First Trimester Nausea and Beyond: Surviving Pregnancy Sickness

Super practical - sometimes messy - tips for surviving pregnancy sickness.

Have the joys of pregnancy been accompanied by queasiness, nausea, gagging, retching or full-blown vomiting? Not the most lovely topic (and I recommend you save this article for after you've eaten your lunch), but unfortunately pregnancy sickness - from Morning Sickness to Hyperemesis Gravidarum - is common...and very unpleasant!  

I have luckily been spared any intense sickness with both of my pregnancies, so I'm very grateful to share several guest posts on the topic from fellow Occupational Therapist Sarah Lyon, OTR/L. Here are Sarah's tips for surviving pregnancy sickness:

When Saltine Crackers Don't Cut It

I became nauseated at week 6 of my first pregnancy and actively vomited and dry-heaved throughout my entire pregnancy. I am now entering into week 10 of my second pregnancy, and the sickness has returned. 

The tips I was regularly given by well-meaning people throughout my pregnancy always felt trite. Would I really vomit every day for eight months if the solution were as simple as eating crackers before I got out of bed?

All of the lessons I learned during my first pregnancy have come flooding back; from the way I do my eye-make up to cover the red speckles around my eyes (popped blood vessels from the pressure of throwing up) to the way every decision in my day has to be filtered through controlling my nausea. My hope for these posts is that women who, like myself, are struggling through pregnancy sickness will find some encouragement and camaraderie. 

These are not posts with ginger lollipop suggestions. This is a post with the hard lessons I learned and I'll follow it up with a post full of nitty-gritty suggestions for women who are battling full-blown pregnancy sickness - all day nausea, daily vomiting and dry-heaving.

Prenatal Health Is Crucial But Isn't One-Size Fits All

For some women, this means following an awesome diet and exercise plan. But for those of us experiencing intense pregnancy sickness, prenatal health means a battle in keeping down the absolute necessary calories and nutrients and letting go of the expectations for a perfect pregnancy.

We live in a culture that likes to fix things, but for me there has not been a fix to pregnancy sickness. Instead, it has been a hard-fought journey of tempering expectations, learning to trust my seemingly revolting body, and narrowing in my focus on what really matters in the day to day

Before getting into some of the more nauseating details, I wanted to share some of the good news about pregnancy sickness that it took me a whole 9 months to learn. 

Embrace The Perks of Pregnancy Sickness

Throughout these posts you will hear me refer to the guilt I’ve struggled with about not being able to provide the optimal prenatal experience for my baby. But, over time I’ve learned to take comfort in the fact that my body is doing everything it can to protect my baby, even though it feels quite the opposite. 

We don't know exactly what causes pregnancy sickness, but the one really important thing we do know Is that there is mysterious (yet researched!) evidence that pregnancy sickness actually has a protective effect on your baby. 

Studies have shown that pregnancy sickness produces a

  • Lower rate of miscarriage and stillbirth
  • Lower risk of having a baby with birth defect(s)
  • Increased chance of a healthy child 

The other good news is that once you survive pregnancy sickness you will find that it was the ultimate life-cleanse. Along with the disruption of virtually every life habit you had comes the opportunity to build new routines once the baby is born. 

I experienced this in little ways like finally kicking the afternoon pop and coffee habit that I had tried to give up for years. My schedule never went back to being as busy as it was before my pregnancy, which is a good thing. I now have significantly fewer life commitments, which I invest in more wholeheartedly.

After my first pregnancy, we also moved to a new city and I started a completely new business endeavor. Somehow, it feels like if I had not had the life-cleanse of pregnancy sickness, we never would have been in a place to take on these new adventures. 

Lower Your Expectations When You Visit Your Doctor

I have really liked both of my OB's. Both were sympathetic. I had a great experience during delivery. But, overall, they helped me very little with my pregnancy sickness. 

I would always get my hopes up when I had a doctor’s appointment that they would somehow produce the magical answer to make pregnancy more bearable, and was always disappointed. 

My doctors were always (rightly) concerned that mine and the baby's health stats looked good—which somehow they always did. I gained weight just slightly behind schedule, but never slow enough for it to be a concern. I always kept at least one meal down and a little water, so I never had to be admitted to the hospital. I am very thankful (yet baffled) that I looked healthy on paper. But, my quality of life felt so low—surely there was a pill for that?

The advice they gave me was the same as I found online, but usually more vague. I felt like since my numbers looked good, my doctors simply did not have the time to really get into my schedule, my triggers, my cravings, or how much I was struggling.

During my second pregnancy I’ve had a much different mindset going to the doctor’s office. Instead of talking through the details of my wellness, I focus on two conversations— medications and mental health. 

Read on for a discussion of medication.

As far as your mental health, depression can be associated with pregnancy sickness and while this is a common occurrence, your doctor will likely not screen for it unless you ask her about it.  Here is a great article by Alison Bowen of the Chicago Tribune on this topic.  

Who knows, maybe your doctor or midwife will be a great support through your pregnancy. I hope that for you. But I also hope you feel empowered to be your own expert on your pregnancy sickness. Do your research yourself and advocate for your needs

Weigh The Decision To Medicate or Not To Medicate

Pregnancy sickness. To medicate or not.

The bottom line about my experience with medications is that you do have to temper expectations. There is no silver bullet, but through trial and error and a little research, you may find a concoction that makes your day more bearable. 

