Nausea and vomiting during pregnancy. Everything you need to know

Nausea and vomiting are the most common complaint in the first half of pregnancy. It is also one of the most searched topics on Google, which is why the midwives at Happymami have prepared this post for you on nausea and vomiting during pregnancy: everything you need to know.

Nausea and vomiting during pregnancy. Everything you need to know

Nausea and vomiting usually appear between weeks 4-6 of pregnancy, with a peak between weeks 8 and 12. They can have a negative impact on your quality of life, but don't worry: they usually disappear by week 20 of pregnancy. What is more, knowing the possible triggers and taking therapeutic measures early on can help you a great deal to prevent nausea and vomiting during pregnancy. A curious fact is that only 17% of pregnant women experience this nausea and vomiting in the mornings, while for the rest it persists throughout the whole day. They are also characteristically triggered by certain stimuli, especially specific smells. But why do these nausea and vomiting occur?

What causes nausea and vomiting during pregnancy?

There is an interesting hypothesis suggesting that the presence of nausea and vomiting is a protective factor. In fact, it has been shown that women who suffer from them have a lower risk of miscarriage, perinatal death and preterm birth. The reality, however, is that the cause behind them remains a mystery, although a series of hormonal, anatomical, neuromuscular, metabolic and psychological changes may influence their onset.

Hormonal factors

During pregnancy your body will go through hormonal changes that appear to be linked to the presence of nausea and vomiting, such as a rise in human chorionic gonadotropin (hCG) and high oestrogen and progesterone levels. Levels of prostaglandins, thyroid hormones and placental proteins (SP1 protein) also increase.

Gastrointestinal factors

Other possible causes of nausea and vomiting during pregnancy may include the presence of Helicobacter pylori in the digestive system. Add to this the reduced gastrointestinal motility caused by the action of sex hormones during pregnancy and the reduced pressure of the oesophageal sphincter. It has also been found that up to 67% of women with nausea and vomiting have raised levels of the following liver enzymes, both glutamate oxaloacetate transaminase (GOT) and glutamate pyruvate transaminase (GPT), as well as increased pancreatic amylase.

Nutritional deficiencies

A deficiency of pyridoxine (vitamin B6), thiamine and vitamin K, as well as changes in some trace elements such as zinc and copper, make nausea and vomiting more likely.

Anatomical factors

The presence of a corpus luteum in the right ovary is linked to nausea and vomiting.

Psychological factors

There are times when psychological difficulties arise because of a possible rejection of the pregnancy, or fear of being pregnant, of childbirth and of the postnatal period, as well as the fear of not being able to care for the newborn. These factors could be linked to the origin of nausea and vomiting during pregnancy. That is why they are more common in cases of unwanted pregnancy, in women with family conflicts, mainly with their mother, and in women with a history of dysmenorrhoea.

Types of vomiting during pregnancy

Mild nausea and vomiting

• Description: They occur in the first trimester and are common, usually without complications.
• Symptoms: Occasional nausea and episodes of vomiting, especially in the morning.

Hyperemesis gravidarum

• Description: A severe form of nausea and vomiting that can cause dehydration and weight loss.
• Symptoms: Frequent vomiting (more than 3-4 times a day), inability to keep down food or fluids, extreme fatigue.

Food-related vomiting

• Description: They may occur after eating certain foods or in response to smells.
• Symptoms: Occasional vomiting associated with eating foods that cause discomfort.

Late vomiting

• Description: They occur in the second and third trimesters, often due to pressure from the uterus on the stomach.
• Symptoms: Occasional vomiting related to digestion or indigestion.

Vomiting due to medical conditions

• Description: They may be caused by conditions such as infections, migraines or gastrointestinal problems.
• Symptoms: Vomiting unrelated to pregnancy that requires medical attention.

