morning is called break-fast.) Still, most women who experience morning sickness will tell you that the name is anywhere between confusing to cruel. Symptoms do tend to get easier as the day progresses, but unlike what the name suggests, morning sickness can – and often does – appear throughout the day or night. 

It is important to state that urinary tract infections (UTIs) can also cause nausea and vomiting. So, if you feel nauseous or have been throwing up during your pregnancy, ask your doctor to rule out UTIs. If you don’t want to wait for your doctor, Antidote’s certified clinicians are only one click away. 

What helps with morning sickness? 

We wish we could provide you with a list of things to eat or avoid. We know that many similar health and medical blogs do. But in reality, diet and nutrition are very personal and no one knows better than you what makes you nauseous. As a rule of thumb: 

• Notify all of your doctors about your pregnancy: This sounds obvious, doesn’t it? Yet, there are women who hide their pregnancy for a multitude of reasons, including traumatic past experiences. Even if you choose to keep your pregnancy quiet, make sure you find doctors you can trust and share the information with them. Medication can affect your pregnancy for better or worse – including morning sickness. Talk to your healthcare provider about any drug, supplement, and vitamin you’re taking.
• Eat more small meals and drink a lot: This is a good thing for everyone to do, but especially for those who suffer from morning sickness. Eating small amounts of easily digestible foods frequently will help stabilize your blood sugar and ease the nausea. 
• Eat throughout the day – and night: Start your day with a dry cracker or toast, even in bed. You may also set an alarm at night and eat something small to break up the long overnight fast.
• Avoid fatty and salty foods: Eat foods that are high in protein and complex carbohydrates. 
• Try to learn your triggers and keep your surroundings clear of odors: Open a window and keep air flowing through your room, ditch the perfume, and perhaps switch your toothpaste. 
• Try ginger products: Ginger tea, ginger candy, and ginger soda have been shown to be effective against morning sickness. 
  

What is hyperemesis gravidarum (HG)?

In the vast majority of cases, morning sickness is uncomfortable but doesn’t pose any danger to the mother-to-be or the fetus. Some are concerned that the act of vomiting might harm the unborn, but we are here to assure you that that isn’t the case. A slight loss of weight, often associated with pregnancy sickness, isn’t dangerous either. When, then, might pregnancy sickness be harmful? 

Extreme pregnancy sickness, characterized as persistent and severe, is called hyperemesis gravidarum (HP). Hyperemesis gravidarum in Latin literally mean above normal (hyper) vomiting (emesis) in pregnant women (gravidarum). HP is rarer and more severe than morning sickness. It is characterized by a rapid loss of weight (more than 5% of body weight), vomiting more than 8 times a day, or vomiting that extends past the first trimester. 

If you are experiencing HG, you should know that you are not alone. Soon after newspapers in England announced that Kate Middleton, the Duchess of Cambridge, and her husband, Prince William were expecting a first child, joy merged with worry as news emerged about Kate’s hospitalization. Early in her pregnancy, Middleton was diagnosed with HG and spent several days in the hospital. Middleton experienced HG in all three pregnancies. More recently, comedian Amy Schumer was very open about her hyperemesis, saying that her “pregnancy was like having food poisoning for 9 and a half months.” Schumer produced the documentary Expecting Amy, that follows the thrill and pain of having a child while experiencing HG. 

Both Schumer and Middleton successfully gave birth to babies. Schumer stated that although the pregnancy was hard, “once you meet you baby, you’re like ‘I would’ve been sick like that for 10 years just to meet you for an hour.’” With proper care, HG can be managed, especially if treated early. If you feel like your nausea is persistent and extreme, if you lose weight, feel constipated, show signs of dehydration (such as fainting, dry skin, and dark urine), or struggle to eat or drink, please reach out to a health professional. 

If the mother-to-be becomes dehydrated or can’t eat enough to nourish the fetus, an IV might be administered to replenish fluids. In certain cases, a doctor might prescribe oral medications as well as vitamins. If there is a danger to either the mother or baby, admission to a hospital for treatment might be needed.

Pregnancy sickness can have a psychological effect as well. The constant discomfort and pain, disruption to routine, and difference between how excited you and everyone around you are and how you physically feel, can take a toll on your mental health, and lead to heightened levels of depression or anxiety. If you feel like your mental state is decreasing during your pregnancy, reach out to a health professional. Antidote’s board-certified mental health doctors are more than happy to assist you, even with no insurance. Don’t hesitate when it comes to your and your baby’s health.