Coping with Morning Sickness

                          Pregnancy brings about a spate of changes in women's body, so as to facilitate the growth and development of fetus in the womb. During pregnancy, many adjustments occur in structure, functions, metabolism and hormones in the mother's body. Certain restrictions of activities are natural and women have to change their lifestyle and eating habits to cope up with changes and to have a trouble free pregnancy. In most of the women, Morning Sickness is mild, bearable and usually limited to first trimester of pregnancy, but in about 20% of the cases, problem continues in the later stages of pregnancy, even into the third trimester. Many problems during pregnancy are considered natural and a normal outcome of pregnancy. Almost every pregnant woman encounters nausea or vomiting, also known as "Morning Sickness" during early pregnancy. Some societies consider it as a sign of pregnancy. In most of the women, Morning Sickness is mild, bearable and usually limited to first trimester of pregnancy, but in about 20% of the cases, problem continues in the later stages of pregnancy, even into the third trimester. Some women may suffer from prolonged intractable symptom, called "Hyperemesis Gravidarum". Why pregnant women suffer from Morning Sickness? More than 90% of women suffer from Morning Sickness, but its exact cause is not known. Many scientists put forth theories like Biological hormonal changes, body changes and psychological changes etc as the cause of Morning Sickness, but even they are unsure of the exact reason. How to cope with morning sickness? l In most of the women, problems due to nausea and vomiting are very mild and they should learn to bear with it and should know that it is transient. But, if the problem is severe, then one should consult the doctor immediately. Morning Sickness, mild or moderate, is tolerated by most of the pregnant women. They need to be reassured that these symptoms are a natural outcome of pregnancy and self-limiting. l Women should consume small meals at more frequent intervals. Food should be rich in carbohydrates and low in proteins & fats to get relief from nausea and vomiting. l After getting up in the morning, women should eat biscuits as soon as possible with their morning tea, which can also control the problem to some extent. l Foods and odors that precipitate the symptoms should be avoided during the pregnancy. l Most women are advised to consume iron tablets during pregnancy to prevent anemia. These tablets should be consumed with discretion of timing, if the lady has problem of nausea and vomiting. Especially in first trimester, the timing of tablet intake becomes important because iron tablets may make the problem worse. l Drugs to get relief from vomiting should be consumed only when absolutely necessary and only under the advice of a doctor. They must seek advise on the drugs and must be informed about the potential danger, if any, from these drugs. Remember, no drug is totally safe during pregnancy. l Vomiting during pregnancy at times can be due to other associated diseases like Viral Hepatitis, Dyspepsia, Peptic Ulcer etc. These diseases should be treated. Hyperemesis Gravidarum If vomiting continues in the later part of pregnancy and is accompanied by dehydration, metabolic & electrolyte disturbances and the weight decreases by more than 5% then such a condition is called as "Hyperemesis Gravidarum". Due to continued vomiting, pregnant ladies fail to eat properly and therefore suffer from nutritional and fluid deficiency, resulting in adverse effects on the fetus. This condition calls for immediate treatment, and if not treated properly, mother and fetus's life may be in danger. Treatment of Hyperemesis Gravidarum Women suffering from intractable vomiting should be hospitalized immediately. They should be given water, electrolytes, nutrients and vitamins intravenously. When vomiting gets controlled then small frequency of liquid meals should be given. This can subsequently be followed by semi-solid and finally solid food. Such women can be given antiematic drugs like Pysidoxine, Cyclizine, Meclizine, Metroclopromide, etc. If vomiting is not controlled and mother & child's life is at risk, they may be advised for abortion. Measures to get relief from Morning Sickness l Pregnant women should be reassured. They should consider nausea and vomiting as a natural outcome of pregnancy. l Pregnant women suffering from nausea and vomiting should make adjustments / alterations in their meals and should eat small meals, more frequently. l They should avoid food and odors that provoke vomiting. l They should consume low protein, low fat diet, that is rich in carbohydrates. l Avoid iron capsules if suffering from nausea. l Exclude other causes/ diseases that may be responsible for vomiting, and these diseases should be treated promptly. l Safer alternate therapy is also advisable.