Pregnancy Vomiting: When is Bad Too Bad?

Published on March 14, 2023 .

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Young sick woman sitting on floor near toilet — Image by Halfpoint via Shutterstock

Next to a missed period, women worldwide understand that nausea and vomiting are associated with the early days of pregnancy. But when you find mornings spent hugging a toilet, the delight of pregnancy is not very delightful.

The common feelings of nausea normally begin at 5-6 weeks gestation and end before 20 weeks gestation.
A rare population of women experiences severe vomiting, which is accompanied by symptoms of dehydration, ketonuria, and ketonemia.
Ginger and motion sickness bands have been shown to provide relief for many pregnant women.

Do you feel like everything is inedible? Is the food or drink you consume only borrowed before running to the toilet AGAIN? This article will review normal and abnormal pregnancy-related vomiting.

What's normal?

Nausea and vomiting are commonly experienced by pregnant women. According to the National Institutes of Health (NIH), approximately 90% of pregnant women report feeling nausea during their pregnancy. Up to 30% of these women experience only nausea, and over 50% suffer from both nausea and vomiting.

Normally, the onset of pregnancy related nausea occurs around 5-6 weeks gestation and is resolved by 20 weeks gestation. Only 3% of women report nausea and vomiting in the third trimester.

Though the causes of first trimester pregnancy related nausea is unknown, there are some valid theories. Estrogen refers to a group of hormones, which affect both the male and female physiology. Estradiol is a type of estrogen hormone.

Estradiol levels rise early in pregnancy and fall later in pregnancy. This rise and fall of estradiol is often mirrored in the typical pattern of nausea and vomiting. Furthermore, since nausea and vomiting are known side effects of estrogen-containing medications, it is thought that estradiol levels may be the primary cause of this common pregnancy symptom.

Secondly, the muscular band at the top of the stomach, which keeps food and fluids inside the stomach, relaxes during pregnancy. This relaxation of the esophageal sphincter often causes reflux. Reflux is also known to cause vomiting.

When to be concerned

Some women suffer from severe vomiting during pregnancy known as hyperemesis gravidarum. Depending on the source, 0.3%-3% of women experience hyperemesis gravidarum during pregnancy with a greater occurrence in western countries. Unfortunately, no specific criteria currently exist for diagnosis.

Women suffering from hyperemesis gravidarum experience uncontrollable nausea and vomiting which leads to other complications, such as dehydration, ketone bodies in the urine (ketonuria), and/or abnormally high levels of ketone bodies in the blood (ketonemia).

Some symptoms of hyperemesis gravidarum:

Excessive vomiting.
Dehydration.
Dry mouth.
Decreased urine output.

Dark colored urine.
Lightheadedness.
Sleep disturbances.
Irritability.

Tips to relieve nausea and vomiting

Initial treatment begins with non-pharmacological interventions.

After consulting your Ob/Gyn, women find that simply switching their prenatal vitamin to a folic acid only capsule provides great relief.

Ginger is a natural herb which throughout history has proven to relieve stomachache, nausea, reflux, and vomiting.

This herb is often used in some of your favorite Asian dishes. However, it's capsule form can be taken to relieve nausea and vomiting. Research done by the NIH recommends women take 250 mg capsules 4 times a day for best results.

Acupressure wrists bands have also been very effective in providing relief. These painless bands provide mild tension on the wrists' pressure points. They are inexpensive, easy to apply, and can be purchased online or at your local pharmacy.

Check out this article to find more practical ways to deal with NVP.

Things to notice

If you feel like you may be suffering from hyperemesis gravidarum, it is important to record your findings. Not only is this helpful for you to know, but it is also useful information for you Ob/Gyn doctor.

Some things to ask yourself

About how many hours each day are you nauseated?
Approximately, how many times each day do you vomit?
Roughly, how many times a day do you have dry heaves. This is when you have the motion of vomiting but are unable to expel anything.

If you are concerned, this is information to record and report to your Ob/Gyn or another healthcare provider.

FAQ

What is a normal amount of emesis or vomiting?

Everyone's experience is different. Some women report nausea throughout the day. Others, vomit in the morning and experience relief until the next morning.

When should I be concerned?

Excessive vomiting is the symptom of greatest concern. If your vomiting is so intense that you are unable to perform your normal daily chores, or if you are having symptoms of dehydration, talk to your doctor immediately. Hyperemesis gravidarum can have a negative impact on both you and your baby.

When will nausea and vomiting end?

Nausea and vomiting related to pregnancy normally subside by 20 weeks' gestation.

Does vomiting hurt my baby?

Studies have shown that normal pregnancy-related vomiting does not harm the baby. There has been no indication of an increased risk of malnutrition, birth defects, miscarriages, or other complications.

Are there medications to help with first trimester nausea?

Yes, there are medications your doctor can prescribe. However, your provider will want you to first try some of the lifestyle changes to help relieve the symptoms. Careful and informed use of medications, especially during the first trimester, is essential.

Nausea and vomiting during the first trimester of pregnancy are not normally something to worry about. It is a common occurrence suspected to be caused by hormone changes. The herb ginger and motion sickness bands are some examples of homeopathic remedies that provide relief for pregnancy-related vomiting. Though rare, hyperemesis gravidarum is a serious diagnosis. If you are experiencing severe vomiting, talk to your doctor about it.