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Pregnancy

Sickness and hyperemesis

Nausea and vomiting are common in pregnancy, especially in the first three months. Up to half of all pregnant women experience vomiting, and more than 80% of women (80 out of 100) experience nausea in the first 12 weeks (NHS Choices 2015). This is traditionally called 'morning sickness', but although some people do have it mainly in the morning, it can also happen at any time of day, and sometimes all day long (see Interview 31 and Interview 34 below).

 

She was very sick every morning for about twenty minutes and then fine the rest of the day.

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Age at interview: 39
Sex: Female
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So it used to be, I used, when I used to sit up in the morning, I used to think, 'God I feel really sick.' But then I'd think, 'No, I'll be alright, I'll be alright.' I used to go to the bathroom and as soon as I started cleaning my teeth, so there's always that, you know, even now when I clean my teeth if I just hit the wrong bit then I think 'Oh bleh.' But this was, I used to just touch a point on my back teeth and that used be it for about twenty minutes, which is [laughs]... really horrible, and very different to any other time because it came from nowhere and then it would actually go to nowhere. I, well I used to think, 'Oh, that really didn't happen.' No, it definitely did happen, because it used to be every morning. I think that probably went on for about fourteen weeks.

How early did it start?

About six.

Did you find anything that helped?

No, because I think it was, it was kept in its place, in that it would be twenty minutes, half an hour in the morning and that used to be it.

So the rest of the day you'd be fine?

The rest of the day was absolutely fine.

Does it pose additional problems having something like that when you're in a wheelchair?

Well, I just used to sit over the sink [laughs]. I used to put the cold tap on full and just sit over the sink and that was, that was my morning. So I, you know, when I was working then I just used to get up a bit earlier, and get that out of the way and then carry on [laughs].

Some people experience sickness only once or twice or not at all. Some people feel sick but never actually vomit, but as one mother pointed out feeling sick all day is miserable enough. Frequent vomiting experienced by some people is not only very unpleasant but makes it very difficult to work and look after other children.

 

Feeling sick all day was horrible and she had to take time off work. Ginger ale helped a bit. ...

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Age at interview: 37
Sex: Female
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Well, I just, in terms of work I did take some time off from work, and I did inform my manager who, you know, confidentially - he said he wouldn't say anything.  So I did take some time off, but it wasn't actually, in terms of feeling sick, it was more the, it was the nausea, but I wasn't actually vomiting, but it was the feeling of nausea. And so I just said to people I had a virus and things and, you know, that was it, so I got away with it. But some people did start guessing, but I didn't sort of say yes or no to them.

Did you have the sickness in both pregnancies?

No, I didn't the first time, no. I was fine.

Oh, that's interesting. 

Yeah, I was fine.

So this must have come as a bit of a shock to suddenly?

Yeah, definitely [laugh]. Yeah, it was, yeah. It was horrible.

When did it start?

I'd say sort of like about, I don't know, 7, 8 weeks, 6,7 weeks, I think it did. And, and they did say to me that the, you know, a lot of the times it does disappear sort of like in your first, after your first trimester. And it did, it sort of disappeared after about 14 weeks, after 14 I was not so bad.

Was there anything you found that helped?

Oof, nothing, absolutely nothing. I couldn't eat, couldn't drink. My husband used to force me to eat things, but I'd eat bland things like - in terms of Asian food no way - things like sandwiches or something fizzy, you know, like, I don't know, ginger ale helped a little bit. Ginger, I was told about ginger and I thought, “Well, I'll try ginger ale and I'll try ginger biscuits and dry toast. I'll try anything.”

So it did help a little bit?

It helped a little bit, but I think the feeling of nausea is probably worse than actually being nauseous, in actually, when you bring it up it's not so bad, you know, it's out of your system. But when it's still in there and you're, you're just constantly feeling nausea all day, it's horrible, you can't do anything.

Because vomiting happens very early in pregnancy, it comes at a time when many friends and colleagues may not know about the pregnancy. Some people had to tell work colleagues what was happening, but others preferred to struggle on and keep the pregnancy quiet (see Interview 31 above).

