Dr Rahul Sen | Specialist care for birth and beyond | Sydney, Australia

Rooms : Edgecliff 02 9363 9474
Macquarie Street 02 9221 2600

Advice on Pregnancy Sickness

Introduction

Many women experience nausea in early pregnancy and some women experience vomiting.  Although often referred to as morning sickness the feeling of queasiness can last all day.

The symptoms occur in part because of your levels of pregnancy hormone, which is why they may be stronger with twins, but can also be affected by your background mood and feelings towards your pregnancy.

In general the symptoms get worse until around 8-10 weeks then level off, and usually improve from around 12-13 weeks.  Some women experience nausea symptoms throughout pregnancy and even when the nausea settles there may be days on which the nausea symptoms return.

Nausea in general is associated with good pregnancy outcomes, although some women may have nausea of pregnancy even when the pregnancy is not progressing and some women may have a normally progressing pregnancy with no nausea symptoms.  That is why having a dating scan at around 8 weeks is generally a good idea.

How to Manage Nausea Symptoms:

1. Avoid the Triggers:
  • Big meals
  • Rich meals
  • Spicy food
  • Fatty food
2. Settle the stomach:
  • Start the day with a cracker or dry piece of toast even before getting out of bed
  • Snack or graze constantly or frequently throughout the day
  • Favour carbohydrates – crackers, toast, pasta,
  • Ginger, either fresh or in tea, drinks or lollies
  • Keep hydrated by sipping water or sucking on ice cubes
3. Over the counter medication:
  • Ginger and Pyridoxine (Vit B6), such as Elevit Nausea Tablets
  • Doxylamine (Restavit) – this is an antihistamine and very safe in pregnancy.  Its safety in pregnancy has been widely studied and it is recommended by Mothersafe, so do not be put off by the “Do not use in pregnancy or breastfeeding” printed in black, but beware Doxylamine is very sedating, especially when you take it for the first time, and can make you feel groggy, even the next day
4. Prescription medication:

For these you need a script from me or from your GP

  • Maxolon: take one tablet half an hour before meals.  Helpful for nausea but too late if you are already vomiting
  • Ondansetron (Zofran): these wafers you can dissolve on your tongue and are very effective but often constipating
  • Stemetil: suppositories are no longer available
5. Hospitalisation for severe intractable nausea and vomiting:
  • The best option if you cannot even keep water down or have lost a lot of weight
  • You can be admitted for the day for intravenous fluids and medication.
  • Sometimes you may need to stay overnight or even for a couple of days.

Further information: Mothersafe: http://www.mothersafe.org.au
Royal College of O&G: https://www.rcog.org.uk/globalassets/documents/guidelines/green-top-guidelines/gtg69-hyperemesis.pdf