During the first trimester of pregnancy, many women experience the bouts of nausea
and vomiting known as morning sickness.
Despite its name, morning sickness can occur at any time, day or night. It usually
begins around the 6th week of pregnancy, peaks around week 9, and disappears by weeks
16 to 18. Although unpleasant, morning sickness is considered a normal part of a healthy
But what's not normal is when morning sickness becomes so severe that
a woman persistently vomits several times a day, loses weight, and becomes dehydrated
or at risk for dehydration.
When this rare pregnancy-related condition is left untreated, it can interfere
with a woman's health and her baby's ability to thrive.
About Severe Morning Sickness
The medical term for severe morning sickness is "hyperemesis gravidarum" (which
means "excessive vomiting during pregnancy"). It usually follows a timeline that is
similar to morning sickness; however, it often begins earlier in the pregnancy, between
weeks 4 and 5, and lasts longer.
Although some women with severe morning sickness feel better about halfway through
their pregnancy (around week 20), some continue to experience it throughout the entire
pregnancy. Often, the symptoms become less severe as the pregnancy progresses.
Most of the time, hyperemesis gravidarum occurs during a woman's first pregnancy.
Unfortunately, women who experience it in one pregnancy are more likely to experience
it again in later pregnancies.
The cause of severe morning sickness is unknown. Research suggests that it might
be related to hormonal changes that occur during pregnancy. Specifically, a hormone
called human chorionic gonadotropin, or HCG, might be to blame because the condition
primarily occurs when HCG is at its highest levels in a pregnant woman's body.
Severe morning sickness also might be hereditary because it is more common in women
whose close family members (such as mothers and sisters) have had it.
Certain factors can increase a woman's chances of having severe morning sickness
during pregnancy. In addition to having a personal or family history of the condition,
the following can put a woman at risk:
carrying multiples (twins, triplets, etc.)
history of motion sickness
migraine headaches with nausea or vomiting
The nausea and vomiting that happens in a case of severe morning sickness are so
extreme that they can have harmful effects on both the mother and baby. The inability
to keep down food makes it difficult for a woman to meet her nutritional needs. As
a result, she might lose weight. And a loss of fluids, combined with the loss of stomach
acid that occurs during vomiting, also can cause dehydration and electrolyte imbalances.
If a woman does not receive treatment, it can cause many complications, including
organ failure and the premature birth of her baby.
When to Call the Doctor
It's important to call the doctor right away if a pregnant woman has any of the
nausea that persists throughout the day, making it impossible to eat or drink
vomiting that occurs three to four times per day or an inability to keep anything
in the stomach
vomit that is a brownish color or has blood or streaks of blood in it
fainting or dizziness
a rapid heart rate
unpleasant, fruity mouth or body odor
Although treatments that are commonly used for morning sickness, such as eating
dry crackers in the morning or consuming a bland diet, may be recommended for women
with extreme morning sickness, they may not be effective on their own because of the
severity of the condition.
Medical treatment may include:
a short period of not eating by mouth to rest the gastrointestinal system
intravenous (IV) fluids
vitamin and nutritional supplements
If necessary, the woman might also receive medicine to stop the vomiting, either
by mouth or through an IV. The doctor might recommend eating foods with ginger
or taking vitamin B6 supplements to help alleviate nausea. The following can also
consuming a bland diet
eating frequent small meals
drinking plenty of fluids when not feeling nauseated
avoiding spicy and fatty foods
eating high-protein snacks
avoiding sensory stimuli that can act as triggers
Additionally, if a woman is feeling anxious or depressed as a result of her condition,
talking to a therapist or counselor might help her cope with her feelings.
With treatment, a woman with a case of severe morning sickness can feel better
and receive the nourishment she needs to help her and her baby thrive. And lifestyle
changes can help to minimize nausea and vomiting and make the pregnancy more enjoyable.
With time, symptoms usually do improve, and — of course — resolve completely
by the beginning of a woman's next miraculous journey: parenthood./p>