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Warning signs for vomiting during pregnancy

• Persistent vomiting
  • Description: Vomiting that occurs more than 3-4 times a day over a prolonged period.
  • What to do: See a doctor to assess the severity and rule out hyperemesis gravidarum.
• Dehydration
  • Symptoms: Excessive thirst, dry mouth, dark urine or little urine production.
  • What to do: Seek immediate medical attention to avoid complications.
• Significant weight loss
  • Description: Loss of more than 5% of body weight since the start of pregnancy.
  • What to do: Tell your doctor so they can assess maternal and foetal health.
• Severe abdominal pain
  • Description: Acute or persistent abdominal pain that accompanies the vomiting.
  • What to do: See a doctor straight away to rule out more serious problems.
• Vomiting with blood
  • Description: Vomiting that contains blood or looks like coffee grounds.
  • What to do: Seek urgent medical attention, as it may be a sign of internal bleeding.
• High fever
  • Description: A temperature above 38 °C (100.4 °F) accompanied by vomiting.
  • What to do: See a doctor, as it may indicate an infection.
• Dizziness or confusion
  • Symptoms: A feeling of faintness, severe dizziness or mental confusion.
  • What to do: Seek immediate medical attention, as it may indicate a more serious problem.

What can you do to prevent nausea and vomiting?

First of all, you should know that in most cases nausea and vomiting during pregnancy resolve on their own between weeks 16 and 20 of pregnancy. To help ease these symptoms, the approach you need to take is based on three main pillars: dietary and hygiene habits, complementary non-pharmacological treatment and pharmacological treatment.

Dietary and hygiene habits

The following dietary and nutritional habits can help you ease nausea and vomiting in pregnancy:

• Eat light, frequent, small meals and keep to regular mealtimes.
• Split your diet into 5 or 6 meals a day; this reduces the volume of food per meal, making digestion easier and, if you do vomit, your loss of energy and nutrients will not be so severe.
• Eat carbohydrates (biscuits, toast or cereal) 15 minutes before getting out of bed in the morning and stay resting until the feeling of nausea passes.
• Avoid drinking water on an empty stomach or very acidic juices.
• Eat foods high in protein and carbohydrates, and avoid foods high in fat and salt.
• Eat plenty of fruit and vegetables.
• Avoid very cold or very hot meals.
• Drink fluids, especially between meals (water, herbal teas, juices or natural smoothies).
• Do not drink fizzy drinks.
• Avoid unpleasant smells and foods that are hard to digest or that you find off-putting.
• Keep a good posture.
• Avoid smoking, both actively and passively.

Complementary non-pharmacological treatment

Acupressure

It consists of applying pressure to the acupuncture point pericardium (P6) or Neiguan, which is located on the front of the wrist, between the tendons of the flexor carpi radialis and the palmaris longus. It is usually found about three fingers' width from the flexor crease. It is the most widely used acupuncture point to control nausea and vomiting during pregnancy.

Ginger

Ginger infusion can help you ease nausea during pregnancy. You can have it as a tea, and you will even find ginger biscuits in supermarkets.

Pharmacological treatment

If the above recommendations have not been enough, you may consider pharmacological treatment with antiemetics. Ask your midwife or gynaecologist what you could take.

Bonus: nausea and vomiting during pregnancy, everything you need to know.

Remember that every mum is unique, and that these recommendations are general. The approach should include changes in dietary and hygiene habits, non-pharmacological treatment such as acupressure and, in cases where these measures are not enough, pharmacological treatment with antiemetics. From Happymami we wish you a healthy pregnancy; enjoy every stage, even if it comes with nausea and vomiting.

Frequently asked questions about vomiting during pregnancy

What does nausea in pregnancy feel like?

Nausea in pregnancy usually feels like an upset stomach that may be accompanied by dizziness. It is most common in the mornings, but it can happen at any time of day.

How do you know if it is pregnancy nausea?

Nausea related to pregnancy is more persistent, is often accompanied by tiredness and sensitivity to certain smells, and it can appear at different times of the day, not only in the morning.

When does nausea in pregnancy start?

As a rule, nausea starts between week 4 and week 6 of pregnancy, but every woman is different and, in some cases, it may start later or earlier.