Various things can make sickness worse, including cooking and other strong smells, cleaning your teeth (see Interview 32 above), or getting too hungry. Some people found eating little and often helped to stop hunger turning into nausea. Women are often advised to try dry biscuits, toast or ginger, although several said nothing really worked for them. Ginger biscuits helped one woman while another had tried a special music tape supposed to reduce dizziness and sickness by acting on the inner ear but it had no effect.

In most women sickness improves in the second trimester, but in some people it goes on for several months. In a few cases vomiting becomes so severe and prolonged that it can require medical treatment or even hospitalisation. This condition is called hyperemesis or hyperemesis gravidarum (extreme vomiting in pregnant women). Exactly how many pregnant women get hyperemesis gravidarum is not known as some cases may go unreported, but it's thought to be around 1 in every 100 (NHS choice 2016).‚Äč Women may be given anti-emetic drugs, antacids such as ranitidine, and fluids to prevent dehydration. Fluids may be given by intravenous drip if the woman cannot keep any fluids down. (Pregnant women should only use medicines when a doctor advise it). One woman's sickness made her resent being pregnant so much that she originally planned not to get pregnant again. Being diabetic may have increased her risk of hyperemesis.

 

In every pregnancy she has had hyperemesis (severe vomiting) all the way through. An antacid...

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Age at interview: 37
Sex: Female
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With every pregnancy I've had, I've had severe sickness, even with the ones that I've miscarried, for literally from five, six weeks the vomiting has started - all day, every day. And then up until twelve weeks with the missed abortions when I have the D & Cs, and then it just stops, just like that. With my son it was, it started I think at about seven weeks and just went on. I took all the anti-emetics that they gave me, which also made me wonder about the heart condition, if that could have caused it. But I've looked into it and, and - you know, that was one of the things I thought, 'Oh my God, it must have been everything that I took whilst I was pregnant', but they just say it's one of those things. Took all the anti-emetics, I went to the hospital every two weeks for my antenatal appointment and, without doubt, in the end I used to go up with an overnight bag, because I knew that when I went there they would say to me, 'You've got to come in and be rehydrated.' 

And that was one of the things, the reasons that I felt so resentful about being pregnant. I'd wanted this for so long, and then how could I feel so bloody crappy for the whole time? Yeah, I mean it's just, that was another big factor in deciding not to have any more, because I thought I cannot even imagine having to look after a child when you're feeling like this. I felt as if I just had a constant hangover. I'd walk round Tesco's with a plastic bag, because I knew that I'd get sick in Tesco's or somewhere like that. And then it, I'd get a taxi to work every morning and have to stop the taxi on the way to work. I only work ten minutes away but it was just, it was just awful. And it never stopped, never stopped the whole way through, until the day that he was born. And as soon as I was, as soon as he came out, the sickness stopped. 

I've got the same with this one, although it's not quite as bad. I mean, it has been up until about sixteen weeks, all day, every day. But it seems to have eased off a little bit, but I'm not sure. I'm taking a drug called ranitidine. They've found out - well, they think this is the, could be a cause - with diabetes you get a problem called diabetic myopathy, where the nerve endings in your feet die off if you've been a diabetic for a long time, so you have to be really careful with your feet. And I didn't know this, I'd never heard of this, but apparently the same thing can happen to your stomach nerve endings. So what it means is that when I eat anything, I mean, the symptoms that they describe now, are symptoms that I've always got' feeling bloated, get full up really easily, low blood pressure, dizzy when I stand up. 

All those sorts of things that you think are just part of normal life are symptoms of this diabetic myopathy. And what it basically means is that the food that you eat sits in your stomach for too long. The nerve endings don't actually force it down into your small bowel. So that's why when I'm pregnant it aggravates the situation. This is their thinking on it, anyway, and increased acid, which a lot of women get when they're pregnant anyway. So they've just started me on a drug called ranitidine, which is like an antacid type thing. And I've been taking that for two weeks, and I've started to feel a little bit better. I'm not being sick - I'm being sick every day but not multiple times during the day. So I'm hoping that I'm going to start feeling a bit better.

