Vomiting And Nausea In Pregnancy

Vomiting And Nausea In Pregnancy

Most women experience some nausea in the first period of their pregnancy. Although popularly called morning sickness it may occur at any time. The extent to which the nausea develops into vomiting varies; some women never vomit, whereas others do so to a severe and incapacitating degree. One theory as to the cause is that the hormone progesterone acts on the smooth muscle of the stomach, reducing muscle tone and gastric motility, leading to nausea and even vomiting. The pregnancy hormone might be a cause as well.

However, psychological factors are important in some women, who may react to stress by feeling sick. Some find even the thought of certain foods nauseous. If a woman does suffer badly from vomiting, she can take heart in the fact that it usually subsides Spontaneously about the end of the third month. She may find it helps to eat a couple of dry biscuits when she wakes up, 10 or 15 minutes before getting out of bed – which she should always do slowly. During the rest of the day plain, lightly cooked meals, eaten little and often, are best. It is thought that the nausea is worse with hunger.

Some women find fatty foodstuffs particularly nauseating, even just cooking them for other people. If this is the case the woman should try to avoid completely anything containing or cooked in fat, including milk and butter.

If vomiting becomes severe or there is a significant loss of weight, the woman should tell her doctor. The cause might be a problem such as urinary tract infection, even though she has no symptoms when passing water. If not, the doctor may prescribe an antiemetic which has been proved safe in pregnancy. As a general rule, a pregnant woman should never take any drugs or medicines unless they have been prescribed by a doctor. Even non-prescription drugs obtained from the chemist’s are not always without risk for an unborn baby.

Vomiting which is so severe that no fluids or food can be kept down, a condition known as hyperemesis gravidarum, is rare and requires hospital treatment because severe dehydration may result, which is potentially dangerous for both the mother and child.

Heartburn

This is another complication of the relaxing effect which progesterone has on smooth muscle, this time because it allows the highly acidic stomach contents to regurgitate into the oesophagus, the tube connecting the mouth and stomach. Once this has happened the oesophagus becomes inflamed and further regurgitation into the irritated area causes the burning sensation in the middle of the chest which is heartburn.

Another contributing factor is the increasing size of the uterus, which reduces the space normally available for the stomach.

A woman should tell her doctor if heartburn causes serious discomfort. He or she may prescribe an antacid to neutralize the regurgitated acid stomach contents, or alternatively a preparation which will coat the inflamed area, allowing it to heal.

Measures which may help to prevent heartburn include avoiding bending down, sleeping with three or four pillows, avoiding spicy foods, and eating small meals at frequent intervals. Swallowing saliva or air will probably make symptoms worse, not better.

Constipation

The relaxed smooth muscle of the intestine, together with the increasing size of the uterus which presses on the bowel, are largely to blame for constipation in pregnancy. Although uncomfortable, constipation is not serious. A pregnant woman should try to avoid it from the start by including plenty of fibre in her diet, in the form of wholemeal bread, bran, fresh fruit and vegetables. Drinking lots of fluid will also help. She should thus be able to ensure a daily action of the bowel. She should also get into the habit of always emptying her bowels when she feels the need to. If she becomes severely constipated, the doctor may prescribe a mild laxative but the woman should never take one without medical advice because they can cause premature labour. If the iron supplement she is prescribed causes constipation the doctor can prescribe a different brand.

Nosebleeds

Nosebleeds are quite common in pregnancy, probably because the nasal membranes have an increased blood supply which may easily be damaged. They do not usually last long or result in excessive bleeding; if they are heavy and recurrent, however, the doctor should be told. Bleeding can usually be stopped by pinching the nostrils between the fingers for several minutes, while leaning forward.

Oedema

Swelling (oedema) of the feet, ankles and fingers is a not uncommon problem, usually occuring towards the end of pregnancy. It is caused by fluid retention in the tissues, usually as a result of hormones altering the amount of salt excreted by the kidneys. It is often worse in hot weather and is helped by resting, particularly with the legs up. In a serious case the doctor may advise a reduction in salt intake. If high blood pressure occurs with or without oedema more rigid treatment is necessary because a risk of toxaemia is probably present.