What is happening to me?
It is not clearly understood why nausea and vomiting in pregnancy (commonly referred to as morning sickness) occurs. Experts believe there may be a combination of factors that lead to nausea vomiting in pregnancy (NVP). This much is known:

• More than half of pregnant women experience NVP
• Usually begins between the first and second missed period
• Typically begins to ease by the end of the third month of pregnancy (but occasionally will last throughout pregnancy)
• Can occur anytime of the day and last a few minutes or many hours
• Does NOT mean there is something wrong with you or the baby

What Causes NVP?

• Heightened sensitivity during pregnancy to smells, noise, motion and temperature
• Hormones that are abundant during pregnancy may cause nausea
• Changes in your digestion system related to pregnancy
• Routine medications

What Can I Do About NVP?
Morning sickness is variable in nature. Many things, such as sights, smells, noises, motion, temperature changes, etc. can affect the level of nausea. Finding out what triggers your symptoms and then making some changes as suggested below may help you feel better.

• Avoid or decrease sights, sounds, smells that produce symptoms
• Get out of bed slowly – avoid sudden movements
• Adjust room temperatures to a cooler setting
• Go outside for some fresh air
• Get adequate sleep and rest
• Ask your physician about taking your prescription vitamins/iron at bedtime
• Avoid brushing your teeth immediately after eating
• Avoid using a straw
• Avoid anxiety producing situations that can lead to increased agitation and nausea
• Practice relaxation techniques
• Talk to your physician about conventional measures (acupressure wristbands, acupuncture or hypnosis)
• Get help – ask friends or family to help out until you feel better

What About Eating And Drinking?

• Eat small, frequent meals (every 2-3 hours)
• Carbohydrate foods such as crackers, toast, potatoes or cereal, tend to digest easily and can help ease nausea
• Serve food either very warm or very cold
• Avoid greasy or fatty foods
• Try small amounts of a single food – add variety as you feel better
• Avoid highly seasoned food – lightly season and salt to taste
• Weak tea, ginger tea, very cold carbonated drinks, fruit drinks, and crushed ice or ice-pops, may sit easier on your stomach
• Try not to eat and drink at the same meal – sip fluids between meals
• Sit upright after meals
• Anything that you are craving can be eaten (within reason) but you should avoid spicy, fatty and greasy foods
• Consider taste (salty, sweet, sour, bland, bitter) - one might be easier to tolerate than the others
• Consider texture (soft, hard, smooth, lumpy, crunchy, wet, dry)- might be more appetizing to you
• Keep a food dairy – you may find that eating certain foods at certain times of the day will help you break the cycle of NVP

Are There Other Treatments?
Your physician might prescribe various treatment options:

• Dietary changes
• Medications
• Intravenous (IV) fluids to correct dehydration
• IV nutrition if necessary

What Medications Are Used To Manage NVP?
Several different medications are commonly prescribed to treat NVP. Your physician will discuss the risks and the benefits of these medications (called antiemetics). Some of the more common drugs are:

• promethazine (PHENERGAN)
• prochlorperazine (COMPAZINE)
• trimethobenzamide (TIGAN)
• metoclopramide (REGLAN)
• ondansetron (ZOFRAN)

Depending on the drug, it may be given orally, rectally, by injection, in the vein (IV), or just under the skin in the tissues (SQ). Your doctor will decide if one of these, or the many other medications that are available, are safe and beneficial for both you and your baby.

To learn more about NVP, refer to linked educational pamphlet from ACOG: Education Pamphlet AP126: Morning Sickness