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  Frequently Asked Questions:

Nausea and Vomiting

Q. I am in my 8th week of pregnancy and for the last week and a half I have been extremely nauseous. I have seen my GP and he tells me that I have picked up a stomach bug as well. I have not been to work all this week, and cannot keep having time off work. No one knows I'm pregnant, so it is become extremely more difficult to explain.

I feel hungry, but then as soon as I eat something (and what I actually end up eating is fairly minimal), I feel sick. I have had a constant headache for the past week and a half, and I really don't know what to do with myself. I am not a stressful person, and have no real stresses in my life other than my nausea. I have not actually vomited yet, but have at times come close. I have had a bloated tummy and at times it feels so sore that I cannot lay on it. As soon as I begin to feel better, it never lasts long. Driving seems to exacerbate my nausea...

I'm at my wits end here, and I don't know what to do next. I cannot keep having time off work, and I just want to feel better! Any help you can give me will be most appreciated.

A.

I know it is not my sympathy that you need at this time but I do understand what you are going through. Different solutions work for different women. I am assuming you have read the suggestion on my web site www.ourmidwife.com.au/articles/morningsickness.html

For some women nothing seems to work completely. What you need to do is find a way to control the nausea as best you can on a day to day basis. It will pass in 4 to 6 weeks. Having a very small amount of dry food about half an hour before you get out of bed in the morning is one suggestion. Get as much sleep as you can during this time. Late nights are definitely out. Does your partner understand what you are going through? His complete support is very important and although it does not stop the distress you are feeling it will help you cope with it.

Your headache could be caused by several things. Because you are unable to eat normally it could be low blood sugar. Unfortunately the only solution to this is to eat a high energy snack when it is really bad and I know that has problems for you. It could be due to dehydration. When a woman is feeling nauseous it is possible that she may neglect to take sufficient fluids because even water will make her feel sick. Again the solution is to drink more water. Try to take small sips frequently. Some women find that sucking ice helps them. It is worth a try.

Another cause is sensitivity to the increased pregnancy hormones. These settle down at about 12 to 14 weeks. Acupuncture may help with the headaches but it would be important to find someone who is experienced in women's health issues. If you live in Sydney there are several I could recommend. There may be not be one complete answer for you but I would suggest that you try to find ways to make it as easy as possible for yourself until it passes.

   
Q.

I have had two children, with both I had terrible morning sickness up to six months and both times was admitted to hospital for dehydration. It is impossible to even keep down a mouthful of water, let alone food. I am now with a new partner and we would both like a child but I am extremely scared of the way I feel when pregnant. Is there any type of medication that can be taken, that doesn't harm the baby or me.

My last pregnancy after two days in hospital, I felt quite good but after 36 hours at home, I went down again. I have tried a lot of things from ginger to having plain biscuits before getting out of bed in the morning, Maxalon (I think that's the name of the tablets) to resting constantly. With my first child at 6 months I still only weighed 47 kg and I am tall. Please help I would love another child but this is putting me off.

A.

What you seem to be describing is more likely to be hyperemesis gravidarum rather than nausea and vomiting of pregnancy (morning sickness). The exact cause of this condition is unknown although it is generally believed to be caused by an increased sensitivity to the pregnancy hormones. Unfortunately, if it has occurred in your previous pregnancies it is likely to re occur in future pregnancies. The usual form of treatment is to treat the symptoms as they occur.

There is current research that appears to show an association between a bacteria in the stomach called helicobactor pylori and hyperemesis gravidarum. You may want to talk to your G.P. about being tested for this bacterium. There are several ways of testing for it. The most common way is with a blood sample or a breath test. If it is present and treated before you get pregnant, it could make a difference. The studies that I have read are not conclusive as some women show positive for the bacteria without having the severe problem of hyperemesis. I am sorry that I cannot give you a more positive answer to your query.

   
Q.

I am currently trying to gather information on 'hyperemeses gravidarum'. I read your article on morning sickness, which was very beneficial, and I would like to hear of any other information you may have.

I became pregnant with my first child in Jan 02. I experiences morning sickness from the very beginning and it continued all day and all night until I was exactly 3 months pregnant. At first I experienced dry wrenching which occurred at least fifteen times per day. This then rapidly changed to vomiting was occurred on average every hour, day and night. I was hospitalised on three separate occasions as I was losing weight and was extremely dehydrated. I tried taking ginger, eating dry crackers, injecting Maxalon and drinking tea - none of which were successful. When the morning sickness finally stopped, I had gone 11 weeks without eating a meal, I had lost twelve kilos, resigned from my full time work and had dealt with many different psychological barriers. Fortunately in Nov 03 I gave birth to a wonderful baby boy who I adore and has given my husband and me so much happiness.

Unfortunately my experiences of pregnancy are not positive and I have thoughts of not having any more children. However, my loving husband would like to have a second child. I would love to know any statistics that may show my chances of avoiding hyperemeses gravidarum for my second pregnancy.

Any information or advice would be greatly appreciated.

A. Thank you for your email. Unfortunately I am not going to be able to add to the information that you may already have. As a midwife the treatment of hyperemesis gravidarum is outside my scope of practice. Apart from knowing what it is, its effect on pregnant women and the usual treatment, I have not looked into it any further. Usually, knowing of the cause of a condition is useful in knowing how to avoid it. With this condition the cause is not known although there are many theories, none of which has been conclusively proven. Quoting from Mosby's Medical Dictionary; "an increase in chorionic gonadotropins or other hormones, an immunologic sensitivity to products of conception, or aggravation of pre-existing emotional conflicts has been suggested". It then goes on to say that a causal relationship has not been proven.

I do know that women who have suffered from severe hyperemesis often fear a subsequent pregnancy and, like you, consider the possibility of being a single child family. The information you need know is the likelihood of it occurring again in order to make an informed choice about you options of proceeding with a second pregnancy. In the event that you were to consider a second pregnancy and you were prepared to cope with the first three months, you would be well placed to be able to deal with it. Once it was over there would be no reason why it should colour the experience of the remainder of your pregnancy. Knowing that properly treated, the condition is not going to have a lasting effect on the baby, should be encouraging for you and eliminate an enormous amount of worry and stress that you may have experienced through the remainder of your first pregnancy.

Although I have not answered your question regarding statistics, I hope you find this information useful.
   
Q. I'm 25 and 7 weeks pregnant with our first child. We are very excited however morning sickness has set in. It isn't too bad but enough to have made me miss 2 days off work. I have tried ginger nut biscuits, ginger ale, dry food, the lot. A friend suggested Blackmore herbal tablets for morning sickness. Do you think they are safe to take? I am also trying to quit smoking and having trouble without patches etc. Is there anywhere in Toowoomba Qld where I could find some help? Like acupuncture or something along those lines? Thank you so much for your help.
A. Thank you for your question. There is insufficient ginger in biscuits or ginger ale to have a therapeutic effect, which is why they would not be working. You will get a better result from the Blackmores morning sickness formula as it is contains a medicinal grade ginger (as apposed to a culinary grade), as well as vitamin B6. It is formulated for pregnancy and is considered safe.

Acupuncture will be an appropriate way to stop smoking without the use of patches. I am not personally familiar with any practitioners in Toowoomba. You may want to ask amongst your friends and work colleagues to see if any of them could recommend an acupuncturist. The Natural Health Clinic 311 Margaret Street TOOWOOMBA QLD may be a place to start.

It is important to get plenty of rest during this time and manage your symptoms as best you can. It may help to remind yourself that it is not going to last forever.
   
 
Our Midwife - Midwifery Practice in Sydney
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Email: akal@ourmidwife.com.au