How to Survive Morning Sickness
It's horrible, I know. Here are some suggestions for what can help.
By the time I was 15 weeks pregnant, I had practically worn an impression into the linoleum in front of my toilet. I was afraid to fall asleep because I knew I would wake up to a whole new day of vomiting. As Nitzia Logothetis, Seleni's founder, recently wrote, experiencing nausea and vomiting during pregnancy is like "plunging into a disorienting rabbit hole of horrendous nausea."
If I tried to eat something I wasn't craving, I would throw it all up. One day I could only handle kimchi. The next day only tater tots would stay down. One rainy night, my husband found himself driving 40 miles to get me a roast beef sandwich.
Another time, I quenched my thirst with a juice box at a little girl's birthday party and immediately wanted to die. (As it turned out, sugar made me sicker.) At times like that, I wasn't sure how I would survive the next hour, let alone the next day. And I had no idea how I would survive another 25 weeks of morning sickness hell.
Over my pregnancies, I've thrown up everywhere from a gas station bathroom in Pennsylvania to a train in San Francisco, and I've gained some hard-won wisdom along the way. This is my thoroughly "researched" survival guide.
Find a fluid you can stand
Besides being dangerous, dehydration makes your symptoms worse, so find a liquid you can tolerate. Plain water made me vomit, as did anything with sugar. On my worst days, I could only manage sugar-free popsicles. I also made giant vats of decaffeinated black tea sweetened with stevia, which I could usually stomach. “I could only drink sparkling water,” says Logothetis. “Normal water would throw me over the edge of a toilet bowl. Diet coke helped too.”
Figuring out what you can drink can take a lot of experimentation, and you may have to lower your standards about artificial sugar or other ingredients you didn't expect to include in your pregnancy diet. The important thing is getting any sort of liquid to stay down.
Experiment with complimentary therapy
Many women “swear by the mechanical stuff,” says Kurt Wharton, MD, clinical professor in the department of obstetrics and gynecology and reproductive sciences at the University of California, San Francisco. These include acupuncture, acupressure, and those wristbands people often wear to prevent motion sickness. I tried wearing a wristband, but it didn't help. I experienced short periods of relief after acupuncture sessions, but symptoms always came back within a day or two.
Try well-known remedies
There are plenty of tried and true remedies that work for some women. Eating before you get up out of bed can be effective, but for me, it just meant I had more to throw up once I was upright. My great-grandmother drank a cup of black tea before getting up, which she said helped prevent her from vomiting. And Logothetis found that eating small amounts and “never getting full” was helpful.
"Candy or crackers that stimulate stomach emptying and processing in the small bowel can make you less nauseous and less likely to throw up," says Wharton. His patients have found relief from pure ginger products, such as candy and ginger ale.
Control what you can
Wharton also suggests treating nausea as you would a migraine by removing sources of noise, bright lights, and loud sounds from your environment. "Get away from computers and TV, cell phones, and light if you can," he recommends. Of course, that's not easy when you already have one or two children who want to be near mama, even when she's headfirst in a toilet bowl.
During the darkest times of my second full-term pregnancy when taking care of a child was beyond my depleted abilities, I enrolled my young daughter at a local Montessori school. It wasn't my initial plan to put her into daycare, but like so many other parts of parenthood, it was an accommodation we made for survival.
Do what works for you
There will be some trial and error until you find out what helps you get through the day, and you may be surprised at what helps. Throughout my pregnancies, I discovered that playing the piano, doing math equations, and swimming could briefly keep my symptoms at bay. Logothetis found that taking walks and increasing her heart rate would bring some relief.
Wharton believes Zofran (ondansetron) is "exceedingly safe and effective with minimal side effects," a position supported by a 2013 study that found no adverse effects to fetuses exposed to Zofran. Though the FDA recently raised a concern that there may be a chance of serotonin syndrome associated with the use of Zofran, many OB’s (including Wharton) find that the benefits of the drug far outweigh any potential risks.
Following this advice, my doctor and I decided that I would take a daily dose of Zofran during my second and third full-term pregnancies. Because the idea of swallowing a pill was repulsive to me, I opted to take Zofran in orally disintegrating tablets, which were tolerable. It did take the edge off.
For severe cases, Wharton also prescribes Compazine, Phenergan and Tigan. Just as with Zofran, these medications work by modifying brain signals to relieve nausea and vomiting symptoms. Sometimes Wharton also prescribes Reglan, a drug that works directly on your digestive system by increasing intestinal motility.
Worrying about the baby
Many women, myself included, worry that the baby is not getting what she needs nutritionally. But as Wharton says, "a 10-week fetus is pretty tiny and doesn't need an awful lot. If you lose a little weight, it's going to the baby." He emphasizes that it's helpful not to add stress about your baby's nutritional status to your discomfort. If you are concerned, discuss it with your doctor. Having this discussion can be an important way to help control your worry.
Managing the emotional side of morning sickness
"The physical process of being pregnant is a huge physical and identity shift. The nausea and vomiting is often the first sign that this change is underway, and there is a normal ambivalence associated with that," says Christiane Manzella, PhD, clinical director at the Seleni Institute. She also says that recognizing ambivalence is an expected – and normal – part of your experience can help curb the anxiety some women experience with morning sickness.
And then there's just the psychological wear that comes from feeling ill day in and day out. One of the best things you can do for yourself recommends Logothetis, is connect with someone who has been through what you're experiencing. And she says it’s important “to not push yourself, be kind to yourself and remember that this is a temporary state that will pass,” says Logothetis. “Life is long, and there will be plenty of time to make up on any time you have lost.”
During the depths of my own nausea and vomiting, I met with a therapist once a week who specialized in working with pregnant women. I was able to share that I was afraid of having a miscarriage and how these fears seemed to heighten the despondency I felt related to morning sickness. Many women find that by making these connections – either with an experienced friend or a specialized therapist – the "rabbit hole" becomes somewhat more bearable.
When you need professional help
Wharton cautions that you may need IV fluids if you can't tolerate any oral medication or fluids, or if you're experiencing dark urine, fatigue, or dizziness. This indicates a type of extreme morning sickness, called hyperemesis gravidarum, which is serious but very treatable. So make sure your doctor knows about your symptoms and call immediately if they worsen or you experience any of these.
And keep tabs on your emotional health. Manzella suggests talking to your doctor and seeking expert mental health treatment if you have any symptoms of prenatal depression. These include persistent sadness or anxiety, difficulty concentrating, sleeping too little or too much, losing interest in activities you usually enjoy, having recurring thoughts about death or suicide, or experiencing feelings of guilt, worthlessness, and hopelessness. A treatment plan could include participating in a support group or individual psychotherapy, taking medication, or finding some combination of these.
No matter what you call it, the nausea and vomiting associated with pregnancy is terrible. I will never get back the many hours I logged in front of that toilet. But with my doctor's help, some tried and true tools (including Zofran), quiet times, and a little piano playing, I made it though. You can too.