Your doctor will likely recommend that you start with over the counter treatments, like Unisom and B6. 

I take ½ a Unisom before bed, which helps me keep ½ of my prenatal vitamin down. I tried to take another ½ in the middle of the night, but always felt just as sick in the morning and a little hung over. Here is a discussion on Baby Center about it.

Here is the Baby Center discussion on B6. Many women seem to find that it relieves nausea. Unfortunately, B6 does not give me relief from vomiting. I had difficulty taking B6 and felt no improvement, so have not continued it. 

After having tried these conservative options, your doctor may suggest other prescription medications. Here is a list of commonly prescribed medications

My first pregnancy, I took Zofran throughout. It helped my nausea throughout the day, but it did not stop me from vomiting. I was working on a psychiatric ward at the time and I felt like this drug helped me continue to do my job safely. 

There were some negative studies out about Zofran during my first pregnancy, but now there are even more. Zofran has been consistently linked to severe birth defects. These defects are caused when women take Zofran in their first trimester. I may fill a prescription when I’m done with my 1st trimester and take it on days I know will be particularly hard. 

I am intrigued by Dicelgis, which is an older drug back on the market. I’ve hesitated to try it because it is B6 based, which as I mentioned before I haven’t had success with it. But maybe I will try it in my 2nd trimester. 

At the end of the day, deciding to take medications comes down to the weighing the risks versus the benefits. This is a great conversation to have with your doctor. Whichever route you chose, you are not alone. There are many women who chose medication to safely get through their pregnancy.  This post from Wellness Mama has some great tips for using a natural diet remedy for pregnancy sickness.

Sleep As Much As Possible

Being pregnant is exhausting. Being pregnant and sick is extremely exhausting. Look at your schedule and figure out how you can sleep as much as possible. 

I’m talking like 10+ hours a night along with a nap during the day, if you can!

Because I am working from home during this pregnancy and caring for my toddler, I have more flexibility in my sleep schedule versus when I had to get up for work. Now my husband takes a morning shift and I sleep when my toddler sleeps.

I’m not sure if sleeping actually helps pregnancy sickness, but it does give you less awake hours in the day in which to feel miserable and throw-up. 

Clear Your Schedule

Once pregnancy sickness sets in, prioritization of your schedule becomes absolutely necessary. You may have to go to work and care for children, but honestly everything else should be on the table. Last pregnancy, we still met up with friends in the evening, which always had tough consequences. This pregnancy, if I want to have dinner with someone, I tell him or her it has to be at 5:00. 

Do not feel guilty about backing out of commitments you typically keep.  You will be able to go back to them once your baby is born. 

Travel plans are one of the most difficult plans to negotiate. Last pregnancy I had to swallow the costs of my registration and hotel room to a national occupational therapy conference. I had held out hope to the last minute that I would somehow make it, but when I was too weak to pack for the conference, I told my husband I didn’t think I could make the cross-country plane trip. I did road trip with my family to the coast…and I threw-up along on the roadside in every state along the way. 

Some travel may be necessary, perhaps even for a change of scene, but weigh that with the increased sickness that comes with disruption of your schedule. 

Find New Ways to Take Care of Yourself

As many of your typical commitments and self-care routines go out the window, it becomes very necessary to find new ways to care for yourself.  

My mom is a big proponent of having at least one thing per day that you are looking forward to. As I struggle to get out of bed each morning, I try to keep that one thing at the forefront of my mind. 

Here are some ideas: 

  • Go for walks
  • Buy an audiobook you’ve been wanting to read
  • Revisit a favorite TV show or movie
  • Call a friend
  • Seek out your favorite sour candy from childhood

OK, that list looks kind of sad as I write it, but really, try to enjoy the little things.  Right now I am in the process of re-watching Harry Potter and am absolutely loving it. 

My biggest self-care triumph this second pregnancy has been cutting my hair short. Because my mornings are so rough, I’ve had to switch my showers to the evening. Blow-drying my hair is always a huge trigger for me, so last pregnancy I always went to bed with long wet hair that was never fully dried by morning. Now, at least my hair dries over night. An added bonus is that I have not thrown up in my hair. 

Lastly, my most important self-care tip: always carry a toothbrush or mini-mouthwash with you. Throwing up at work or in public is the worst, but not having a way to clean out your mouth is the absolute worst. 

Shift Your Pregnancy Sickness Mindset

Vomiting for months on end takes a certain mindset. 

My biggest mental mistake during my first pregnancy was to fixate on the weeks that people told me I might feel relief. The end of the first trimester. Week 16. Week 20. Week 22. All of these weeks came and went with no relief of my symptoms to my incredible disappointment. 

In the ancient world the number 40 (then number of weeks of pregnancy), has special significance as a time of cleansing and trial. Pregnancy sickness has certainly felt like a trial in  the desert at times. 

But this number always accompanies the transition to a new significant event or period of time. It gave me comfort to feel like I was going through an ancient rite of passage to enter into a remarkable new season of motherhood.

Stay tuned for Part 2, when Sarah shares her nitty-gritty tips for identifying your pregnancy sickness triggers, creating an eating schedule and even the best strategies for losing your lunch when away from home. 

Sarah Lyon - Occupational Therapist

Sarah Lyon, OTR/L, serves as the Occupational Therapy expert for where she shares her OT expertise to promote optimal health and to inform those who might be in need of OT services. She also blogs and shares valuable resources with fellow therapists on her site, Potential.

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