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The do’s and don’ts of treating nausea during pregnancy

Most women who have ever been pregnant are familiar with that queasy, lingering nausea that comes with carrying a baby. 

“Nausea during pregnancy is one of the most common and uncomfortable symptoms that impacts about 70% of pregnant women,” says Janelle Luk, MD, medical director and co-founder of Generation Next Fertility in New York City. 

What causes nausea during pregnancy?

“Nausea is linked to the pregnancy hormone (human chorionic gonadotropin [or HCG] hormone), which is released when the fertilized egg attaches to the uterine lining,” Dr. Luk says. 

What week of pregnancy does nausea start?

Nausea is usually most severe during early pregnancy within the first trimester (which includes up to week 13 of pregnancy), and may even be associated with vomiting. Luckily, symptoms should start to disappear in the second trimester after HCG hormone has peaked. Unfortunately for some women, pregnancy nausea can last all nine months. You’ve probably heard the term “morning sickness,” but that’s a misnomer. It should really be called “all day sickness” because the truth is that it can strike at any time of the day or night. And it feels awful.

The good news is, the typical nausea and vomiting related to hormone changes experienced during pregnancy is unlikely to harm your baby. If nausea and vomiting is so severe that you can’t keep any food or fluids down—a condition known as hyperemesis gravidum—medical attention should be obtained since if left untreated has the potential to be harmful to the developing fetus. More on this in a bit. Aside from this very rare scenario, pregnancy nausea and vomiting is harmless. To the baby.

For the baby’s mama, it’s a relentless queasiness that makes you want to hide in bed all day (as long as there’s a bathroom nearby). Here’s how you can battle through.

Lifestyle changes and natural nausea remedies to try

Outside of pregnancy, nausea might have you running to the pharmacy for an over-the-counter (OTC) solution. However, drug choice requires more thought when you’re carrying a little one. 

Often, pregnant women are able to manage their nausea on their own, according to Rebecca Berens, MD, assistant professor of family and community medicine at Baylor College of Medicine in Houston. 

“Home remedies with small, frequent, bland snacks, such as saltine crackers [may be enough],” says Dr. Berens. “Hard candies such as peppermints, sour candies, and commercial products such as ‘Preggie Pops’ can also be effective. Products containing ginger are known to be helpful, such as ginger candies and ginger teas.” 

Family nurse practitioner and owner of Staunton Primary Care in Cincinnati, Ciara Staunton agrees. She also says that avoiding nausea triggers is important. 

“Examples of some triggers include stuffy rooms, odors (e.g., perfume, chemicals, food, smoke), heat, humidity, noise, and visual or physical motion,” says Staunton. “Quickly changing positions and not getting enough rest/sleep may also aggravate symptoms. Lying down soon after eating and lying on the left side are additional potentially aggravating factors.” She explains that this could slow down digestion and keep food in your stomach for longer.

Here’s a checklist of natural remedies to try if you experience nausea while pregnant:

  • Eating small meals or bland snacks (like hard candies or dry toast)
  • Trying ginger products (like ginger candies, ginger teas, or ginger ale)
  • Limiting acidic or spicy foods
  • Avoiding stuffy rooms or strong odors
  • Getting enough rest
  • Wearing anti-nausea wristbands

You can also try homeopathic remedies like acupressure, but be sure to seek a practitioner who has experience treating pregnant patients. 

What OTC treatments can you take for nausea during pregnancy?

Our experts say if those interventions fail to ease your nausea, it’s time to talk to your provider. There are OTC and prescription medications that may help—and some you should avoid.

The FDA recommends against using Pepto Bismol (bismuth subsalicylate) during pregnancy. According to a recent review in the journal American Family Physician, pregnant women especially shouldn’t take this medicine in the second or third trimesters because of an increased risk of bleeding problems.

Nauzene, a popular upset stomach chew, is listed in the FDA’s pregnancy Category C. This means that controlled studies in animals have shown that the drug can harm the fetus if taken during pregnancy, but doctors might still recommend it if the health benefits outweigh the risks.

Your best bet for nausea, Staunton says, is vitamin B6 supplements: “Vitamin B6, 50–100 mg orally once daily, is nontoxic and may help some patients.” If your prenatal vitamin already contains vitamin B6, which is also known as pyridoxine, consult your healthcare provider before taking additional supplements. Too much vitamin B6 can cause nerve damage and numbness.

Dr. Berens says that Unisom (doxylamine 25mg) is another drug that is safe and sometimes effective in treating nausea and vomiting during pregnancy. In fact, the FDA has approved a prescription medication for use during pregnancy that is a combination of Vitamin B6 and Unisom. It is called Diclegis.This is the only FDA approved medication for treating nausea and vomiting during pregnancy.

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“The same effect is possible, and much cheaper, by buying [Vitamin B6 and doxylamine] over the counter,” says Dr. Berens. “Many physicians recommend trying Vitamin B6 alone first, then adding doxylamine, which is also a sleep aid, if Vitamin B6 alone is not effective. The sedating side effects of doxylamine may not be desired by a woman in her first trimester who is already exhausted!” One way to potentially avoid the unwanted sedating effects of doxylamine—but also to reap the anti-nausea benefits!—is taking it first at bedtime and waiting to see if it reduces daytime nausea. 

Researchers are not totally sure why the Unisom/Vitamin B6 combination works to treat morning sickness. It might be because the drug combination blocks the neurotransmitters that send nausea signals in your brain. Or it could be that it simply disrupts your bodily processes that lead to vomiting. 

Vomiting and severe nausea during pregnancy

Some women experience extreme nausea and vomiting during pregnancy that can’t be controlled with diet changes or OTC medications; this is known as hyperemesis gravidarum. If this is the case for you, talk to your provider to first make sure no other medical conditions are involved and to explore other prescription medications that might help. 

Per Dr. Berens, “Dehydration associated with hyperemesis gravidarum … can be serious and requires urgent treatment.”

There are many prescription medication options available to treat extreme nausea and vomiting, but unfortunately clinical trials often exclude pregnant women, which makes it difficult to fully understand if potential harm exists when used during pregnancy. Working with your healthcare provider, it is important to weigh the potential risks of leaving your nausea and vomiting untreated with the benefits of trialing these medications on a case-by-case basis.