Control of diet is important in conditions such as diabetes, and of course sickness can make this difficult. A mother with epilepsy explained that her attacks could be triggered by hunger, so any sickness had to be monitored closely. As it turned out, the drugs she had to take for epilepsy also had an anti-emetic effect, and she did not feel sick at all.

 

Because hunger triggers her epilepsy, it was important that she should not get too sick. Her...

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Age at interview: 33
Sex: Female
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And what about the sickness? Was that a problem for you in the end?

Morning sickness?

Yeah.

No. He did - when we went to see the neurologist, he did warn - he did say - that the drug I take has quite a good, some of the things in it are good for - well, some of its ingredients are the sort of things you use to stop sickness, so actually it worked a dream. It was great. I didn't feel sick once.

Had they talked to you about what would happen if you did - I mean because it would affect the drug levels - are there alternatives like pessaries or intravenous drugs?

I would have probably had to go in. Another thing he was worried about was whether I didn't feel like eating, because I was, felt so sick, and my epilepsy is very triggered by lack of food, and I, so what I would have had to do was go into hospital and have IV fluids, food, whatever, and drugs, in the hope that I got over it and could go back to normal. But as it happened - best laid plans.

The notion that sickness in pregnancy has a mainly psychological cause is wrong, and one woman with hyperemesis strongly objected to it. Another thought professionals never quite understood how bad the sickness was, and was left feeling it was just something she had to put up with.

 

She cannot believe that hyperemesis could be psychological. It is a recognised illness in pregnancy.

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Age at interview: 37
Sex: Female
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Well they, I mean, I read a little bit about it a while ago and someone in the paper, or on the news or something, saying that they've, they've now decided, they've done a study and all morning sickness is, it's psychological. It's in your head. And it just makes me laugh, because I'm sure, I'm sure that with some women they, they think that it is a symptom that you have of pregnancy and they do feel nauseous. And a lot of time that might be psychological. But I think hyperemesis, which is a known illness in pregnancy, is certainly not psychological, because no woman would wish that upon themselves. A constant feeling of.. sickness, nausea, vomiting, not being able to eat, losing weight, and I mean, that's what I feel all the time.

 
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She never felt professionals really understood how bad the vomiting was, even when she asked for...

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Age at interview: 24
Sex: Female
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Do you think that people were taking you seriously enough when you were saying that you were in a lot of pain or?

I think, I think not, actually, because the kind of vomiting I experienced while I was pregnant was, it was severe, and I can't stress how bad it was. It was, I couldn't eat anything, and at one point, you know, I went to the doctor's and she said, 'Look, you know, if you carry on vomiting we'll have to send you to the hospital to have a drip' and she says, 'You're going to' - she gave me sachets which are absolutely nasty to take and I couldn't, I couldn't even take them. Each time, you know, I tried to take a sip I'd just start vomiting continuous and there was, I felt there was nothing I could do to stop them. It was just, you know, and I don't think I was, it, anyone could understand how bad it was for me.

Were those sachets the dehydration?

Yeah, yeah. Rehydra, I think they were called - something like that, yeah.

Do you think it was anything to do with how you were, how you were telling? I mean did you, did you really sort of, were you... 

Yeah.

Very assertive in telling or were you a bit sort of restrained about it?

I went to the doctor's a few times, you know, and even through my antenatal appointments I did tell her and I said, 'Look, is there nothing you can do? Because I am absolutely dying, I don't know how long I can cope with this for. It's just killing me.' And she said, you know, 'No there isn't. You know, it's just one of those things', and that's it, kind of shrugged it off, really. And I, I've just become resigned to it, thinking that, you know, this is how it's going to be.

Did you look for any other, like I said, another opinion or any other..

No.

Source of information?

No, I'm not that kind of person, no.
 

People often worry that the baby will not get enough nourishment if they are very sick, but the evidence suggests babies still manage to get all the nourishment they need from the mother's body. Some mothers were amazed that their baby's birthweight was normal.

For more information see our pregnancy resources.
 

Last reviewed May 2017.
Last updated May 2017.

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