Nausea and Vomiting

Nausea and vomiting are very common in early pregnancy but usually go away by the first trimester. There are behavioral and medical treatments for nausea and vomiting.

People who have nausea in the first trimester are less likely to miscarry. This does not mean that the absence of nausea is a bad thing, this is certainly not a sign of impending miscarriage.

Nausea and vomiting almost always get better by the second trimester, usually by 13 weeks. This issue usually does not just go away all at once but slowly improves over time. You may notice that you have good days and bad days. As the pregnancy progresses the good days become more common and the bad days become less frequent and less severe.

The most important thing is to stay hydrated. Fluids with some calories are preferred over plain water but water is alright as well. I usually recommend sports drinks such as Gatorade or juices.

Keeping some food in the stomach will help the nausea. One of the reasons people often have the worst nausea in the morning is because that is when the stomach is most empty. Eating small amounts throughout the day can help. One trick is to put snacks like crackers or nuts at the bedside to snack on when you awake in the night.

There are many anti-nausea medications that are safe in pregnancy. Zofran is probably the best one. Until recently Zofran was was so expensive that it was difficult to get. Now there are generics available that make Zofran inexpensive. Zofran is safe in pregnancy and does not make most people sleepy or feel “drugged”. Phenergan and Compazine are other medications that can be used. These medications tend to cause drowsiness and most people cannot work while taking them. Reglan is another choice. It has less drowsiness associated with it but does not work as well for most people as Zofran.

There are many non-pharmaceutical things that people use for pregnancy associated nausea and vomiting. Ginger candies are used with some success by some women. Some people believe that magnets worn as bracelets around the wrist help with nausea. There is no real evidence to support magnet therapy but it is not dangerous and safe to try if you want.

Severe nausea and vomiting in pregnancy is called Hyperemesis Gravidarum. For a minority of women this can be severe. If the women is unable to keep anything down even with medications then replacement of fluids and rarely even nutrition can be given through an IV. A long term IV called a PICC Line (peripherally inserted central catheter) is sometimes used for this purpose. Hospitalization is sometimes needed. Often home health can be arranged to allow you to be at home while getting fluids through an IV.