Nausea & Vomiting

Not a sign of a stronger pregnancy, just a sign of pregnancy...

“Morning Sickness” is a misnomer…it can happen anytime of the day or night. It is very common and affects up to 80% of pregnant women. Patients ask whether nausea and vomiting means they have a stronger pregnancy – unfortunately, no. Morning sickness doesn’t actually mean anything - it can happen in one normal pregnancy and not another in the very same person. It can happen in normal pregnancies or not at all in complicated pregnancies. For most women, it peaks by about 10 weeks and has resolved by the end of the first trimester. Unfortunately, for some women, nausea and vomiting can continue throughout pregnancy or it reappears in the third trimester. Don’t feel you have to suffer through - there are all kinds of safe ways (non-medical and medical) to deal with nausea.

Non-medical:

Some women find separting wet and dry food, eating small quantities to keep something in their stomach or avoiding certain foods, such as spicy and fatty foods can help.

Exerting pressure on the P6 accupuncture point on the wrist, either through acupuncunture or the wearing of Sea Bands, has had varying success in studies.

Ginger tablets (up to 250 mg) may ease nausea.

Stop your prenatal vitamins for a while, some people find prenatal vitmains makes the nasuea and vomiting worse.

Medications considered safe to use:

Antacids (TUms, ranitidine, etc.)

Benadryl (antihistamine)

Gravol (antihistamine)

Diclectin (Vitamin B6 + antihistamine) is the only drug specifically licesed in Canada for use in pregnancy for nausea and vomiting.

Chlorpormazine

Metoclopramide

Prochlorperazine

Promethazine

Ondansetron - this is a medication normally used for nausea and vomiting associated with chemotherapy. We tend to use it as a last resort but it can be very effective. The evidence suggests that it is safe to use in pregnancy but it is very expensive compared to some of the other medications, which is why we try other options first. Steroids are also sometimes used, but again, as a last resort.

Motherisk at the Hospital for Sick Kids has put out an excellent report on nausea and vomiting in pregnancy and they have also developed a forum where you can submit questions: www.motherisk.org/women/forum.jsp