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Article originally published March 19, 2020.

Nausea and vomiting of pregnancy (NVP) is a very common occurrence affecting up to 90% of pregnancies. NVP is often referred to as “morning sickness” but can occur during any part of the day. It is typically not harmful to you or your developing baby, but it can interfere with your daily life, as well as your ability to work or care for yourself and your family.

There are varying degrees of severity of nausea and vomiting during pregnancy ranging from mild to severe. Mild NVP may involve a short period of nausea each day and one or two occurrences of vomiting (if any). Severe NVP may involve hours of nausea with even more frequent episodes of vomiting. It is important to discuss duration of nausea and the frequency of vomiting with your physician.

If you are experiencing symptoms that are not typically associated with NVP, such as: headache, fever, abdominal pain, onset of vomiting after week nine of pregnancy, or an enlarged thyroid gland, your physician may want to rule out other conditions before creating a treatment plan for you.

When Does NVP Usually Begin?

Nausea and vomiting of pregnancy usually begins before week nine of pregnancy. For most women, symptoms go away by week 14 of pregnancy – although some may experience symptoms for several weeks or months. In rare cases, NVP lasts the entire pregnancy.

What is Hyperemesis Gravidarum?

Hyperemesis Gravidarum (HG) is a rare, but very severe, form of nausea and vomiting of pregnancy. It is estimated to occur in less than 2% of pregnancies. Patients with HG may lose 5% or more of their body weight due to severe and persistent nausea and vomiting; this also can lead to dehydration and vitamin and mineral imbalances. If severe HG is left untreated, it can lead to dangerous complications for mom and baby.

Many women with HG require hospitalization at least once during pregnancy to receive medication to stop the vomiting and treatment to restore hydration and nutrients through an intravenous (IV) infusion. Hospitalization may last until symptoms are under control.

What Causes NVP?

The cause of NVP is not entirely known, although the following risk factors have been associated with developing symptoms:

  • It is your first pregnancy
  • You are expecting a baby girl
  • Family or personal history of NVP
  • History of motion sickness or migraines
  • Carrying multiples (twins, triplets, etc.)

When Should I Call My Doctor?

Call your health care provider if:

  • You are experiencing severe nausea and vomiting (nausea that lasts several hours; vomiting more than twice daily)
  • You are passing only small amounts of urine that appear dark in color
  • You feel dizzy or lightheaded when you stand up
  • You have an increased heart rate (racing pulse)
  • You are unable to keep any liquids down
  • You notice blood in your vomit

Treatment of Nausea and Vomiting of Pregnancy (NVP)

Your physician may recommend some lifestyle and dietary changes for you to try in an attempt to control your NVP without medical intervention. If these are unsuccessful in relieving your symptoms, or if your symptoms worsen despite your efforts, further treatment may be necessary.

What Can I Do to Relieve Symptoms?

Committing to a few lifestyle changes may help prevent or alleviate symptoms of NVP:

  • Take a multivitamin or prenatal vitamin. If you’re having a hard time keeping these down, try taking them at bedtime.
  • Eat small, frequent meals (about every two hours) – do not skip meals; an empty stomach can worsen symptoms.
  • In some cases, eating a salty snack (pretzels or potato chips) prior to a meal can settle your stomach, allowing you to eat.
  • You may need to avoid hard-to-digest greasy and fried foods. Dairy, tomatoes, garlic and citrus can irritate the stomach.
  • Avoid stuffy, hot places. Fresh air and sunshine can relieve feelings of nausea.
  • Keep a journal of foods and smells that trigger symptoms in order to better avoid them.
  • Drink plenty of fluids, but avoid drinking these during your meal or immediately after.
  • Try foods and beverages made with real ginger.
  • Get plenty of rest! Fatigue can contribute to symptoms.
  • Avoid stress as much as possible–reach out to friends and family for support when needed.
  • Eat a snack before bed and after getting out of bed in the morning. Move slowly when getting up.

What Might My Doctor Do to Relieve Symptoms?

Treatment may include medications and/or administration of intravenous (IV) fluids either at home or in a hospital setting. Medications that may be suggested by your provider for NVP may be prescription or over-the-counter, and often include:

  • Vitamin B6
  • Doxylamine (unisom)
  • Benadryl
  • Dramamine
  • Compazine
  • Phenergan
  • Zantac
  • Reglan
  • Pepcid
  • Zofran

Suggested Food Choices

Low-fat complex carbohydrates:

  • Rice
  • Pasta
  • Potatoes
  • Bread
  • Oatmeal
  • Cereal

Low-fat foods high in protein:

  • Eggs
  • Chicken (without skin)
  • Broiled or canned fish
  • Cheese
  • Tofu
  • Roasted nuts

For more information, contact the childbirth educator at 740-687-8218.