Nausea and vomiting are common in pregnancy. What hyperemesis gravidarum is, the signs of dehydration, when to seek care and how treatment is planned.
Nausea and vomiting are common complaints in pregnancy and in most people ease in the first half of pregnancy. However, if the nausea gets in the way of daily life and makes it hard to eat and drink enough, this is called hyperemesis gravidarum, and it carries a risk of fluid loss (dehydration).
Does morning sickness happen only in the morning?
No. Pregnancy nausea is related to pregnancy hormones, begins in early pregnancy and can happen at any time of the day. The name "morning sickness" is misleading for this reason.
When does it start and when does it ease?
Nausea and vomiting begin in early pregnancy. In most people they ease in the first half of pregnancy; in some people they last longer.
Who may be affected more severely?
Having had nausea in a previous pregnancy and having a multiple pregnancy are counted among the risk factors for severe nausea. You do not need to blame yourself for the nausea.
How does hyperemesis gravidarum differ from usual nausea?
Hyperemesis gravidarum is the most severe form of pregnancy nausea. In this case the complaint gets in the way of daily tasks and makes normal eating and drinking difficult. According to the current definition, hyperemesis is severe nausea and vomiting that leads to dehydration and marked weight loss. The difference between hyperemesis and usual nausea is that the complaint gets in the way of daily life and makes it hard to eat and drink enough.
How can you tell dehydration?
Signs of dehydration include feeling very thirsty and dry, feeling sleepy and weak, and darkening of the colour of the urine. These signs may show that fluid loss is continuing.
Do not delay seeking care by trying things at home. Trying other methods at home does not replace an assessment when you cannot take in fluids.
Could there be another cause?
Not all vomiting is pregnancy nausea. If you have abdominal pain or pain when passing urine, or a history of a stomach ulcer or gallstones, other causes need to be investigated. If you have any of these symptoms, tell your doctor. If nausea or vomiting develops with swelling of the abdomen after IVF treatment, tell the doctor who is following your treatment without delay.
What can you do on your own?
For mild complaints, it is recommended that you eat small, frequent meals, choose carbohydrate-based and low-fat foods, and keep away from smells or foods that trigger your nausea. These are general measures aimed at easing the complaint. If you cannot take in fluids, do not settle for these measures; seek care. Before you start any medicine, supplement or herbal product on your own, consult your doctor.
What does your doctor assess with the examination and tests?
Your doctor assesses how severe your complaint is, how much fluid you can take in and whether there are signs of dehydration. Blood tests may be requested when needed; abnormal blood test results are among the situations in which hospital care may be recommended. Your doctor also reviews whether another illness is causing the nausea.
How is drug treatment for nausea chosen?
There are anti-sickness medicines that can be used in pregnancy; the doctor decides which one and how it will be used, and this decision varies from person to person. Do not start or stop a medicine on your own.
When may hospital care and fluids through a vein be needed?
Admission to hospital may be recommended if there is dehydration, if you cannot keep down fluids or oral medicines, if there are abnormal blood test results, rapid weight loss or some accompanying illnesses. Hospital care may include fluids given through a vein, monitoring of the fluid taken in and passed out, anti-sickness and vitamin support, and measures aimed at reducing the risk of clotting. Your doctor decides whether admission is needed.
What can you do if nausea affects your mood and daily life?
Pregnancy nausea can affect your mood, your work, your home life and your social relationships; in some people depression can develop and extra support such as counselling may be needed. Finding it hard to work or do daily tasks is not a weakness. Share the changes in your mood with the health professional who is following you.
What information can you share when you go to your doctor?
- Describe when the nausea started, at which times of the day it happens and how much fluid you can take in.
- Report any change in the colour of your urine, weakness and dizziness.
- Say whether you had a similar complaint in a previous pregnancy.
- State the medicines, vitamins and supplements such as iron that you use.
- Ask in which situations an assessment in hospital may be needed and which symptoms mean you should seek care without waiting.
Frequently Asked Questions
Does anti-sickness medicine harm the baby?
The recommended anti-sickness medicines are regarded as safe in pregnancy. Severe nausea that is not treated may carry more risk for the baby than these medicines. So rather than avoiding treatment out of fear of the medicine, talk about your concern with your doctor; your doctor decides which medicine is suitable for you.
If vitamin and iron tablets increase the nausea, can I stop them?
Do not stop or change the vitamin or iron tablet you are using on your own; tell your doctor that it is increasing your nausea. In hospital care iron tablets may be paused for a time, but your doctor makes this decision.
Is vomiting that starts later in pregnancy usual?
Vomiting that newly starts later in pregnancy needs another cause to be investigated; in this case the vomiting should not be assumed to be pregnancy nausea. Tell your doctor.
Can morning sickness also happen at other times of the day?
Yes. Pregnancy nausea can happen at any time of the day; the name morning sickness is misleading for this reason.
Does the nausea ease at the same time for everyone?
No. In most people it eases in the first half, and in some people it may last longer.
Is it important if I cannot do my daily tasks and cannot eat and drink enough?
Yes. These are the features that set hyperemesis apart from usual nausea. Hyperemesis can lead to dehydration and marked weight loss.
Can darkening of the urine be a sign of fluid loss?
Yes. Darkening of the colour of the urine, together with feeling very thirsty and dry and feeling sleepy and weak, is among the signs of dehydration.
If I cannot take in fluids, should I keep trying other methods at home?
No. Trying methods at home does not replace an assessment when you cannot take in fluids. Do not delay seeking care.
Is all vomiting regarded as pregnancy nausea?
No. If you have abdominal pain, pain when passing urine, or a history of an ulcer or gallstones, other causes should be investigated. Tell your doctor about these.
After IVF, should I report nausea or vomiting with swelling?
Yes. Tell the doctor who is following your treatment without delay.
If nausea affects my mood, can I ask for support?
Yes. Nausea can affect your mood, your work and your social life; in some people depression can develop. Share the changes with your health professional.
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